Nayana Maria Gomes de Souza, Viviane Martins da Silva, Marcos Venícios de Oliveira Lopes, Emanuela Aparecida Teixeira Gueiros, Ana Luisa Brandão de Carvalho Lira, Rosely Leyliane Dos Santos
{"title":"先天性心脏病患儿无效呼吸模式中间范围理论的实证检验","authors":"Nayana Maria Gomes de Souza, Viviane Martins da Silva, Marcos Venícios de Oliveira Lopes, Emanuela Aparecida Teixeira Gueiros, Ana Luisa Brandão de Carvalho Lira, Rosely Leyliane Dos Santos","doi":"10.1111/jocn.17533","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>To test a middle-range theory (MRT) for the nursing diagnosis of ineffective breathing pattern in children with congenital heart disease (CHD) based on analysis of two general propositions.</p><p><strong>Methods: </strong>This cross-sectional study is guided by STROBE. The propositions represent hypotheses about the relationships between the concepts of this MRT to be tested empirically, and thus, log-linear models were used to verify the structure of the proposition related to the stimuli. Diagnostic accuracy measures, univariate logistic regressions and the Mann-Whitney test were used to analyse the structure of the propositions related to behaviours.</p><p><strong>Results: </strong>The analysis of the propositions related to the stimuli (eight concepts, four of which were classified as focal stimuli and four as contextual stimuli) suggested a reclassification of the stimulus \"deformities in the thoracic wall\" which became too focal. In the analysis of the propositions related to behaviours (17 concepts, five of which were classified as acute confirmatory, nine as acute clinical deterioration and three classified as chronic), guided changes in the operationalisation of concepts were suggested after comparing clinical findings; thus, acute confirmatory behaviours now have 10 concepts, while acute clinical deterioration behaviours and chronic behaviours continued with nine and three concepts, respectively, but with reclassifications between them.</p><p><strong>Conclusion: </strong>Changes in the operationalisation of the classification of the elements of the two propositions occurred after comparing the clinical findings with the theoretical model.</p><p><strong>Relevance to clinical practice: </strong>By establishing precise causal relationships and describing how IBP manifests itself over time in children with CHD, empirical testing of this MRT helps nurses understand clinical reasoning based on temporal logic and spectral interaction between diagnostic components, which in turn will improve the use and accuracy of nursing diagnoses.</p><p><strong>Patient contribution: </strong>Children and adolescents with CHD were recruited for this study sharing their clinical history and physical lung examination.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Empirical Testing of a Middle-Range Theory for Ineffective Breathing Pattern in Children With Congenital Heart Disease.\",\"authors\":\"Nayana Maria Gomes de Souza, Viviane Martins da Silva, Marcos Venícios de Oliveira Lopes, Emanuela Aparecida Teixeira Gueiros, Ana Luisa Brandão de Carvalho Lira, Rosely Leyliane Dos Santos\",\"doi\":\"10.1111/jocn.17533\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>To test a middle-range theory (MRT) for the nursing diagnosis of ineffective breathing pattern in children with congenital heart disease (CHD) based on analysis of two general propositions.</p><p><strong>Methods: </strong>This cross-sectional study is guided by STROBE. The propositions represent hypotheses about the relationships between the concepts of this MRT to be tested empirically, and thus, log-linear models were used to verify the structure of the proposition related to the stimuli. Diagnostic accuracy measures, univariate logistic regressions and the Mann-Whitney test were used to analyse the structure of the propositions related to behaviours.</p><p><strong>Results: </strong>The analysis of the propositions related to the stimuli (eight concepts, four of which were classified as focal stimuli and four as contextual stimuli) suggested a reclassification of the stimulus \\\"deformities in the thoracic wall\\\" which became too focal. In the analysis of the propositions related to behaviours (17 concepts, five of which were classified as acute confirmatory, nine as acute clinical deterioration and three classified as chronic), guided changes in the operationalisation of concepts were suggested after comparing clinical findings; thus, acute confirmatory behaviours now have 10 concepts, while acute clinical deterioration behaviours and chronic behaviours continued with nine and three concepts, respectively, but with reclassifications between them.</p><p><strong>Conclusion: </strong>Changes in the operationalisation of the classification of the elements of the two propositions occurred after comparing the clinical findings with the theoretical model.</p><p><strong>Relevance to clinical practice: </strong>By establishing precise causal relationships and describing how IBP manifests itself over time in children with CHD, empirical testing of this MRT helps nurses understand clinical reasoning based on temporal logic and spectral interaction between diagnostic components, which in turn will improve the use and accuracy of nursing diagnoses.</p><p><strong>Patient contribution: </strong>Children and adolescents with CHD were recruited for this study sharing their clinical history and physical lung examination.</p>\",\"PeriodicalId\":50236,\"journal\":{\"name\":\"Journal of Clinical Nursing\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2024-11-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Nursing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/jocn.17533\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/jocn.17533","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
Empirical Testing of a Middle-Range Theory for Ineffective Breathing Pattern in Children With Congenital Heart Disease.
Aim: To test a middle-range theory (MRT) for the nursing diagnosis of ineffective breathing pattern in children with congenital heart disease (CHD) based on analysis of two general propositions.
Methods: This cross-sectional study is guided by STROBE. The propositions represent hypotheses about the relationships between the concepts of this MRT to be tested empirically, and thus, log-linear models were used to verify the structure of the proposition related to the stimuli. Diagnostic accuracy measures, univariate logistic regressions and the Mann-Whitney test were used to analyse the structure of the propositions related to behaviours.
Results: The analysis of the propositions related to the stimuli (eight concepts, four of which were classified as focal stimuli and four as contextual stimuli) suggested a reclassification of the stimulus "deformities in the thoracic wall" which became too focal. In the analysis of the propositions related to behaviours (17 concepts, five of which were classified as acute confirmatory, nine as acute clinical deterioration and three classified as chronic), guided changes in the operationalisation of concepts were suggested after comparing clinical findings; thus, acute confirmatory behaviours now have 10 concepts, while acute clinical deterioration behaviours and chronic behaviours continued with nine and three concepts, respectively, but with reclassifications between them.
Conclusion: Changes in the operationalisation of the classification of the elements of the two propositions occurred after comparing the clinical findings with the theoretical model.
Relevance to clinical practice: By establishing precise causal relationships and describing how IBP manifests itself over time in children with CHD, empirical testing of this MRT helps nurses understand clinical reasoning based on temporal logic and spectral interaction between diagnostic components, which in turn will improve the use and accuracy of nursing diagnoses.
Patient contribution: Children and adolescents with CHD were recruited for this study sharing their clinical history and physical lung examination.
期刊介绍：
The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice.
JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice.
We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.
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