DEFINING CHARACTERISTICS OF NANDA-I NURSING DIAGNOSTICS IN PATIENTS WITH HEART FAILURE: SCOPING REVIEW
Creators: name: Borges, Alyne
name: CAVALCANTI, ANA
Publisher: name: Open Science Framework
Year: 2022
Subjects: subject: Medicine and Health Sciences
subject: Nursing
subject: FOS: Health sciences
subject: #heartfailure #nursingdiagnosis

description: INTRODUCTION Currently, Heart Failure (HF) has stood out as an important public health problem, due to its complexity and subjectivity. HF is a multifaceted syndrome, due to the union of several comorbidities, from physical to psychological.1 HF is characterized as the final route of cardiovascular disease, in which the heart undergoes an initial aggression, triggering hemodynamic changes resulting in cardiac remodeling perpetuating HF. Such remodeling disables adequate cardiac pumping, making it difficult to supply the body's metabolic tissue demands. Its classic signs and symptoms are dyspnea, fatigue, intolerance to exercise, elevated jugular venous pressure, hepato-jugular reflex, presence of a third heart sound, among others.2 Updated data from the Ministry of Health shows that in the year 2020 alone there were more than 45 thousand hospital admissions in Brazil, among which 5,000 ended in death with a mortality rate of approximately 11%. Considering the extent of this disease, there are projections that the worldwide prevalence of HF will increase by up to 45% by 2030.3,4 The scenario worsen due to the epidemiological transition triggering the increase in Chronic Noncommunicable Diseases (NCDs), since cardiovascular diseases are classified as the main cause of death in the world, falling behind causes like cancer, chronic respiratory diseases and diabetes mellitus. Studies show that such diseases are mainly characterized by non-adherence to modifiable lifestyle habits, such as the practice of physical activities, healthy eating and the non-use of illicit drugs, such as tobacco and alcohol.5 In this context, the performance of the multiprofessional team is extremely important, based on pharmacological and non-pharmacological treatment. Considering changes of daily habits through health education can improve the quality of life and help treatment adherence.6 This reality occurs in clinics specialized in HF, where a multidisciplinary team composed of nurses, doctors, nutritionists, psychologists, social workers and physiotherapists guide and monitor through outpatient consultations, home visits or through telephone consultations. Studies show that the performance of multiprofessional teams significantly reduces the number of rehospitalizations due to HF, increasing the patients' functional capacity and survival.7,8 The nurse with advanced practices, acts in this scenario as a preponderant factor, through nursing consultations, in this way this professional is able to assess classic signs and symptoms, enabling interventions in a unique way to the patient. The nursing consultation comprises one of the stages of the Nursing Process (NP), which is a methodological instrument that guides care through the Systematization of Nursing Assistance (SAE).9,10 To perform SAE efficiently, it is necessary to use Standardized Language Systems (SLP), through taxonomies, so that there is a linguistic unification among professionais nurses, contributing to the development of clinical reasoning in the structuring of Nursing Diagnoses (IN). The NANDA - I taxonomy brings several diagnostic possibilities and it is up to the nurse to judge which is the most appropriate, through the defining characteristics and related factors presented by the patient. 11-12 Review Question What defining characteristics are present in patients with Heart Failure? Inclusion Criteria POPULATION Studies that are related to heart failure, adults (older than 18 years), studies that present the defining characteristics and related factors of patients with heart failure. CONCEPT Studies aimed at nursing diagnosis based on NANDA-I. CONTEXT Validation studies as topic. SOURCE TYPES Validation, descriptive, cross-sectional studies , randomized controlled clinical, methodological, case control, qualitative and / or quantitative trials, indexed in databases published in Portuguese, English and Spanish. METHOD Develop a scope review in order to map the main defining characteristics according to NANDA-I existing in the literature, aiming to find which ones are more prevalent in patients with HF. The scoping review will be conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyzes extension for Scoping Reviews (PRISMA-ScR) model, an extension of the original model, which is specifically aimed at mapping evidence. In order to carry out this review, it was necessary to use the protocol of the Joanna Briggs Institute (JBI) in order to identify in a systematic and rigorous way, gaps in the proposed key concept. SEARCH STRATEGY To build the search strategies, the PCC strategy will be used (P: patient, C: Concept and C: Context). The PCC strategy is a derivation of the PICO strategy, this strategy is used to guide the elaboration of the research question and the bibliographic search, helping the researcher to accurately locate the best scientific information available. The use of the PRISMA-ScR instrument was necessary to guide the elaboration of the scope review, so that in this way it systematically organized the methodological rigor of the study. In this way, an explanatory flowchart was built containing the following topics: Identification, Eligibility, Selection and Inclusion. STUDY SELECTION The search strategy will be carried out from an initial search in the PubMed database with analysis of titles and abstracts. At the same time, the most appropriate descriptors for searching the titles were established. Then a new search for a second reviewer was carried out, following the same search strategy, independently. The participation of a third reviewer was also agreed in case of disagreement between the authors. The full texts were analyzed for their methodology, duplicate articles were excluded and the eligibility criteria were applied. Meetings were held by the Google Meet device, for discussion among reviewers, thus clarifying possible disagreements. SUMMARY MEASURES The summary measures were established based on the JBI protocol, and they are listed and tabulated according to authors, country and year of publication, objectives and purposes, method and the main findings related to the research question. Duplicate articles or articles that do not meet the eligibility criteria will be excluded. SUMMARY OF RESULTS After the reviewers' agreement, the results of the study will be gathered from a table, grouping the articles selected based on their similarity. They were characterized from the author, year / country, design, context and objective of the study. RISK OF BIAS To reduce the risk of bias, the selected studies will be analyzed by two reviewers and it is necessary to include one more reviewer in case of disagreement between the results. The same terms and descriptors already established will be used. Meetings will be held between the reviewers in order to obtain 100% agreement at the end of the findings.