Diagnóstico de enfermagem mobilidade física prejudicada em pacientes submetidos à cirurgia cardíaca

Abstract

The nursing diagnosis Impaired physical mobility has a high incidence in patients in the postoperative period of cardiac surgery. In this context, the objective was to analyze evidence of validity of the diagnosis Impaired physical mobility in patients in the postoperative period of cardiac surgery. This is a methodological study of validation of a nursing diagnosis, carried out in two stages proposed in the literature: 1) theoretical-causal validity, through the construction of a middle-range theory of the referred nursing diagnosis; 2) content validity by experts. In the first stage, the theoretical-causal validity was performed through the development of a middle-range theory, which was operationalized from an integrative review in four databases. In the second stage, the diagnosis was analyzed by 09 experts, through the nominal group. The research was approved by the Ethics Committee of the responsible institution. The results showed that 03 essential attributes were identified in the 19 selected articles: Difficulty moving, Difficulty changing position and contracting muscles freely, Dependent physical movement; 04 clinical antecedents: Reduced tolerance to physical effort, Angina pain, Muscle weakness, Prolonged time of bed rest; and 07 clinical consequences: Change in gait, Difficulty turning, Reduction in range of motion, Limited muscular capacity to perform fine motor activities, Limited muscular capacity to perform gross motor activities and Dyspnea on exertion. A pictogram, 05 propositions and 09 causal relationships were developed. In the second stage, the analysis of the diagnosis by the experts allowed the improvement of the title, concept of the diagnosis, 04 antecedents and 03 clinical consequences. The addition of the population at risk and associated condition, which resulted in a diagnostic structure with 07 defining characteristics, 05 related factors, 01 population at risk and 01 associated condition. It is concluded that the theoretical-causal validity, through a middle-range theory, and the content validity evidenced important elements for the diagnosis of Impaired Physical Mobility in patients undergoing cardiac surgery, which are not yet present in NANDA-I. Therefore, it is expected to contribute to the advancement of the work process of nurses, through a more precise and reliable identification of the diagnosis of Impaired Mobility in this population. In addition, it seeks to promote the strengthening of practices aimed at the development of measures that promote early mobilization and reduction of injuries aimed at the rehabilitation of patients in the postoperative period of cardiac surgery.