Operational Definitions for the Indicators of the Nursing Diagnosis Ineffective Breathing Pattern

Tuesday, 14 July 2009

Thelma Leite de Araujo, MSc, PhD
Beatriz Amorim Beltrão, BA
Viviane Martins da Silva, MSc, PhD
Marcos Venícios de Oliveira Lopes, MSc, PhD
Nursing Department, Federal University of Ceará, Fortaleza, Brazil

Learning Objective 1: Discuss the importance of the operational definitions for the indicators of the nursing diagnosis Ineffective breathing pattern.

Learning Objective 2: Reflect about the continuity of nursing evaluation in children with congenital heart disease, based on operational definitions.

Purpose: Operational definitions help the nursing evaluation, since they are basis to conceptual definitions, expliciting what must be measured and what methods must be used for such measurement. They can be used on the evaluation of nursing diagnosis. The objective is to analyze indicators based on operational definitions, in children with congenital heart disease, with or without the nursing diagnosis Ineffective breathing pattern. This diagnosis has significant presence in children with congenital heart disease.

Methods: Exploratory-descriptive study in which an instrument made with 18 indicators related to the nursing diagnosis Ineffective breathing pattern was used, each indicator with its respective operational definition.  The data was taken through interviews and physical test with emphasis in the respiratory function. The data was compared to the operational indicators and classified by commitment.

Results: Sixty-three children with congenital heart disease were evaluated and divided in two groups: the ones who presented this diagnosis and the ones who didn’t. The Respiratory difficulty item was the indicator with the highest compromisation in both groups. In the group that did not have a Nursing diagnosis Ineffective breathing pattern, the Respiratory depth item presented considerable differences, evaluated as non-compromised in less than 50% of the children. In the children that presented the diagnsosis, seven items showed higher commitment, classified as non-compromised in less than half of the children: Respiratory rhythm, Accessory muscles use, Pursed lip breathing, Chest retraction, Chest x-ray findings, Orthopnea and Ausculated breath sounds. These items compose the defining characteristics of the researched diagnosis, or are part of the results of Respiratory status: ventilation, which is directly linked to the diagnosis.

Conclusion: The use of the instrument showed that it can also be used to determine the Nursing diagnosis Ineffective breathing pattern, allowing, also, the evaluation of its characteristics.