The middle-range theory of the nursing diagnosis “ineffective health self-management”

Costa, Rebecca Stefany da; Menezes, Harlon França de; Prado, Nanete Caroline da Costa; Pereira, Ana Beatriz; Ferreira, Thais Targino; Holanda, Jose Rebberty Rodrigo; Silva, Richardson Augusto Rosendo da

doi:10.1590/0034-7167-2024-0470

person Rebecca Stefany da Costa

contributed to the conception or design of the study/research · analysis and/or interpretation of data · final review with critical and intellectual participation in the manuscript

schoolUniversidade Federal do Rio Grande do Norte. Natal, Rio Grande do Norte, Brazil

0000-0002-1191-0232

person Harlon França de Menezes

contributed to the conception or design of the study/research · analysis and/or interpretation of data · final review with critical and intellectual participation in the manuscript

schoolUniversidade Federal do Rio Grande do Norte. Natal, Rio Grande do Norte, Brazil

0000-0001-9884-6511

person Nanete Caroline da Costa Prado

contributed to the conception or design of the study/research · analysis and/or interpretation of data · final review with critical and intellectual participation in the manuscript

schoolUniversidade Federal do Rio Grande do Norte. Natal, Rio Grande do Norte, Brazil

0000-0002-9079-0450

person Ana Beatriz Pereira

contributed to the conception or design of the study/research · analysis and/or interpretation of data · final review with critical and intellectual participation in the manuscript

schoolUniversidade Federal do Rio Grande do Norte. Natal, Rio Grande do Norte, Brazil

0000-0001-8339-6482

person Thais Targino Ferreira

contributed to the conception or design of the study/research · analysis and/or interpretation of data · final review with critical and intellectual participation in the manuscript

schoolUniversidade Federal do Rio Grande do Norte. Natal, Rio Grande do Norte, Brazil

0000-0001-7409-4669

person Jose Rebberty Rodrigo Holanda

contributed to the conception or design of the study/research · analysis and/or interpretation of data · final review with critical and intellectual participation in the manuscript

schoolUniversidade Federal do Rio Grande do Norte. Calco, Rio Grande do Norte, Brazil

0000-0003-2307-4515

person Richardson Augusto Rosendo da Silva

contributed to the conception or design of the study/research · analysis and/or interpretation of data · final review with critical and intellectual participation in the manuscript

schoolUniversidade Federal do Rio Grande do Norte. Natal, Rio Grande do Norte, Brazil

0000-0001-6290-9365

personCorresponding author: Rebecca Stefany da Costa Santos E-mail:
enf.rebecca@outlook.com

EDITOR IN CHIEF:

Antonio José de Almeida Filho

ASSOCIATE EDITOR:

Rosane Cardoso

Objective/Problem	Population	Concept	Context
Extraction	Pessoas vivendo com HIV	Autogestão ineficaz da saúde	Todos os níveis de complexidade
Conversion	People living with HIV/Aids	Ineffective self-management of health	All levels of complexity
Combination	Acquired Immunodeficiency Syndrome; HIV; Aids	Patient Acceptance of Health Care; Treatment Adherence and Compliance	Health Services; Primary Health Care
Construction	“Acquired Immunodeficiency Syndrome” OR “HIV” OR “Aids”	“Patient Acceptance of Health Care” OR “Treatment Adherence and Compliance”	“Health Services” OR “Primary Health Carel”
Usage	(“Acquired Immunodeficiency Syndrome” OR “HIV” OR “Aids”) AND (“Patient Acceptance of Health Care” OR “Treatment Adherence and Compliance”) AND (“Health Services” OR “Primary Health Carel”)

Nº	Antecedents	n(%)
01	Alcohol use(²⁹, ⁴², ⁴⁸)	3 (9.6%)
02	Side effects of ART(²¹, ²⁸, ²⁹, ³³, ³⁷, ³⁸, ⁴⁷, ⁴⁸, ⁴⁹)	9 (29%)
03	Illicit drug use(²², ²⁴, ²⁶, ²⁹, ³⁸, ³⁹, ⁴³, ⁴⁴, ⁴⁸, ⁴⁹)	10 (32.2%)
04	Stigma and social isolation(¹⁹, ²³, ²⁵, ²⁸, ²⁹, ³¹, ³², ³⁴, ³⁵, ⁴⁰, ⁴¹, ⁴⁷)	12 (38.7%)
05	Low education level(²⁰, ²², ²⁴, ³⁰, ³¹, ³², ⁴⁰, ⁴², ⁴⁴, ⁴⁹)	10 (32.2%)
06	Mental disorders(²⁰, ²², ²⁶, ²⁸, ³¹, ³², ³⁶, ³⁷, ³⁸, ⁴¹, ⁴², ⁴³, ⁴⁷)	14 (45.1%)
07	Low i ncome(²⁰, ³⁰, ³¹, ³², ³⁴, ³⁶, ³⁹, ⁴⁰, ⁴², ⁴³, ⁴⁴, ⁴⁸)	12 (38.7%)
08	Barriers to accessing healthcare services(¹⁹, ²², ²³, ²⁵, ²⁶, ²⁷, ³², ³⁶, ³⁸, ⁴⁰, ⁴², ⁴³, ⁴⁴, ⁴⁵, ⁴⁶, ⁴⁹)	16 (51.6%)
09	Lack of support network(¹⁹, ²¹, ²², ²⁵, ³¹, ³², ³⁵, ³⁷, ³⁸, ⁴⁰, ⁴¹, ⁴², ⁴⁴, ⁴⁸, ⁴⁹)	15 (48.3%)
10	Forgetfulness(²¹, ²⁹, ³⁵, ³⁷, ³⁸, ⁴³, ⁴⁴, ⁴⁸)	8 (25.8%)
11	Fear of diagnosis disclosure(¹⁹, ²⁹, ³¹, ³⁴, ³⁵, ⁴¹, ⁴⁹)	7 (22.5%)
12	High medication burden(³⁶, ³⁹, ⁴³, ⁴⁹)	4 (12.9%)
13	Race (Black or Brown)(²¹, ³⁹, ⁴²)	3 (9.6%)
14	Denial of disease(²¹, ²⁵, ⁴¹)	3 (9.6%)
15	Age < 40 years(²⁰, ²⁸, ³⁶, ³⁹, ⁴², ⁴⁶, ⁴⁸)	7 (22.5%)
16	Occupational activity(²⁴, ²⁹, ³⁰, ³¹, ⁴⁰, ⁴¹, ⁴⁶, ⁴⁹)	8 (25.8%)
17	Quality of care and/or relationship with healthcare professionals(²¹, ²³, ²⁵, ²⁸, ³⁰, ³¹, ³², ³⁸, ⁴⁰)	9 (29%)
18	Treatment duration < 1 year(³⁵, ³⁸, ³⁹, ⁴⁹)	4 (12.9%)
19	Treatment duration < 2 years(¹⁹, ³⁷, ⁴⁰, ⁴⁸)	4 (12.9%)
20	Self-centeredness(²¹, ⁴⁸)	2 (6.4%)
21	Unhealthy environment(²⁹, ⁴¹)	2 (6.4%)
22	Absence/deficiency of public policies(²⁴, ²⁷, ³⁰)	3 (9.6%)
23	Malesex(²⁰, ²¹, ²⁶, ³², ³⁹)	5 (16.2%)
24	Change in therapeutic regimen(³³, ³⁹)	2 (6.4%)
25	Medication unavailability(²⁴, ²⁷, ³⁰, ⁴¹)	4 (12.9%)
26	Destabilizing situations(¹⁹, ²⁵, ²⁹, ³¹, ³⁷, ⁴², ⁴⁵)	7 (22.5%)
27	Food insecurity(¹⁹, ²⁷, ³⁴, ⁴⁰, ⁴⁵, ⁴⁶)	6 (19.3%)
28	HIV clinical stage (WHO)(²¹, ²⁴, ²⁶, ³⁵, ³⁶, ³⁸, ⁴⁹)	7 (22.5%)
29	Coinfection (hepatitis and tuberculosis)(²⁴, ²⁶, ³⁵, ⁴⁹)	4 (12.9%)
30	Religion/beliefs opposing the therapeutic plan(²¹, ³⁵, ⁴⁴)	3 (9.6%)
Nº	Consequences	N(%)
01	Morbimortality(²¹, ²³, ²⁶, ²⁷, ³¹, ³², ³⁶, ³⁷, ³⁸, ⁴², ⁴⁵, ⁴⁹)	13 (41.9%)
02	Disease progression(²¹, ²³, ²⁶, ²⁷, ³¹, ³², ³⁶, ³⁷, ³⁸, ⁴², ⁴⁵, ⁴⁹)	15 (48.3%)
03	Increased susceptibility to opportunistic infections(²⁸, ³⁰, ³⁴, ³⁵, ³⁶, ³⁸, ⁴⁰, ⁴⁶, ⁴⁸)	9 (29%)
04	Increased transmissibility potential(²², ³⁰, ³⁷, ³⁹, ⁴³, ⁴⁵, ⁴⁹)	7 (22.5%)
05	Medication resistance(²¹, ²², ²³, ²⁶, ²⁸, ²⁹, ³¹, ³², ³³, ³⁴, ³⁶, ³⁸, ³⁹, ⁴², ⁴⁴, ⁴⁶, ⁴⁹)	17 (54.8%)
06	Increased viral load(²¹, ²², ²³, ²⁶, ²⁸, ²⁹, ³¹, ³², ³³, ³⁴, ³⁵, ³⁶, ³⁷, ³⁹, ⁴³, ⁴⁴, ⁴⁵)	17 (54.8 %)
07	Reduced quality of life(²⁸, ³¹, ³⁴, ³⁶, ³⁹, ⁴⁶)	6 (19.3%)
08	Neurological and/or motor dysfunctions(⁶, ²⁰, ²², ³¹, ⁴², ⁴⁸)	4 (12.9%)
09	Recurrent and/or prolonged hospitalizations(²⁷, ⁴⁴)	2 (6.4%)

Predisposing factor
01	Alcohol use
02	Illicit drug use
03	Stigma and social isolation
04	Low education level
05	Mental disorders
06	Low income
07	Barriers to accessing healthcare services
08	Lack of support network
09	Race (Black or Brown)
10	Denial of disease
11	Age < 40 years
12	Time since diagnosis < 2 years
13	Unhealthy environment
14	Male sex
15	Religion/beliefs opposing the therapeutic plan
Disabling factor
01	Side effects of ART
02	Forgetfulness
03	Fear of diagnosis disclosure
04	High medication burden
05	Quality of care and/or relationship with healthcare professionals
06	Self-centeredness
07	Food insecurity
08	HIV clinical stage (WHO)
09	Coinfection (hepatitis and tuberculosis)
10	Medication unavailability
Precipitating factor
01	Destabilizing situations
02	Change in therapeutic regimen
Reinforcing factor
01	Occupational activity
02	Treatment duration < 1 year
03	Absence/deficiency of public policies

The middle-range theory of the nursing diagnosis “ineffective health self-management”

Teoria de rango medio del diagnóstico de enfermería “autogestión ineficaz de la salud”

ABSTRACT