Content analysis of clinical indicators for Impaired gas exchange

To analyze the relevance of clinical indicators and the clarity and precision of conceptual and operational definitions of the diagnosis Impaired gas exchange.

Methods

Content analysis, by 39 nurse judges, divided into the phases of conceptual definition of the phenomenon of interest, construction of the structure of the phenomenon of interest and analysis of the judges on the built structure.

Results

From the 22 indicators, 21 were considered relevant Impaired gas exchange. The indicators that obtained absolute relevance were Cyanosis, Hypercapnia, Hypoxemia and Tachycardia. The indicator Headache upon waking did not show any statistically significant relevance for the diagnosis. All conceptual and operational definitions were clear and precise.

Conclusion

The indicators listed for Impaired gas exchange were relevant to the phenomenon, except Headache upon waking because it does not correspond to a safe manifestation to identify the diagnosis, according to the analysis of the judges. Each conceptual and operational definition was adequate for its indicator.

Keywords
Nursing diagnosis; Validation study; Content validation; Pulmonary gas exchange

Variables	IGE Diagnostic
Variables	Relevance
Clinical Indicators	n	%	P-value^*
Cyanosis²	38	100.0	1.000
Hypercapnia¹	39	100.0	1.000
Hypoxemia¹	39	100.0	1.000
Tachycardia¹	39	100.0	1.000
Abnormal arterial pH¹	38	97.4	0.998
Tachypnea²	38	97.4	0.998
Dyspnea¹	36	97.3	0.997
Decreased oxygen saturation²	37	94.9	0.986
Restlessness¹	37	94.9	0.986
Decreased carbon dioxide¹	35	94.6	0.981
Hypoxia¹	36	92.3	0.945
Nose wing flick¹	35	89.7	0.856
Diaphoresis²	35	89.7	0.856
Changes in respiratory rate²	35	89.7	0.856
Confusion¹	34	87.2	0.715
Irritability¹	34	87.2	0.715
Changes in respiratory depth²	34	87.2	0.715
Bradypnea²	33	84.6	0.541
Abnormal skin color (pale, darkened)¹	32	84.2	0.514
Drowsiness¹	31	81.6	0.341
Visual disturbances²	29	74.4	0.057
Headache upon waking¹	25	65.8	0.002

Variables	Conceptual definition						Empirical reference
Variables	Clarity			Precision			Clarity			Precision
Clinical Indicators	n	%	Value p^†	n	%	Value p^†	n	%	Value p^†	n	%	Value p^†
Decreased O₂ saturation²^*	39	100.0	1.000	38	97.4	0.998	38	97.4	0.998	35	92.1	0.938
Changes in respiratory rate²^*	39	100.0	1.000	38	97.4	0.998	37	94.9	0.986	33	84.6	0.541
Changes in respiratory depth²^*	39	100.0	1.000	38	97.4	0.998	33	84.6	0.541	34	87.2	0.715
Tachycardia¹^*	39	100.0	1.000	37	94.9	0.986	39	100.0	1.000	35	92.1	0.938
Diaphoresis²	38	100.0	1.000	35	92.1	0.938	38	100.0	1.000	36	94.7	0.984
Dyspnea¹^*	38	100.0	1.000	38	97.4	0.998	39	100.0	1.000	38	97.4	0.998
Hypercapnia¹^*	38	100.0	1.000	38	97.4	0.998	38	100.0	1.000	35	92.1	0.938
Abnormal arterial pH¹^*	38	100.0	1.000	37	94.9	0.986	39	100.0	1.000	39	100.0	1.000
Cyanosis²^*	38	97.4	0.998	39	100.0	1.000	38	97.4	0.998	38	97.4	0.998
Confusion¹^*	38	97.4	0.998	36	92.3	0.945	37	94.9	0.986	36	92.3	0.945
Hypoxia²^*	38	97.4	0.998	37	94.9	0.986	37	94.9	0.986	36	92.3	0.945
Restlessness¹^*	38	97.4	0.998	36	92.3	0.945	38	97.4	0.998	37	94.9	0.986
Tachypnea²	38	97.4	0.998	38	97.4	0.998	38	97.4	0.998	36	92.3	0.945
Bradypnea²^*	38	97.4	0.998	38	97.4	0.998	36	92.3	0.945	34	87.2	0.715
Abnormal skin color (pale, darkened)¹	37	97.4	0.997	36	94.7	0.984	36	94.7	0.984	35	92.1	0.938
Nose wing flick¹^*	37	94.9	0.986	38	97.4	0.998	37	94.9	0.986	38	97.4	0.998
Headache upon waking¹	37	94.9	0.986	33	86.8	0.693	34	87.2	0.715	30	76.9	0.120
Hypoxemia¹^*	37	94.9	0.986	36	94.7	0.984	37	94.9	0.986	35	89.7	0.856
Irritability¹^*	37	94.9	0.986	35	89.7	0.856	37	94.9	0.986	36	94.7	0.984
Decreased carbon dioxide¹^*	36	97.3	0.997	34	94.4	0.978	36	100.0	1.000	34	94.4	0.978
Visual disturbances²^*	36	97.3	0.997	32	86.5	0.669	35	92.1	0.938	33	86.8	0.693
Drowsiness¹^*	36	92.3	0.945	35	89.7	0.856	33	86.8	0.693	35	89.7	0.856

Universidade Federal do Rio Grande do Sul. Escola de Enfermagem Rua São Manoel, 963 -Campus da Saúde , 90.620-110 - Porto Alegre - RS - Brasil, Fone: (55 51) 3308-5242 / Fax: (55 51) 3308-5436 - Porto Alegre - RS - Brazil
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[1] Corresponding author
Lívia Maia Pascoal Email: livia_mp@hotmail.com