Specific causal validation of nursing diagnosis Risk for thrombosis: A case–control study

Author:

de Souza Hilário Thamires12,Mantovani Vanessa Monteiro23ORCID,Aliti Graziella Badin2456,de Fátima Lucena Amália2478,de Oliveira Lopes Marcos Venícios69ORCID,Rabelo‐Silva Eneida Rejane2841011ORCID

Affiliation:

1. Postgraduate Program in Nursing Universidade Federal do Rio Grande do Sul Porto Alegre Rio Grande do Sul Brazil

2. Nursing Research Group on the Care of Adults and the Elderly (GEPECADI‐CNPq) Porto Alegre Rio Grande do Sul Brazil

3. Social Projects Leader at Department of Social Responsibility Hospital Moinhos de Vento Porto Alegre Rio Grande do Sul Brazil

4. School of Nursing Universidade Federal do Rio Grande do Sul Porto Alegre Rio Grande do Sul Brazil

5. Hospital de Clínicas de Porto Alegre ‐ Intensive Care Unit Porto Alegre Rio Grande do Sul Brazil

6. Member of the Lab of Health Measurement Universidade Federal do Ceará Fortaleza Brazil

7. Nursing Process Committee Hospital de Clínicas de Porto Alegre Porto Alegre Rio Grande do Sul Brazil

8. Researcher at CNPq‐level 1D Porto Alegre Rio Grande do Sul Brazil

9. Department of Nursing Universidade Federal do Ceará Fortaleza Brazil

10. Vascular Access Program Hospital de Clínicas de Porto Alegre Porto Alegre Rio Grande do Sul Brazil

11. Head of the Clinical Research Service at Hospital de Clínicas de Porto Alegre Porto Alegre Rio Grande do Sul Brazil

Abstract

AbstractPurposeThis study aims to perform specific causal validation of nursing diagnosis Risk for thrombosis (00291) of the NANDA International (NANDA‐I) classification.MethodsThis is a case–control study conducted in a university hospital from January to October 2020. A total of 516 adult patients were included—344 in the Case Group (with venous or arterial thrombosis evidenced by imaging) and 172 in the Control Group (without thrombosis). Statistical analysis was performed by univariate and multivariate logistic regression test, and odds ratios were calculated to measure the effect of exposure between groups. The study was approved by the Research Ethics Committee.FindingsThe patients were predominantly female and aged 59 ± 16 years. In the univariate logistic analysis, five risk factors were significantly associated with thrombosis, two at‐risk populations and 12 associated conditions. In the multivariate regression model, the following risk factors remained independently associated (p < 0.05): inadequate knowledge of modifiable factors (OR: 3.03; 95% CI: 1.25–8.56) and ineffective medication self‐management (OR: 3.2; 95% CI:1.77–6.26); at‐risk populations with history (OR: 2.16; 95% CI: 1.29–3.66) and family history of thrombosis (OR:2.60; 95% CI: 1.03–7.49); and the conditions associated with vascular diseases (OR:6.12; 95% CI:1.69–39.42), blood coagulation disorders (OR: 5.14; 95% CI:1.85–18.37), atherosclerosis (OR:2.07; 95% CI: 1.32–3.27), critical illness (OR: 2.28; 95% CI: 1.42–3.70), and immobility (OR: 2.09; 95% CI: 1.10–4.12).ConclusionsThe clinical validation allowed to establish strong evidence for the refinement of the diagnosis Risk for thrombosis and, consequently, to raise its level of evidence in the classification of NANDA‐I.Implications for nursing practiceThe evidence pointed out by this study favors the establishment of thrombosis diagnosis in an accurate way by nurses in clinical practice, directing preventive interventions to patients in this risk condition.

Publisher

Wiley

Subject

Fundamentals and skills,Research and Theory

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