背景:健康方面的进步突出了将技术作为诊断的基本部分的必要性,治疗,以及有健康变化风险或有健康变化的患者的康复。为此,数字平台已经证明了它们在识别护理需求方面的适用性。护理是心血管疾病患者护理的基本组成部分,在诊断人类对这些健康状况的反应中起着至关重要的作用。因此,通过正在进行的研究过程对护理诊断进行验证已成为必要,这可能会对患者和医疗保健专业人员产生重大影响.
目的:我们旨在描述开发移动应用程序的过程,以验证急性心肌梗死患者的护理诊断“对身体活动不耐受”。
方法:我们描述了移动系统的开发和试点测试,以支持数据收集,以验证活动不耐受的护理诊断。这是一项描述性研究,对11名成年人(年龄≥18岁)进行了描述性研究,他们在2019年8月至9月期间在Floridablanca因高度复杂的需求而被怀疑诊断为冠状动脉综合征,哥伦比亚。在急性冠状动脉综合征患者中开发了一种用于临床验证活动不耐受的应用程序(北美护理诊断协会[NANDA]代码00092),分为两个步骤:(1)护理诊断的可操作性和(2)应用程序开发过程,其中包括对初始要求的评估,形式的发展和数字化,和试点测试。用κ指数评价2名评估护士之间的一致水平。
结果:我们开发了一种包含社会人口统计数据的表格,入院数据,病史,目前的药物治疗,心肌梗死溶栓风险评分(TIMI-RS)和GRACE(全球急性冠脉事件注册)评分。要识别定义特征,我们包括官方指导方针,生理测量,以及Piper疲劳量表和Borg量表等量表。试点测试的参与者(n=11)的平均年龄为63.2(SD4.0)岁,男性占82%(9/11);18%(2/11)的小学教育不完整。对于大多数定义特征,评估人员之间的一致性约为80%。最普遍的特征是运动不适(10/11,91%),弱点(7/11,64%),呼吸困难(3/11,27%),运动时心率异常(2/10,20%),心电图异常(1/10,9%),和对活动反应的异常血压(1/10,10%)。
结论:我们开发了一个移动应用程序来验证“活动不耐受”的诊断。它的使用不仅保证了最佳的数据收集,最小化错误以执行验证,但也将允许识别个人护理需求。
BACKGROUND: Advances in health have highlighted the need to implement technologies as a fundamental part of the diagnosis, treatment, and recovery of patients at risk of or with health alterations. For this purpose, digital platforms have demonstrated their applicability in the identification of care needs. Nursing is a fundamental component in the care of patients with cardiovascular disorders and plays a crucial role in diagnosing human responses to these health conditions. Consequently, the validation of nursing diagnoses through ongoing research processes has become a necessity that can significantly impact both patients and health care professionals.
OBJECTIVE: We aimed to describe the process of developing a mobile app to validate the nursing diagnosis \"intolerance to physical activity\" in patients with acute myocardial infarction.
METHODS: We describe the development and pilot-testing of a mobile system to support data collection for validating the nursing diagnosis of activity intolerance. This was a descriptive study conducted with 11 adults (aged ≥18 years) who attended a health institution for highly complex needs with a suspected diagnosis of coronary syndrome between August and September 2019 in Floridablanca, Colombia. An app for the clinical validation of activity intolerance (North American Nursing Diagnosis Association [NANDA] code 00092) in patients with acute coronary syndrome was developed in two steps: (1) operationalization of the nursing diagnosis and (2) the app development process, which included an evaluation of the initial requirements, development and digitization of the forms, and a pilot test. The agreement level between the 2 evaluating nurses was evaluated with the κ index.
RESULTS: We developed a form that included sociodemographic data, hospital admission data, medical history, current pharmacological treatment, and thrombolysis in myocardial infarction risk score (TIMI-RS) and GRACE (Global Registry of Acute Coronary Events) scores. To identify the defining characteristics, we included official guidelines, physiological measurements, and scales such as the Piper fatigue scale and Borg scale. Participants in the pilot test (n=11) had an average age of 63.2 (SD 4.0) years and were 82% (9/11) men; 18% (2/11) had incomplete primary schooling. The agreement between the evaluators was approximately 80% for most of the defining characteristics. The most prevalent characteristics were exercise discomfort (10/11, 91%), weakness (7/11, 64%), dyspnea (3/11, 27%), abnormal heart rate in response to exercise (2/10, 20%), electrocardiogram abnormalities (1/10, 9%), and abnormal blood pressure in response to activity (1/10, 10%).
CONCLUSIONS: We developed a mobile app for validating the diagnosis of \"activity intolerance.\" Its use will guarantee not only optimal data collection, minimizing errors to perform validation, but will also allow the identification of individual care needs.