Validação clínica do diagnóstico de enfermagem envolvimento em atividade de recreação diminuído em pacientes diabéticos

Abstract

This study aimed to validate the Nursing Diagnosis Decreased diversional activity engagement in diabetic patients. This is a cross-sectional study, carried out at the Endocrinology outpatient clinic linked to the University Hospital of the Federal University of Maranhão, in the city of São Luís - MA. The sample consisted of 170 individuals with type 2 diabetics, both genders, ≥ 18 years of age and who underwent follow-up in this service. Data collection occurred from October 2019 to February 2020, with audio recorded interviews, using two forms. The first referred to sociodemographic, clinical and risk factors for diabetes, including questions about participation in recreational activities. The second characterized the presence or absence of defining characteristics and related factors of the Nursing Diagnosis Decreased diversional activity engagement. For the appointment of this nursing diagnosis, the reference model was Gordon, following Taxonomy II of the North American Nursing Diagnosis Association published in 2018. The data were compiled in spreadsheets of the Microsoft Excel software (2019), using the statistical package SPSS version 24, with a significance level of 5%. The descriptive analysis of the data occurred by calculating absolute and relative measures. To evaluate possible associations between the Nursing Diagnosis and sociodemographic, clinical and risk factors for diabetes mellitus, binary logistic regression models were used, with an estimate of the odds ratios and respective 95% confidence intervals. Diagnostic accuracy measures of the defining characteristics of the nursing diagnosis were used through sensitivity, specificity, positive and negative predictive values. All ethical precepts were followed during the study stages. Regarding sociodemographic data, most participants were female, aged over 40 years, married or in stable union, retirees/pensioners with low schooling and income. Regarding clinical data, participants with up to ten years of diabetes diagnosis, presence of overweight, obesity and non-follow-up of an adequate dietary plan stand out. Among the risk factors, the most frequent was a family history of diabetes, followed by sedentary lifestyle, hypertension and hypercholesterolemia. Of the participants, 60.0% manifested the Nursing Diagnosis Decreased diversional activity engagement. The variables that presented a significant association with the Nursing Diagnosis were: being single and presenting capillary glycaemia within normal limits as protective measures, while being autonomous and not following an adequate dietary plan presented higher chances for diagnosis. All defining characteristics presented significant association. Regarding diagnostic accuracy measures, the defining characteristics that presented the highest sensitivity were: Dissatisfaction with the situation, Lack of physical conditioning and Mood changes, while Superficial affect, frequent naps and boredom had greater specificity. Therefore, the Nursing Diagnosis Decreased diversional activity engagement is prevalent in diabetic patients and its defining characteristics predict its occurrence in this clientele. In addition, understanding the diagnostic profile is believed to contribute to the nursing planning and interventions that can achieve results directed to human responses, thus improving the quality of nursing care.