Patients with stroke : validation the constitutive and operational definitions created for the mobility nursing outcome
Notice bibliographique
Résumé
The study aimed at identifying and validating the constitutive and operational definitions of the mobility outcome and its indicators present in the Nursing Outcomes Classification (NOC 2010). The study was of methodology type and was performed in three stages: concept analysis, validation by specialists and clinical validation of the instrument. For the selection of productions it was used the online access to five databases: Scopus, PubMed, Cinahl, Lilacs and Cochrane, with the descriptors: mobility, stroke, nursing and their synonyms in both Portuguese and Spanish languages. 1521 articles were identified in all the databases searched and a careful selection resulted in 49 articles. Amongst the fifteen different countries, we highlight the articles published in Canada (26.7%), especially works from 2001 (95.9%) by physiotherapists (34.6%) in rehabilitation units (61.5 %). The attributes identified for Mobility were: walking, standing, sitting, placing the leg side to side, turning around, start and stop walking, climbing stairs, motor function, transfer and motor skill. For Mobility limitation: hemiplegia, hemiparesis, gait deficit and decreased motor skills. It was also created a sample case and an opposite case and were identified antecedents and consequences for both terms Mobility and Mobility limitation. After the concept analysis stage, it was brought forward an instrument with the constitutive and operational definitions for the indicators of the Mobility outcome by using the principles of psychometrics. This instrument was assessed by 23 specialist nurses who met the criteria adapted from Fehring (1994). The data were compiled into a spreadsheet program Microsoft Office Excel 2007 and analyzed by SPSS version 16.0. Most specialists was female (95.7%), worked in the State of Ceará (76.0%) in institution of higher education and hospitals (56.5%), was a master (78.3%) and had experience working with mobility and / or stroke. It was noted that the following indicators: Run, Jump, Crawl and Movements performed with ease showed ratios statistically less than 85% for most of the psychometrics criteria. Moreover, most of the nurses suggested the removal of these indicators by judging they were not representative for patients who had strokes. Thus, these indicators were excluded when defining the instrument to be applied in the clinical validation of the instrument stage. The data collection for the third stage took place in the neurology first-aid room of a referral hospital for treatment of patients with stroke in Ceará State and all ethical aspects have been followed at all stages of the study. After the researcher of the study confirmed the existence of the Impaired physical mobility nursing diagnosis in patients who had stroke, a pair of nurses applied the instrument with the constitutive and operational definitions identified and validated in the first two stages of the study while another pair used the same instrument without the definitions. As for the analysis of the nurses evaluations, there was similarity amongst the pair of evaluators who used the instrument with the constitutive and operational definitions for all indicators and amongst the pair who used the instrument without these definitions in applying the statistical tests from Fridman and the Intraclass Correlation Coefficient. With the use of this coefficient to such indicators: Balance, Walking, Joint movement and Body positioning performance, it was found a higher correlation between the evaluators who used the definitions as compared to those who did not. As for the following indicators: Gait, Muscle movement, Performance in the transfer and coordination, the agreement was higher amongst the nurses who did not adopt the definitions. But overall, it was observed that for most indicators there was greater agreement amongst the pair who used the instrument with the constitutive and operational definitions. However, it is recommended to execute other validation researches with the Mobility nursing outcome in patients with stroke and in several other clinical situations as well. This research may contribute to the improvement of the NOC taxonomy.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,125 | 0,199 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,003 |
| Bibliométrie | 0,008 | 0,008 |
| Études des sciences et des technologies | 0,001 | 0,003 |
| Communication savante | 0,004 | 0,004 |
| Science ouverte | 0,002 | 0,005 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».