Clinical Validation of the Nanda-I "Caregiver Role Strain" Nursing Diagnosis in the Context of Palliative Care

Abstract

Objective: to clinically validate the defining characteristics of the “Caregiver Role Strain” Nursing diagnosis for caregivers of people in a palliative care situation. Method: a cross-sectional, quantitative, descriptive and analytical study. It was developed based on Fehring's Clinical Validation Model and on the diagnostic accuracy measures (sensitivity, specificity, predictive values and Receiver Operating Characteristic curve). The data collection instrument used was a form, applied in 2017 by two nurses to a sample of 111 caregivers of people in a palliative care situation, in Portugal. The caregivers were divided into two groups (with and without the diagnosis), being identified by the simultaneity of three criteria, namely: Zarit Burden Interview values greater than 56; agreement of two nurses about the diagnosis; and caregiver's perception of the presence of signs and symptoms. The defining characteristics were classified as major, secondary and irrelevant, according to the models used. Results: the prevalence of diagnosis was 42.3%. Of the 29 characteristics subjected to the validation process, 9 were considered major, 13 secondary and 7 irrelevant. Ineffective coping, depressive mood, frustration, worsening of previous diseases, stress and fatigue were the characteristics which proved to be more associated with the diagnosis in both analyses. The overall score of the diagnosis was 0.68. Conclusion: the study results contribute to the improvement of the diagnosis, making it more accurate. In addition, they enable better clinical decision in Nursing, allowing nurses to make a diagnostic judgment supported by scientific evidence.

Práticas Assistenciais De Equipes Médicas E De Enfermagem Às Pessoas Em Cuidados Paliativos Hospitalizadas

“…Sobre esse aspecto, um estudo português 29 , que validou clinicamente as características definidoras do diagnóstico de enfermagem "Tensão do Papel de Cuidador da pessoa em situação paliativa", evidenciou que mesmo sob cuidados paliativos os cuidadores, notadamente cônjuges, experienciam a tensão do papel de cuidador, evidenciada pela sensação de aprisionamento ao papel que desempenham, pela fadiga e pela apreensão em relação ao futuro do familiar adoecido.…”

Assistance Practices of Medical and Nursing Teams for Hospitalized People in Palliative Care

“…Regarding this aspect, a Portuguese study 29 , which clinically validated the defining characteristics of the "Caregiver Role Strain of a person in a palliative situation" Nursing diagnosis, showed that even under Palliative Care, caregivers, notably spouses, experience the tension of their role, evidenced by the feeling of being trapped in their function, fatigue and apprehension in relation to the future of the sick family member.…”

Tensão do cuidador e sua relação com segurança do idoso no domicílio

“…O diagnóstico de enfermagem "Tensão do Papel de Cuidador" é definido na taxonomia NANDA International (NANDA-I) como a "dificuldade para atender a responsabilidades, expectativas e/ou comportamentos de cuidados relacionados à família ou a pessoas significativas" (Lourenço et al, 2021).…”