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      Middle-Range Theory of Ineffective Breathing Pattern in children with Congenital Heart Disease Translated title: Teoria de Médio Alcance do Padrão Respiratório Ineficaz em Crianças com Cardiopatia Congênita Translated title: Teoría de Mediano Alcance del Patrón de Respiración Ineficiente en niños con cardiopatías congénitas

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          Abstract

          Objective:

          to develop and evaluate a middle-range theory for the Nursing Diagnosis of Ineffective Breathing Pattern in children with congenital heart disease.

          Method:

          a methodological study carried out in two stages: 1) development of a middle- range theory for Ineffective Breathing Pattern in children with congenital heart diseases from the analysis of the NANDA-International taxonomy, Callista Roy’s Adaptation Model and a literature review; and 2) assessment of the middle-range theory developed using expert panel evaluation.

          Results:

          after three panel evaluations, the final version of the middle-range theory resulted in four metaparadigms, two key concepts, two pictorial diagrams, two propositions and a description of the interrelationships between the key concepts of Ineffective Breathing Pattern in children with congenital heart diseases and evidence for the Nursing practice.

          Conclusion:

          the middle-range theory developed and evaluated by experts identified stimuli and behaviors that can assist nurses in identifying the reasons why Ineffective Breathing Pattern is diagnosed and how it manifests itself in children with congenital heart disease, increasing understanding of the relationships between the causes and their temporality.

          Resumo

          Objetivo:

          desenvolver e avaliar uma teoria de médio alcance para o Diagnóstico de Enfermagem de Padrão Respiratório Ineficaz em crianças com cardiopatia congênita.

          Método:

          um estudo metodológico realizado em duas etapas: 1) desenvolvimento de uma teoria de médio alcance para padrão respiratório ineficaz em crianças com doenças cardíacas congênitas a partir da análise da taxonomia NANDA-Internacional, modelo de adaptação de Callista Roy e uma revisão da literatura; e 2) avaliação da teoria de médio alcance desenvolvida por meio da avaliação de painéis de especialistas.

          Resultados:

          após três avaliações de painéis, a versão final da teoria de médio alcance resultou em quatro metaparadigmas, dois conceitos-chave, dois diagramas pictóricos, duas propostas e uma descrição das inter-relações entre os conceitos-chave do Padrão Respiratório Ineficaz em crianças com cardiopatias congênitas e evidências para a prática de Enfermagem.

          Conclusão:

          a teoria do médio alcance desenvolvida e avaliada por especialistas identificou estímulos e comportamentos que podem auxiliar os enfermeiros na identificação das razões pelas quais o Padrão Respiratório Ineficaz é diagnosticado e como ele se manifesta em crianças com cardiopatia congênita, aumentando a compreensão das relações entre as causas e sua temporalidade.

          Resumen

          Objetivo:

          desarrollar y evaluar una teoría de mediano alcance para el Diagnóstico de Enfermería “Patrón de Respiración Ineficiente” en niños con cardiopatías congénitas.

          Método:

          estudio metodológico desarrollado en dos etapas: 1) Desarrollo de una teoría de mediano alcance para el Patrón de Respiración Ineficiente en niños con cardiopatías congénitas a partir del análisis de la taxonomía NANDA-Internacional, del Modelo de Adaptación de Callista Roy y de una revisión de la literatura; y 2) Evaluación de la teoría de mediano alcance desarrollada por medio de una evaluación de un panel de expertos.

          Resultados:

          después de tres evaluaciones a cargo del panel, la versión final de la teoría de mediano alcance derivó en cuatro metaparadigmas, dos conceptos clave, dos pictogramas, dos propuestas y una descripción de las interrelaciones entre los conceptos clave del Patrón de Respiración Ineficiente en niños con cardiopatías congénitas y evidencia para la práctica de Enfermería.

          Conclusión:

          la teoría de mediano alcance desarrollada y evaluada por expertos identificó estímulos y comportamientos que pueden ayudar a los enfermeros a identificar los motivos por los cuales se diagnostica el Patrón de Respiración Ineficiente y cómo se manifiesta en niños con cardiopatías congénitas, mejorando así la comprensión de las relaciones entre las causas y su temporalidad.

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          Most cited references29

          • Record: found
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          The effect of body position on pulmonary function: a systematic review

          Background Pulmonary function tests (PFTs) are routinely performed in the upright position due to measurement devices and patient comfort. This systematic review investigated the influence of body position on lung function in healthy persons and specific patient groups. Methods A search to identify English-language papers published from 1/1998–12/2017 was conducted using MEDLINE and Google Scholar with key words: body position, lung function, lung mechanics, lung volume, position change, positioning, posture, pulmonary function testing, sitting, standing, supine, ventilation, and ventilatory change. Studies that were quasi-experimental, pre-post intervention; compared ≥2 positions, including sitting or standing; and assessed lung function in non-mechanically ventilated subjects aged ≥18 years were included. Primary outcome measures were forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC, FEV1/FVC), vital capacity (VC), functional residual capacity (FRC), maximal expiratory pressure (PEmax), maximal inspiratory pressure (PImax), peak expiratory flow (PEF), total lung capacity (TLC), residual volume (RV), and diffusing capacity of the lungs for carbon monoxide (DLCO). Standing, sitting, supine, and right- and left-side lying positions were studied. Results Forty-three studies met inclusion criteria. The study populations included healthy subjects (29 studies), lung disease (nine), heart disease (four), spinal cord injury (SCI, seven), neuromuscular diseases (three), and obesity (four). In most studies involving healthy subjects or patients with lung, heart, neuromuscular disease, or obesity, FEV1, FVC, FRC, PEmax, PImax, and/or PEF values were higher in more erect positions. For subjects with tetraplegic SCI, FVC and FEV1 were higher in supine vs. sitting. In healthy subjects, DLCO was higher in the supine vs. sitting, and in sitting vs. side-lying positions. In patients with chronic heart failure, the effect of position on DLCO varied. Conclusions Body position influences the results of PFTs, but the optimal position and magnitude of the benefit varies between study populations. PFTs are routinely performed in the sitting position. We recommend the supine position should be considered in addition to sitting for PFTs in patients with SCI and neuromuscular disease. When treating patients with heart, lung, SCI, neuromuscular disease, or obesity, one should take into consideration that pulmonary physiology and function are influenced by body position. Electronic supplementary material The online version of this article (10.1186/s12890-018-0723-4) contains supplementary material, which is available to authorized users.
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            Criteria for Evaluation of Theory

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              Causation and Validation of Nursing Diagnoses: A Middle Range Theory: Causation and Validation of Nursing Diagnoses

                Author and article information

                Contributors
                Role: Study concept and designRole: Obtaining dataRole: Data analysis and interpretationRole: Statistical analysisRole: Obtaining financingRole: Drafting the manuscriptRole: Critical review of the manuscript as to its relevant intellectual content
                Role: Study concept and designRole: Data analysis and interpretationRole: Drafting the manuscriptRole: Critical review of the manuscript as to its relevant intellectual content
                Role: Data analysis and interpretationRole: Statistical analysisRole: Drafting the manuscriptRole: Critical review of the manuscript as to its relevant intellectual content
                Journal
                Rev Lat Am Enfermagem
                Rev Lat Am Enfermagem
                rlae
                Revista Latino-Americana de Enfermagem
                Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo
                0104-1169
                1518-8345
                2022
                06 January 2023
                : 30
                : e3783
                Affiliations
                [1 ] Universidade Federal do Ceará, Fortaleza, CE, Brazil.
                Author notes
                [Corresponding author ] Nayana Maria Gomes de Souza. E-mail: nayanamgs@ 123456hotmail.com

                Associate Editor: Lucila Castanheira Nascimento

                Conflict of interest: The authors have declared that there is no conflict of interest.

                Author information
                http://orcid.org/0000-0002-5038-0836
                http://orcid.org/0000-0002-8033-8831
                http://orcid.org/0000-0001-5867-8023
                Article
                00353
                10.1590/1518-8345.5826.3783
                9818354
                36629731
                ed6cbc6e-2ea3-47ea-aee1-f3247c75b337

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                History
                : 10 November 2021
                : 29 July 2022
                Page count
                Figures: 6, Tables: 3, Equations: 0, References: 24, Pages: 0
                Categories
                Original Article

                nursing diagnosis,nursing research,nursing theory,nursing process,validation study,heart diseases, congenital,diagnóstico de enfermagem,pesquisa em enfermagem,teoria de enfermagem,processo de enfermagem,estudo de validação,cardiopatias congênitas,diagnóstico de enfermería,investigación en enfermería,teoría de enfermería,proceso de enfermería,estudio de validación,cardiopatías congénitas

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