Diagnósticos de enfermagem angústia espiritual e resiliência comprometida em pessoas em tratamento de fertilidade

: estudo de validação clínica

Abstract

Introduction: Human responses to infertility highlight spiritual distress and the ability of individuals to be resilient. In this regard, most diagnoses listed in NANDA-I have a low level of evidence and requires clinical validation in specific populations, such as people with infertility. This doctoral thesis arises from a diagnostic improvement necessary for an effectively integrative, holistic nursing intervention focused on the uniqueness of the Portuguese persons who face this condition and its treatment. Objectives: To conduct a clinical validation of NANDA-I nursing diagnoses of “Spiritual Distress (00066)” and “Impaired Resilience (00210)” in people undergoing fertility treatment. Method: It was an exploratory, quantitative, observational, cross-sectional study, and clinical validation of the mentioned nursing diagnoses, based on the Rasch model. Data collection took place between September 2019 and June 2020 in a sample of 104 Portuguese adults undergoing fertility treatment or on the verge of treatment, through an online questionnaire made available on fertility websites. It was a non-probabilistic and convenience sampling. Ethical principles were guaranteed and safeguarded, and an informed consent form was presented. Results: Twenty-two defining characteristics of the nursing diagnosis “Spiritual Distress (00066)” were validated and the diagnosis had a prevalence of 23.6% in this sample; “Perceived suffering” was the most sensitive defining characteristic (94.1%); “Anger over Power greater than self” (87.3%) and “Feeling unloved” (87.3%) were the most specific. “Impaired Resilience (00210)” had a prevalence of 15.4% in the sample, with seven defining characteristics having been validated. “Renewed elevation of distress” (93.8%) and “Low self-esteem” (93.8%) were the most sensitive characteristics, and “Social isolation” was the most specific (71.6%). Conclusions: This study contributes to increase the level of evidence of the NANDA-I diagnoses studied. Similar methodological procedures are proposed in other studies that would help to prove the scientific robustness of these results, in larger and heterogeneous samples to allow generalization, and/or longitudinal studies capable of observing the changes that occur in different phases of fertility treatment.

Date of Award	27 Feb 2023
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Sílvia Caldeira (Supervisor)