PREVIEW NOTES

ICNP® terminological subset for tumor wounds in palliative care: a methodological study

Maria Cristina Freitas de Castro¹, Patrícia dos Santos Claro Fuly¹

¹Fluminense Federal University

ABSTRACT
Aim: To build a terminological subset to control the symptoms of tumor wounds in patients under palliative care, using the International Classification for Nursing Practice (ICNP®).
Method: This is a descriptive, exploratory research, with a quantitative approach, based on the construction of a terminological subset to control the symptoms of tumor wounds in patients under palliative care, using the ICNP® and the Wanda Horta reference system. The research setting is the Antonio Pedro College Hospital (HUAP, in Portuguese), located in the city of Niterói, Brazil. The studied population will be composed of nurses and professors, experts in tumor wounds who provide assistance to patients under palliative care at the HUAP. The validation of the statements regarding nursing diagnoses/interventions/results will be based on the opinion of these specialists using simple statistical analysis of the indexes generated by the answers of the participants.
Descriptors: Wounds and Injuries; Palliative Care; Nursing Process.

CONTEXTUALIZING THE TOPIC AND ITS RELEVANCE

Because of its epidemiological, social and economic magnitude, cancer is considered a complex issue for public health services, and every year the number of new cases increases in Brazil⁽¹⁾.  Among the government recommendations to control the spread of the disease there is palliative care, which aims to improve the quality of life of patients by controlling the distressing symptoms⁽¹⁾. Among these patients, a large number will, at some time in the future, have tumor wounds due to the primary tumor or metastasis, which demonstrates the need for qualified nursing care sustained by systematic tasks, supported by science.

The International Classification for Nursing Practice (ICNP®) is presented as an important tool with regard to terminological standardization and for improving the exchange of information among nurses worldwide. The data and information generated through this system can be used to represent nursing practice in health information systems, in care planning and in management⁽²⁾.

The development of ICNP® terminological subsets and their validation are important contributions to the strengthening of nursing procedures, both during assistance and in education/research⁽²⁾.

Therefore, this study aims to build a terminological subset to control the symptoms of tumor wounds of patients under palliative care, using the ICNP®, in an attempt to find an effective means of control of symptoms based on scientific evidence, given the existing gap in specialized literature in the field of nursing.

GUIDING QUESTION

What are the nursing diagnoses/interventions/results for patients with tumor wounds under palliative care?

OBJECTIVES

General Objective
Build a terminological subset to control the symptoms of tumor wounds in patients under palliative care, using the ICNP®.

Specific Objectives
To identify, in the literature, empirical indicators related to the control of the symptoms of tumor wounds.
To elaborate a form with the ICNP® terminological subset, using the terminologies present in the ICNP® 7-Axis Model Version 2.0, and Wanda Horta’s theoretical references, which include demonstrations of nursing diagnoses, interventions and results for patients in palliative care with tumor wounds.
To analyze the rate of agreement among nurses with experience in oncology and wound treatment, about the nursing diagnoses, interventions and results here proposed.

METHOD

This is a methodological study. It will take place from June to August 2014 at the Antonio Pedro College Hospital (HUAP, in Portuguese), which has been an Oncology High Complexity Assisting Unit located in the city of Niterói, Brazil, since 2005. The investigated population will be composed of nurses and professors, experts in tumor wounds who, as part of their daily routine, assist patients under palliative care at the HUAP, both in the palliative care ward and at any other ward or emergency service. The inclusion criteria in this study will be  five years’ minimum experience in this field, and working with oncology patients. The criteria of exclusion will be for resident nurses or those on leave at the time of the research.

Initially, there will be a review of the literature held in such databases as Medline, LILACS, CINAHL, and Cochrane. The review will involve searching for empirical indicators related to the control of symptoms related to tumor wounds. In order to execute this search, the following descriptors will be used: “wounds and injuries”, “palliative care” and “nursing processes”. The criteria for inclusion in terms of the findings will be articles written after 2002, published in English, Portuguese or Spanish, related to the topic. Papers with content related to children and adolescents will not be included. After identification, the evidence will be classified according to the basic human needs described in the Wanda Horta theoretical references.

In the second stage of the research, the statements with regard to nursing diagnoses, results and interventions will be produced according to the terminologies present in the ICNP® 7-Axis Model, version 2.0⁽³⁾. After this stage, a catalogue will be generated, according to the steps proposed by the Guidelines for ICNP® Catalogue Development, from the International Nurses Council. Finally, there will be a validation of the expert statements with regard to nursing diagnoses/interventions/results. During this stage, the participants will respond to a questionnaire, with a scale describing their level of agreement with the proposals⁽³⁾. Based on the information gathered from the questionnaires and the statements, that which achieves an agreement rate of ≥ 0.8 will be considered valid. This Project was approved by the Committee of Ethics in Research of the HUAP in Oct/11/2013, under protocol #422.494, according to Resolution 466/12, of the Brazilian National Health Council, which regulates studies involving human beings.

REFERENCES

1. Instituto Nacional de Câncer (Brasil). ABC do câncer: abordagens básicas para o controle do câncer [ internet ]. 2nd ed. Rio de Janeiro: Inca; 2012 [ cited 2013 Nov ]. Available from: http://www1.inca.gov.br/inca/Arquivos/livro_abc_2ed.pdf

2. Furtado LG, Medeiros ACT, Nóbrega MML. Terminological subset of the international classification for nursing practice: an integrative review. Online Braz J Nurs [ Internet ]. 2013 Apr [ cited 2013 Dec 01 ] 12 (1): 178-93. Available from: http://www.objnursing.uff.br/index.php/nursing/article/view/3932

3. International Council of Nurses (United States). Guidelines for ICNP® Catalogue Development [ internet ]. Geneva: International Council of Nurses; 2008. [ cited 2013 Nov ]. Available from: http://www.icn.ch/images/stories/documents/programs/ic np/icnp_catalogue_development.pdf

PROJECT INFORMATION
Dissertation Project, at the Professional Master Program in Assisting Nursing, at the Fluminense Federal University.

All authors participated in the phases of this publication in one or more of the following steps, in According to the recommendations of the International Committee of Medical Journal Editors (ICMJE, 2013): (a) substantial involvement in the planning or preparation of the manuscript or in the collection, analysis or interpretation of data; (b) preparation of the manuscript or conducting critical revision of intellectual content; (c) approval of the versión submitted of this manuscript. All authors declare for the appropriate purposes that the responsibilities related to all aspects of the manuscript submitted to OBJN are yours. They ensure that issues related to the accuracy or integrity of any part of the article were properly investigated and resolved. Therefore, they exempt the OBJN of any participation whatsoever in any imbroglios concerning the content under consideration. All authors declare that they have no conflict of interest of financial or personal nature concerning this manuscript which may influence the writing and/or interpretation of the findings. This statement has been digitally signed by all authors as recommended by the ICMJE, whose model is available in http://www.objnursing.uff.br/normas/DUDE_eng_13-06-2013.pdf

Received: 06/09/2014
Revised:08/04/2014
Approved:08/04/2014