Aim: validate the nursing result Dry eye severity in adult patients admitted to the intensive care unit (ICU). Method: this is a methodological study to be developed in three steps: (1) content analysis, in which experts will judge items related to the result of dry eye severity, and the analysis will be given by the index of content validity and agreement of inter-evaluators; (2) semantic analysis by nurses of a university hospital, considering items with a concordance value equal to or greater than 85%; (3) clinical validation will be performed through a cross-sectional study with 140 patients hospitalized in the ICU of a university hospital. The data from this study will be analyzed descriptively and the difference between evaluators will be verified through the Friedman test and intraclass correlation coefficient.
Descriptors: Dry Eye Syndromes; Standardized Terminology in Nursing; Validation Studies.
The Nursing Outcome (NO) Dry eye severity was developed to assess the severity of signs and symptoms of lacrimal insufficiency and ocular surface condition(1). Thus, this taxonomic component of the Nursing Outcomes Classification (NOC) is proposed to evaluate the nursing diagnosis (ND) of dry eye risk in individuals hospitalized in intensive care units (ICU). In this environment, the tear film may be compromised by the disorder in the mechanisms responsible for lubrication, ocular protection, predisposing factors such as mechanical ventilation, low humidity, low temperature, and simultaneous drug therapy(2).
In view of this, the health team needs to develop and ensure a safe environment, in addition to interventions that minimize the risk of eye damage in the ICU. Therefore, nursing can provide direct assistance to patients in order to prevent serious injuries resulting in ocular dryness(2).
When considering the high prevalence of dry eye phenomenon in ICU, caused by the failure to perform an ocular care routine, the need to validate instruments aimed at this problem is verified. It is intended that the validation of dry eye gravity NO contributes to the advancement of nursing science knowledge by proposing the refinement of NOC taxonomy components to meet the demands of clinical practice to accurately assess ocular health status.
Validate nursing outcome Severity of dry eye in adult ICU patients.
This is a methodological study to be developed in three steps based on psychometry(3). In the first stage, content analysis by experts, participants will be selected through their curricula hosted in the Lattes Platform of the National Council for Scientific and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnológico – CNPq). The inclusion criteria were: be a master or doctor in the health area; have developed a dissertation or thesis in the areas of ocular health, intensive care or systematization of nursing care; have published works in the field of ocular health; be a research group participant that involves the themes; have at least one year of professional experience in care or as a disciplinary teacher that addresses the systematization of nursing care, intensive care or eye health.
After signing the Free and Informed Consent Term, the specialists will complete an instrument composed of participant characterization variables and items related to dry eye severity NO, which will be evaluated by a five point Likert scale. The data will be stored in Microsoft Excel for Windows 2010 and will be analyzed by the Statistical Package for the Social Sciences (SPSS) version 22.0. For the analysis of the data, the content validity index and the inter-rater concordance index will be used.
For the second stage, semantic analysis, nurses will be selected from the Onofre Lopes University Hospital (HUOL) of the Federal University of Rio Grande do Norte (UFRN)(3), whose inclusion criteria will be: be part of the professional staff of the institution; and have at least one year of experience as an ICU nurse. The exclusion criteria will be: be on a managing function in the ICU; be on vacation or leave in the period of data collection.
The professionals will be given an instrument containing variables of the nurse's characterization, the constitutive, operational definitions and operational magnitudes of dry eye severity NO, which will be evaluated using a five-point Likert scale. Acceptance of intelligibility will occur when the valuation of the item presents a value equal to or greater than 85% of agreement.
The clinical validation, corresponding to the third stage, will occur through a transversal study with adult patients hospitalized in the ICU of a Brazilian university hospital. The inclusion criteria will be: be admitted to the ICU of said hospital; be aged 18 years or more; and present the ND Risk of dry eye. Patients who present an emergency situation, at risk of death, during data collection will be excluded.
The sample will be established second to psychometrics, which establishes the quantitative of five to 10 individuals for each item of the instrument. Thus, the sample will consist of 140 patients. The collection of data will be performed by doubles of nurse assessors. The data will be organized in Microsoft Office Excel 2010 and exported to SPSS test version 22.0. For the descriptive analysis the measures of central tendency and its variabilities will be calculated. To verify the difference between the reviewers the Friedman test will be applied. The project was approved by the Research Ethics Committee under CAAE No. 71452817.5.0000.5537, in compliance with Resolution 466/12 of the National Health Council.
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 version 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: 08/09/2017 Revised: 09/21/2018 Approved: 09/24/2018