Accuracy of the defining characteristics of the nursing diagnosis hypothermia in patients on hemodialysis

Damasceno, Jackson Rodrigues; Cavalcante, Tahissa Frota; Ferreira, José Erivelton de Souza Maciel; Barbosa, Eloise da Silva; Moreira, Rafaella Pessoa; Lopes, Marcos Venícios de Oliveira; Lira, Ana Luisa Brandão de Carvalho

doi:10.1590/0034-7167-2021-0620

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 75 (04) • 2022 • https://doi.org/10.1590/0034-7167-2021-0620 copy

Accuracy of the defining characteristics of the nursing diagnosis hypothermia in patients on hemodialysis

Exactitud de las características definitorias del diagnóstico de enfermería hipotermia en pacientes en hemodiálisis

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to analyze the accuracy of the defining characteristics of hypothermia in patients on hemodialysis.

Methods:

a diagnostic accuracy study was assembled within a cross-sectional study with 124 patients from two dialysis centers. A latent class model was used for data analysis.

Results:

the nursing diagnosis hypothermia was present in 13 (10.48%) study participants. The most prevalent defining characteristics were hypoxia (100%), decrease in blood glucose level (83.1%), hypertension (65.3%), piloerection (45.2%), and skin cool to touch (41.1%). The defining characteristics acrocyanosis (99.96%) and cyanotic nail beds (99.98%) had a high sensitivity. Acrocyanosis (91.8%), skin cool to touch (64.8%), and peripheral vasoconstriction (91.8%) had high specificity.

Conclusion:

specific and sensitive indicators of hypothermia work as good clinical indicators for confirming this diagnosis in patients on hemodialysis. The study findings can assist nurses in their clinical reasoning for a correct inference of hypothermia.

Descriptors:
Nursing; Nursing Diagnosis; Hypothermia; Renal Insufficiency; Chronic; Renal Dialysis

Defining characteristics		n	%			95% CI^a a 95% CI - 95% confidence interval; OR - Odds Ratio.
Hypoxia		124	100.0			96.2 - 100.0
Decrease in blood glucose level		103	83.1			75.0 - 89.0
Hypertension		81	65.3			56.2 - 73.5
Piloerection		56	45.2			36.3 - 54.3
Skin cool to touch		51	41.1			32.5 - 50.3
Slow capillary refill		44	35.5			27.2 - 44.6
Hypoglycemia		23	18.5			12.3 - 26.7
Acrocyanosis		22	17.7			11.7 - 25.8
Peripheral vasoconstriction		18	14.5			9.1 - 22.2
Cyanotic nail beds		14	11.3			6.5 - 18.5
Bradycardia		11	8.9			4.7 - 15.7
Shivering		9	7.3			3.6 - 13.7
Tachycardia		7	5.6			2.5 - 11.7
Hypothermia		13	10.48			5.9 - 17.6
Variables	Hypothermia			OR	95% CI
Variables	Present	Absent		OR	95% CI
Sex
Male	8 (6.5%)	50 (40.3%)		1.821	0.631 - 5.256
Female	5 (4.0%)	61 (49.2%)		0.933	0.824 - 1.056
Marital status
With partner	9 (7.3%)	71 (57.3%)		1.238	0.404 - 3.788
Without partner	4 (3.2%)	40 (57.3%)		0.976	0.864 - 1.103
Complications
Yes	12 (9.7%)	6 (84.7%)		0.718	0.108 - 4.762
No	1 (0.8%)	6 (4.8%)		1.047	0.768 - 1.425

Defining characteristics	Se (%)	95% CI	Sp (%)	95% CI
Acrocyanosis	99.96	99.10 - 100.00	91.87	82.47 - 95.87
Cyanotic nail beds	99.98	99.45 - 100.00	99.07	1.39 - 99.98
Skin cool to touch	92.28	0.32 - 99.86	64.85	54.87 - 73.08
Shivering	46.24	20.77 - 75.59	97.29	49.50 - 99.84
Peripheral vasoconstriction	69.34	11.42 - 95.79	91.89	72.37 - 97.46
Prevalence: 10.48%	G²2 Herdman TH, Kamitsuru S, Lopes CT. Nursing diagnosis: definitions and classification 2021-2023. New York: Thieme; 2021.: 10.06	DF: 20	p = 0.967	Entropy: 0.998

Set	Defining characteristics^a a DC1 - acrocyanosis; DC2 - cyanotic nail beds; DC3 - skin cool to touch; DC4 - shivering; DC5 - peripheral vasoconstriction.					n	Hypothermia
Set	DC1	DC2	DC3	DC4	DC5	n	Present	Absent
1	0	0	0	0	0	59	0.00	1.00
2	0	0	0	0	1	7	0.00	1.00
3	0	0	0	1	0	1	0.00	1.00
4	0	0	1	0	0	30	0.00	1.00
5	0	0	1	0	1	2	0.00	1.00
6	0	0	1	1	0	2	0.00	1.00
7	0	1	1	0	0	1	0.00	1.00
8	1	0	0	0	0	5	0.00	1.00
9	1	0	1	0	0	4	0.00	1.00
10	1	1	0	1	1	1	1.00	0.00
11	1	1	1	0	0	2	0.99	0.01
12	1	1	1	0	1	5	1.00	0.00
13	1	1	1	1	0	2	1.00	0.00
14	1	1	1	1	1	3	1.00	0.00

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[1] Corresponding author: Tahissa Frota Cavalcante, E-mail: tahissa@unilab.edu.br