DEVELOPMENT OF TERMINOLOGICAL SUBSET FOR PEOPLE WITH COVID-19 SEQUELAE

methodological study, which followed the steps: Identification of the relevant terms contained in the literature related to Covid-19 sequelae; Cross-mapping of the terms identified in the review with the terms of the classification; Construction of the statements of diagnoses, outcomes and nursing interventions and mapping of the constructed statements; Content validation of the statements by specialist nurses; and Structuring of the subset based on Roy's Adaptation Model. For data analysis, the Content Validity Index was used, and the statements with Content Validity Index were validated ≥ 0.80. Content validation was performed by 28 specialist nurses.

Results

178 statements of nursing diagnoses/outcomes were constructed, with 450 nursing intervention statements. After content validation, a quantity of 127 diagnoses/outcomes and 148 nursing interventions were obtained, which comprised the terminological subset proposed in the study.

Conclusion

the validated statements that make up the terminological subset with greater predominance were those outlines in the physiological adaptive mode. However, the repercussions on the spiritual, social and personal dimensions are also highlighted.

DESCRIPTORS
Covid-19; Standardized terminology in nursing; Validation study; Nursing theory; Nursing process

NURSING DIAGNOSES/OUTCOMES
Physiological/Oxygenation Adaptive Mode
Dyspnea; Function of the Respiratory System, Impaired; Hypoxia; Respiratory System Process, Impaired; Risk of Respiratory Failure; Risk of Aspiration; Risk of Respiratory System Function, Impaired; Circulatory System, Impaired; Cough.
Physiological/Nutrition Adaptive Mode
Appetite, Negative/Absent; Swallowing, Impaired; Malnutrition; Lack of Appetite; Nutritional Intake, Impaired; Taste, Impaired; Weight, Impaired; Body Weight Problem; Risk of Nutritional Deficit.
Physiological/Elimination Adaptive Mode
Diarrhea; Nausea; Urinary Retention.
Physiological/Activity and Rest Adaptive Mode
Agitation; Psychomotor Activity, Impaired; Intense Tiredness; Leg Cramp; Body Energy, Reduced; Fatigue; Hypoactivity; Insomnia; Motricity, Impaired; Movement, Impaired; Paralysis; Mobility Risk, Impaired; Risk of Fall; Vital Signal, Altered; Sleep, Impaired.
Physiological/Protection Adaptive Mode
Arrhythmia; Skin Layer, Impaired; Cardiovascular Condition, Ineffective; Erythema; Exposure to Contamination; Infection; Inflammation; Hematoma; Risk of Death; Risk of Skin Integrity, Impaired; Risk of Deep Vein Thrombosis; Sign of Infection; Symptom of Infection; Circulatory System, Impaired; Tachycardia.
Physiological/Senses Adaptive Mode
Attention, Impaired; Verbal Communication, Impaired; Pain; Smell, Impaired; Sensory Perception, Impaired; Sensory System, Impaired.
Physiological/Fluids and Electrolytes Adaptive Mode
Pulmonary Congestion; Dehydration; Peripheral Edema; Transudative Edema; Fever; Heart Rate, High; Hypotension; Blood Pressure, Altered; Risk of Dehydration; Risk of Embolism.
Physiological/Neurological Function Adaptive Mode
Amnesia; Headache; Cognition, Impaired; Consciousness, Impaired; Convulsion; Concentration, Impaired; Reasoning Deficit; Deficit in the execution of common day-to-day tasks; Delirium; Delirium, Hyperactive; Delirium, Hypoactive; Disorientation; Lack of Consciousness (or Cognition) of Symptoms; Weakness; Memory, Reduced; Memory, Impaired; Perception of Reality, Impaired; Problem with Understanding; Emotional Problem; Nervous System Process, Impaired; Psychological Response, Impaired.
Physiological/Endocrine Function Adaptive Mode
Lymphatic Edema; Hypoglycemia; Regulatory System Process, Impaired.
Role Function Adaptive Mode
Adhering to the Therapeutic Regimen; Family Process, Impaired; Social Process, Impaired.
Self-concept Adaptive Mode
Anguish; Spiritual Anguish; Moral Distress; Separation Anxiety; Anxiety Against Death; Anxiety; Self-image, Negative; Self-mutilation; Self-care deficit; Hopelessness; Lack of Confidence; Lack of Knowledge about Disease; Lack of Knowledge about Drug Regimen; Lack of Knowledge about Diagnostic Testing; Humor, Depressed; Mood, Decreased; Suicidal Ideation; Body Image, Impaired; Fear of Death; Fear of Contagion; Risk of Spiritual Distress; Mood Risk, Depressed; Risk of Loneliness; Suicide Risk; Stress Overload; Suffering; Solitude; Sadness; Death.
Inter-dependence Adaptive Mode
Concern; Sexual Behavior, Committed; Relationship Problem.

NURSING INTERVENTIONS
Physiological/Oxygenation Adaptive Mode
Monitor the occurrence of dyspnea and events that improve or worsen it; Keep the airways clear; Position the patient aiming at the relief of dyspnea; Monitor frequency and respiratory pattern; Auscultate respiratory sounds; Monitor the tissue perfusion; Interpret the result of arterial blood gas; Offer oxygen therapy if necessary; Prevent aspiration; Assess risk of aspiration; Investigate cause of cough; Monitor blood oxygen saturation using pulse oximeter.
Physiological/Nutrition Adaptive Mode
Identify the prescribed diet; Give opportunity for food to be smelled to stimulate appetite; Ask the patient about food preferences to be requested; Guide the patient to chew food well; Keep the environment quiet; Observe swallowing and emptying of the mouth; Help the patient to feed; Investigate chewing problems; Guide the patient and/or companion regarding the nutrients needed for health recovery; Monitor the patient for anorexia, nausea, vomiting, changes in taste, esophagitis and diarrhea, as appropriate; Determine the patient's perception of changes in taste, swallowing, voice quality and comfort; Monitor weight daily; Monitor trends of increase and weight loss; Administer nutritional supplement if necessary; Obtain data on attitude towards nutritional condition.
Physiological/Elimination Adaptive Mode
Obtain data on diarrhea; Guide on management (control) of diarrhea; Manage diarrhea; Manage nausea; Get data on nausea; Guide on management (control) of nausea; Obtain data on urinary retention; Assess psychological response; Monitor psychological response.
Physiological/Activity and Rest Adaptive Mode
Determine causes of agitation; Monitor agitation; Evaluate psychomotor impairment; Monitor the patient's tolerance to activity; Observe occurrence of clinical manifestations of hypercalcemia; Obtain data on insomnia; Reassess the need for auxiliary devices at regular intervals together with the physiotherapist, occupational therapist and recreational; Determine the patient's commitment to learn and use a correct posture; Determine how much the patient understands body mechanics and exercises; Demonstrate prevention of falls; Identify cognitive or physical deficits of the patient, capable of increasing the potential for falls in a given environment; Identify behaviors and factors that affect the risk of falls; Establish predictable routines to promote regular sleep/wake cycles; Monitor/record the patient's pattern and amount of sleep hours.
Physiological/Protection Adaptive Mode
Determine with the patient and family the history of heart disease and arrhythmias; Monitor extremities for areas of heat, pain or edema; Observe the appearance of signs of infection; Monitor vital signs; Assess risk of fall; Adopt fall prevention measures; Adopt skin care; Obtain data on susceptibility to infection; Select the appropriate injection site; Examine the skin for bruising, inflammation, edema, lesions or discoloration; Stimulate the change of position; Monitor the occurrence of thrombophlebitis and deep vein thrombosis; Monitor the occurrence of signs of infection; Change the position of the patient every two hours, or walk as tolerated.
Physiological/Senses Adaptive Mode
Provide a structured and physically secure environment; Use a calm and reassuring approach; Listen carefully to the patient and/or companion; Stimulate communication; Identify barriers to communication; Assess pain in terms of location, frequency and duration; Evaluate the effectiveness of pain control measures; Favor adequate rest/sleep for pain relief; Assess impaired smell; Ask one question at a time; Monitor the level of perception and sensory/motor function; Stimulate the use of resources that increase sensory input; Assess mental status, understanding, motor function, sensory function, duration of attention and affective responses.
Physiological/Fluids and Electrolytes Adaptive Mode
Control liquids; Fill out water balance; Evaluate edema and peripheral pulses; Examine skin for ulcers and skin tears; Observe signs and symptoms of congestion; Observe signs of dehydration; Evaluate water and food intake; Measure urine output; Guide the patient and/or companion on voiding techniques; Get data on edema; Guide on fever management (control); Monitor temperature at the appropriate frequency; Monitor heart rate; Monitor blood pressure; Monitor the occurrence of pain in the affected area.
Physiological /Neurological Function Adaptive Mode
Evaluate the patient's memory; Stimulate cognitive exercises; Monitor level of consciousness; Consult the family to establish the cognitive level of the patient before trauma; Offer environmental stimuli through contact with various professionals; Monitor the size, shape, symmetry and reaction of the pupils; Observe and record the signs and symptoms in the seizure; Remove objects that can hurt the patient; Assess ability to perform daily activities; Manage (control) delirium; Guide in the recognition of signs/symptoms of tolerance/intolerance to exercises during and after the sessions; Monitor energy level, malaise, tiredness and weakness; Use simple language; Provide (provide, provide) emotional support.
Physiological /Endocrine Function Adaptive Mode
Control the fluid intake; Observe edemas; Evaluate response to fluid infusion; Evaluate blood glucose tests.
Role Function Adaptive Mode
Adopt therapies; Assess the need for a therapeutic regimen; Evaluate the results of the adopted therapeutic regimen; Promote positive relationships; Manage relationships; Evaluate relationships; Assist the patient to identify interpersonal problems resulting from deficits in social skills; Encourage the patient to verbalize feelings associated with interpersonal problems; Help the patient identify the desired results of problematic interpersonal relationships or situations.
Self-concept Adaptive Mode
Request psychological support; Determine probable causes of distress; Stimulate expressions of feelings about sexuality, self-image and self-esteem; Communicate the expectations and consequences of behaviors to the patient; Promote self-care; Investigate causes of hopelessness; Establish trust; Obtain data on family knowledge regarding the disease; Monitor and regulate the level of activity and stimulation in the environment according to the patient's needs; Obtain data on exposure to contagion; Guide on contagion; Be open to individual expressions of loneliness and impotence; Encourage participation in interactions with family, friends and others; Treat the person with dignity and respect; Implement precautions against suicide; Promote stress reduction; Use therapeutic communication to establish trust and care with empathy; Use the instruments to monitor and assess individual well-being, as appropriate; Provide post-mortem care; Allow the family to see the body after death when possible.
Inter-dependence Adaptive Model
Guide on normal development and behavior, as appropriate; Inform about realistic expectations regarding patient behavior; Determine the patient's common methods for solving problems; Demonstrate an attitude of acceptance of the condition/state of health; Communicate, verbally, empathy or understanding of the patient's experience; Listen to the patient's concerns; Monitor family coping, impaired; Obtain data on family process; Guide on family process.

Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Campus Universitário Trindade, 88040-970 Florianópolis - Santa Catarina - Brasil, Tel.: (55 48) 3721-4915 / (55 48) 3721-9043 - Florianópolis - SC - Brazil
E-mail: textoecontexto@contato.ufsc.br

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[1] CORRESPONDING AUTHOR
Harlon França de Menezes harlonmenezes@hotmail.com