Discussion
Among the various nursing diagnoses of NANDA-I, studies highlight that diagnoses of IBP, IAC, and IGE have been frequently reported in the literature in different situations and age groups (Silva et al., 2011). The occurrence of respiratory nursing diagnoses in children with ARI can be explained because the infectious process, in addition to causing direct injury to the respiratory epithelium resulting in airway obstruction due to edema, abnormal secretions and cellular debris, also elevates airway resistance, causing a significant increase in respiratory work (Kleigman, Stanton, St Geme, Schor, & Berhman, 2011).
Characteristics that have demonstrated the best discriminative capacity for the three diagnoses in this study were identified by frequencies ranging from 68.7% to 3.2%. Some characteristics with high frequencies, such as ineffective cough, tachypnea and diminished breath sounds, did not demonstrate good discriminatory power, while characteristics with frequencies below 10%, such as diaphoresis, nasal flaring, and difficult verbalizing, formed subgroups representing different dimensions.
This study demonstrates that clinicians cannot restrict their clinical reasoning process to the observed frequency of defining characteristics. The quality of these characteristics and their more sensitive or specific relationship with the nursing diagnosis has been advocated as a guideline for clinical validation studies (Lopes et al., 2012). Thus, the ability of the defining characteristics to enable the differentiation of respiratory nursing diagnoses can be associated with their sensitivity and/or specificity for a specific diagnosis.