Deficient Heart Function Syndrome: a new nursing diagnosis for people with heart failure.
Ana Paula Dias de Oliveira, Marcos Venícios de Oliveira Lopes, Rita de Cassia Gengo E Silva Butcher and 4 others
PMID 41059848WHAT IT FOUND
Among 360 emergency room admissions with decompensated heart failure, five nursing diagnoses often appeared together.
A syndrome was estimated in 61.49%. Fatigue and fluid volume were the most useful identifying features; comfort and cardiac output were the most useful confirming features.
Key findings
01In 360 people with decompensated heart failure, individual nursing diagnoses were common: fatigue 84.17%, excessive fluid volume 80.24%, decreased activity tolerance 54.16%, impaired comfort 44.71%, and decreased cardiac output 37.22%.
02The syndrome was estimated in 61.49% of participants, nine combinations of diagnoses showed conditional dependence, and most participants with the syndrome had three or more diagnoses together.
03Fatigue and excessive fluid volume had the highest sensitivity for the syndrome, while impaired comfort and decreased cardiac output had the highest specificity; decreased activity tolerance had sensitivity and specificity around 70%.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The findings apply only to adults with decompensated heart failure assessed in one highly specialised emergency room, not to all people with heart failure. A single investigator made the nursing diagnosis judgments, without validation by other specialists. The syndrome definition relied on clinical judgment for most diagnoses, not an independent reference standard. Data were collected during the pandemic, which may have affected fatigue findings. The study used an older NANDA-I classification; some diagnoses were later removed from the current edition. No patient outcomes or nursing interventions were tested, so it does not show that the syndrome label improves care.
Declared interests
Funded by CNPq. The supplied text does not report a commercial sponsor or conflicts of interest.
The easy way to misread this
Do not read this as evidence that diagnosing the syndrome improves patient care or outcomes. It was an observational classification study in one emergency room, with no interventions tested and no external validation.