Modelo predictor de internación hospitalaria para niños y adolescentes con enfermedades crónicas

Araújo, Yana Balduíno de; Santos, Sérgio Ribeiro dos; Neves, Nívea Trindade de Araújo Tiburtino; Cardoso, Érika Leite da Silva; Nascimento, João Agnaldo

doi:10.1590/0034-7167-2018-0467

Brasil

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 73 (2) • 2020 • https://doi.org/10.1590/0034-7167-2018-0467 linkcopiar

Modelo predictor de internación hospitalaria para niños y adolescentes con enfermedades crónicas

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivos: Describir un modelo predictor de frecuencia de internación hospitalaria para niños y adolescentes con enfermedades crónicas.

Métodos: Se construyó un modelo basado en árboles de decisión, utilizando un banco de datos de 141 niños y adolescentes con enfermedades crónicas internados en hospital público federal. Para elaborar el modelo fueron consideradas 18 variables, la frecuencia de internación fue definida como desenlace.

Resultados: Se obtuvo un árbol de decisiones capaz de clasificar correctamente al 80,85% de los participantes. La lectura del modelo permitió entender que las situaciones de mayor vulnerabilidad, como desempleo, bajos ingresos, restricciones y ausencia de compromiso familiar para el cuidado, actuaron como predictoras de mayor frecuencia de internación hospitalaria.

Conclusiones: El modelo sugiere a la enfermería y equipo acciones preventivas para aquellos factores modificables, e inversión en promoción de salud para los factores no modificables; fortaleciendo también el debate sobre el cuidado diferenciado para esta población.

Descriptores: Árboles de Decisión; Enfermedad Crónica; Hospitalización; Niño; Adolescente

A	B
75	9
18	39

Decision rules
Variable	Decision
1. IF the number of residents in one home is up to 3 residents.	THEN admission occurs up to 2 times a year.
2. IF the number of residents is 4.	THEN race/skin color should be considered.
3. IF the number of residents is 4 and the race/skin color is white.	THEN admission occurs up to 2 times a year.
4. IF the number of residents is 4 and the race/skin color is non-white.	THEN the current disease stage should be considered.
5. IF the number of residents is 4 and the race/skin color is non-white and the disease is in its early stage.	THEN admission occurs up to 2 times a year.
6. IF the number of residents is 4 and the race/skin color is non-white and the disease is in its healed/rehabilitation stage.	THEN admission occurs up to 2 times a year.
7. IF the number of residents is 4 and the race/skin color is non-white and the disease is in its chronic stage.	THEN the caregiver's employment situation should be considered.
8. IF the number of residents is 4 and the race/skin color is non-white and the disease is in its chronic stage and the caregiver is employed.	THEN admission occurs up to 2 times a year.
9. IF the number of residents is 4 and the race/skin color is non-white and the disease is in its chronic stage and the caregiver is unemployed.	THEN admission occurs 3 times a year or more.
10. IF the number of residents is 4 and the race/skin color is non-white and the disease is in its chronic stage and the caregiver is dependent.	THEN admission occurs up to 2 times a year.
11. IF the number of residents is 5 or more.	THEN dependency on complex care should be considered.
12. IF the number of residents is 5 or more and one is dependent on complex care.	THEN family income should be considered.
13. IF the number of residents is 5 or more and one is dependent on complex care, and the family income is up to one minimum wage.	THEN admission occurs 3 times a year or more.
14. IF the number of residents is 5 or more and one is dependent on complex care, and the family income is over one minimum wage and less than two minimum wages.	THEN admission occurs 3 times a year or more.
15. IF the number of residents is 5 or more and one is dependent on complex care, and the family income is over two minimum wages.	THEN the existence of disability should be considered.
16. IF the number of residents is 5 or more and one is dependent on complex care, and the family income is over two minimum wages and one has a disability.	THEN admission occurs up to 2 times a year.
17. IF the number of residents is 5 or more and one is dependent on complex care, and the family income is over two minimum wages and there is no disability.	THEN admission occurs 3 times a year or more.
18. IF the number of residents is 5 or more and there is no dependency on complex care.	THEN the current disease stage should be considered.
19. IF the number of residents is 5 or more and there is no dependency on complex care and the disease is in its healed/rehabilitation stage.	THEN admission occurs up to 2 times a year.
20. IF the number of residents is 5 or more and there is no dependency on complex care and the disease is in its early stage.	THEN any disease-related restriction should be considered.
21. IF the number of residents is 5 or more and there is no dependency on complex care and the disease is in its early stage and there is a disease-related restriction.	THEN admission occurs 3 times a year or more.
22. IF the number of residents is 5 or more and there is no dependency on complex care and the disease is in its early stage and there is no disease-related restriction.	THEN admission occurs up to 2 times a year.
23. IF the number of residents is 5 or more and there is no dependency on complex care and the disease is in its chronic stage.	THEN the caregiver's employment situation should be considered.
24. IF the number of residents is 5 or more and there is no dependency on complex care and the disease is in its chronic stage and the caregiver is dependent.	THEN admission occurs up to 2 times a year.
25. IF the number of residents is 5 or more and there is no dependency on complex care and the disease is in its chronic stage and the caregiver is employed.	THEN family involvement in care should be considered.
26. IF the number of residents is 5 or more and there is no dependency on complex care and the disease is in its chronic stage and the caregiver is employed and the family is involved in care.	THEN admission occurs up to 2 times a year.
27. IF the number of residents is 5 or more and there is no dependency on complex care and the disease is in its chronic stage and the caregiver is employed and the family is not involved in care.	THEN admission occurs 3 times a year or more.
28. IF the number of residents is 5 or more and there is no dependency on complex care and the disease is in its chronic stage and the caregiver is unemployed.	THEN a second disease diagnosis should be considered.
29. IF the number of residents is 5 or more and there is no dependency on complex care and the disease is in its chronic stage and the caregiver is unemployed and there is a second disease diagnosis.	THEN admission occurs up to 2 times a year.
30. IF the number of residents is 5 or more and there is no dependency on complex care and the disease is in its chronic stage and the caregiver is unemployed and there is not a second disease diagnosis.	THEN family enrollment in social programs should be considered.
31. IF the number of residents is 5 or more and there is no dependency on complex care and the disease is in its chronic stage and the caregiver is unemployed and there is not a second disease diagnosis and the family is enrolled in social programs.	THEN admission occurs up to 2 times a year.
32. IF the number of residents is 5 or more and there is no dependency on complex care and the disease is in its chronic stage and the caregiver is unemployed and there is not a second disease diagnosis and the family is not enrolled in social programs.	THEN family pets should be considered.
33. IF the number of residents is 5 or more and there is no dependency on complex care and the disease is in its chronic stage and the caregiver is unemployed and there is not a second disease diagnosis and the family is not enrolled in social programs and has pets.	THEN admission occurs 3 times a year or more.
34. IF the number of residents is 5 or more and there is no dependency on complex care and the disease is in its chronic stage and the caregiver is unemployed and there is not a second disease diagnosis and the family is not enrolled in social programs and has no pets.	THEN family involvement in care should be considered.
35. IF the number of residents is 5 or more and there is no dependency on complex care and the disease is in its chronic stage and the caregiver is unemployed and there is not a second disease diagnosis and the family is not enrolled in social programs and has no pets and the family is involved in care.	THEN admission occurs up to 2 times a year.
36. IF the number of residents is 5 or more and there is no dependency on complex care and the disease is in its chronic stage and the caregiver is unemployed and there is not a second disease diagnosis and the family is not enrolled in social programs and has no pets and the family is not involved in care.	THEN admission occurs 3 times a year or more.

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Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[TFN1] Note: a=admission up to 2 times a year; b=admission 3 times or more.