title: Defining the key clinical indicators for ineffective breathing pattern in paediatric patients: a meta-analysis of accuracy studies.
abstract: OBJECTIVE
  The purpose of this study was to identify the key clinical indicators of ineffective breathing pattern among paediatric patients.
  
  
  BACKGROUND
  When nurses perform clinical reasoning, certain characteristics represent the clinical indicators necessary to confirm the presence of a particular diagnosis. Some quantitative studies have reported the prevalence of ineffective breathing pattern in different samples of patients. However, these findings should be synthesised.
  
  
  METHODS
  Meta-analysis of quantitative nursing studies.
  
  
  METHODS
  Studies were identified via systematic searches of CINAHL, LILACS, PubMed and Scopus using the key search terms 'ineffective', 'breathing' and 'pattern'. Additional quality-related inclusion criteria were gleaned from the Cochrane Collaboration for Systematic Reviews of Diagnostic Test Accuracy, the Standards for Reporting of Diagnostic Accuracy and the Quality Assessment of Diagnostic Accuracy Studies. The pertinent results from each study were extracted and analysed via meta-analysis.
  
  
  RESULTS
  Six studies using paediatric populations met the inclusion criteria. Summary measures indicated that the following defining characteristics had the highest accuracy values for ineffective breathing pattern among children: bradypnoea, dyspnoea, nasal flaring, orthopnoea, tachypnoea and the use of accessory muscles to breathe.
  
  
  CONCLUSIONS
  This meta-analysis provides information regarding the accuracy of the clinical indicators of ineffective breathing pattern from studies sampling diverse paediatric populations.
  
  
  CONCLUSIONS
  Nurses can better use clinical indicators to infer the presence of ineffective breathing pattern when they are aware of the most relevant defining characteristics. Nursing students and professionals can also improve their critical thinking abilities and diagnostic reasoning based on these findings.
authors: Ministry of Education of Brazil, CAPES Foundation, Brasília, Brazil.
authors: Vanessa Emille Carvalho
authors: VE
authors: de Sousa
authors: Federal University of Ceará, Fortaleza, Brazil.
authors: Marcos Venícios de Oliveira
authors: MV
authors: Lopes
authors: Federal University of Ceará, Fortaleza, Brazil.
authors: Viviane Martins
authors: VM
authors: da Silva
authors: College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.
authors: Gail M
authors: GM
authors: Keenan
mesh_terms: D002648:Child; D002675:Child, Preschool; D000066491:Clinical Decision-Making; D006801:Humans; D007223:Infant; D009733:Nursing Diagnosis; D012120:Respiration Disorders / Q000175:diagnosis*
keywords: clinical judgement; decision-making; nursing assessment; nursing diagnosis