Validação de protocolo de assistência para pessoas com úlcera venosa na atenção primária

Detalhes bibliográficos
Autor(a) principal: Costa, Isabelle Katherinne Fernandes
Data de Publicação: 2013
Tipo de documento: Tese
Idioma: por
Título da fonte: Repositório Institucional da UFRN
Texto Completo: https://repositorio.ufrn.br/jspui/handle/123456789/14750
Resumo: People with venous ulcers constitute as an important public health problem, its treatment is onerous and require assistance provided by trained professionals, systematized through protocols, however what lies in the assistance is that the management of this group of people differs from that preconized in the scientific literature, interfering with wound healing and quality of life of affected. In this sense, the construction of a assistance protocol specific to people with venous ulcers (VU) can help professionals of the Family Health Strategy both in patient assessment as and in establishment of quality assistance. Thus, this study aimed to analyse the validity of a multiprofessional assistance protocol for people with venous ulcers in primary care by health professionals using Delphi technique. This is a quantitative study, the methodological type conducted in two steps: first step related to integrative literature review to subsidize the development of the protocol, then these aspects were organized and proposed to the judges of the study through the Delphi technique. The study was initiated after approval by the Research Ethics Committee. The first step was performed between August and September 2012, in the virtual library of health, in the page of the Coordination of Improvement of Higher Education Personnel, of Municipal Health Secretariat and international guidelines of associations and in the subsequent step carried out between September 2012 to January 2013, was performed search by Lattes platform of the National Council of Technological and Scientific Development, in order to identify health professionals in Brazil who act as judges of the instrument and then, via online, the form was submitted to them.The sample for the second step was 51 judges in the first round and 35 for the second round Delphi. The analysis was done by adopting Kappa index ≥ 0.81 and Content Validity Index (CVI)> 0.80. In the first submission for the judges, items that did not reach Kappa and CVI established were: request / realization / test results, demographic data, medical history, risk factors, verification of pain / vital signs / pulse / infection signs / lesion location/ edema and pain treatment. After removal of items which have not obtained Kappa or CVI index established, it was found achieving optimal levels of these index for the categories. In the next step was the ressubmissão of protocol to judges through the Delphi technique in it was found that, of the 15 categories of the protocol, 12 presented higher scores in Delphi 2 phase and the other three categories remained the same Kappa and IVC of the previous phase. As for the average of evaluation requirements of the protocol was found that the scores assigned by the judges were higher in the second phase in nine of the 10 items, remaining the same in only one of the items indicating validity of the instrument before the consensus of the judges. Thus, we accepted the alternative hypothesis in this study, as they were obtained in the second Delphi phase the validity index greater than or equal to the Delphi 1 phase. The formulation of this assistance protocol valid and reproducible will enable a reorganization and redesign of assistance, with standardization of actions and continuity of care for persons with venous ulcers in primary health care
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spelling Costa, Isabelle Katherinne Fernandeshttp://lattes.cnpq.br/5903265312273525http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4708368Z6&dataRevisao=nullBachion, Maria Márciahttp://lattes.cnpq.br/8503907944360635Tourinho, Francis Solange Vieirahttp://lattes.cnpq.br/5614479933447169Miranda, Francisco Arnoldo Nunes dehttp://lattes.cnpq.br/9242337504601387Lira, Ana Luisa Brandao de Carvalhohttp://lattes.cnpq.br/4545130167501174Alchieri, João Carloshttp://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4790051D1&dataRevisao=nullTorres, Gilson de Vasconcelos2014-12-17T14:46:53Z2013-04-262014-12-17T14:46:53Z2013-02-05COSTA, Isabelle Katherinne Fernandes. Validação de protocolo de assistência para pessoas com úlcera venosa na atenção primária. 2013. 151 f. Tese (Doutorado em Assistência à Saúde) - Universidade Federal do Rio Grande do Norte, Natal, 2013.https://repositorio.ufrn.br/jspui/handle/123456789/14750People with venous ulcers constitute as an important public health problem, its treatment is onerous and require assistance provided by trained professionals, systematized through protocols, however what lies in the assistance is that the management of this group of people differs from that preconized in the scientific literature, interfering with wound healing and quality of life of affected. In this sense, the construction of a assistance protocol specific to people with venous ulcers (VU) can help professionals of the Family Health Strategy both in patient assessment as and in establishment of quality assistance. Thus, this study aimed to analyse the validity of a multiprofessional assistance protocol for people with venous ulcers in primary care by health professionals using Delphi technique. This is a quantitative study, the methodological type conducted in two steps: first step related to integrative literature review to subsidize the development of the protocol, then these aspects were organized and proposed to the judges of the study through the Delphi technique. The study was initiated after approval by the Research Ethics Committee. The first step was performed between August and September 2012, in the virtual library of health, in the page of the Coordination of Improvement of Higher Education Personnel, of Municipal Health Secretariat and international guidelines of associations and in the subsequent step carried out between September 2012 to January 2013, was performed search by Lattes platform of the National Council of Technological and Scientific Development, in order to identify health professionals in Brazil who act as judges of the instrument and then, via online, the form was submitted to them.The sample for the second step was 51 judges in the first round and 35 for the second round Delphi. The analysis was done by adopting Kappa index ≥ 0.81 and Content Validity Index (CVI)> 0.80. In the first submission for the judges, items that did not reach Kappa and CVI established were: request / realization / test results, demographic data, medical history, risk factors, verification of pain / vital signs / pulse / infection signs / lesion location/ edema and pain treatment. After removal of items which have not obtained Kappa or CVI index established, it was found achieving optimal levels of these index for the categories. In the next step was the ressubmissão of protocol to judges through the Delphi technique in it was found that, of the 15 categories of the protocol, 12 presented higher scores in Delphi 2 phase and the other three categories remained the same Kappa and IVC of the previous phase. As for the average of evaluation requirements of the protocol was found that the scores assigned by the judges were higher in the second phase in nine of the 10 items, remaining the same in only one of the items indicating validity of the instrument before the consensus of the judges. Thus, we accepted the alternative hypothesis in this study, as they were obtained in the second Delphi phase the validity index greater than or equal to the Delphi 1 phase. The formulation of this assistance protocol valid and reproducible will enable a reorganization and redesign of assistance, with standardization of actions and continuity of care for persons with venous ulcers in primary health careAs pessoas com úlcera venosa constituem-se um importante problema de saúde pública, o seu tratamento é oneroso e necessitam de uma assistência prestada por profissionais capacitados, sistematizada por meio de protocolos, contudo o que se encontra na assistência é que o manejo a este grupo de pessoas difere do que é preconizado na literatura científica, interferindo na cicatrização da ferida e na qualidade de vida dos acometidos. Nesse sentido, a construção de um protocolo de assistência específico para pessoas com úlcera venosa (UV) pode auxiliar os profissionais da Estratégia Saúde da Família tanto na avaliação do paciente como no estabelecimento de uma assistência de qualidade. Assim, este estudo objetivou analisar a validade de um protocolo de assistência multiprofissional a pessoas com úlcera venosa na atenção primária por profissionais de saúde mediante técnica Delphi. Trata-se de um estudo quantitativo, do tipo metodológico realizado em duas etapas: primeira etapa referente a revisão integrativa da literatura para subsidiar a elaboração do protocolo; em seguida, esses aspectos foram organizados e propostos aos juízes do estudo por meio da técnica Delphi. O estudo foi iniciado após aprovação do Comitê de Ética em Pesquisa. A primeira etapa foi realizada entre agosto e setembro de 2012, na biblioteca virtual de saúde, na página da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, de Secretarias Municipais de Saúde e guidelines de associações internacionais e na etapa subsequente realizada no período de setembro de 2012 a janeiro de 2013, realizou-se busca por meio da plataforma Lattes do Conselho Nacional de Desenvolvimento Científico e Tecnológico, a fim de identificar profissionais de saúde do Brasil que atuassem como juízes do instrumento e em seguida, via online, submeteu-se o formulário aos pesquisados. A amostra para a segunda etapa foi de 51 juízes na primeira rodada e de 35 para a segunda rodada Delphi. A análise foi feita adotando-se índice Kappa ≥0,81 e Índice de Validade de Conteúdo (IVC)>0,80. Na primeira submissão aos juízes, os itens que não atingiram os índices Kappa e IVC estabelecidos pertenciam as categorias: solicitação/ realização/ resultados de exames, dados sociodemográficos, anamnese, fatores de risco, verificação de dor/ sinais vitais/ pulso/ sinais de infecção/ localização da lesão/ edema e tratamento da dor. Após a remoção dos itens que não obtiveram os índices Kappa ou IVC estabelecidos, verificou-se alcance de níveis ótimos desses índices para as categorias. Na etapa seguinte houve a ressubmissão do protocolo aos juízes por meio da técnica Delphi em que se verificou que, das 15 categorias do protocolo, 12 apresentaram melhores escores na fase Delphi 2 e as outras três categorias mantiveram os mesmos índices Kappa e IVC da fase anterior. Quanto à média dos requisitos de avaliação do protocolo verificou-se que as notas atribuídas pelos juízes na segunda fase foram maiores em nove dos 10 itens, permanecendo a mesma em apenas um dos itens indicando validade do instrumento perante o consenso dos juízes. Assim, aceita-se a hipótese alternativa no estudo, a medida que foram obtidos na fase Delphi 2 índices de validade maiores ou iguais aos da fase Delphi1. A formulação deste protocolo de assistência válido pode embasar a reorganização e replanejamento da assistência, com padronização das ações e a continuidade da assistência às pessoas com úlcera venosa na atenção primáriaCoordenação de Aperfeiçoamento de Pessoal de Nível Superiorapplication/pdfporUniversidade Federal do Rio Grande do NortePrograma de Pós-Graduação em EnfermagemUFRNBRAssistência à SaúdeProtocolos. Úlcera varicosa. Enfermagem. Saúde coletiva. Atenção Primária à Saúde. Estudos de validaçãoProtocols. Varicose ulcer. Public Health. Quality of Life. Primary Health Care. Validation StudiesCNPQ::CIENCIAS DA SAUDE::ENFERMAGEMValidação de protocolo de assistência para pessoas com úlcera venosa na atenção primáriainfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRNinstname:Universidade Federal do Rio Grande do Norte (UFRN)instacron:UFRNORIGINALIsabelleKFC_TESE.pdfapplication/pdf2724396https://repositorio.ufrn.br/bitstream/123456789/14750/1/IsabelleKFC_TESE.pdf3b262a5786188d2dec0fcd890fc26fd4MD51TEXTIsabelleKFC_TESE.pdf.txtIsabelleKFC_TESE.pdf.txtExtracted texttext/plain294519https://repositorio.ufrn.br/bitstream/123456789/14750/6/IsabelleKFC_TESE.pdf.txt94f303f0095ee32ad127533ee55eec13MD56THUMBNAILIsabelleKFC_TESE.pdf.jpgIsabelleKFC_TESE.pdf.jpgIM Thumbnailimage/jpeg2181https://repositorio.ufrn.br/bitstream/123456789/14750/7/IsabelleKFC_TESE.pdf.jpge750d547825c288a57bdc55c42f2df2fMD57123456789/147502017-11-01 05:49:14.148oai:https://repositorio.ufrn.br:123456789/14750Repositório de PublicaçõesPUBhttp://repositorio.ufrn.br/oai/opendoar:2017-11-01T08:49:14Repositório Institucional da UFRN - Universidade Federal do Rio Grande do Norte (UFRN)false
dc.title.por.fl_str_mv Validação de protocolo de assistência para pessoas com úlcera venosa na atenção primária
title Validação de protocolo de assistência para pessoas com úlcera venosa na atenção primária
spellingShingle Validação de protocolo de assistência para pessoas com úlcera venosa na atenção primária
Costa, Isabelle Katherinne Fernandes
Protocolos. Úlcera varicosa. Enfermagem. Saúde coletiva. Atenção Primária à Saúde. Estudos de validação
Protocols. Varicose ulcer. Public Health. Quality of Life. Primary Health Care. Validation Studies
CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM
title_short Validação de protocolo de assistência para pessoas com úlcera venosa na atenção primária
title_full Validação de protocolo de assistência para pessoas com úlcera venosa na atenção primária
title_fullStr Validação de protocolo de assistência para pessoas com úlcera venosa na atenção primária
title_full_unstemmed Validação de protocolo de assistência para pessoas com úlcera venosa na atenção primária
title_sort Validação de protocolo de assistência para pessoas com úlcera venosa na atenção primária
author Costa, Isabelle Katherinne Fernandes
author_facet Costa, Isabelle Katherinne Fernandes
author_role author
dc.contributor.authorID.por.fl_str_mv
dc.contributor.authorLattes.por.fl_str_mv http://lattes.cnpq.br/5903265312273525
dc.contributor.advisorID.por.fl_str_mv
dc.contributor.advisorLattes.por.fl_str_mv http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4708368Z6&dataRevisao=null
dc.contributor.referees1.pt_BR.fl_str_mv Bachion, Maria Márcia
dc.contributor.referees1ID.por.fl_str_mv
dc.contributor.referees1Lattes.por.fl_str_mv http://lattes.cnpq.br/8503907944360635
dc.contributor.referees2.pt_BR.fl_str_mv Tourinho, Francis Solange Vieira
dc.contributor.referees2ID.por.fl_str_mv
dc.contributor.referees2Lattes.por.fl_str_mv http://lattes.cnpq.br/5614479933447169
dc.contributor.referees3.pt_BR.fl_str_mv Miranda, Francisco Arnoldo Nunes de
dc.contributor.referees3ID.por.fl_str_mv
dc.contributor.referees3Lattes.por.fl_str_mv http://lattes.cnpq.br/9242337504601387
dc.contributor.referees4.pt_BR.fl_str_mv Lira, Ana Luisa Brandao de Carvalho
dc.contributor.referees4ID.por.fl_str_mv
dc.contributor.referees4Lattes.por.fl_str_mv http://lattes.cnpq.br/4545130167501174
dc.contributor.referees5.pt_BR.fl_str_mv Alchieri, João Carlos
dc.contributor.referees5ID.por.fl_str_mv
dc.contributor.referees5Lattes.por.fl_str_mv http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4790051D1&dataRevisao=null
dc.contributor.author.fl_str_mv Costa, Isabelle Katherinne Fernandes
dc.contributor.advisor1.fl_str_mv Torres, Gilson de Vasconcelos
contributor_str_mv Torres, Gilson de Vasconcelos
dc.subject.por.fl_str_mv Protocolos. Úlcera varicosa. Enfermagem. Saúde coletiva. Atenção Primária à Saúde. Estudos de validação
topic Protocolos. Úlcera varicosa. Enfermagem. Saúde coletiva. Atenção Primária à Saúde. Estudos de validação
Protocols. Varicose ulcer. Public Health. Quality of Life. Primary Health Care. Validation Studies
CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM
dc.subject.eng.fl_str_mv Protocols. Varicose ulcer. Public Health. Quality of Life. Primary Health Care. Validation Studies
dc.subject.cnpq.fl_str_mv CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM
description People with venous ulcers constitute as an important public health problem, its treatment is onerous and require assistance provided by trained professionals, systematized through protocols, however what lies in the assistance is that the management of this group of people differs from that preconized in the scientific literature, interfering with wound healing and quality of life of affected. In this sense, the construction of a assistance protocol specific to people with venous ulcers (VU) can help professionals of the Family Health Strategy both in patient assessment as and in establishment of quality assistance. Thus, this study aimed to analyse the validity of a multiprofessional assistance protocol for people with venous ulcers in primary care by health professionals using Delphi technique. This is a quantitative study, the methodological type conducted in two steps: first step related to integrative literature review to subsidize the development of the protocol, then these aspects were organized and proposed to the judges of the study through the Delphi technique. The study was initiated after approval by the Research Ethics Committee. The first step was performed between August and September 2012, in the virtual library of health, in the page of the Coordination of Improvement of Higher Education Personnel, of Municipal Health Secretariat and international guidelines of associations and in the subsequent step carried out between September 2012 to January 2013, was performed search by Lattes platform of the National Council of Technological and Scientific Development, in order to identify health professionals in Brazil who act as judges of the instrument and then, via online, the form was submitted to them.The sample for the second step was 51 judges in the first round and 35 for the second round Delphi. The analysis was done by adopting Kappa index ≥ 0.81 and Content Validity Index (CVI)> 0.80. In the first submission for the judges, items that did not reach Kappa and CVI established were: request / realization / test results, demographic data, medical history, risk factors, verification of pain / vital signs / pulse / infection signs / lesion location/ edema and pain treatment. After removal of items which have not obtained Kappa or CVI index established, it was found achieving optimal levels of these index for the categories. In the next step was the ressubmissão of protocol to judges through the Delphi technique in it was found that, of the 15 categories of the protocol, 12 presented higher scores in Delphi 2 phase and the other three categories remained the same Kappa and IVC of the previous phase. As for the average of evaluation requirements of the protocol was found that the scores assigned by the judges were higher in the second phase in nine of the 10 items, remaining the same in only one of the items indicating validity of the instrument before the consensus of the judges. Thus, we accepted the alternative hypothesis in this study, as they were obtained in the second Delphi phase the validity index greater than or equal to the Delphi 1 phase. The formulation of this assistance protocol valid and reproducible will enable a reorganization and redesign of assistance, with standardization of actions and continuity of care for persons with venous ulcers in primary health care
publishDate 2013
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2014-12-17T14:46:53Z
dc.date.issued.fl_str_mv 2013-02-05
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identifier_str_mv COSTA, Isabelle Katherinne Fernandes. Validação de protocolo de assistência para pessoas com úlcera venosa na atenção primária. 2013. 151 f. Tese (Doutorado em Assistência à Saúde) - Universidade Federal do Rio Grande do Norte, Natal, 2013.
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