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Previous issue date: 2013-02-05 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / 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 ressubmiss?o 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 / As pessoas com ?lcera venosa constituem-se um importante problema de sa?de p?blica, o seu
tratamento ? oneroso e necessitam de uma assist?ncia prestada por profissionais capacitados,
sistematizada por meio de protocolos, contudo o que se encontra na assist?ncia ? que o
manejo a este grupo de pessoas difere do que ? preconizado na literatura cient?fica,
interferindo na cicatriza??o da ferida e na qualidade de vida dos acometidos. Nesse sentido, a
constru??o de um protocolo de assist?ncia espec?fico para pessoas com ?lcera venosa (UV)
pode auxiliar os profissionais da Estrat?gia Sa?de da Fam?lia tanto na avalia??o do paciente
como no estabelecimento de uma assist?ncia de qualidade. Assim, este estudo objetivou
analisar a validade de um protocolo de assist?ncia multiprofissional a pessoas com ?lcera
venosa na aten??o prim?ria por profissionais de sa?de mediante t?cnica Delphi. Trata-se de
um estudo quantitativo, do tipo metodol?gico realizado em duas etapas: primeira etapa
referente a revis?o integrativa da literatura para subsidiar a elabora??o do protocolo; em
seguida, esses aspectos foram organizados e propostos aos ju?zes do estudo por meio da
t?cnica Delphi. O estudo foi iniciado ap?s aprova??o do Comit? de ?tica em Pesquisa. A
primeira etapa foi realizada entre agosto e setembro de 2012, na biblioteca virtual de sa?de, na
p?gina da Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior, de Secretarias
Municipais de Sa?de e guidelines de associa??es internacionais e na etapa subsequente
realizada no per?odo de setembro de 2012 a janeiro de 2013, realizou-se busca por meio da
plataforma Lattes do Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico, a fim
de identificar profissionais de sa?de do Brasil que atuassem como ju?zes do instrumento e em
seguida, via online, submeteu-se o formul?rio aos pesquisados. A amostra para a segunda
etapa foi de 51 ju?zes na primeira rodada e de 35 para a segunda rodada Delphi. A an?lise foi
feita adotando-se ?ndice Kappa ≥0,81 e ?ndice de Validade de Conte?do (IVC)>0,80. Na
primeira submiss?o aos ju?zes, os itens que n?o atingiram os ?ndices Kappa e IVC
estabelecidos pertenciam as categorias: solicita??o/ realiza??o/ resultados de exames, dados
sociodemogr?ficos, anamnese, fatores de risco, verifica??o de dor/ sinais vitais/ pulso/ sinais
de infec??o/ localiza??o da les?o/ edema e tratamento da dor. Ap?s a remo??o dos itens que
n?o obtiveram os ?ndices Kappa ou IVC estabelecidos, verificou-se alcance de n?veis ?timos
desses ?ndices para as categorias. Na etapa seguinte houve a ressubmiss?o do protocolo aos
ju?zes por meio da t?cnica Delphi em que se verificou que, das 15 categorias do protocolo, 12
apresentaram melhores escores na fase Delphi 2 e as outras tr?s categorias mantiveram os
mesmos ?ndices Kappa e IVC da fase anterior. Quanto ? m?dia dos requisitos de avalia??o do
protocolo verificou-se que as notas atribu?das pelos ju?zes 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 ju?zes. Assim, aceita-se a hip?tese alternativa no estudo, a
medida que foram obtidos na fase Delphi 2 ?ndices de validade maiores ou iguais aos da fase
Delphi1. A formula??o deste protocolo de assist?ncia v?lido pode embasar a reorganiza??o e
replanejamento da assist?ncia, com padroniza??o das a??es e a continuidade da assist?ncia ?s
pessoas com ?lcera venosa na aten??o prim?ria
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/14750 |
| Date | 05 February 2013 |
| Creators | Costa, Isabelle Katherinne Fernandes |
| Contributors | CPF:51326728415, http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4708368Z6&dataRevisao=null, Bachion, Maria M?rcia, CPF:08130556871, http://lattes.cnpq.br/8503907944360635, Tourinho, Francis Solange Vieira, CPF:78150361987, http://lattes.cnpq.br/5614479933447169, Miranda, Francisco Arnoldo Nunes de, CPF:04960360330, http://lattes.cnpq.br/9242337504601387, Lira, Ana Luisa Brandao de Carvalho, CPF:64194892372, http://lattes.cnpq.br/4545130167501174, Alchieri, Jo?o Carlos, CPF:34616055068, http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4790051D1&dataRevisao=null, Torres, Gilson de Vasconcelos |
| Publisher | Universidade Federal do Rio Grande do Norte, Programa de P?s-Gradua??o em Enfermagem, UFRN, BR, Assist?ncia ? Sa?de |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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