Continuing education in the child health handbook: an educational software for primary care1

Abstract Objective: To present, the process of development and evaluation of an educational software on the Child Health Handbook proposed for the continuing education of primary care nurses and physicians. Methods: Quantitative study of methodological development. For software development, the following steps were followed: definition of objectives; determination of the target audience; choice of pedagogical and theoretical reference for content; content selection and structuring; software development and evaluation by experts (five nurses and four physicians). All responded to an instrument that included four domains: pedagogical; content; functionality; system presentation and usability. The evaluation criteria were arranged on a Likert-type scale. The percentage of agreement and Content Validity Index were used for the quantitative analysis of the degree of agreement, considering a Content Validity Index cutoff point equal to 0.80. Results: The overall agreement index, calculated by the arithmetic mean of the Contents Validity Index of the evaluated domains, was 0.96, with scores ranging from 0.90 to 1.00. The average percentage of agreement of the experts per domain was 92.86%, with lower agreement in the content (80.95%), presentation, and usability (90.48%) domains. 100% of percentage of agreement was observed in the pedagogical and functionality domains among the evaluated specialists. Conclusion: The percentage of agreement, Content Validity Index and overall agreement index of the Child Health Handbook educational software in the context of primary care disclosed the software adequacy as an educational resource for continuing education of primary care nurses and physicians. Considering the assessed dimensions, it can also be used by other health professionals and undergraduate students.

Continuing education in the child health handbook: an educational software for primary care1.

OBJECTIVE: To present, the process of development and evaluation of an educational software on the Child Health Handbook proposed for the continuing education of primary care nurses and physicians. METHODS: Quantitative study of methodological development. For software development, the following steps were followed: definition of objectives; determination of the target audience; choice of pedagogical and theoretical reference for content; content selection and structuring; software development and evaluation by experts (five nurses and four physicians). All responded to an instrument that included four domains: pedagogical; content; functionality; system presentation and usability. The evaluation criteria were arranged on a Likert-type scale. The percentage of agreement and Content Validity Index were used for the quantitative analysis of the degree of agreement, considering a Content Validity Index cutoff point equal to 0.80. RESULTS: The overall agreement index, calculated by the arithmetic mean of the Contents Validity Index of the evaluated domains, was 0.96, with scores ranging from 0.90 to 1.00. The average percentage of agreement of the experts per domain was 92.86%, with lower agreement in the content (80.95%), presentation, and usability (90.48%) domains. 100% of percentage of agreement was observed in the pedagogical and functionality domains among the evaluated specialists. CONCLUSION: The percentage of agreement, Content Validity Index and overall agreement index of the Child Health Handbook educational software in the context of primary care disclosed the software adequacy as an educational resource for continuing education of primary care nurses and physicians. Considering the assessed dimensions, it can also be used by other health professionals and undergraduate students.

Mild cognitive impairment in the elderly Relationship between communication and functional capacity.

Mild Cognitive Impairment is characterized as an intermediate form between age-related change and dementia. For the elderly, autonomy and independence are related to the ability to remain active in conducting their social activities and, for this to occur, communication is fundamental in this process. OBJECTIVE: To assess the association between communication and the abilities of elderly people with mild cognitive impairment to perform instrumental activities of daily living. METHODS: A cross-sectional, quantitative, analytical, correlational study was conducted at the Open University of the Third Age (UnATI), a program of the Federal University of Pernambuco. This study included 92 people, comprising 46 elderly with mild cognitive impairment and a caregiver or family member who met the inclusion criteria. The elderly were asked to complete a sociodemographic questionnaire and Lawton-Brody's Instrumental Activities of Daily Living Scale. The caregivers were asked to complete the Functional Assessment of Communication Skills. The following variables were studied: social communication skills and instrumental activities of daily living. Data were stored in an Excel® 2007 spreadsheet, and the Pearson correlation test was used for the statistical analysis. RESULTS: There were statistically significant correlations in four domains of social communication: referring to family members by name (p=0.0033); requesting information about people or events (p=0.0355); understanding conversations in a noisy environment (p=0.0448); and understanding what they watch on television or listen to on the radio (p=0.0127). CONCLUSION: Changes in the communication of elderly people with mild cognitive impairment interfere with their ability to perform instrumental activities autonomously and independently.

O comprometimento cognitivo leve se caracteriza como forma intermediária entre a alteração ocasionada pela idade e a demência. Para o idoso, autonomia e independência estão relacionadas à capacidade de se manter ativo na realização das suas atividades sociais e, para que isso aconteça, a comunicação se torna fundamental neste processo. OBJETIVO: Avaliar a relação entre comunicação e desempenho dos idosos com comprometimento cognitivo leve na realização das atividades instrumentais da vida diária. MÉTODOS: Estudo transversal, quantitativo, analítico e correlacional, realizado na Universidade aberta à Terceira Idade da Universidade Federal de Pernambuco. Participaram do estudo 92 pessoas, sendo 46 idosos com comprometimento cognitivo leve e seus respectivos cuidador ou familiar que atenderam aos critérios de inclusão. Aos idosos, foram aplicados o questionário sociodemográfico e a Escala de Lawton-Brody; e, a seus informantes, a escala de Avaliação Funcional das Habilidades Comunicativas. As seguintes variáveis foram estudadas: habilidades de comunicação social e atividades instrumentais de vida diária. Os dados foram organizados em planilha Excel® 2007 e para análise estatística foi aplicado o Teste de Correlação de Pearson. RESULTADOS: Evidenciou-se correlação estatisticamente significativa em quatro domínios da comunicação social, a saber: nomeia pessoas familiares pelo nome (p=0,0033); solicita informação sobre pessoas ou acontecimentos (p=0,0355); compreende conversas em ambiente barulhento (p=0,0448) e, compreende o que assiste na televisão ou ouve no rádio (p=0,0127). CONCLUSÃO: as alterações existentes na comunicação de idosos com comprometimento cognitivo leve interferem na capacidade de realização de atividades instrumentais com autonomia e independência.

Treatment for Vocal Polyps: Lips and Tongue Trill.

Vocal polyps do not have a well-defined therapeutic indication. The recommended treatment is often laryngeal microsurgery, followed by postoperative speech therapy. Speech therapy as the initial treatment for polyps is a new concept and aims to modify inappropriate vocal behavior, adjust the voice quality, and encourage regression of the lesion. This study aimed to determine the effectiveness of the sonorous lips and tongue trill technique in the treatment of vocal polyps. The sample consisted of 10 adults diagnosed with a polyp who were divided into two subgroups: treatment and control. Ten speech therapy sessions were conducted, each lasting 30-45 minutes, based on the sonorous lips and tongue trill technique, accompanied by continuous guidance about vocal health. Speech therapy was effective in three of the five participants. The number of symptoms presented by the participants decreased significantly after voice therapy (P = 0.034) and vocal self-evaluation (P = 0.034). The acoustic evaluation showed improvements in parameters of noise values (P = 0.028) and jitter (P = 0.034). The size of the polyp and the degree of severity of dysphonia, hoarseness, and breathiness showed a significant reduction after treatment (P = 0.043). Among the remaining two participants, one opted out of laryngeal surgery, indicating that the improvement obtained was sufficient to avoid surgery. The sonorous lips and tongue trill technique was thus considered effective in 60% of the participants, and as laryngeal surgery was avoided in 80% of them, it should be considered a treatment option for vocal polyps.

Clinical and videofluoroscopic diagnosis of dysphagia in chronic encephalopathy of childhood.

OBJECTIVE: To evaluate the contribution of deglutition videofluoroscopy in the clinical diagnosis of dysphagia in chronic encephalopathy of childhood. MATERIALS AND METHODS: The study sample consisted of 93 children diagnosed with chronic encephalopathy, in the age range between two and five years, selected by convenience among patients referred to the authors' institution by speech therapists, neurologists and gastroenterologists in the period from March 2010 to September 2011. The data collection was made at two different moments, by different investigators who were blind to each other. RESULTS: The method presented low sensitivity for detecting aspiration with puree consistency (p = 0.04). Specificity and negative predictive value were high for clinical diagnosis of dysphagia with puree consistency. CONCLUSION: In the present study, the value for sensitivity in the clinical diagnosis of dysphagia demonstrates that this diagnostic procedure may not detect any change in the swallowing process regardless of the food consistency used during the investigation. Thus, the addition of the videofluoroscopic method can significantly contribute to the diagnosis of dysphagia.

OBJETIVO: Avaliar se o diagnóstico clínico da disfagia foi potencializado pelo método videofluoroscópico na encefalopatia crônica da infância. MATERIAIS E MÉTODOS: A amostra foi constituída por 93 crianças com diagnóstico de encefalopatia crônica da infância, com idade entre dois e cinco anos, selecionadas por conveniência, de encaminhamentos vindos de fonoaudiólogos, neuropediatras e gastrenterologistas no período de março de 2010 a setembro de 2011. A coleta se deu em dois momentos distintos, com pesquisadores diferentes e cegos entre si. RESULTADOS: Foi observada baixa sensibilidade para detectar a aspiração na consistência pastosa (p = 0,04). Os valores de especificidade e valor preditivo negativo foram altos para diagnóstico clínico da disfagia na consistência pastosa. CONCLUSÃO: Neste estudo, o valor da sensibilidade do diagnóstico clínico da disfagia demonstra que este procedimento de diagnóstico pode não detectar comportamentos alterados no processo de deglutição, independente da consistência utilizada durante a investigação. Desta forma, o diagnóstico clínico da disfagia foi potencializado pelo método videofluoroscópico.