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BACKGROUND: The Intensive Care Delirium Screening Checklist (ICDSC) demonstrates good psychometric characteristics in research settings. However, evidence about these characteristics in pragmatic ICU settings is inconsistent. This study evaluated psychometric properties and user-friendliness of the ICDSC when administered by ICU nurses in daily practice. METHODS: This prospective study included 77 patients from a surgical intensive care unit. To examine the psychometric characteristics, the scores on the ICDSC (performed by bedside nurses) were compared with the scores on the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) (performed by researchers as gold standard). The user-friendliness was evaluated by 34 ICU nurses with a 20-item questionnaire. RESULTS: The ICDSC had an area under the curve of 0.843. It showed a good diagnostic accuracy with a sensitivity of 81.0%, a specificity of 87.7%, and a 53.1% positive and 96.4% negative predictive value. The overall Cronbach's alpha coefficient for all ICDSC scores was high (0.839). Overall, ICU nurses experienced the ICDSC as easy-to-use. The scale was usable in most surgical ICU patients. Yet, some nurses (11.8%) had problems to score the items 'inappropriate speech' and 'symptom fluctuation' in intubated patients. CONCLUSIONS: The ICDSC is a valid and user-friendly tool for delirium screening in daily ICU nursing practice. Yet, some problems were reported in intubated patients. Therefore, validation studies with specific focus on intubated patients are needed.
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BACKGROUND: Increasingly healthcare policies emphasise the importance of person-centred, empathic care. Consequently, healthcare professionals are expected to demonstrate the 'human' aspects of care in training and in practice. The Consultation and Relational Empathy (CARE) Measure is a patient-rated measure of the interpersonal skills of healthcare practitioners. It has been widely validated for use by healthcare professionals in both primary and secondary care. This paper reports on the validity and reliability of the CARE Measure with sexual health nurses. METHODS: Patient questionnaires were collected for 943 consultations with 20 sexual health nurses. Participating patients self-completed the questionnaire immediately after the encounter with the nurse. The questionnaire included the ten item CARE Measure, the Patient Enablement Index, and overall satisfaction instruments. Construct validity was assessed through Spearman's correlation and principal component analysis. Internal consistence was assessed through Cronbach's alpha and the inter-rater reliability through Generalisability Theory. Data were collected in 2013 in Scotland. RESULTS: Female patients completed 68% of the questionnaires. The mean patient age was 28.8 years (standard deviation 9.8 years). Two of the 20 participating nurses withdrew from the study. Most patients (71.7%) regarded the CARE Measure items as very important to their consultation and the number of 'not applicable' and missing responses' were low (2.6% and 0.1% respectively). The participating nurses had high CARE Measure scores; out of a maximum possible score of 50, the overall mean CARE measure score was 47.8 (standard deviation 4.4). The scores were moderately correlated with patient enablement (rho = 0.232, p = 0.001) and overall satisfaction (rho = 0.377, p = 0.001. Cronbach's alpha showed the measure's high internal consistency (Cronbach's alpha coefficient = 0.95), but the inter-rater reliability could not be calculated due to the high achieved CARE Measure scores that varied little between nurses. CONCLUSIONS: Within this clinical context the CARE Measure has high perceived relevance and face validity. The findings support construct validity and some evidence of reliability. The high CARE Measure scores may have been due to sample bias. A future study which ensures a representative sample of patients on a larger group of nurses is required to determine whether the measure can discriminate between nurses.
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Background and Purpose: The aims of this study are as follows: to adapt and validate the psychometric properties of the Spanish version of the Practice Environment Scale of the Nursing Work Index (PES-NWI) adapted to the nursing home environment across seven Spanish-speaking countries and to cross-culturally adapt the Scale of the Nursing Work Index with nurses from seven countries. Methods: Adaptation process and psychometric validation of the instrument included translation and back-translation, content validity, test-retest reliability, internal consistency, and construct validity. Results: A total of 134 nursing homes belonging to the same religious order were randomly selected from seven Spanish-speaking countries with a sample of 378 nurses. The exploratory factor analysis explained a five-factor structure (56% of the explained variance) with adequate goodness-of-fit indices in the final factor solution. Conclusions: The validation process indicates that the Spanish language version of the PES-NWI with five factors and 31 items, for long-term care facilities for the elderly, is valid and reliable in its current version and can be used to measure the environment of nurses working in clinical practice in Spanish-speaking nursing homes.
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The Fear COVID-19 Scale (FCV-19S) is a tool that assesses fears related to COVID-19. The objective was to know the validity and reliability of the FCV-19S in Colombian physicians. Five hundred thirty-one physicians aged between 21 and 69 years participated (M = 30.0, SD = 9.4). Internal consistency was estimated with Kuder-Richardson and McDonald's omega coefficients. The one-dimensional structure was corroborated with confirmatory factor analysis and goodness of fit coefficients. The FCV-19S showed Kuder-Richardson's coefficient of 0.16 and McDonald's omega of 0.42. The five-item version (FCV-19S-5), without items 3 and 7, showed Kuder-Richardson's coefficient of 0.67 and McDonald's omega of 0.68. In conclusion, the FCV-19S presented a poor psychometric performance in Colombian doctors, and the FCV-19S-5 showed acceptable internal consistency and dimensionality.
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OBJECTIVE: The aim of this study was to develop and validate a stepwise tool to aid primary health care professionals in the process of deprescribing potentially inappropriate medication in older persons. METHODS: We carried out a systematic review to identify previously published tools. A composite proposal of algorithm was made by following the steps from clinical experience to deprescribe medications. A 2-round electronic Delphi method was conducted to establish consensus. Eighteen experts from different countries (Colombia, Spain and Argentina) accepted to be part of the panel representing geriatricians, internists, endocrinologist, general practitioners, pharmacologists, clinical pharmacists, family physicians and nurses. Panel members were asked to mark a Likert Scale from 1 to 9 points (1= strongly disagree, 9= strongly agree). The content validity ratio, item-level content validity, and Fleiss' Kappa statistics was measured to establish reliability. The same voting method was used for round 2. RESULTS: A 7-question algorithm was proposed. Each question was part of a domain and conduct into a decision. In round 1, a consensus was not reached but statements were grouped and organized. In round 2, the tool met consensus. The inter-rater reliability was between substantial and almost perfect for questions with Kappa=0.77 (95% CI 0.60-0.93), for domains with Kappa= 0.73 (95%CI 0.60-0.86) and for decisions with Kappa= 0.97 (95%CI 0.90-1.00). CONCLUSIONS: This is a novel tool that captures and supports healthcare professionals in clinical decision-making for deprescribing potentially inappropriate medication. This includes patient's and caregiver's preferences about medication. This tool will help to standardize care and provide guidance on the prescribing/deprescribing process of older persons' medications. Also, it provides a holistic way to reduce polypharmacy and inappropriate medications in clinical practice.
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BACKGROUND: The importance of nurse staffing levels in acute hospital wards is widely recognised but evidence for tools to determine staffing requirements although extensive, has been reported to be weak. Building on a review of reviews undertaken in 2014, we set out to give an overview of the major approaches to assessing nurse staffing requirements and identify recent evidence in order to address unanswered questions including the accuracy and effectiveness of tools. METHODS: We undertook a systematic scoping review. Searches of Medline, the Cochrane Library and CINAHL were used to identify recent primary research, which was reviewed in the context of conclusions from existing reviews. RESULTS: The published literature is extensive and describes a variety of uses for tools including establishment setting, daily deployment and retrospective review. There are a variety of approaches including professional judgement, simple volume-based methods (such as patient-to-nurse ratios), patient prototype/classification and timed-task approaches. Tools generally attempt to match staffing to a mean average demand or time requirement despite evidence of skewed demand distributions. The largest group of recent studies reported the evaluation of (mainly new) tools and systems, but provides little evidence of impacts on patient care and none on costs. Benefits of staffing levels set using the tools appear to be linked to increased staffing with no evidence of tools providing a more efficient or effective use of a given staff resource. Although there is evidence that staffing assessments made using tools may correlate with other assessments, different systems lead to dramatically different estimates of staffing requirements. While it is evident that there are many sources of variation in demand, the extent to which systems can deliver staffing levels to meet such demand is unclear. The assumption that staffing to meet average need is the optimal response to varying demand is untested and may be incorrect. CONCLUSIONS: Despite the importance of the question and the large volume of publication evidence about nurse staffing methods remains highly limited. There is no evidence to support the choice of any particular tool. Future research should focus on learning more about the use of existing tools rather than simply developing new ones. Priority research questions include how best to use tools to identify the required staffing level to meet varying patient need and the costs and consequences of using tools. TWEETABLE ABSTRACT: Decades of research on tools to determine nurse staffing requirements is largely uninformative. Little is known about the costs or consequences of widely used tools.
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Recursos Humanos de Enfermagem Hospitalar , Admissão e Escalonamento de Pessoal , Carga de Trabalho , HumanosRESUMO
OBJECTIVE: To develop and validate DFConhecimento, an instrument to assess Brazilian healthcare professional providers' knowledge on sickle cell disease. METHOD: Study carried out in four stages: (1) instrument development; (2) content validation by an Expert Committee; (3) cultural adequacy check at pre-test; (4) instrument reliability analysis by healthcare professional providers supported by Intraclass Correlation Coefficient calculation. The data for content validation and reliability analyses were collected through the web tool eSurv and analyzed within the statistical software and environment R. RESULTS: The instrument, consisting of 13 multiple-choice questions, showed acceptability, with an average Content Validity Index of 0.88. The reliability analysis showed moderate agreement (0.67) indicating that test-retest reproducibility is acceptable. CONCLUSION: The instrument DFConhecimento showed reliability and internal consistency, proving suitable for measuring Brazilian healthcare professional providers' acquisition of knowledge on sickle cell disease.
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BACKGROUND: Previous attempts to develop an instrument to measure factors that influence prescribing decisions among physicians were relatively insufficient and lacked validation scale. OBJECTIVE: We present a new tool that attempts to address this shortcoming. Hence, this study aims to develop and validate a self-administrated instrument to explain factors that influence the prescribing decisions of physicians. METHODS: The questionnaire was developed based on literature and then subjected to an exhaustive assessment by a board of professionals and a pilot examination before being administered to 705 physicians. Three pre-tests were carried out to evaluate the quality of the survey items. In pre-test 1, after items are generated and the validity of their content is assessed by academics and physicians. In pre-test 2, the scale is carried out with a small sample of 20 respondents of physicians. In pre-test 3, fifty drop-off questionnaires were piloted amongst physicians to test the reliability. RESULTS: On the basis of partial least squares structural equation modelling (PLS-SEM) analyses using SmartPLS 3, the content and convergent validity of the instrument were confirmed with 44 items grouped into four categories, namely, marketing efforts, patient characteristics, pharmacist variables, and contextual factors with 13 reflective constructs. CONCLUSIONS: The study outcomes prove that the scale is more valid and reliable for measuring factors that influence the decision of the physician to prescribe the drug. The development and presentation of a scale of thirteen factors related to physicians prescribing decisions help to ensure valid findings and facilitates comparisons of studies and research settings.
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Resumo Objetivo Validar o conteúdo e a aparência de um protocolo gráfico para avaliação do cuidado seguro de enfermagem a pacientes em hemodiálise. Método Estudo metodológico com abordagem quantitativa, organizado em três procedimentos: teóricos, a partir de uma scoping review; empíricos, na qual ocorreu processo de construção do protocolo gráfico e checklist para avaliação do cuidado seguro; por fim, os analíticos, para a validação propriamente dita com uso da técnica Delphi e participação de nove juízes especialistas em duas rodadas para o alcance da concordância. Resultados Elaboraram-se o checklist e o protocolo gráfico. Quanto à validade de conteúdo, em Delphi I, três critérios obtiveram Coeficiente de Validade de Conteúdo =0,77 no checklist. No que corresponde ao Delphi II, foram alcançados 80% em todos os itens referentes ao Coeficiente de Validade de Conteúdo, e todos os índices ficaram acima de 0,80. A validação de aparência ocorreu utilizando critérios de Suitability Assessment of Materials no Delphi I. Foi possível atingir um Coeficiente de Validade de Conteúdo total maior que 0,80 em todos, enquanto que, no Delphi II, os protocolos alcançaram concordância maior que 80% e Coeficiente de Validade de Conteúdo maior que 0,88, já que o checklist apresentou maior Coeficiente de Validade de Conteúdo com 0,91. Conclusão Apresentam-se o protocolo gráfico e o checklist para avaliação do cuidado seguro aos pacientes em hemodiálise válidos em seu conteúdo e aparência.
Resumen Objetivo Validar el contenido y la apariencia de un protocolo gráfico para la evaluación del cuidado seguro de enfermería a pacientes en hemodiálisis. Métodos Estudio metodológico con enfoque cuantitativo, organizado en tres procedimientos: teórico, a partir de una scoping review; empírico, donde se realizó el proceso de elaboración del protocolo gráfico y checklist para la evaluación del cuidado seguro; y por último, analítico, para la validación propiamente dicha mediante el uso del método Delphi y la participación de nueve jueces especialistas en dos rondas para alcanzar la concordancia. Resultados Se elaboró la checklist y el protocolo gráfico. Respecto a la validez del contenido, en Delphi I tres criterios obtuvieron Coeficiente de Validez de Contenido = 0,77 en la checklist. En lo referente al Delphi II, se alcanzó el 80 % en todos los ítems relacionados con el Coeficiente de Validez de Contenido, y todos los índices fueron superiores a 0,80. La validación de la apariencia se realizó con los criterios de la Suitability Assessment of Materials en Delphi I. Se logró alcanzar un Coeficiente de Validez de Contenido total mayor a 0,80 en todos, mientras que en Delphi II, los protocolos lograron una concordancia mayor a 80 % y Coeficiente de Validez de Contenido mayor a 0,88, ya que la checklist presentó mayor Coeficiente de Validez de Contenido con 0,91. Conclusión El protocolo gráfico y la checklist para la evaluación del cuidado seguro a pacientes en hemodiálisis demostraron ser válidos en su contenido y apariencia.
Abstract Objective To validate the content and appearance of a graphic protocol for evaluating safe nursing care for hemodialysis patients. Methods Methodological study with a quantitative approach, organized into three procedures: theoretical from a Scoping Review; empirical in which the process of constructing the graphic protocol and checklist for the evaluation of safe care took place; finally, the analytics for the validation itself using the Delphi technique and the participation of nine expert judges in two rounds to reach agreement. Results The checklist and the graphic protocol were elaborated. As for content validity in Delphi I, three criteria obtained Content Validity Coefficient =0.77 in the checklist. In what corresponds to Delphi II, 80% was achieved in all items regarding the Content Validity Coefficient, all indices were above 0.80. Appearance validation took place using criteria of the Suitability Assessment of Materials in Delphi I, it was possible to achieve a total Content Validity Coefficient greater than 0.80 in all, while in Delphi II the protocols reached agreement greater than 80% and Content Validity Coefficient greater than 0.88, since the checklist showed a higher Content Validity Coefficient with 0.91. Conclusion The graphic protocol and checklist for evaluating safe care for hemodialysis patients are presented, valid in their content and appearance.
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ABSTRACT Objectives: to validate the Brazilian version of the Modified Scale for Delineating Advanced Practice Nursing Roles. Methods: this was a methodological study for the clinical validation of an instrument, conducted with 207 nurses working in primary care. Exploratory and confirmatory factor analysis, Cronbach's alpha test, and z-test for proportion comparison were used. Results: the internal reliability of the scale was 0.944, with alpha greater than 0.80 in most domains, except for Education (0.786). In the exploratory factor analysis, considering the criterion of eigenvalue greater than one, eight factors were identified, explaining 79.38% of the variance. In the comparison of proportions, the adequate responses (≥ 2) in the domain of Comprehensive Direct Care, in both analyzed groups, were statistically equal. This domain had the highest score of adequate responses, followed by Education and Systems Support. Insufficient scoring was observed in the domains of Publication and Professional Leadership. Conclusions: the instrument demonstrated stability and reliability to be used in the evaluation of advanced nursing practice.
RESUMEN Objetivos: validar la Escala Modificada de Delimitación de la Función del Enfermero de Prácticas Avanzadas, versión brasileña. Métodos: estudio metodológico de validación clínica de un instrumento, realizado con 207 enfermeros activos en la atención primaria. Se utilizaron análisis factorial exploratorio y confirmatorio, prueba alfa de Cronbach y prueba z para la comparación de proporciones. Resultados: la fiabilidad interna de la escala fue de 0,944, y el alfa fue mayor que 0,80 en la mayoría de los dominios, excepto en Educación (0,786). En el análisis factorial exploratorio, considerando el criterio de autovalor mayor que uno, se identificaron ocho factores, explicando el 79,38% de la varianza. En la comparación de proporciones, las respuestas suficientes (≥ 2) en el dominio de Cuidados Integrales Directos, en ambos grupos analizados, fueron estadísticamente iguales. Este dominio tuvo la mayor puntuación de respuestas suficientes, seguido por Educación y Apoyo de Sistemas. Se observó una puntuación insuficiente en los dominios de Publicación y Liderazgo Profesional. Conclusiones: el instrumento demostró estabilidad y fiabilidad para ser utilizado en la evaluación de la práctica avanzada de enfermería.
RESUMO Objetivos: validar a Escala Modificada de Delineamento da Função do Enfermeiro de Práticas Avançadas, versão brasileira. Métodos: estudo metodológico de validação clínica de instrumento, realizado com 207 enfermeiros atuantes na atenção primária. Utilizaram-se análise fatorial exploratória e confirmatória, teste alfa de Cronbach e teste z para comparação de proporções. Resultados: a confiabilidade interna da escala foi de 0,944, e o alfa maior que 0,80 na maioria dos domínios, exceto Educação (0,786). Na análise fatorial exploratória, considerando o critério do autovalor maior que um, identificaram-se oito fatores, explicando 79,38% da variância. Na comparação de proporções, as respostas suficientes (≥ 2) no domínio Cuidados Abrangentes Diretos, em ambos os grupos analisados, foram estatisticamente iguais. Esse domínio teve a maior pontuação de respostas suficientes, seguido por Educação e Suporte de Sistemas. Pontuação insuficiente foi observada nos domínios Publicação e Liderança Profissional. Conclusões: o instrumento demonstrou estabilidade e confiabilidade para ser utilizado na avaliação da prática avançada de enfermagem.
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Introduction: assessing the ability to cope with regret can contribute to support strategies for health professionals. However, in Brazil only few instruments evaluate this ability in general. Objective: this study aimed was to adapt and validate the Regret Coping Scale for Healthcare Professionals (RCS-HCP) to Brazilian Portuguese . Methods: the instruments were translated, and the psychometric properties evaluated for validity and reliability. Three hundred and forty-one professionals participated, with an average age of 38.6 ± 9.2, and 87 participated in a retest survey 30 days later. Results: exploratory factor analysis showed adequacy of the structure (KMO = 0.786) composed of three factors. In the confirmation, the performance was close to acceptable. Reliability was good for the maladaptive strategies (α = 0.834) and adequate for the problem-focused initiatives (α = 0.717), but slightly too low for adaptive strategies (α = 0.595). Test- retest showed lower than expected values, with a Spearman- Brown coefficient of 0.703. Conclusion: the RCS-HCP scale showed satisfactory performance in relation to the properties evaluated.
Introdução: a avaliação da capacidade de lidar com o arrependimento pode contribuir para estratégias de apoio aos profissionais de saúde. No entanto, no Brasil existem poucos instrumentos que avaliam essa habilidade no contexto geral. Objetivo: o objetivo do estudo foi adaptar e validar a Regret Coping Scale for Healthcare Professionals (RCS-HCP) para profissionais de saúde brasileiros. Método: na validação, os instrumentos foram traduzidos e as propriedades psicométricas avaliadas quanto à validade e confiabilidade. Participaram 341 profissionais, com média de idade de 38,6 ± 9,2, e 87 participaram de uma pesquisa de reteste 30 dias depois. Resultados: a análise fatorial exploratória mostrou adequação da estrutura (KMO = 0,786) composta por três fatores. Na confirmação, o desempenho ficou próximo do aceitável. A confiabilidade foi boa para as estratégias mal adaptativas (α = 0,834) e adequada para as estratégias focadas no problema (α = 0,717), mas um pouco baixa demais para as estratégias adaptativas (α = 0,595). Teste-reteste apresentou valores abaixo do esperado, com coeficiente de Spearman-Brown de 0,703. Conclusão: a escala RCS-HCP apresentou desempenho satisfatório em relação às propriedades avaliadas.
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Objetivo: construir e validar as competências profissionais para enfermeiros atuantes em Unidades de Hemodinâmica. Método: trata-se de uma pesquisa metodológica de construção e validação das competências do enfermeiro de hemodinâmica, aprovada pelo Comitê de Ética em Pesquisa sob protocolo nº 67891517.8.0000.5462 e realizada em instituição pública de cardiologia do estado de São Paulo. Na primeira etapa, foi construído o instrumento para identificar as competências do enfermeiro no setor de hemodinâmica a partir de revisão de literatura e observação local; na segunda, o instrumento foi validade por especialistas. Os dados foram analisados pelo Índice de Validade de Conteúdo (IVC) e média ponderada do IVC. Resultados: a validação das competências ocorreu após duas rodadas de avaliação junto aos especialistas, resultando num total de sete competências relativas ao processo de trabalho da Enfermagem, com média ponderada de IVC entre 88,4 e 99,2 e 74 habilidades, as quais foram classificadas quanto ao tipo de competência; 14 itens foram avaliados como básicos, 10 como intermediários, 34 como avançados e 16 como inconclusivos. Conclusão: as competências profissionais para enfermeiros atuantes em Unidades de Hemodinâmica foram construídas e validadas por especialistas, os quais poderão subsidiar novas diretrizes sobre a formação e a educação permanente dos profissionais nessa área.(AU)
Objective: to build and validate professional skills for nurses working in Hemodynamics Units. Method: this is a methodological study for the construction and validation of hemodynamic nurses' skills, approved by the Research Ethics Committee under protocol number 67891517.8.0000.5462 and carried out in a public institution of cardiology in the state of São Paulo. In the first stage, an instrument was built to identify the skills of nurses in the hemodynamics sector based on a literature review and local observation; in the second, the instrument was validated by specialists. Data were analyzed by Content Validity Index (CVI) and CVI weighted average. Results: competency validation took place after two rounds of evaluation with specialists, resulting in a total of seven competencies related to the Nursing work process, with a weighted average CVI between 88.4 and 99.2 and 74 skills, which were classified according to the type of competence; 14 items were assessed as basic, 10 as intermediate, 34 as advanced and 16 as inconclusive. Conclusion: the professional competences for nurses working in Hemodynamics Units were built and validated by specialists, who can subsidize new guidelines on the formation and permanent education of professionals in this area.(AU)
Objetivo: construir y validar las competencias profesionales para enfermeros que trabajan en Unidades de Hemodinámica. Método: se trata de una investigación metodológica de construcción y validación de las competencias del enfermero de hemodinámica, aprobada por el Comité de Ética en Investigación bajo el protocolo nº 67891517.8.0000.5462 y realizada en la institución pública de cardiología del estado de São Paulo. En la primera etapa, se realizó la construcción de un instrumento para identificar las competencias de los enfermeros en hemodinámica a partir de la revisión bibliográfica y la observación local, y en la segunda etapa, la validación del instrumento por expertos. Los datos se analizaron mediante el Índice de Validez del Contenido (IVC) y la media ponderada del IVC. Resultados: la validación de las competencias se realizó tras dos rondas de evaluación junto a los especialistas, resultando ...(AU)
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Humanos , Competência Profissional , Educação em Enfermagem/métodos , Profissionais de Enfermagem , Guias de Prática Clínica como AssuntoRESUMO
ABSTRACT Objective: The aim of this study was to validate the content of a questionnaire in order to assess the attitudes and practices in childcare consultations, knowledge on overweight and obesity, their risk factors, and barriers in addressing the issue by pediatricians and family physicians. Methods: The Delphi technique was used, with the objective of reaching a consensus on a certain subject, through experts' opinions. The content validity index (CVI) of each item, axis, and questionnaire was calculated. The inter-rater reliability was calculated using an agreement coefficient suitable for the answer distribution such as Gwet's AC2 with ordinal weight. Results: A total of 63 experts were invited to assess and give their opinion on the questionnaire. In all, 52 accepted the invitation and analyzed the instrument. After two rounds, the questionnaire reached the proper CVI for the study and was considered complete, with its final version having 40 questions, a final index of 95%, and an inter-rate reliability of 0.905. Conclusions: This instrument, developed to assess attitudes and practices, knowledge, and barriers found in addressing the obesity by primary care physicians, obtained a CVI greater than 0.8 and an excellent agreement coefficient of the 52 judges. Therefore, its content can be considered validated.
RESUMO Objetivo: Validar o conteúdo de um questionário para a avaliação das atitudes e práticas nas consultas de puericultura, para o reconhecimento do sobrepeso e da obesidade, seus fatores de risco e barreiras encontradas para abordar o tema por pediatras e médicos da família. Métodos: Foi utilizada a técnica de Delphi, com o objetivo de alcançar um consenso sobre determinado assunto, por meio da opinião dos especialistas. Foi mensurado o índice de validade de conteúdo por item, por eixo e para o questionário geral. A concordância entre os avaliadores foi calculada utilizando-se coeficiente de concordância adequado à distribuição de respostas, tal como o AC2 de Gwet com ponderação ordinal. Resultados: Foram convidados 63 juízes para avaliar e opinar sobre o questionário. Cinquenta e dois aceitaram o convite e analisaram o instrumento. Após duas rodadas, o questionário foi finalizado por atingir o índice de validação de conteúdo (IVC) adequado para o presente estudo. O questionário final terminou com 40 questões, e o índice final do questionário atingiu 95%. O índice de concordância geral entre os juízes foi de 0,905. Conclusões: Este instrumento, construído para avaliar as atitudes e práticas, conhecimento e barreiras encontrados na abordagem do problema da obesidade por médicos da atenção básica, obteve IVC maior que 0,8 e excelente índice de concordância dos 52 juízes. Assim, seu conteúdo pode ser considerado validado.
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Resumo Objetivo Analisar a acurácia dos indicadores clínicos da proposta diagnóstica de enfermagem Ressecamento ocular em pacientes adultos em Unidade de Terapia Intensiva. Métodos Estudo de acurácia diagnóstica, com delineamento analítico transversal e de abordagem quantitativa. A amostra foi composta por 206 pacientes internados em uma unidade de terapia intensiva adulto. Foi aplicado um instrumento elaborado de acordo com variáveis relacionadas aos dados sociodemográficos, clínicos, indicadores clínicos, fatores etiológicos, população em risco e condições associadas do Ressecamento ocular . Um modelo de classe latente foi utilizado para identificação da prevalência do diagnóstico e identificação da especificidade e sensibilidade dos indicadores clínicos. Resultados Dentre os participantes do estudo, 52,4% eram do sexo masculino e apresentaram média de idade de 58,69 anos (±14,61). A prevalência do Ressecamento ocular foi de 76,22%. Os indicadores clínicos volume lacrimal diminuído e excesso de secreção mucoide apresentaram valores elevados de especificidade (81,63% e 99,99%, respectivamente). Além disso, vasos sanguíneos dilatados na superfície ocular, excesso de secreção mucoide, filamento mucoide e quemose apresentaram valores mais altos para sensibilidade (74,52%, 99,99%, 100,0% e 71,97%, respectivamente). Conclusão Após a análise da acurácia dos indicadores clínicos, conclui-se que cinco características definidoras foram capazes de apresentar valores elevados de especificidade ou sensibilidade. Este achado corrobora para uma inferência diagnóstica acurada, de modo a possibilitar a otimização de resultados com o intuito de impedir o declínio clínico referente à resposta humana indesejável Ressecamento ocular .
Resumen Objetivo Analizar la precisión de los indicadores clínicos de la propuesta diagnóstica de enfermería Sequedad ocular en pacientes adultos en Unidad de Cuidados Intensivos. Métodos Estudio de precisión diagnóstica, con diseño analítico transversal y de enfoque cuantitativo. La muestra estuvo compuesta por 206 pacientes internados en una unidad de cuidados intensivos adulta. Se aplicó un instrumento elaborado de acuerdo con variables relacionadas con datos sociodemográficos, clínicos, indicadores clínicos, factores etiológicos, población en riesgo y condiciones asociadas a la sequedad ocular . Se utilizó un modelo de clase latente para identificar la prevalencia del diagnóstico y para identificar la especificidad y sensibilidad de los indicadores clínicos. Resultados De los participantes del estudio, el 52,4 % era de sexo masculino y con edad promedio de 58,69 años (±14,61). La prevalencia de la sequedad ocular fue de 76,22 %. Los indicadores clínicos volumen lagrimal reducido y exceso de secreción mucoide presentaron valores elevados de especificidad (81,63 % y 99,99 %, respectivamente). Además, vasos sanguíneos dilatados en la superficie ocular, exceso de secreción mucoide, filamento mucoide y quemosis presentaron valores más altos de sensibilidad (74,52 %, 99,99 %, 100,0 % y 71,97 %, respectivamente). Conclusión Después del análisis de precisión de los indicadores clínicos, se concluye que cinco características definitorias fueron capaces de presentar valores elevados de especificidad o sensibilidad. Este descubrimiento corrobora una inferencia diagnóstica precisa, a fin de permitir la optimización de resultados con el objetivo de impedir el deterioro clínico referente a la respuesta humana indeseable sequedad ocular .
Abstract Objective To analyze the clinical indicator accuracy of Ocular dryness nursing diagnostic proposal in adult patients in the Intensive Care Unit. Methods This is a diagnostic accuracy study, with cross-sectional analytical design and quantitative approach. The sample consisted of 206 patients admitted to an adult Intensive Care Unit. An instrument designed according to variables related to sociodemographic and clinical data, clinical indicators, etiological factors, population at risk and associated conditions of Ocular dryness was applied. A latent class model was used to identify the prevalence of diagnosis and to identify clinical indicator specificity and sensitivity. Results Among the study participants, 52.4% were male and had a mean age of 58.69 years (±14.61). The prevalence of Ocular dryness was 76.22%. The reduced tear volume and excessive mucous secretion clinical indicators showed high specificity values (81.63% and 99.99%, respectively). Moreover, extended blood vessels on the ocular surface, excessive mucous secretion, mucoid filaments and chemosis presented higher values for sensitivity (74.52%, 99.99%, 100.0% and 71.97%, respectively). Conclusion After analyzing clinical indicator accuracy, it is concluded that five defining characteristics were able to present high values of specificity or sensitivity. This finding corroborates an accurate diagnostic inference, in order to enable the optimization of results in order to prevent the clinical decline related to the undesirable human response Ocular dryness .
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ABSTRACT Objective: To develop and validate the content of the Nurses' Work Methods Assessment Scale. Methods: Methodological study conducted between January and February 2022, based on the Quality Standards for Nursing Care and Imogene King's framework. A literature review was previously undertaken to design the scale. The content validation was carried out by 23 experts. Results: The initial version consisted of 40 items organized in four work methods identified in the literature. In the first dimension, from ten items, seven were considered, and one was reformulated. Seven of the initial ten items were considered in the second version. The third dimension consisted of seven items. In the fourth dimension, three items were reformulated, and three were excluded, leaving seven items. The final version ended with 28 items, whose Content Validity Index ranged between 0.83 and 1. Conclusions: The involvement of experts has become pivotal in the development and validation of the items, providing confidence to the continuity of psychometric procedures.
RESUMEN Objetivo: Construir y validar contenido de Escala de Evaluación de Métodos de Trabajo de Enfermeros. Métodos: Estudio metodológico realizado entre enero y febrero de 2022, basado en Estándares de Calidad de Atención de Enfermeríay referencial de Imogene King. Para construcción de Escala, realizado previamente revisión de literatura. La validez de contenido contó con 23 peritos. Resultados: La versión inicial contenía 40 items, organizados en cuatro métodos de trabajo identificados en la literatura. La primera dimensión, de diez items, fueron considerados siete y uno fue reformulado. La segunda, de diez iniciales, fueron considerados siete. La tercera dimensión constituída por siete ítems. La cuarta dimensión, reformulados tres y excluidos tres, quedando siete. La versión final quedó con 28 items, cuyo Índice de Validez de Contenido osciló entre 0,83 y 1. Conclusiones: Recorrer a peritos volvió fundamental en la construcción y validez de los items, confiriendo seguridad a continuidad de procedimientos psicométricos.
RESUMO Objetivo: Construir e validar o conteúdo da Escala de Avaliação dos Métodos de Trabalho dos Enfermeiros. Métodos: Estudo metodológico realizado entre janeiro e fevereiro de 2022, baseado nos Padrões de Qualidade dos Cuidados de Enfermagem e no referencial de Imogene King. Para construção da Escala, realizou-se previamente revisão de literatura. A validação de conteúdo contou com 23 peritos. Resultados: A versão inicial continha 40 itens, organizados nos quatro métodos de trabalho identificados na literatura. Na primeira dimensão, dos dez itens, foram considerados sete e um foi reformulado. Na segunda, dos dez iniciais, foram considerados sete. A terceira dimensão constituiu-se por sete itens. Na quarta dimensão, reformularam-se três e excluíram-se três, ficando sete. A versão final ficou com 28 itens, cujo Índice de Validade de Conteúdo oscilou entre 0,83 e 1. Conclusões: Recorrer aos peritos tornou-se fundamental na construção e validação dos itens, conferindo segurança à continuidade dos procedimentos psicométricos.
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BACKGROUND: Despite the increasing complexity of medication therapies and the expansion of pharmaceutical clinical services to optimize patient care working in collaboration with physicians. In this sense, interdisciplinary education has been encouraged. However, no instrument is available to measure attitudes toward collaborative relationships. OBJECTIVE: To translate, cross-cultural adaptation and validation an instrument to measure collaboration attitudes toward students of medicine/pharmacy and physicians/pharmacists. METHODS: The process of cross-cultural adaptation was carried out using international recommendations and was performed from January 2014 to April 2015. The instrument under consideration was translated and re-translated. A panel of experts compared the generated documents and the translation was evaluated for 20 undergraduate students of Pharmacy, 20 undergraduate students of Medicine and professionals (20 pharmacists and 20 physicians). RESULTS: The process of cross-cultural translation and validation result in the Portuguese version. Modifications to the grammatical structures were made in order to establish a cross-cultural similarity between the English and Portuguese versions. Regarding the evaluation of the expert panel, six questions required modifications. CONCLUSIONS: Psychometric evaluation demonstrated and confirmed the validity of the Brazilian-Portuguese version to assess collaborative attitudes among pharmacists and physicians. Moreover, the scale can be used to evaluate undergraduates and postgraduates and foster the development of teaching methods that promote comprehensive attitudes in patient care.
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BACKGROUND: Recent implementation of national health coverage and the increasing health burden in Indonesia require health professionals, including pharmacists, to work more collaboratively to improve access and quality of health care. Nevertheless, relatively little is known about Indonesian pharmacists' attitude towards collaboration. OBJECTIVE: To assess and compare the attitude of Indonesian pharmacy students and pharmacists towards collaboration with physicians. METHODS: A survey of 95 pharmacy students (Universitas Surabaya) and 114 pharmacists (public health facilities in East Java) in Indonesia was conducted using the validated questionnaire, Scale of Attitudes Toward Physician-Pharmacist Collaboration (SATP2C), which was translated in Bahasa Indonesia. The questionnaire contained 16 items which were based on a 4-point Likert scale. Descriptive statistics were used to summarise the responses, (i.e., individual scores, factor scores and total scores). RESULTS: Response rates of 97.9% and 65.8% were reported for students and pharmacists, respectively. The mean total score of SATP2C among Indonesian students and pharmacists were 56.53 versus 56.77, respectively; indicating positive attitudes toward collaboration. Further analysis of each item of SATP2C confirmed the positive attitudes in which mean and median scores of ≥3 were reported for most items in both groups. Significant differences between students and pharmacists were found regarding the following items: (i) 'there are many overlapping areas of responsibility between pharmacists and physicians' (3.28 versus 2.89, respectively; p<0.001), (ii) 'pharmacist should clarify a physician's order' (3.54 versus 3.71, respectively; p=0.046); and (iii) 'physicians should consult with pharmacists about adverse reactions or refractory to drug treatment' (3.60 versus 3.44, respectively; p=0.022). CONCLUSIONS: Indonesian pharmacists reported positive attitudes toward collaboration with physicians. Further research is needed to understand other factors contributing in translating those positive attitudes into actual practice, and thus, providing a good foundation for policy makers, researchers and practitioners to support pharmacist-physician collaboration in Indonesia.
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Resumo Enquadramento: O acolhimento institucional é uma estratégia protetora para crianças/adolescentes em situação de risco na qual a educação, promoção e cuidados de saúde são da responsabilidade do enfermeiro. Objetivo: Validar um protocolo de atribuições do enfermeiro em serviço de acolhimento institucional de crianças e adolescentes. Metodologia: Estudo de Delphi com duas rondas para validação de protocolo construído após revisão de literatura e pesquisa de campo. Utilizou-se um inquérito Delphi para validar o protocolo, por 12 peritos internacionais, com experiência assistencial, na docência e investigação. Considerou-se o índice de concordância mínimo de 80%. Foi utilizada a recomendação modificada para a condução e elaboração de relatórios dos estudos Delphi (CREDES). Resultados: O protocolo foi validado com um índice de concordância de 90% na segunda ronda, após convergencia entre os peritos quanto aos itens que constituem as atribuições dos enfermeiros categorizadas em "gerenciais", "assistenciais", "educativas" e "socio-políticas". Conclusão: O protocolo foi considerado válido em conteúdo e aparência, e servirá para subsidiar as atribuições do(a) enfermeiro(a) em serviços de acolhimento institucional de crianças/adolescentes.
Abstract Background: Institutional foster care is a protective strategy for children/adolescents at risk in which nurses are responsible for health education, health promotion, and health care. Objective: To validate a protocol of nurses' responsibilities in institutional foster care settings for children and adolescents. Methodology: Delphi study with two rounds for validation of the protocol that was built after a literature review and field research. A Delphi survey was used to validate the protocol by 12 international experts with experience in clinical practice, teaching, and research. The minimum agreement rate of 80% was considered. The modified Guidance on Conducting and REporting DElphi studies (CREDES) was used. Results: The protocol was validated, with an agreement rate of 90% in the second round, after expert consensus on the items related to the managerial, care, educational, and sociopolitical categories of nurses' responsibilities. Conclusion: The protocol had content and face validity and will be used to define nurses' responsibilities in institutional foster care settings for children/adolescents.
Resumen Marco contextual: El acogimiento institucional es una estrategia de protección para los niños/adolescentes en situación de riesgo en la que la educación, la promoción y el cuidado de la salud son responsabilidad del enfermero. Objetivo: Validar un protocolo de atribuciones del enfermero en el servicio de acogimiento institucional a niños y adolescentes. Metodología: Estudio Delphi con dos rondas para la validación de un protocolo construido tras la revisión de la literatura y la investigación de campo. Se utilizó una encuesta Delphi para validar el protocolo por parte de 12 expertos internacionales con experiencia en asistencia, docencia e investigación. Se consideró el índice de concordancia mínimo de 80%. Se utilizó la recomendación modificada para conducir y elaborar informes de los estudios Delphi (CREDES). Resultados: El protocolo fue validado con un índice de concordancia del 90% en la segunda ronda, tras la convergencia entre los expertos en cuanto a los ítems que constituyen las atribuciones de los enfermeros categorizadas en "directivas", "asistenciales", "educativas" y "sociopolíticas". Conclusión: El protocolo se consideró válido en cuanto a su contenido y apariencia, y servirá para subsidiar las atribuciones de los enfermeros en los servicios de acogimiento institucional de niños y adolescentes.
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ABSTRACT Objective: To analyze the content of the conceptual and operational definitions of the related factors, associated condition and defining characteristics of the nursing diagnosis "Excess fluid volume (00026)" in hemodialysis renal patients. Methods: Methodological study, of the content analysis type, with 49 specialists who reached a score equal to or greater than 5, according to Fehring's criteria. Thirty elements were evaluated for relevance, clarity, and precision. The experts' profile was analyzed using descriptive statistics, and the binomial test analyzed the agreement between them in relation to the terms. Results: The main validated indicators were "Oliguria", "Anasarca", "Paroxysmal nocturnal dyspnea", "Dyspnea", "Change in blood pressure", "Edema", "Ingestion greater than elimination" and "Increased central venous pressure". This shows that this phenomenon is present in this population. Conclusion: 29 elements were validated for relevance, clarity, and precision. This result clarifies the terms that make up the phenomenon, providing a better understanding of the concept; and assists in the accurate diagnostic proposition.
RESUMEN Objetivo: Analizar el contenido de las definiciones conceptuales y operacionales de los factores relacionados, condición asociada y características definidoras del diagnóstico de enfermería "Volumen de líquido excesivo (00026)" en pacientes renales hemodialíticos. Métodos: Estudio metodológico, del tipo análisis de contenido, con 49 especialistas que alcanzaron puntuación igual o mayor a 5, segundo criterios de Fehring. Treinta elementos fueron evaluados cuanto a la relevancia, claridad y precisión. El perfil de los especialistas fue analizado por medio de la estadística descriptiva, y la prueba binomial analizó concordancia entre ellos en relación a los términos. Resultados: Los principales indicadores validados fueron "Oliguria", "Anasarca", "Disnea paroxística nocturna", "Disnea", "Alteración en la presión arterial", "Edema", "Ingestión mayor que la eliminación" y "Aumento de la presión venosa central". Eso evidencia que tal fenómeno está presente en esa población. Conclusión: Fueron validados cuanto a la relevancia, claridad y precisión, 29 elementos. Ese resultado clarifica los términos que componen el fenómeno, confiriendo una mejor comprensión del concepto; y auxilia en la proposición diagnóstica cuidada.
RESUMO Objetivo: Analisar o conteúdo das definições conceituais e operacionais dos fatores relacionados, condição associada e características definidoras do Diagnóstico de Enfermagem "Volume de líquido excessivo (00026)" em pacientes renais hemodialíticos. Métodos: Estudo metodológico, do tipo análise de conteúdo, com 49 especialistas que atingiram pontuação igual ou maior a cinco, segundo critérios de Fehring. Trinta elementos foram avaliados quanto à relevância, clareza e precisão. O perfil dos especialistas foi analisado por meio da estatística descritiva, e o teste binomial analisou concordância entre eles em relação aos termos. Resultados: Os principais indicadores validados foram "Oligúria", "Anasarca", "Dispneia paroxística noturna", "Dispneia", "Alteração na pressão arterial", "Edema", "Ingestão maior que a eliminação" e "Aumento da pressão venosa central". Isso evidencia que tal fenômeno está presente nessa população. Conclusão: Foram validados quanto à relevância, clareza e precisão, 29 elementos. Esse resultado clarifica os termos que compõem o fenômeno, conferindo uma melhor compreensão do conceito; e auxilia na proposição diagnóstica acurada.
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Resumen Objetivo: Validar un video educativo sobre parto humanizado, dirigido al personal de salud, con el fin de fortalecer e incentivar prácticas en salud pública que aseguren el respeto de los derechos de las maternas y promuevan el bienestar del binomio madre-hijo. Metodología: Validación de tecnología educativa en formato video. Se realizó una búsqueda bibliográfica y una selección de contenidos. También se elaboró el libreto y se produjo un video, que fue validado por 6 especialistas, seleccionados según su hoja de vida, y por 222 profesionales y técnicos del área de salud, quienes atienden gestantes y maternas. Los evaluadores fueron contactados por redes sociales, usando muestreo en "bola de nieve". Se calculó el índice de validez de contenido, considerado aceptable cuando es mayor que 0,60. Resultados: Un video que expone, en 2 minutos y 20 segundos, los derechos de las gestantes y maternas, y motiva su cumplimiento. En su validación participaron 6 especialistas, 4 con título de maestría y 2 con doctorado, quienes calificaron el índice de validez de contenido con máxima puntuación. La población objetivo, principalmente médicos y enfermeras, asignaron el índice de validez de contenido entre 0,92 y 0,99, con una concordancia de 97,87. Ambos grupos hicieron comentarios positivos y dieron su aprobación al video. Conclusión: Se obtuvo un video educomunicativo corto, calificado con altos índices de validez por especialistas y público objetivo, quienes lo consideraron útil para fortalecer las prácticas de parto humanizado entre el personal de salud e incentivar el respeto de los derechos de las maternas.
Abstract Objective: To validate an educational video about humanized childbirth, aimed at healthcare workers, in order to strengthen and encourage public health practices that ensure respect for the rights of mothers and promote the well-being of the mother-infant dyad. Methodology: Validation of educational technology in video format. A bibliographic search and a selection of contents were carried out. A script was created and a video was produced, which was validated by 6 specialists, selected according to their resume, and by 222 health professionals who work with pregnant women. Evaluators were contacted by social networks, using a "snowball " sampling. The content validity index was calculated, and was considered acceptable when greater than 0.60. Results: A 2 minutes and 20 seconds video presented the rights of pregnant women and mothers in order to motivate their compliance to treatments. For video validation, 6 specialists participated, 4 hold a master's degree and 2 hold a doctorate, who rated the content validity index with the highest score. The target population, mostly doctors and nurses, assigned the content validity index between 0.92 and 0.99, with a concordance of 97.87. Both groups made positive comments and approved the video. Conclusion: A short educational video was obtained, qualified with high validity rates by specialists and target audience, who considered it useful to strengthen humanized childbirth practices among healthcare workers and encourage respect for the rights of mothers.
Resumo Objetivo: Validar um vídeo educativo sobre parto humanizado, dirigido ao pessoal da área de saúde, com o objetivo de fortalecer e incentivar as práticas em saúde pública que possam garantir o respeito aos direitos das gestantes e que promova o bem-estar do binômio mãe-filho. Metodologia: Validação da tecnologia educacional em formato de vídeo. Foram realizadas uma pesquisa bibliográfica e uma seleção de conteúdos. Além disso, foi elaborado um texto para a produção do vídeo, validado por 6 especialistas, selecionados de acordo a seus Curricula Vitae e por 222 profissionais e técnicos da área de saúde, os quais atendem a gestantes e puérperas. Os avaliadores foram contatados pelas redes sociais, usando amostragem em "bola de neve". Foi calculado o índice de validade de conteúdo e se considera aceitável quando seja superior a 0,60. Resultados: Um vídeo que expõe, em 2 minutos e 20 segundos, os direitos das gestantes e puérperas e motiva seu cumprimento. Em sua validação participaram 6 especialistas, 4 com títulos de mestrado e 2 com doutorado, os quais deram a nota máxima ao índice de validade de conteúdo. O público-alvo, principalmente médicos e enfermeiras, designou o índice de validade do conteúdo entre 0,92 e 0,99 com uma concordância de 97,87. Ambos os grupos fizeram comentários positivos e deram sua aprovação ao vídeo. Conclusão: Foi obtido um vídeo educomunicativo curto, qualificado com altos índices de validade por especialistas e público-alvo, que o consideraram útil para fortalecer as práticas de parto humanizado entre o pessoal da área de saúde e incentivar o respeito aos direitos das gestantes.