RESUMEN
Although self-report instruments are currently considered a valuable tool for measuring adherence, due to their low cost and ease of implementation, there are still important factors that impact measurement accuracy, such as social desirability and memory bias. Thus, the Global Assessment of Medication Adherence Instrument (GEMA) was developed to provide an accurate measure of this construct. The aim of this study was to evaluate the properties of the measurement of the Global Evaluation of Medication Adherence Instrument (GEMA) among patients with chronic diseases. A methodological study was conducted in the public hospital of the state of São Paulo, Brazil. The adherence to anticoagulants as well as the international normalized ratio (INR) was assessed on 127 patients. Besides GEMA, two other instruments were used to assess adherence: the Morisky Medication Adherence Scale-8 (MMAS-8) and the Measurement of Adhesion to Treatments (MAT). The GEMA presented a satisfactory level of specificity (0.76) to identify adherents among those with a stable INR, low sensitivity (0.43) for the identification of non-adherents among those with an unstable INR, and a Positive Predictive Value of 0.70. Positive and weak to moderate correlations were observed between the proportion of doses assessed with GEMA and the scores on the MMAS-8 (r = .26 and r = .22, respectively) and the MAT (r = .22 and r = .30, respectively). The GEMA presented good practicality, acceptability, and evidence of specificity regarding the stability of the INR. The validity of the construct was partially supported by the relationship with self-reported measures of adherence.
Asunto(s)
Anticoagulantes , Cumplimiento de la Medicación , Humanos , Psicometría , Reproducibilidad de los Resultados , Brasil , Anticoagulantes/uso terapéuticoRESUMEN
Objective: Identifying and describing the knowledge of graduate students of the first semester of medicine and nursing course at a Brazilian College, related to the subject of first aid before and after the conduct of training guided by active methods of teaching-learning. Method: this research is a quasi-experimental type pre-test/post-test, conducted in a Brazilian city in 2009. The sample was non-probabilistic and included 110 students who were enrolled in that series of both courses. There was used a pre-test/post-test consisting of closed questions. Data were analyzed using descriptive parametric statistics. Results: among the participants, 35 students were enrolled in nursing course and 75 in the medicine course, with an average age of 24 years old. There was a significantly higher score on the post-test compared to the pre-test. Conclusion: the training showed up as a valid strategy for the training of graduate students. It is suggested its dissemination beyond the academic realm.
Objetivo: Identificar e descrever o conhecimento de estudantes da primeira série de medicina e enfermagem de uma faculdade estadual, relacionado à temática de primeiros socorros, antes e após a realização de um treinamento norteado por metodologias ativas de ensino-aprendizagem. Método: esta pesquisa é um quase experimento do tipo pré-teste/pós-teste, conduzida em uma cidade paulista em 2009. A amostra foi não probabilística e compreendeu 110 estudantes que estavam matriculados naquela série de ambos os cursos. Utilizou-se um pré-teste e um pós-teste composto por questões fechadas. Os dados foram analisados por estatística descritiva e estatística paramétrica. Resultados: dos participantes, 35 eram estudantes de enfermagem e 75 estudantes de medicina, com idade média de 24 anos. Houve um aumento significativo de acertos no pós-teste, comparativamente ao pré-teste, obtendo significância estatística em 10 assertivas. Conclusão: o treinamento mostrou-se como uma estratégia válida de capacitação dos estudantes. Sugere-se sua difusão para além do âmbito acadêmico.
Objetivo: Identificar y describir el conocimiento de estudiantes del primer semestre de medicina y enfermeria de una universidad brasileña, acerca de primeros auxilios, antes y despues de una capacitación enfocada en dos metodologias de aprendizaje activa. Método: es un estudio quase-experimental del tipo preprueba y post-prueba, acontecío en una ciudad brasileña en 2009. La muestra no-probabilística fue composta por 110 estudiantes matriculados en el primer semestre de los dos cursos. Se usó preprueba y post-prueba con preguntas cerradas. Se analizaron los datos por la estatística descriptiva y estatística paramétrica. Resultados: de los 110 estudiantes, 35 eran de enfermeria y 75 de medicina, con una média de edad de 24 años. Hubo una mejora de aciertos en la post-prueba, comparado con la preprueba, obteniendo significancia estatística en 10 preguntas. Conclusión: la capacitacíon se parece una estratégia válida para el entrenamiento de estudiantes. Sugere su propagación más allá del ámbito académico.
