Translation, cross-cultural adaptation and validation of the sickle cell self-efficacy scale (SCSES)

ABSTRACT Objective: To translate, cross-culturally adapt and validate the Sickle Cell Self-Efficacy Scale for application in the Brazilian cultural context. Methods: This is a methodological study performed in 6 steps: 1- Forward translation; 2- Translation synthesis; 3- Back-translation; 4- Assessment by expert committee, with computation of the Content Validity Index (CVI); 5- Cultural adequacy (pre-test); 6- Reproducibility. A pre-test was performed with the participation of 10 adolescents/young adults with sickle cell disease through a telephone call and their responses were recorded on a form in a web platform. The instrument validation step was carried out with 55 adolescents/young adults with sickle cell disease, 43 of them having participated in the retest. The analysis of internal consistency and reproducibility was calculated using the Cronbach's alpha coefficient and the Intraclass Correlation Coefficient (ICC), in the R statistical programming environment. Results: The translated instrument had good acceptance among the experts, reaching an average CVI of 1.0. In assessing reliability, the scale showed acceptable internal consistency, with a Cronbach's alpha of 0.84. In the agreement analysis, the ICC was 0.923 (95% CI: 0.857 to 0.958), which indicates good temporal reproducibility. Conclusions: Following the process of translation, cross-cultural adaptation and validation, we obtained the Brazilian version of the Sickle Cell Self-Efficacy Scale, considered valid and reliable to be applied to adolescents and young adults with sickle cell disease in Brazil.

Construction and Validation of a Protocol Targeting Patients on Oral Anticoagulation with Warfarin. / Construção e Validação do Protocolo EmpoderACO Direcionado a Pacientes em Anticoagulação Oral com Varfarina.

BACKGROUND: Warfarin is an oral anticoagulant that is very useful in preventing thromboembolism, though it is considered a drug with a high risk of causing adverse events. Considering the practical challenges in controlling oral anticoagulation, the patients on warfarin could benefit from educational strategies aimed at behavioral changes, active participation in self-care, and adherence to drug therapy. OBJECTIVE: The aim was to construct and validate the EmpoderACO protocol for behavioral changes in warfarin patients. METHODS: The methodological steps were: definition of concepts and domains of self-care, identification of objectives, construction and selection of items, assessment of content validity, and pre-test in the target population. RESULTS: Relevance, adequacy, clarity, and internal reliability of the instrument's items were assessed by a multidisciplinary judges committee (JC) through the E-surv web platform, obtaining an average agreement of ≥0.91. The understanding of the instrument measured by the target population revealed adequate clarity with a coefficient average of 0.96. CONCLUSION: EmpoderACO can aid in qualifying the communication process between medical professionals and patients, as well as in improving adherence to both treatment and clinical outcomes, and can be replicated in healthcare settings.

FUNDAMENTO: A varfarina é um anticoagulante oral útil para prevenção de tromboembolismo, embora seja considerado fármaco de alto risco de causar eventos adversos. Considerando os desafios práticos no controle da anticoagulação oral, os pacientes poderiam se beneficiar de estratégias educacionais que visem mudança de comportamento, participação ativa no autocuidado e adesão à farmacoterapia. OBJETIVO: Construir e validar o protocolo EmpoderACO para mudança de comportamento em pacientes em uso de varfarina. MÉTODOS: As etapas metodológicas foram: definição de conceitos e domínios do autocuidado, identificação dos objetivos, construção e seleção dos itens, avaliação da validade de conteúdo e pré-teste na população alvo. RESULTADOS: Relevância, adequação, clareza e confiabilidade interna dos itens do instrumento foram avaliadas por comitê de juízes multiprofissional pela plataforma web E-surv, obtendo-se média de concordância ≥0,91. A compreensão do instrumento pela população-alvo teve clareza adequada com média de 0,96. CONCLUSÃO: O EmpoderACO poderá contribuir para qualificar o processo de comunicação entre profissionais e pacientes, melhorar a adesão ao tratamento e os resultados clínicos, podendo ser replicado nos serviços de saúde.

Usability of Telehealth Systems for Noncommunicable Diseases in Primary Care From the COVID-19 Pandemic Onward: Systematic Review.

BACKGROUND: During the COVID-19 pandemic, telehealth was expanded without the opportunity to extensively evaluate the adopted technology's usability. OBJECTIVE: We aimed to synthesize evidence on health professionals' perceptions regarding the usability of telehealth systems in the primary care of individuals with noncommunicable diseases (NCDs; hypertension and diabetes) from the COVID-19 pandemic onward. METHODS: A systematic review was performed of clinical trials, prospective cohort studies, retrospective observational studies, and studies that used qualitative data collection and analysis methods published in English, Spanish, and Portuguese from March 2020 onward. The databases queried were MEDLINE, Embase, BIREME, IEEE Xplore, BVS, Google Scholar, and grey literature. Studies involving health professionals who used telehealth systems in primary care and managed patients with NCDs from the COVID-19 pandemic onward were considered eligible. Titles, abstracts, and full texts were reviewed. Data were extracted to provide a narrative qualitative evidence synthesis of the included articles. The risk of bias and methodological quality of the included studies were analyzed. The primary outcome was the usability of telehealth systems, while the secondary outcomes were satisfaction and the contexts in which the telehealth system was used. RESULTS: We included 11 of 417 retrieved studies, which had data from 248 health care professionals. These health care professionals were mostly doctors and nurses with prior experience in telehealth in high- and middle-income countries. Overall, 9 studies (82%) were qualitative studies and 2 (18%) were quasiexperimental or multisite trial studies. Moreover, 7 studies (64%) addressed diabetes, 1 (9%) addressed diabetes and hypertension, and 3 (27%) addressed chronic diseases. Most studies used a survey to assess usability. With a moderate confidence level, we concluded that health professionals considered the usability of telehealth systems to be good and felt comfortable and satisfied. Patients felt satisfied using telehealth. The most important predictor for using digital health technologies was ease of use. The main barriers were technological challenges, connectivity issues, low computer literacy, inability to perform complete physical examination, and lack of training. Although the usability of telehealth systems was considered good, there is a need for research that investigates factors that may influence the perceptions of telehealth usability, such as differences between private and public services; differences in the level of experience of professionals, including professional experience and experience with digital tools; and differences in gender, age groups, occupations, and settings. CONCLUSIONS: The COVID-19 pandemic has generated incredible demand for virtual care. Professionals' favorable perceptions of the usability of telehealth indicate that it can facilitate access to quality care. Although there are still challenges to telehealth, more than infrastructure challenges, the most reported challenges were related to empowering people for digital health. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42021296887; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=296887. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.21801/ppcrj.2022.82.6.

Evaluating User Experience With a Chatbot Designed as a Public Health Response to the COVID-19 Pandemic in Brazil: Mixed Methods Study.

BACKGROUND: The potential of chatbots for screening and monitoring COVID-19 was envisioned since the outbreak of the disease. Chatbots can help disseminate up-to-date and trustworthy information, promote healthy social behavior, and support the provision of health care services safely and at scale. In this scenario and in view of its far-reaching postpandemic impact, it is important to evaluate user experience with this kind of application. OBJECTIVE: We aimed to evaluate the quality of user experience with a COVID-19 chatbot designed by a large telehealth service in Brazil, focusing on the usability of real users and the exploration of strengths and shortcomings of the chatbot, as revealed in reports by participants in simulated scenarios. METHODS: We examined a chatbot developed by a multidisciplinary team and used it as a component within the workflow of a local public health care service. The chatbot had 2 core functionalities: assisting web-based screening of COVID-19 symptom severity and providing evidence-based information to the population. From October 2020 to January 2021, we conducted a mixed methods approach and performed a 2-fold evaluation of user experience with our chatbot by following 2 methods: a posttask usability Likert-scale survey presented to all users after concluding their interaction with the bot and an interview with volunteer participants who engaged in a simulated interaction with the bot guided by the interviewer. RESULTS: Usability assessment with 63 users revealed very good scores for chatbot usefulness (4.57), likelihood of being recommended (4.48), ease of use (4.44), and user satisfaction (4.38). Interviews with 15 volunteers provided insights into the strengths and shortcomings of our bot. Comments on the positive aspects and problems reported by users were analyzed in terms of recurrent themes. We identified 6 positive aspects and 15 issues organized in 2 categories: usability of the chatbot and health support offered by it, the former referring to usability of the chatbot and how users can interact with it and the latter referring to the chatbot's goal in supporting people during the pandemic through the screening process and education to users through informative content. We found 6 themes accounting for what people liked most about our chatbot and why they found it useful-3 themes pertaining to the usability domain and 3 themes regarding health support. Our findings also identified 15 types of problems producing a negative impact on users-10 of them related to the usability of the chatbot and 5 related to the health support it provides. CONCLUSIONS: Our results indicate that users had an overall positive experience with the chatbot and found the health support relevant. Nonetheless, qualitative evaluation of the chatbot indicated challenges and directions to be pursued in improving not only our COVID-19 chatbot but also health chatbots in general.

Tradução, adaptação cultural e validação do Instrumento de Autoavaliação em Diabetes / Translation, cultural adaptation and validation of the diabetes self-report tool / Traducción, adaptación cultural y validación de la herramienta de autoevaluación de la diabetes

Objetivo: realizar tradução, adaptação cultural e validação do Instrumento de Autoavaliação em Diabetes para aplicação no contexto brasileiro. Métodos: estudo metodológico realizado com 132 profissionais, entre os anos de 2016 e 2018, em seis etapas: 1 - Tradução inicial; 2 - Síntese da tradução; 3 - Retrotradução (back translation); 4 - Avaliação pelo comitê de juízes; 5 - Adequação cultural (pré teste); e 6 - Reprodutibilidade. Houve participação de profissionais de equipes multiprofissionais envolvidas no tratamento do diabetes por meio da plataforma e-surv. Resultados: entre os participantes, predominaram o sexo feminino (73,5%), profissionais com especialização (pós-graduação Lato Sensu) (51,5%) e com experiência na assistência a pessoas com diabetes (84,4%). O Índice de Validade de Conteúdo (IVC) foi satisfatório (0,850). O instrumento apresentou boa consistência interna (Alfa de Cronbach = 0,878). A análise de confiabilidade do instrumento, realizada pelo cálculo do coeficiente de correlação intraclasse (CCI), indicou concordância adequada em todas as medidas, 0,878 (IC 95%: 0,864 - 0,891), com Kappa Ponderado médio de 0,714 e índices acima de 0,60 em 85% os itens, mostrando boa concordância teste e reteste. Conclusão: a versão traduzida e culturalmente adaptada do Instrumento d e Autoavaliação em Diabetes apresentou boa confiabilidade, aceitabilidade e estabilidade temporal satisfatórias conforme os parâmetros internacionais, podendo ser utilizada, pelos profissionais da saúde, para autoavaliação em diabetes.(AU)

Objective: to carry out translation, cultural adaptation, and validation of the Diabetes Self-Report Instrument for application in the Brazilian context. Methods: methodological study carried out with 132 professionals, between 2016 and 2018, in six steps: 1 - Initial translation; 2 - Synthesis of the translation; 3 - Back translation; 4 - Evaluation by the judging committee; 5 - Cultural adequacy (pre-test); and 6 - Reability. There was participation of professionals from multidisciplinary teams involved in the treatment of diabetes through the e-surv platform. Results: among the participants, there was a predominance of females (73.5%), professionals with specialization (Lato sensu postgraduate degree) (51.5%) and with experience in caring for people with diabetes (84.4%). The Content Validity Index (CVI) was satisfactory (0.850). The instrument showed good internal consistency (Cronbach's alpha=0.878). The instrument's reliability analysis, carried out by calculating the intraclass correlation coefficient (ICC), indicated adequate agreement in all measurements, 0.878 (95% CI: 0.864 - 0.891), with mean weighted Kappa of 0.714 and indices above 0. 60 out of 85% of the items, showing good test-retest agreement. Conclusion: the translated and culturally adapted version of the Diabetes Self-report Instrument showed good reliability, acceptability, and satisfactory temporal stability according to international parameters, and can be used by healthcare professionals for self-report of diabetes.(AU)

Objetivo: realizar la traducción, adaptación cultural y validación de la Herramienta de Autoevaluación de Diabetes para aplicación en el contexto brasileño. Métodos: estudio metodológico realizado con 132 profesionales, entre 2016 y 2018, en seis etapas: 1 ­ Traducción inicial; 2 ­ Síntesis de la traducción; 3 ­ Traducción inversa; 4 ­ Evaluación por el comité de jueces; 5 ­ Adecuación cultural (pre-test); y 6 ­ Reproducibilidad. Se contó con la participación de profesionales de equipos multidisciplinarios...(AU)

Translation, cross-cultural adaptation and validation of the sickle cell self-efficacy scale (SCSES).

OBJECTIVE: To translate, cross-culturally adapt and validate the Sickle Cell Self-Efficacy Scale for application in the Brazilian cultural context. METHODS: This is a methodological study performed in 6 steps: 1- Forward translation; 2- Translation synthesis; 3- Back-translation; 4- Assessment by expert committee, with computation of the Content Validity Index (CVI); 5- Cultural adequacy (pre-test); 6- Reproducibility. A pre-test was performed with the participation of 10 adolescents/young adults with sickle cell disease through a telephone call and their responses were recorded on a form in a web platform. The instrument validation step was carried out with 55 adolescents/young adults with sickle cell disease, 43 of them having participated in the retest. The analysis of internal consistency and reproducibility was calculated using the Cronbach's alpha coefficient and the Intraclass Correlation Coefficient (ICC), in the R statistical programming environment. RESULTS: The translated instrument had good acceptance among the experts, reaching an average CVI of 1.0. In assessing reliability, the scale showed acceptable internal consistency, with a Cronbach's alpha of 0.84. In the agreement analysis, the ICC was 0.923 (95% CI: 0.857 to 0.958), which indicates good temporal reproducibility. CONCLUSIONS: Following the process of translation, cross-cultural adaptation and validation, we obtained the Brazilian version of the Sickle Cell Self-Efficacy Scale, considered valid and reliable to be applied to adolescents and young adults with sickle cell disease in Brazil.

Construção e Validação do Protocolo EmpoderACO Direcionado a Pacientes em Anticoagulação Oral com Varfarina / Construction and Validation of a Protocol Targeting Patients on Oral Anticoagulation with Warfarin

Resumo Fundamento A varfarina é um anticoagulante oral útil para prevenção de tromboembolismo, embora seja considerado fármaco de alto risco de causar eventos adversos. Considerando os desafios práticos no controle da anticoagulação oral, os pacientes poderiam se beneficiar de estratégias educacionais que visem mudança de comportamento, participação ativa no autocuidado e adesão à farmacoterapia. Objetivo Construir e validar o protocolo EmpoderACO para mudança de comportamento em pacientes em uso de varfarina. Métodos As etapas metodológicas foram: definição de conceitos e domínios do autocuidado, identificação dos objetivos, construção e seleção dos itens, avaliação da validade de conteúdo e pré-teste na população alvo. Resultados Relevância, adequação, clareza e confiabilidade interna dos itens do instrumento foram avaliadas por comitê de juízes multiprofissional pela plataforma web E-surv, obtendo-se média de concordância ≥0,91. A compreensão do instrumento pela população-alvo teve clareza adequada com média de 0,96. Conclusão O EmpoderACO poderá contribuir para qualificar o processo de comunicação entre profissionais e pacientes, melhorar a adesão ao tratamento e os resultados clínicos, podendo ser replicado nos serviços de saúde.

Abstract Background Warfarin is an oral anticoagulant that is very useful in preventing thromboembolism, though it is considered a drug with a high risk of causing adverse events. Considering the practical challenges in controlling oral anticoagulation, the patients on warfarin could benefit from educational strategies aimed at behavioral changes, active participation in self-care, and adherence to drug therapy. Objective The aim was to construct and validate the EmpoderACO protocol for behavioral changes in warfarin patients. Methods The methodological steps were: definition of concepts and domains of self-care, identification of objectives, construction and selection of items, assessment of content validity, and pre-test in the target population. Results Relevance, adequacy, clarity, and internal reliability of the instrument's items were assessed by a multidisciplinary judges committee (JC) through the E-surv web platform, obtaining an average agreement of ≥0.91. The understanding of the instrument measured by the target population revealed adequate clarity with a coefficient average of 0.96. Conclusion EmpoderACO can aid in qualifying the communication process between medical professionals and patients, as well as in improving adherence to both treatment and clinical outcomes, and can be replicated in healthcare settings.

Brazilian version of "The Insulin Delivery System Rating Questionnaire": translation, cross-cultural adaptation and validation.

OBJECTIVE: The aim of this study was to translate and cross-culturally adapt the Insulin Delivery System Rating Questionnaire (IDSRQ) for Brazilian users. Validation and reliability analysis of measures were also performed. METHODS: Methodological study comprising the following stages: forward translation, synthesis, back-translation, assessment by Expert Committee, pre-test and validation. International guidelines for translation and cross-cultural adaptation of measurement tools were followed. Validation data provided information about reliability (internal consistency, test-retest) and construct validity of the IDSRQ. RESULTS: Content validation by Experts' assessment was successful, with a mean Content Validity Index of 0.87 (±0.2). The IDSRQ validation study involved 113 T1DM patients, 46% male, mean age 32.61 (±12.59) years and mean age at diagnosis of diabetes of 17.51 (±12.41). The scale presented good internal consistency (Cronbach's alpha =0.786). The reliability analysis of the instrument was conducted by calculating the Intra-class Correlation Coefficient 0.885 (0.834-0.921), which indicated adequate concordance in all measures. CONCLUSION: The translated and cross-culturally adapted Brazilian Portuguese version of the IDSRQ may be used to assess health-related quality of life (HRQOL) and treatment preferences for insulin delivery systems in T1DM Brazilian patients.

Development and validation of an instrument (CSII - Brazil) to assess users' conceptual and procedural knowledge of continuous subcutaneous infusion systems

ABSTRACT Objective: To develop, adapt and validate an instrument named "CSII - Brazil" to assess users' conceptual and procedural knowledge of continuous subcutaneous insulin infusion systems. Materials and methods: Methodological and exploratory study developed in three stages: a) instrument development; b) content validation and cultural adaptation (evaluation by a committee of experts and pre-test with CSII users); c) psychometric validation through instrument application in a sample of 60 patients by means of the web tool e-Surv. Internal consistency and reproducibility analyses were performed within IBM SPSS Statistics 20 programming environment. Results: The 16 multiple-choice question instrument successfully attained a content validity index of 0.97, showing satisfactory internal consistency, with 0.61 Cronbach's alpha [95% CI 0.462-0.746] and an intraclass correlation coefficient of 0.869 [95% CI: 0.789-0.919] between the test and retest scores. Conclusion: The CSII - Brazil instrument is considered adequate and validated to assess continuous subcutaneous infusion system users' conceptual and procedural knowledge.

Empowerment-oriented strategies to identify behavior change in patients with chronic diseases: An integrative review of the literature.

BACKGROUND: Chronic diseases in the Americas account for about 80 % (5.2 million) of all deaths. Instruments are needed to enhance knowledge, skills, behavior change and self-care attitudes drawing on patient autonomy. OBJECTIVE: To identify empowerment-oriented strategies focused on behavioral change in patients with chronic diseases. PATIENT INVOLVEMENT: None. METHODS: This is an integrative review of articles published from any period until June 2020 by journals indexed in the following databases: National Library of Medicine National Institutes of Health (PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Biblioteca Virtual em Saúde (BVS). RESULTS: Out of 1,287 articles, 25 met our selection criteria. Reported health interventions were based on self-management and behavior change, shared decisions and a personalized collaborative process, peer support and self-confidence, as well as strategies involving educational media and health literacy. DISCUSSION: Over 80 % of health interventions were patient-centered and focused on patient knowledge and skill development towards personal goal setting, including effective problem-solving strategy development. Behavior change is not only an outcome of education, but also implicates revisiting values, attitudes, and experiences. Knowledge is important to facilitate decision-making leading to positive outcomes in chronic disease management. PRACTICAL VALUE: Empowerment-oriented strategies are important tools for providing trust and motivation to people with chronic diseases. Healthcare professionals should support and encourage patient empowerment as a strategy for behavior change and able to offer qualified care for shared decision making. Thus, patients will be able to participate more actively in their own health condition management and to make decisions to promote self-care.

Development and validation of an instrument (CSII - Brazil) to assess users' conceptual and procedural knowledge of continuous subcutaneous infusion systems.

OBJECTIVE: To develop, adapt and validate an instrument named "CSII - Brazil" to assess users' conceptual and procedural knowledge of continuous subcutaneous insulin infusion systems. METHODS: Methodological and exploratory study developed in three stages: a) instrument development; b) content validation and cultural adaptation (evaluation by a committee of experts and pre-test with CSII users); c) psychometric validation through instrument application in a sample of 60 patients by means of the web tool e-Surv. Internal consistency and reproducibility analyses were performed within IBM SPSS Statistics 20 programming environment. RESULTS: The 16 multiple-choice question instrument successfully attained a content validity index of 0.97, showing satisfactory internal consistency, with 0.61 Cronbach's alpha [95% CI 0.462-0.746] and an intraclass correlation coefficient of 0.869 [95% CI: 0.789-0.919] between the test and retest scores. CONCLUSION: The CSII - Brazil instrument is considered adequate and validated to assess continuous subcutaneous infusion system users' conceptual and procedural knowledge.

Latino Students Patient Safety Questionnaire: cross-cultural adaptation for Brazilian nursing and medical students.

OBJECTIVES: to perform a cross-cultural adaptation of the Latino Student Patient Safety Questionnaire for Brazilian Nursing and Medical students. METHODS: methodological study carried out in six stages - forward translation, synthesis, back-translation, expert committee assessment, pre-test and reporting to the authors of the original instrument. Data at the expert committee and pre-test stages were collected and analyzed using the web platform e-Surv. The level of agreement adopted for the expert committee evaluation with 20 participants and the pre-test evaluation with 38 students was ≥ 90%. RESULTS: the first evaluation round by the expert committee showed a <90% agreement for 21 out of the 26 questionnaire items, requiring adjustments. In the pre-test, three items in the instrument reached a <90% agreement and were revised to obtain the final version. CONCLUSIONS: the Brazilian version of the Latino Student Patient Safety Questionnaire instrument was considered culturally adapted to Brazilian Portuguese.

Brazilian version of "The Insulin Delivery System Rating Questionnaire": translation, cross-cultural adaptation and validation

ABSTRACT Objective The aim of this study was to translate and cross-culturally adapt the Insulin Delivery System Rating Questionnaire (IDSRQ) for Brazilian users. Validation and reliability analysis of measures were also performed. Materials and methods Methodological study comprising the following stages: forward translation, synthesis, back-translation, assessment by Expert Committee, pre-test and validation. International guidelines for translation and cross-cultural adaptation of measurement tools were followed. Validation data provided information about reliability (internal consistency, test-retest) and construct validity of the IDSRQ. Results Content validation by Experts' assessment was successful, with a mean Content Validity Index of 0.87 (±0.2). The IDSRQ validation study involved 113 T1DM patients, 46% male, mean age 32.61 (±12.59) years and mean age at diagnosis of diabetes of 17.51 (±12.41). The scale presented good internal consistency (Cronbach's alpha =0.786). The reliability analysis of the instrument was conducted by calculating the Intra-class Correlation Coefficient 0.885 (0.834-0.921), which indicated adequate concordance in all measures. Conclusion The translated and cross-culturally adapted Brazilian Portuguese version of the IDSRQ may be used to assess health-related quality of life (HRQOL) and treatment preferences for insulin delivery systems in T1DM Brazilian patients.

Elaboração, validação e adequação de protocolo para aplicativo em diabetes tipo 1 / Elaboración, validación y adaptación de protocolo para aplicación en diabetes tipo 1 / Development, validation and adaptation of a protocol for a self-management app targeting adolescents with type 1 diabetes

Resumo Objetivo Elaborar, efetuar a validação de conteúdo e a adequação cultural do protocolo AGITO no autocuidado em diabetes tipo 1. Métodos Estudo metodológico realizado no período de fevereiro de 2017 a março de 2019, abrangendo três etapas: elaboração, validação de conteúdo e adequação cultural. Foram contemplados os principais temas de práticas de autocuidado em diabetes tipo 1, concernentes a aspectos educacionais, psicossociais e comportamentais. Na 2ª etapa, 32 profissionais da área da Saúde foram convidados a participar do Comitê de Juízes. A etapa final compreendeu dois ciclos de testes face a face do protocolo com 10 adolescentes com diabetes tipo 1. Resultados O protocolo de autocuidado em diabetes tipo 1 nomeado AGITO foi consolidado em seis seções, denominadas: Glicemia de Jejum; Glicemia antes do almoço; Glicemia antes do lanche da tarde; Glicemia antes do jantar; Glicemia antes do lanche de dormir; e Saúde Emocional. Cada seção do protocolo tem opções de respostas que o adolescente poderá marcar de acordo com a situação vivenciada para o controle glicêmico. A concordância entre os avaliadores e a população-alvo quanto à clareza e relevância dos itens foi confirmada pelo Índice de Validade de Conteúdo, que apresentou variação das médias entre 0,90 e 1,0. As principais alterações realizadas foram a inclusão de termos mais utilizados no cotidiano dos adolescentes. Conclusão Este estudo fornece o protocolo AGITO com conteúdo validado, configurando-se um componente passível de ser utilizado como uma estratégia para o autocuidado em diabetes tipo 1 para adolescentes.

Resumen Objetivo Elaborar, realizar la validación de contenido y adaptación cultural del protocolo AGITO para el autocuidado en diabetes tipo 1. Métodos Estudio metodológico realizado en el período de febrero de 2017 a marzo de 2019, que incluyó tres etapas: elaboración, validación del contenido y adaptación cultural. Fueron contemplados los principales temas sobre prácticas de autocuidado en diabetes tipo 1, relacionados con aspectos educativos, psicosociales y de comportamiento. En la segunda etapa, se invitó a 32 profesionales de la salud para participar en el Comité de Jueces. La etapa final consistió en dos ciclos de pruebas del protocolo cara a cara con 10 adolescentes con diabetes tipo 1. Resultados El protocolo de autocuidado en diabetes tipo 1 llamado AGITO fue consolidado en seis secciones denominadas: Glucemia en ayunas, Glucemia antes del almuerzo, Glucemia antes de la colación de la tarde, Glucemia antes de la cena, Glucemia antes de la colación de dormir y Salud emocional. Cada sección del protocolo tiene opciones de respuestas que el adolescente podrá marcar de acuerdo con la situación vivida para el control glucémico. La concordancia entre los evaluadores y la población destinataria respecto a la claridad y relevancia de los ítems fue confirmada por el Índice de Validez de Contenido, que presentó variación de los promedios entre 0,90 y 1,0. Las principales modificaciones realizadas fueron inclusiones de términos más utilizados en el día a día de los adolescentes. Conclusión Este estudio proporciona el protocolo AGITO con contenido validado y, de esta forma, se convierte en un componente apto para utilizarse como estrategia para el autocuidado en diabetes tipo 1 para adolescentes.

Abstract Objective To develop, validate and adapt a protocol for a self-management app targeting adolescents with type 1 diabetes. Methods Methodological study conducted from February 2017 to March 2019 in three stages: development; content validation; and adaptation. In stage 1, the main issues about self-management practices in type 1 diabetes were discussed regarding educational, psychosocial and behavioral aspects. In stage 2, 32 healthcare professionals were invited to participate as members of the Expert Committee. Stage 3 comprised two of face-to-face tests of the protocol with 10 type 1 diabetes adolescents. Result The type 1 diabetes self-management protocol called AGITO was developed covering six sections: Fasting blood sugar level, blood sugar level before lunch, blood sugar level before an afternoon snack, blood sugar level before dinner, blood sugar level before a bedtime snack, and emotional health. Each section of the protocol has multiple items that are answered by each adolescent according to his/her glycemic control situation. Agreement between the evaluators and the target population regarding the clarity and relevance of the items was confirmed by the content validity index, which ranged from 0.90 to 1.0. Adaptation was carried out to make sure the language in the protocol is closely patterned upon the vocabulary most frequently used by adolescents in their daily lives. Conclusion The AGITO protocol was developed and its content validated, allowing it to be used as a self-management strategy for adolescents with type 1 diabetes.

Latino Students Patient Safety Questionnaire: cross-cultural adaptation for Brazilian nursing and medical students / Latino Students Patient Safety Questionnaire: adaptación transcultural para estudiantes brasileños de enfermería y de medicina / Latino Students Patient Safety Questionnaire: adaptação transcultural para estudantes brasileiros de enfermagem e de medicina

ABSTRACT Objectives: to perform a cross-cultural adaptation of the Latino Student Patient Safety Questionnaire for Brazilian Nursing and Medical students. Methods: methodological study carried out in six stages — forward translation, synthesis, back-translation, expert committee assessment, pre-test and reporting to the authors of the original instrument. Data at the expert committee and pre-test stages were collected and analyzed using the web platform e-Surv. The level of agreement adopted for the expert committee evaluation with 20 participants and the pre-test evaluation with 38 students was ≥ 90%. Results: the first evaluation round by the expert committee showed a <90% agreement for 21 out of the 26 questionnaire items, requiring adjustments. In the pre-test, three items in the instrument reached a <90% agreement and were revised to obtain the final version. Conclusions: the Brazilian version of the Latino Student Patient Safety Questionnaire instrument was considered culturally adapted to Brazilian Portuguese.

RESUMEN Objetivos: realizar la adaptación transcultural del Latino Students Patient Safety Questionnaire para estudiantes brasileños de enfermería y de medicina. Métodos: estudio metodológico realizado en seis etapas — traducción, síntesis de las traducciones, retrotraducción, comité de especialistas, pre-prueba y presentación de los informes para los autores del instrumento original. Los datos de las etapas "comité de especialistas" y pre-prueba se recogieron y analizaron por medio de la plataforma web e-Surv. El nivel de concordancia adoptado para evaluar las respuestas del comité formado por 20 especialistas y de los 38 estudiantes en el pre- prueba fue de ≥ 90%. Resultados: en la primera rodada de evaluación por el comité de especialistas, 21 de los 26 ítems del cuestionario presentaron concordancia < 90%, necesitando de ajustes. En el pre-prueba, tres afirmativas del instrumento tuvieron concordancia < 90% y, fueron reformuladas en la versión final. Conclusiones: la versión brasileña del instrumento Latino Students Patient Safety Questionnaire ha sido considerada adaptada culturalmente para el portugués brasileño.

RESUMO Objetivos: realizar a adaptação transcultural do Latino Students Patient Safety Questionnaire para estudantes brasileiros de Enfermagem e de Medicina. Métodos: estudo metodológico realizado em seis etapas — tradução, síntese das traduções, retrotradução, comitê de especialistas, pré-teste e apresentação dos relatórios para os autores do instrumento original. Os dados das etapas "comitê de especialistas" e "pré-teste" foram coletados e analisados por meio da plataforma web e-Surv. O nível de concordância adotado entre as respostas do comitê formado por 20 especialistas e dos 38 estudantes no pré-teste foi de ≥ 90%. Resultados: na primeira rodada de avaliação pelo comitê de especialistas, 21 dos 26 itens do questionário apresentaram concordância < 90%, necessitando de ajustes. No pré-teste, três afirmativas do instrumento tiveram concordância < 90% e, portanto, foram readequadas para formulação da versão final. Conclusões: a versão brasileira do instrumento Latino Students Patient Safety Questionnaire foi considerada adaptada culturalmente para o português brasileiro.

Knowledge of professional healthcare providers about sickle cell disease: Impact of a distance education course.

OBJECTIVE: To assess the impact of the distance education course "Sickle Cell Disease: Primary Health Care Line" on knowledge acquisition of professional healthcare providers. METHODS: A cross-sectional study was conducted with a quantitative approach at the Educational and Support Center for Hemoglobinopathies (Cehmob-MG), state of Minas Gerais, Brazil, in 2016. One hundred and fifty-three out of 300 professional healthcare providers were invited to participate in the proposed distance course. Of the participating professional healthcare providers, 72 (47%) successfully concluded the course (Group A), whereas 81 (53%) did not complete their course assignments and did not meet the minimum requirements for regular attendance (Group B). Knowledge acquisition was assessed with the Knowledge of Sickle Cell Disease Instrument, DFConhecimento, applied using the web tool eSurv. Univariate analysis by Poisson regression was employed to assess the influence of sociodemographic variables on the DFConhecimento score and to select variables to compose the initial multivariate regression model (p-value<0.20). The analysis was performed in the statistical programming environment R. RESULTS: The average score was 9.76 for Group A and 6.54 for Group B. The two groups were considered statistically different (p-value<0.05) for all items with the proportion of correct items being greater in Group A. Professional healthcare providers who concluded the course had a significantly higher DFConhecimento score (45%) when compared to those who did not successfully conclude the course. CONCLUSION: Participation in a distance education course on sickle cell disease had a positive impact on the acquisition of knowledge about the disease by professional healthcare providers.

Translation and cross-cultural adaptation of the Behavior Change Protocol for educational practices in Diabetes Mellitus. / Tradução e adaptação cultural do Behavior Change Protocol para as práticas educativas em Diabetes Mellitus.

OBJECTIVE: to translate and cross-culturally adapt the Behavior Change Protocol for educational practices in Diabetes Mellitus. METHOD: methodological study aimed at cross-cultural adaptation, comprising the steps of translation, back-translation, assessment by an expert committee and pre-testing of the instrument on a sample of 30 healthcare service users with type 2 Diabetes Mellitus. RESULTS: the instrument was assessed based on criteria pertaining semantic, idiomatic, conceptual and cultural equivalence between the original instrument and the translated version, its mean Content Validity Index being 0.85. CONCLUSION: results showed content validity indicating the instrument's successful cross-cultural adaptation to the Brazilian culture for use in educational practices targeting self-care in type 2 DM.

Development and validation of an instrument to assess Brazilian healthcare professional providers' knowledge on sickle cell disease

ABSTRACT 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.

Development and validation of an instrument to assess Brazilian healthcare professional providers' knowledge on sickle cell disease.

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.

Knowledge of professional healthcare providers about sickle cell disease: Impact of a distance education course

Abstract Objective To assess the impact of the distance education course "Sickle Cell Disease: Primary Health Care Line" on knowledge acquisition of professional healthcare providers. Methods A cross-sectional study was conducted with a quantitative approach at the Educational and Support Center for Hemoglobinopathies (Cehmob-MG), state of Minas Gerais, Brazil, in 2016. One hundred and fifty-three out of 300 professional healthcare providers were invited to participate in the proposed distance course. Of the participating professional healthcare providers, 72 (47%) successfully concluded the course (Group A), whereas 81 (53%) did not complete their course assignments and did not meet the minimum requirements for regular attendance (Group B). Knowledge acquisition was assessed with the Knowledge of Sickle Cell Disease Instrument, DFConhecimento, applied using the web tool eSurv. Univariate analysis by Poisson regression was employed to assess the influence of sociodemographic variables on the DFConhecimento score and to select variables to compose the initial multivariate regression model (p-value < 0.20). The analysis was performed in the statistical programming environment R. Results The average score was 9.76 for Group A and 6.54 for Group B. The two groups were considered statistically different (p-value < 0.05) for all items with the proportion of correct items being greater in Group A. Professional healthcare providers who concluded the course had a significantly higher DFConhecimento score (45%) when compared to those who did not successfully conclude the course. Conclusion Participation in a distance education course on sickle cell disease had a positive impact on the acquisition of knowledge about the disease by professional healthcare providers.