RESUMO
The objective of this study was to evaluate interobserver reliability and the concurrent criterion validity of the adapted version of the International Skin Tear Advisory Panel (ISTAP) Skin Tear Classification System to Brazilian Portuguese. For the evaluation of interobserver reliability using the photograph database, 36 nurses classified 30 skin tears (STs) into three groups, according to its definitions (adapted version). For the evaluation through clinical application, 23 nurses classified 12 STs present in 8 thoracic and cardiovascular postoperative patients at a tertiary hospital in Sao Paulo, Brazil. For the data collection of patients, an enterostomal therapist nurse classified the ST found by simultaneously using the adapted ISTAP version and the Skin Tear Audit Research (STAR) Classification System to test the concurrent criterion validity. The average of 17.83 correct answers (SD = 5.03) resulted from 1080 photograph observations, with Fleiss κ = 0.279 (reasonable concordance level). The interobserver reliability in the clinical application resulted in a global correct answer percentage of 76.7% in 85 observations. The concurrent criterion validity was attested by the total correlation (r = 1) between ISTAP and STAR. The ISTAP classification for ST is a reliable instrument and also valid in Brazil, making it another option to be used in clinical practice.
Assuntos
Pele/lesões , Lesões dos Tecidos Moles/classificação , Adulto , Brasil/epidemiologia , Feminino , Humanos , Masculino , Morbidade/tendências , Portugal/etnologia , Curva ROC , Lesões dos Tecidos Moles/etnologia , Inquéritos e QuestionáriosRESUMO
O tratamento com Warfarina reduz a capacidade de coagulação do sangue, sendo acompanhado laboratorialmente pelo tempo de protrombina expresso como no índice de normatização internacional(INR). Fatores socioeconômicos, culturais e a terapêutica podem influenciar os resultados. Objetivo: caracterizar pacientes em uso de Warfarina e identificar fatores que colaboraram para o INR permanecer fora da faixa terapêutica (INR <2,0 ou >3,0). Estudo descritivo exploratório utilizando instrumento de coleta de dados, com as variáveis: caracterização do paciente, uso da Warfarina e sua forma de utilização, hábitos alimentares, atividade física, controle do INR. Amostra foi de 38 pacientes que recebiam Warfarina há trinta dias com INR fora da faixa terapêutica. Os pacientes apresentavam hábitos alimentares inadequados, interação medicamentosa da Warfarina com antibióticos e antiarrítmicos e adesão prejudicada ao tratamento.
Treatment with Warfarin reduces the blood coagulation capacity, being followed up by the International Normalized Ratio (INR) blood tests. Socioeconomics and cultural factors and the therapeutics may influence the test results. Objective of the study was to characterize patients using Warfarin and to identify factors that contribute to the INR to stay out of the therapeutics range (2,0 to 3,0).Descriptive and exploratory method was applied by means of data acquisition, taking into consideration the following variables: patient profile, use of Warfarina and its administration form, food habits, physical activities and blood control (IRN).The sample, had 38 patients using Warfarin for 30 days and presenting blood test out of the therapeutic range. Patients under study showed inadequate food habits, drug interaction (Warfarin with antibiotics and antiarritmics) and poor adhesion to the treatment.
El tratamiento con Warfarina reduce la capacidad de coagulación de la sangre, siendo acompañado por Indice de Normalización Internacional (RNI ). Factores socioeconómicos, culturales e a terapéutica pueden influenciar en los resultados. Objetivo: caracterizar pacientes en uso de Warfarina e identificar factores que contribuyen para que el INR permanezca fuera del rango terapéutico (INR <2,0 o <3,0). Método descriptivo y exploratorio a través del instrumento de recolección de datos, con las variables: perfil del paciente, uso da Warfarina y forma de utilización, hábitos alimenticios, actividad física y control del INR. La muestra comprendió 38 pacientes que hacían uso de Warfarina desde hace 30 días con INR fuera del rango terapéutico. Los pacientes presentaban hábitos alimenticios inadecuados, interacción medicamentosa de la Warfarina con antibióticos, antiarrítmicos e mala adhesión al tratamiento.