Validação de protocolo de assistência para pessoas com úlcera venosa na atenção primária
People with venous ulcers constitute as an important public health problem, its treatment is onerous and require assistance provided by trained professionals, systematized through protocols, however what lies in the assistance is that the management of this group of people differs from that preconiz...
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| Formato: | doctoralThesis |
| Idioma: | por |
| Publicado em: |
Universidade Federal do Rio Grande do Norte
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| Endereço do item: | https://repositorio.ufrn.br/jspui/handle/123456789/14750 |
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| Resumo: | People with venous ulcers constitute as an important public health problem, its treatment is
onerous and require assistance provided by trained professionals, systematized through
protocols, however what lies in the assistance is that the management of this group of people
differs from that preconized in the scientific literature, interfering with wound healing and
quality of life of affected. In this sense, the construction of a assistance protocol specific to
people with venous ulcers (VU) can help professionals of the Family Health Strategy both in
patient assessment as and in establishment of quality assistance. Thus, this study aimed to
analyse the validity of a multiprofessional assistance protocol for people with venous ulcers
in primary care by health professionals using Delphi technique. This is a quantitative study,
the methodological type conducted in two steps: first step related to integrative literature
review to subsidize the development of the protocol, then these aspects were organized and
proposed to the judges of the study through the Delphi technique. The study was initiated
after approval by the Research Ethics Committee. The first step was performed between
August and September 2012, in the virtual library of health, in the page of the Coordination of
Improvement of Higher Education Personnel, of Municipal Health Secretariat and
international guidelines of associations and in the subsequent step carried out between
September 2012 to January 2013, was performed search by Lattes platform of the National
Council of Technological and Scientific Development, in order to identify health
professionals in Brazil who act as judges of the instrument and then, via online, the form was
submitted to them.The sample for the second step was 51 judges in the first round and 35 for
the second round Delphi. The analysis was done by adopting Kappa index ≥ 0.81 and Content
Validity Index (CVI)> 0.80. In the first submission for the judges, items that did not reach
Kappa and CVI established were: request / realization / test results, demographic data,
medical history, risk factors, verification of pain / vital signs / pulse / infection signs / lesion
location/ edema and pain treatment. After removal of items which have not obtained Kappa or
CVI index established, it was found achieving optimal levels of these index for the categories.
In the next step was the ressubmissão of protocol to judges through the Delphi technique in it
was found that, of the 15 categories of the protocol, 12 presented higher scores in Delphi 2
phase and the other three categories remained the same Kappa and IVC of the previous phase.
As for the average of evaluation requirements of the protocol was found that the scores
assigned by the judges were higher in the second phase in nine of the 10 items, remaining the
same in only one of the items indicating validity of the instrument before the consensus of the
judges. Thus, we accepted the alternative hypothesis in this study, as they were obtained in
the second Delphi phase the validity index greater than or equal to the Delphi 1 phase. The
formulation of this assistance protocol valid and reproducible will enable a reorganization and
redesign of assistance, with standardization of actions and continuity of care for persons with
venous ulcers in primary health care |
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