Validação do instrumento dos indicadores observáveis da qualidade do cuidado em instituições de longa permanência para idosos
The Nursing Homes are an important alternative care in the world, but Brazil still has no valid instrument to monitor the quality these institutions. In the United States, the Observable Indicators of Nursing Home Care Quality Instrument (OIQ) is used to assess the quality of Nursing Home care us...
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| Formato: | Dissertação |
| Idioma: | por |
| Publicado em: |
Universidade Federal do Rio Grande do Norte
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| Endereço do item: | https://repositorio.ufrn.br/jspui/handle/123456789/20196 |
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| Resumo: | The Nursing Homes are an important alternative care in the world, but Brazil still has no valid
instrument to monitor the quality these institutions. In the United States, the Observable
Indicators of Nursing Home Care Quality Instrument (OIQ) is used to assess the quality of
Nursing Home care using 30 indicators of structure (2 dimensions) and process (5 dimensions)
related to quality person-centered care. The present study aimed at cross-culturally adapting the
OIQ in order to evaluate the quality of Nursing Home care in Brazil. Conceptual and item
equivalence were determined to assess the relevance and viability of OIQ in the Brazilian
context, using the Content Validity Index (CVI) and a group of specialists composed of 10
participants directly involved in the object of study. Next, operational, idiomatic and semantic
equivalence were carried out concurrently. This consisted of 5 phases: (1) two translations and
(2) their respective back translations; (3) formal appraisal of referential and general meaning;
(4) review by a second group of specialists; (5) application of the pretest at three Nursing Homes
by different social entities: health professionals, sanitary surveillance regulators and potential
consumers. Measurement equivalence was evaluated by the Cronbach’s alpha test to verify the
internal consistency of the instrument. To measure inter-evaluator agreement, the General
Agreement Index (ICG) and Kappa coefficient were used. Timely compliance and 95%
Confidence Interval of indicators, dimensions and total construct were estimated. The CVI
obtained high results for both relevance (95.3%) and viability (94.3%) in the Brazilian context.
With respect to referential meaning, similarity was observed, ranging between 90-100% for the
first back translation and 70-100% for the second. In relation to general meaning, version 1 was
better, classified as “unchanged” in 80% of the items, whereas in version 2 it was only 47%. In
the pretest, the OIQ was easy to understand and apply. The following outcomes were obtained:
a high Cronbach’s alpha (0.93), satisfactory ICG (75%) and substantial agreement between the
pairs of evaluators (health professionals, regulators from the Superintendency of Sanitary
Surveillance –SUVISA-, and potential consumers), according to the Kappa coefficient (0.65).
It´s possible take the operational equivalence held since it preserved the original layout in the
Brazilian version from the maintenance in application mode, response options, number of items,
statements and scores. The performance of nursing homes obtained approximate average scores
of 87, a variation 55-111 considering a range from 30 to 150 points. The worst outcomes were
related to process indicators with a mean of 2.8 per item, while structure was 3.75 on a scale of 1 to 5. The lowest score was obtained for the care dimension (mean 2). The OIQ version was
deemed to be a valid and reliable instrument in the Brazilian context. It is recommended that
health professionals, regulators and potential consumers adopt it to access and monitor the
quality of Nursing Home care and demonstrating opportunities for improvement. |
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