Construção e validação de um manual de orientações a familiares de pessoas com mobilidade física prejudicada

Abstract

This study aimed to construct and validate educative technology for health promotion in people with impaired physical mobility. This methodological development study was carried out at an emergency hospital in Fortaleza-CE, Brazil. The study involved three phases: construction of the manual, content validation and clinical testing. First, studies were accomplished to support the construction of the manual. Second, for content validation purposes, a Likert-style questionnaire was used, including the quality assessment indicators, so as to determine the inter-rater agreement level. Third, for clinical testing, the manual was applied to caregivers of patients with impaired physical mobility and full or partial dependence for care. The content validation sample consisted of seven judges who were experts in education and neurology, while the clinical test sample comprised 30 caregivers, selected through inclusion and exclusion criteria. Approval for this research was obtained from the Institutional Review Board at Hospital Instituto Dr. José Frota, under protocol No 110.316/09. In the construction process of the manual, first, studies were accomplished to support the selection of the theme and contents. Next, the art editor was contacted to elaborate the manual, in the form of a history with drawings, representing the characters and describing the procedures in a detailed and simple way. The experts’ opinions on the manual were based on the addressed items and the variation in agreement percentages (fully agree/agree) ranged from 42.9% to 100%. The variation in neutral answers went from 14.3% to 57.1% and, among disagreements (fully disagree/disagree), from 14.3% to 42.9%. Inter-rater agreement levels for items 3, 6, 10, 13 and 14 were lower than 70%, demanding review and restructuring to achieve the goals proposed in this study. In clinical testing, agreement levels (fully agree/agree) among the caregivers’ opinions on the addressed items ranged from 90.0% to 100%. No variations were identified among caregivers who stayed neutral or disagreed, with both categories corresponding to 6.7% and 3.3%, respectively. The level set to validate an indicator was 70% or more and, in this phase, all indicators were considered valid. Among the experts’ suggestions, the following stand out: reduce some texts, reformulate technical terms not accessible to lay people, clarify some illustrations and alter the sequence of orientations. The caregivers’ suggested the continuous use of the Manual at the hospital, starting its use soon after admission, so as to contribute to the recovery process of their relative. They affirmed that, after the orientations, they managed to feel safer and that the information would be important when they would be at home. The analyses reinforce the relevance of elaborating new technologies for educative practice in the hospital environment, besides the need to prepare the professionals through continuous in-service training, so that care is developed adequately and safely.