Protocolo assistencial de enfermagem para prevenção dos cânceres de mama e colo de útero em pessoas transmasculinas: estudo metodológico

Abstract

The present study aimed to develop a nursing care protocol for the prevention of breast and cervical cancers among transmasculine individuals. This methodological study was conducted from June 2024 to January 2026, following the Iowa Model of Evidence-Based Practice to Promote Excellence in Health through eight stages: identifying a research question; securing organizational support by recognizing the topic as a priority; conducting a scoping review; designing and implementing a pilot for practice change, involving the team while considering preferences, resources, constraints, and approval processes; developing a protocol and implementation plan, collecting data, and evaluating processes; assessing whether the practice change was appropriate and ready for implementation; integrating the change directly into the current system while monitoring key indicators; and, finally, disseminating the results. The validation stage was conducted using a hybrid format (face-to-face and online). Content validation was performed by seven specialist nurses (online), five individuals from the target care population (hybrid format with members of the Associação Transmasculina do Ceará), and five primary healthcare nurses who evaluated the usability of the protocol (online). Only the penultimate stage was not fully completed. Data were analyzed and presented using descriptive statistics, including absolute and relative frequencies. In addition, item-level content validity indices and the specific calculation required by the evaluation tool were computed. Ethical principles were observed throughout all stages of the study, ensuring participant anonymity. The study results included: the production of a scoping review published in a highly relevant international journal; systematic meetings with the transmasculine population to understand perceptions and preferences regarding the topic; organization, analysis, and interpretation of the data culminating in the development of the protocol; and content validation, in which the overall protocol evaluation by specialists was 0.85, indicating good overall quality, with Domain 5 (Applicability) showing the lowest level of agreement (0.71). Among the transmasculine population, the overall evaluation was 0.95, with Domain 6 (Editorial Independence) presenting the lowest level of agreement (0.55). Following the validation stage, evaluators’ considerations were analyzed, and the relevant modifications were incorporated into the instrument. Regarding usability, the protocol was recognized as a practical and easily implementable tool. In conclusion, the protocol demonstrated valid content and usability within the context of primary healthcare, enabling nurses to guide preventive care practices through evidence-based actions delivered in a more inclusive manner to transmasculine populations.