Desenvolvimento e avaliação de uma cartilha educativa para promoção do estilo de vida saudável em pessoas com HIV

Abstract

The aim of the study was to develop and evaluate an educational booklet for the promotion of healthy lifestyle in people living with HIV (PLHIV) using antiretroviral therapy, as well as the creation and validation of the specific knowledge, attitude and practice (KAP) survey to evaluate the use of the booklet. This is a study of the development of interventional educational technology, adopting the Transtheoretical Model of Behavior Change as a theoretical reference for the elaboration of the booklet. The research consisted of four stages: 1. Development of the booklet; 2. Analysis of content and appearance by 22 expert judges; 3. Semantic analysis by 22 PLHIV; 4. Construction of the KAP survey by the researcher and its validation by expert judges and PLHIV. In the data analysis was measured the proportion of evaluators who agreed on the positive evaluation of the items, considering the percentage greater than or equal to 85%. To characterize the evaluators, frequency distributions, measures of central tendency and dispersion, normality tests were performed, considering a 95% confidence interval for quantitative variables. The Statistical Package for Social Sciences software was used for analysis. The booklet was titled: “My Motivation for Change Booklet! Practices for promoting a healthy lifestyle.” A bibliographic survey and an integrative literature review were carried out, with six domains defined in the booklet: body weight control, healthy eating, physical exercise, smoking, alcohol and other drugs, stress control and drug treatment. The illustrations, layout and diagramming were done by graphic designer, finishing the first version of the booklet, which was printed and delivered to the expert judges. These were nurses (68.2%), doctors (27.3%) and nutritionist (4.5%), mostly female (95.5%) and with a mean age of 42 years. Teaching nurses predominated (40.9%), nursing assistants (27.3%), infectious disease doctors (27.3%) and healthcare nutritionists (4.5%). The average working time in the area was 13 years, and the graduation completion time was 18 years. Most had a doctorate (68.2%), had completed research on HIV (86.4%), were part of a research group (86.4%), had articles published in the area of HIV (100.0%) and experience in instrument validation studies / educational materials analysis (72.7%). Of the 18 items evaluated, most obtained the percentage of agreement proposed by the study, and only two items obtained percentage of agreement below the established (77.3%; 81.8%), suggesting modifications, which were accepted by the researcher. The global average of positive agreement among the experts who evaluated the booklet was 92.4%. After making the suggested changes, the second version of the booklet was formatted for semantic analysis by PLHIV. Among them, most were male (86.4%), with a mean age of 41 years and education with a median of 12 years of study. The category of sexual exposure predominated (100.0%) and the time of diagnosis was median of five years. All items evaluated had positive agreement above 85% by the target audience. Thus, the second version of the booklet did not require modifications, and the final version was approved. Regarding the construction of the KAP survey, 10 questions were elaborated in the knowledge domain and in the attitude domain, and 11 in the practical domain. All domains evaluated had a positive agreement of 100.0%. It was concluded that the developed educational booklet has evidence of adequate validity to be used by PLHIV. In addition, the specific KAP survey has been validated for its content, to be used in future studies of clinical evaluation of the booklet.