Protocolo de rastreio multiprofissional de disfagia em pacientes com infecção HIV: elaboração e validação de conteúdo
Multiprofessional screening protocol for dysphagia in patients with HIV infection: elaboration and content validity
Luise Alexandre Rocha Soutinho; Daniel Aragão Machado; Charles Henrique Dias Marques
Resumo
Objetivo: Elaborar e validar um protocolo multiprofissional para identificação do risco de disfagia em pessoas com HIV no momento da internação hospitalar. Método: Após revisão bibliográfica, o protocolo de rastreio de disfagia criado foi submetido a análise de juízes especialistas em HIV/Aids e público-alvo na aplicação deste instrumento para realização da validação de face/conteúdo. Esses avaliadores poderiam sugerir mudanças no protocolo, julgando os quesitos como clareza, pertinência e abrangência. Para avaliar o grau de concordância do instrumento, foi utilizado o Índice de Validade de Conteúdo (IVC) mínimo de 0,78. Resultados: O protocolo foi elaborado com 16 itens, incluindo aspectos relacionados à fase oral e faríngea da deglutição, e a pontuação final foi calculada baseada nos diferentes riscos para complicações clínicas. O instrumento apresentou IVC acima de 0,78 para todos os itens nas duas fases da validação, bem como IVC total de 0,92. Conclusão: A partir dos dados obtidos, foi possível a construção e validação do protocolo de rastreio do ponto de vista de aparência e conteúdo, uma vez que apresentou IVC total acima do valor mínimo estipulado na validação dos juízes especialistas e do público-alvo, constatando-se assim IVC adequado para o protocolo como um todo.
Palavras-chave
Abstract
Purpose: To elaborate and validate a multiprofessional protocol to identify the risk of dysphagia in people with HIV at the time of hospitalization. Methods: After bibliographic review, the dysphagia screening protocol created was submitted to the analysis of HIV/ Aids expert judges and target audience in the application of this instrument to perform content validity. These evaluators could suggest changes to the protocol, judging clarity, pertinence, and comprehensiveness. The CVI 0.78 was used to confirm the validity of the results. Results: The protocol was created including aspects related to oral and pharyngeal swallowing, and the final score was calculated based on the risks for clinical complications. The instrument presented CVI above 0.78 for all items in the two validation phases, as well as total CVI of 0.92. Conclusion: Based on the obtained data, it was possible to create and validate the screening protocol from the point of view of appearance and content, once it presented total CVI above the minimum value stipulated in the validation of the expert judges and the target public, obtaining an adequate result for the protocol. Therefore, we can consider the resolution instrument, with the capacity to fulfill what was proposed.
Keywords
References
1) Douek DC, Roederer M, Koup RA. Emerging concepts in the immunopathogenesis of AIDS. Annu Rev Med. 2009;60(1):471-84. http://dx.doi.org/10.1146/annurev.med.60.041807.123549 PMid:18947296.
» http://dx.doi.org/10.1146/annurev.med.60.041807.123549
2) UNAIDS: United Nations Joint Programme on AIDS. HIV/AIDS: the global epidemic [Internet]. Geneva: UNAIDS; 2018 [citado em 2018 Jan 5]. Disponível em: http://aidsinfo.unaids.org/
» http://aidsinfo.unaids.org/
3) Sousa AM, Lyra A, Araújo CCF, Pontes JL, Freire RC, Pontes TL. A política da AIDS no Brasil: uma revisão da literatura. J Manag Prim Health Care. 2012;3(1):62-6. http://dx.doi.org/10.14295/jmphc.v3i1.119
» http://dx.doi.org/10.14295/jmphc.v3i1.119
4) Brasil. Ministério da Saúde. Departamento de DST, Aids e Hepatites Virais. Painel de indicadores epidemiológicos [Internet]. 2021 [citado em 2021 Jan 25]. Disponível em: http://indicadores.aids.gov.br/
» http://indicadores.aids.gov.br/
5) Lavreys L, Thompson ML, Martin HL Jr, Mandaliya K, Ndinya-Achola JO, Bwayo JJ, et al. Primary human immunodeficiency virus type 1 infection: clinical manifestations among women in Mombasa, Kenya. Clin Infect Dis. 2000;30(3):486-90. http://dx.doi.org/10.1086/313718 PMid:10722432.
» http://dx.doi.org/10.1086/313718
6) Moro JC, Moreira NM. Clinico-epidemiological and sociodemographic profile of HIV/AIDS patients who are co-infected with Toxoplasma gondii in the border region of Brazil. An Acad Bras Cienc. 2020;92(4):e20200293. http://dx.doi.org/10.1590/0001-3765202020200293 PMid:33237145.
» http://dx.doi.org/10.1590/0001-3765202020200293
7) Jacobi J, Levy DS, Silva LMC. Disfagia: avaliação e tratamento. 1. ed. Rio de Janeiro: Revinter; 2003.
8) Macera CA. A home-based exercise program for women with HIV. Clin J Sport Med. 2007;17(2):172. http://dx.doi.org/10.1097/01.jsm.0000277809.94861.e7 PMid:17431959.
» http://dx.doi.org/10.1097/01.jsm.0000277809.94861.e7
9) Nel ED, Ellis A. Swallowing abnormalities in HIV infected children: an important cause of morbidity. BMC Pediatr. 2012;12(1):68. http://dx.doi.org/10.1186/1471-2431-12-68 PMid:22704533.
» http://dx.doi.org/10.1186/1471-2431-12-68
10) Martinez EJ, Nord HJ, Cooper BG. Significance of solitary and multiple esophageal ulcers in patients with AIDS. South Med J. 1995;88(6):626-9. http://dx.doi.org/10.1097/00007611-199506000-00005 PMid:7777877.
» http://dx.doi.org/10.1097/00007611-199506000-00005
11) Bladon KL, Ross E. Swallowing difficulties reported by adults infected with HIV/AIDS attending a hospital outpatient clinic in Gauteng, South Africa. Folia Phoniatr Logop. 2007;59(1):39-52. http://dx.doi.org/10.1159/000096549 PMid:17172785.
» http://dx.doi.org/10.1159/000096549
12) Hyrkäs K, Appelqvist-Schmidlechner K, Oksa L. Validating an instrument for clinical supervision using an expert panel. Int J Nurs Stud. 2003;40(6):619-25. http://dx.doi.org/10.1016/S0020-7489(03)00036-1 PMid:12834927.
» http://dx.doi.org/10.1016/S0020-7489(03)00036-1
13) Echer IC. Elaboração de manuais de orientação para o cuidado em saúde. Rev Lat Am Enfermagem. 2005;13(5):754-7. http://dx.doi.org/10.1590/S0104-11692005000500022 PMid:16308635.
» http://dx.doi.org/10.1590/S0104-11692005000500022
14) Alexandre NMC, Coluci MZO. Validade de conteúdo nos processos de construção e adaptação de instrumentos de medidas. Cien Saude Colet. 2011;16(7):3061-8. http://dx.doi.org/10.1590/S1413-81232011000800006 PMid:21808894.
» http://dx.doi.org/10.1590/S1413-81232011000800006
15) Beaton D, Bombardier C, Guillemin F, Ferraz MB. Recommendations for the Cross-cultural adaptation of the DASH & QuickDASH outcome measures. Rosemont: American Academy of Orthopaedic Surgeons and Institute for Work & Health; 2007.
16) Polit DF, Beck CT. The content validity index: are you sure you know what’s being reported? Critique and recommendations. Res Nurs Health. 2006;29(5):489-97. http://dx.doi.org/10.1002/nur.20147 PMid:16977646.
» http://dx.doi.org/10.1002/nur.20147
17) Schrock JW, Bernstein J, Glasenapp M, Drogell K, Hanna J. A novel emergency department dysphagia screen for patients presenting with acute stroke. Acad Emerg Med. 2011;18(6):584-9. http://dx.doi.org/10.1111/j.1553-2712.2011.01087.x PMid:21676055.
» http://dx.doi.org/10.1111/j.1553-2712.2011.01087.x
18) Barnard SL. Nursing dysphagia screening for acute stroke patients in the emergency department. J Emerg Nurs. 2011;37(1):64-7. http://dx.doi.org/10.1016/j.jen.2010.11.002 PMid:21237371.
» http://dx.doi.org/10.1016/j.jen.2010.11.002
19) Palli C, Fandler S, Doppelhofer K, Niederkorn K, Enzinger C, Vetta C, et al. Early dysphagia screening by trained nurses reduces pneumonia rate in stroke patients. Stroke. 2017;48(9):2583-5. http://dx.doi.org/10.1161/STROKEAHA.117.018157 PMid:28716980.
» http://dx.doi.org/10.1161/STROKEAHA.117.018157
20) Almeida TM, Cola PC, Pernambuco LA, Magalhães HV Jr, Silva RGInstrumentos de rastreio para disfagia orofaríngea no acidente vascular encefálico. Audiol Commun Res. 2015;20(4):361-70. http://dx.doi.org/10.1590/2317-6431-2015-1571
» http://dx.doi.org/10.1590/2317-6431-2015-1571
21) Boczko F. Patients’ awareness of symptoms of dysphagia. J Am Med Dir Assoc. 2006;7(9):587-90. http://dx.doi.org/10.1016/j.jamda.2006.08.002 PMid:17095424.
» http://dx.doi.org/10.1016/j.jamda.2006.08.002
22) Manor Y, Giladi N, Cohen A, Fliss DM, Cohen JT. Validation of a swallowing disturbance questionnaire for detecting dysphagia in patients with Parkinson’s disease. Mov Disord. 2007;22(13):1917-21. http://dx.doi.org/10.1002/mds.21625 PMid:17588237.
» http://dx.doi.org/10.1002/mds.21625
23) Bergamaschi R, Crivelli P, Rezzani C, Patti F, Solaro C, Rossi P, et al. The DYMUS questionnaire for the assessment of dysphagia in multiple sclerosis. J Neurol Sci. 2008;269(1-2):49-53. http://dx.doi.org/10.1016/j.jns.2007.12.021 PMid:18280504.
» http://dx.doi.org/10.1016/j.jns.2007.12.021
24) Kawashima K, Motohashi Y, Fujishima I. Prevalence of dysphagia among community-dwelling elderly individuals as estimated using a questionnaire for dysphagia screening. Dysphagia. 2004;19(4):266-71. http://dx.doi.org/10.1007/s00455-004-0013-6 PMid:15667063.
» http://dx.doi.org/10.1007/s00455-004-0013-6
25) Govender R, Lee MT, Davies TC, Twinn CE, Katsoulis KL, Payten CL, et al. Development and preliminary validation of a patient-reported outcome measure for swallowing after total laryngectomy (SOAL questionnaire). Clin Otolaryngol. 2012;37(6):452-9. http://dx.doi.org/10.1111/coa.12036 PMid:23039924.
» http://dx.doi.org/10.1111/coa.12036
26) Holland G, Jayasekeran V, Pendleton N, Horan M, Jones M, Hamdy S. Prevalence and symptom profiling of oropharyngeal dysphagia in a community dwelling of an elderly population: a self-reporting questionnaire survey. Dis Esophagus. 2011;24(7):476-80. http://dx.doi.org/10.1111/j.1442-2050.2011.01182.x PMid:21385285.
» http://dx.doi.org/10.1111/j.1442-2050.2011.01182.x
27) Sassi FC, Medeiros GC, Zilberstein B, Jayanthi SK, Andrade CRF. Screening protocol for dysphagia in adults: comparison with videofluoroscopic findings. Clinics. 2017;72(12):718-22. http://dx.doi.org/10.6061/clinics/2017(12)01 PMid:29319716.
» http://dx.doi.org/10.6061/clinics/2017(12)01
28) Fitzner K. Reliability and validity: a quick review. Diabetes Educ. 2007;33(5):775-6, 780. http://dx.doi.org/10.1177/0145721707308172 PMid:17925583.
» http://dx.doi.org/10.1177/0145721707308172
29) Jani MP, Gore GB. Occurrence of communication and swallowing problems in neurological disorders: analysis of forty patients. NeuroRehabilitation. 2014;35(4):719-27. http://dx.doi.org/10.3233/NRE-141165 PMid:25318773.
» http://dx.doi.org/10.3233/NRE-141165
Submitted date:
01/25/2021
Accepted date:
04/12/2021
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email