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Contributo para a validação da versão portuguesa do questionário "Barriers to enterally feeding critically ill patients" e sua aplicação em contexto hospitalar
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Abstract(s)
Introdução: A Nutrição Entérica (NE) pode ter um impacto significativo na redução da mortalidade dos doentes críticos. Para tal é importante evitar tanto a subalimentação como a sobrealimentação desses doentes. Percebendo quais são os obstáculos à NE, podem ser criados protocolos mais adaptados às necessidades e particularidades de cada Unidade de Cuidados Intensivos (UCI), e otimizar a NE. Em Portugal não existe ainda nenhum questionário validado para avaliar os obstáculos à administração da NE ao doente crítico.
Objetivos: A presente dissertação procurou validar o questionário “Barriers to Enterally Feeding Critically Ill Patients” (BEFIP) para uma versão portuguesa, e caracterizar as perceções dos profissionais de saúde sobre os obstáculos à administração da NE.
Metodologia: Aplicou-se o questionário BEFIP a uma amostra (n = 165) composta por médicos, enfermeiros e nutricionistas que trabalham em UCI de hospitais do Serviço Nacional de Saúde. Os dados recolhidos foram analisados no SPSS versão 27, com o qual se procedeu a uma análise descritiva, bem como à análise fatorial exploratória e da consistência interna da escala do questionário BEFIP.
Resultados: Os obstáculos que são entendidos pelos profissionais de saúde como mais prejudiciais são três: (i) o atraso na iniciação de agentes de motilidade em pacientes que não toleram a NE; (ii) o atraso e dificuldade em obter acesso ao intestino delgado em pacientes que não toleram a NE; (iii) o pouco tempo dedicado ao ensino e formação em matéria da correta alimentação dos pacientes. Os enfermeiros consideram o atraso na iniciação de agentes de motilidade como um obstáculo mais prejudicial, e os médicos e os enfermeiros categorizam o pouco tempo dedicado à formação como um obstáculo de maior impacto sobre a administração da NE. A partir do modelo fatorial final da versão portuguesa do questionário BEFIP resultaram 16 obstáculos à NE divididos em 4 dimensões, com valores de alfa de Cronbach satisfatórios que variam entre 0.77 e 0.84.
Conclusões: A presente dissertação demonstra que a versão portuguesa do questionário BEFIP é uma ferramenta fiável e consistente na medição do que se propõe a avaliar, e revela a existência de discrepâncias entre as perceções dos três grupos de profissionais de saúde sobre os obstáculos à administração da NE aos doentes críticos.
Introduction: Enteral Nutrition (EN) can have a significant impact on the reduction of mortality in critically ill patients. To this end, it is important to avoid both underfeeding and overfeeding of these patients. By understanding which are the barriers to EN, protocols more adapted to the needs and particularities of each Intensive Care Unit (ICU) can be created, and EN can be optimised. In Portugal, there is no validated questionnaire to assess the barriers to the administration of EN to critically ill patients. Objectives: This dissertation sought to validate the "Barriers to Enterally Feeding Critically Ill Patients" (BEFIP) questionnaire into a Portuguese version, and to characterise the perceptions of healthcare professionals on the barriers to the administration of EN. Methodology: We applied the BEFIP questionnaire to a sample (n = 165) composed of physicians, nurses and nutritionists working in ICU of hospitals of the National Healthcare System. The data collected were analysed using SPSS version 27, with which a descriptive analysis was performed, as well as an exploratory factor analysis and internal consistency analysis of the BEFIP questionnaire scale. Results: The barriers that are perceived by health professionals as most detrimental are three: (i) the delays in initiating motility agents in patients not tolerating EN; (ii) the delays and difficulties in obtaining small bowel access in patients not tolerating EN; (iii) not enough time dedicated to education and training on how to optimally feed patients. Nurses consider the delays in initiating motility agents as a more harmful barrier, and the physicians and nurses categorize the not enough time dedicated to training as a barrier with the greatest impact on the administration of EN. The final factorial model of the Portuguese version of the BEFIP questionnaire resulted in 16 barriers to EN divided into 4 domains, with satisfactory Cronbach's alpha values ranging between 0.77 and 0.84. Conclusions: This dissertation demonstrates that the Portuguese version of the BEFIP questionnaire is a reliable and consistent tool in measuring what it sets out to assess and reveals that there are discrepancies between the perceptions of the three groups of health professionals on the barriers to the administration of EN to critically ill patients.
Introduction: Enteral Nutrition (EN) can have a significant impact on the reduction of mortality in critically ill patients. To this end, it is important to avoid both underfeeding and overfeeding of these patients. By understanding which are the barriers to EN, protocols more adapted to the needs and particularities of each Intensive Care Unit (ICU) can be created, and EN can be optimised. In Portugal, there is no validated questionnaire to assess the barriers to the administration of EN to critically ill patients. Objectives: This dissertation sought to validate the "Barriers to Enterally Feeding Critically Ill Patients" (BEFIP) questionnaire into a Portuguese version, and to characterise the perceptions of healthcare professionals on the barriers to the administration of EN. Methodology: We applied the BEFIP questionnaire to a sample (n = 165) composed of physicians, nurses and nutritionists working in ICU of hospitals of the National Healthcare System. The data collected were analysed using SPSS version 27, with which a descriptive analysis was performed, as well as an exploratory factor analysis and internal consistency analysis of the BEFIP questionnaire scale. Results: The barriers that are perceived by health professionals as most detrimental are three: (i) the delays in initiating motility agents in patients not tolerating EN; (ii) the delays and difficulties in obtaining small bowel access in patients not tolerating EN; (iii) not enough time dedicated to education and training on how to optimally feed patients. Nurses consider the delays in initiating motility agents as a more harmful barrier, and the physicians and nurses categorize the not enough time dedicated to training as a barrier with the greatest impact on the administration of EN. The final factorial model of the Portuguese version of the BEFIP questionnaire resulted in 16 barriers to EN divided into 4 domains, with satisfactory Cronbach's alpha values ranging between 0.77 and 0.84. Conclusions: This dissertation demonstrates that the Portuguese version of the BEFIP questionnaire is a reliable and consistent tool in measuring what it sets out to assess and reveals that there are discrepancies between the perceptions of the three groups of health professionals on the barriers to the administration of EN to critically ill patients.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Estudo de validação Nutrição entérica Obstáculos à nutrição entérica Questionário BEFIP