Loading...
Publication
Construção de um instrumento de avaliação do ambiente da prática de enfermagem nos cuidados continuados integrados
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 1.19 MB | Adobe PDF |
Advisor(s)
Abstract(s)
Enquadramento: O Ambiente de Prática de Enfermagem nos Cuidados
Continuados Integrados é uma área de intervenção, com carência ao nível do
desenvolvimento do conhecimento e da respetiva evidência científica, mas de marcada
relevância para a qualidade dos cuidados em saúde, não existindo à data um instrumento
que possibilite a avaliação do ambiente de prática de enfermagem nestes contextos. Os
sistemas de saúde devem adaptar-se às necessidades de uma população idosa, promover
a saúde ao longo da vida e oferecer cuidados de alta qualidade, minimizando a
necessidade de internamentos hospitalares, pelo que os cuidados continuados
integrados de qualidade se revelam importantes na gestão dos custos em saúde.
Objetivos: Construir um instrumento que monitorize o ambiente da prática de
enfermagem nos cuidados continuados integrados.
Métodos: Trata-se de um estudo metodológico que seguiu as etapas propostas
por Colluci (2015). A validação do conteúdo foi realizada por consenso de 13 especialistas
através da técnica de Delphi e terminamos com a realização de um pré-teste a 39
enfermeiros que exercem funções na área dos cuidados continuados.
Resultados: Obtiveram-se valores de concordância médios para a relevância de
0,93 e para a clareza de 0,89, após retirados 13 itens que para a relevância e/ou clareza
não superavam um IVC superior a 0,80. Analisou-se também a homogeneidade da
concordância da avaliação dos itens na avaliação dos peritos. Obtiveram-se valores de
concordância de 0,83 na relevância no caso do Alpha de Krippendorff, e de 0,82 no de Fleiss
Kappa. A concordância para a clareza foi de 0,81 e 0.80 respetivamente. Foi realizada a
análise da consistência interna através da correlação item-total corrigida do Alpha de
Cronbach e Ómega de McDonald. Verificou-se que, as correlações são superiores a 0,3 e
os valores de Alpha e Ómega são superiores a 0,7, quer no estudo de cada domínio
individualmente, quer no estudo envolvendo a globalidade dos 43 itens, salientando que
um dos dois itens que não cumpriam um valor mínimo aceitável para a correlação foi
retirado do instrumento, já o outro, pela sua pertinência foi reformulado.
Conclusão: Concluímos com um instrumento com 42 itens organizados em 4
dimensões teóricas, necessidades sociais e de saúde, desempenho, prestação de serviços
e facilitadores do sistema. O instrumento evidencia boa validade e confiabilidade. A continuidade deste estudo para validação do construto e conclusão da primeira versão
deste instrumento de avaliação APE-CCI é fundamental.
Background: The Nursing Practice Environment in Integrated Continuous Care is an area of intervention, with a lack of knowledge development and respective scientific evidence, but of marked relevance for the quality of health care. Health systems must adapt to the needs of an elderly population, promote lifelong health and offer high-quality care, minimizing the need for hospital admissions, which is why the quality of the integrated continuous care is important for managing health costs. Objective: Build an instrument that monitors the nursing practice environment in integrated continuous care. Methods: This is a methodological study that followed the steps proposed by Colluci (2015). Content validation was carried out by consensus of 13 experts using the Delphi technique and we ended with a pre-test carried out on 39 nurses who work in the area of integrated continuous care. Results: Average agreement values were obtained for relevance of 0.93 and for clarity of 0.89, after removing 13 items that for relevance and/or clarity did not exceed a CVI greater than 0.80. The homogeneity of agreement in the assessment of items in the experts' assessment was also analyzed. Agreement values of 0.83 in relevance were obtained in the case of Krippendorff's Alpha, and 0.82 in the case of Fleiss Kappa. The agreement for clarity was 0.81 and 0.80 respectively. Internal consistency analysis was carried out using the corrected item-total correlation of Cronbach's Alpha and McDonald's Omega for almost all items. It was found that the correlations are greater than 0.3 and the Alpha and Omega values are greater than 0.7, whether in the study of each domain individually or in the study involving all 43 items, highlighting that one of the two items that did not meet a minimum acceptable value for correlation were removed from the instrument, while the other, due to its relevance, was reformulated. Conclusion: We concluded with an instrument with 42 items organized into 4 theoretical dimensions, social and health needs, performance, service provision and system facilitators. The instrument shows good validity and reliability. Continuing this study to validate the construct and complete the first version of this APE-CCI assessment instrument is essential.
Background: The Nursing Practice Environment in Integrated Continuous Care is an area of intervention, with a lack of knowledge development and respective scientific evidence, but of marked relevance for the quality of health care. Health systems must adapt to the needs of an elderly population, promote lifelong health and offer high-quality care, minimizing the need for hospital admissions, which is why the quality of the integrated continuous care is important for managing health costs. Objective: Build an instrument that monitors the nursing practice environment in integrated continuous care. Methods: This is a methodological study that followed the steps proposed by Colluci (2015). Content validation was carried out by consensus of 13 experts using the Delphi technique and we ended with a pre-test carried out on 39 nurses who work in the area of integrated continuous care. Results: Average agreement values were obtained for relevance of 0.93 and for clarity of 0.89, after removing 13 items that for relevance and/or clarity did not exceed a CVI greater than 0.80. The homogeneity of agreement in the assessment of items in the experts' assessment was also analyzed. Agreement values of 0.83 in relevance were obtained in the case of Krippendorff's Alpha, and 0.82 in the case of Fleiss Kappa. The agreement for clarity was 0.81 and 0.80 respectively. Internal consistency analysis was carried out using the corrected item-total correlation of Cronbach's Alpha and McDonald's Omega for almost all items. It was found that the correlations are greater than 0.3 and the Alpha and Omega values are greater than 0.7, whether in the study of each domain individually or in the study involving all 43 items, highlighting that one of the two items that did not meet a minimum acceptable value for correlation were removed from the instrument, while the other, due to its relevance, was reformulated. Conclusion: We concluded with an instrument with 42 items organized into 4 theoretical dimensions, social and health needs, performance, service provision and system facilitators. The instrument shows good validity and reliability. Continuing this study to validate the construct and complete the first version of this APE-CCI assessment instrument is essential.
Description
Keywords
Administração em enfermagem Cuidados continuados Ambiente de trabalho Prática integral de cuidados de saúde