Resumo
Objetivos: confirmar e refinar a estrutura de protocolo de assistência multiprofissional para pessoas com úlcera venosa atendidas na atenção primária. Método: Estudo metodológico, uantitativo, realizado em três etapas: elaboração do instrumento, a partir de revisão da literatura; e validação de conteúdo, por meio da técnica Delphi em duas etapas: uma com 51 juízes e outra com 35. A análise utilizou o ín d i c e K a p p a ≥ 0,81 e Ín d i c e d e V a l i d a d e d e C o n t e ú d o (I V C )> 0,80, e o t e s t e d e W i l c o x o n para comparação entre as duas etapas de validação. Resultados: Verificou-se que, das 15 categorias do protocolo, 12 apresentaram melhores escores na fase Delphi 2. Em relação aos requisitos de avaliação do protocolo, constatou-se que as notas atribuídas pelos juízes na segunda fase foram maiores em nove dos 10 itens, confirmando a validade do instrumento. Conclusão: A versão elaborada e validada por profissionais consiste num roteiro de abordagem para pacientes com úlcera venosa na atenção primária..
Referências
Abbade LPF, Lastória S. Venous ulcer: epidemiology, physiopathology, diagnosis and treatment [internet]. Int j dermatol. 2005 [cited 2015 Jan 09]; 44:449-56. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-4632.2004.02456.x/epdf
Raffetto JD, Marston WA. Venous ulcer: what is new?. Plast Reconstr Surg [internet]. 2011 [cited 2015 Jan 09];127(1):S279-S88. Available from: http://journals.lww.com/plasreconsurg/pages/articleviewer.aspx?year=2011&issue=01001&article=00040&type=abstract
Finlayson K, Helen Edwards H, Courtney M. Relationships between preventive activities, psychosocial factors and recurrence of venous leg ulcers: a prospective study. J Adv Nurs [internet]. 2011 [cited 2015 Feb 12];67(10):2180-90. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2648.2011.05653.x/pdf
Purwins S, HerbergerK, Debus ES, Rustenbach SJ, Pelzer P, Rabe E, Scha¨fer E, Stadler R, Augustin M. Cost-of-illness of chronic leg ulcers in Germany. Int Wound J [internet]. 2010 [cited 2015 Jan 09];7:97–102. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1742-481X.2010.00660.x/epdf
Jull A, Parag V, Walker N, Rodgers A. Responsiveness of generic and disease-specific health-related quality of life instruments to venous ulcer healing. Wound Repair Regen [internet]. 2010 [cited 2015 Jan 09];18(1):26-30. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1524-475X.2009.00556.x/epdf
Warriner RA, Carter MJ. The current state of evidence-based protocols in wound care. Plast Reconstr Surg [internet]. 2011 [cited 2015 Feb 12];127(1):S144-S53. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21200285
O'Donnell Jr TF, Balk EM. The need for an Intersociety Consensus Guideline for venous ulcer. J vasc surg [internet]. 2011 [cited 2015 Feb 12];54(6):S83-S90. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2648.2011.05653.x/epdf
Müller-Bühl U, Leutgeb R, Bungartz J, Szecsenyi J, Laux G. Expenditure of chronic venous leg ulcer management in German primary care: results from a population-based study. Int Wound J [internet]. 2013 [cited 2015 Feb 20];10(1):52-6. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1742-481X.2012.00942.x/epdf
Keeney S, Hasson F, McKenna H. Consulting the oracle: ten lessons from the Delphi Technique in nursing research. J Adv Nurs [internet]. 2006 [cited 2015 Feb 20]; 2(53):205-12. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2648.2006.03716.x/epdf
Polit DF, Beck CT. The content validity index: are you sure you know what's being reported? Critique and recommendations. Res Nurs Health [internet]. 2006 [cited 2015 Jan 09];29(5):489-97. Available from: http://cfd.ntunhs.edu.tw/ezfiles/6/1006/attach/33/pta_6871_6791004_64131.pdf
Costa IKF, Salvetti MG, Souza AJG, Dias TYAF, Dantas VD, Torres GV. Assistance protocol to people with venous ulcers: a methodological study. Online braz j nurs [internet]. 2015 [cited 2015 Jun 01];14(1):05-15. Available from: http://www.objnursing.uff.br/index.php/nursing/article/viewFile/4692/pdf_358
Grant JS, Davis LL. Selection and use of content experts for instrument development. Res Nurs Health [internet]. 1997 [cited 2015 Feb 20]; 20(3):269-74. Available from: http://onlinelibrary.wiley.com/doi/10.1002/(SICI)1098-240X(199706)20:3%3C269::AID-NUR9%3E3.0.CO;2-G/pdf
Weller CD, Evans S. Monitoring patterns and quality of care for people diagnosed with venous leg ulcers: the argument for a national venous leg ulcer registry. Wound Practice and Research [internet]. 2014 [cited 2015 Feb 09];22(2):68-73. Available from: http://web.a.ebscohost.com.ez18.periodicos.capes.gov.br/ehost/pdfviewer/pdfviewer?vid=2&sid=4151089a-3f4b-4a9b-98cd-25eb07a5b428%40sessionmgr4004&hid=4109
Greer N, Foman NA, MacDonald R, Dorrian J, Fitzgerald P, Rutks I, Wilt TJ. Advanced wound care therapies for nonhealing diabetic, venous, and arterial ulcers: a systematic review. Ann Intern Med [internet]. 2013 [cited 2015 Jan 09];159(8):532-42. Available from: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0054957/pdf/TOC.pdf
Yarwood-Ross L. Venous ulcers: assessment and wound dressing selection. Nurs Residential Care [internet]. 2013 [cited 2015 Feb 20];15(9):596-601. Available from: http://www.magonlinelibrary.com/doi/full/10.12968/nrec.2013.15.9.596
Harding K, Sumner M, Cardinal M. A prospective, multicentre, randomised controlled study of human fibroblast-derived dermal substitute (Dermagraft) in patients with venous leg ulcers. Int wound j [internet]. 2013 [cited 2015 Feb 20]; 10:132-7. Available from: http://onlinelibrary.wiley.com/doi/10.1111/iwj.12053/epdf
Tobón J. Complementary and alternative medicine for older adults with venous leg ulcer pain. J gerontol nurs [internet]. 2010 [cited 2015 Jan 09];36(11):46-53. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21544964
Maddox D. Effects of venous leg ulceration on patients’ quality of life. Nurs stand [internet]. 2012 [cited 2015 Jan 09];26(38):42-9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22787970
Dolibog P, Franek A, Taradaj J, Dolibog P, Blaszczak E, Polak A, et al. A Comparative Clinical Study on Five Types of Compression Therapy in Patients with Venous Leg Ulcers. Int J Med Sci [internet]. 2014 [cited 2015 Feb 12]; 11(1). Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3880989/
Palfreyman SJ, Tod AM, Brazier JE, Michaels JA. A systematic review of health-related quality of life instruments used for people with venous ulcers: an assessment of their suitability and psychometric properties. Journal of Clinical Nursing [internet]. 2010 [cited 2015 Feb 20]; 19(19-20): 2673–703. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2702.2010.03269.x/pdf