Desenvolvimento e validação de instrumento direcionado a enfermeiros para avaliação dos conhecimentos e práticas acerca dos cuidados paliativos

Abstract

Introduction: the WHO (World Health Organization) considers Palliative Care (PC) a humanitarian need in the whole world. Population-aging and the rising incidence of non-contagious chronic diseases generate the need for these cares be offered. However, health professionals are not yet acquainted with this subject. In the PC multi-professional team, the nurse plays an essential role, because he is on the front line to provide the care. Thus, it is important to know what the nurse understands about PC. However, yet, there is no validated instrument to evaluate nurses' knowledge and practices on PC. Goal: to develop an validated instrument to evaluate the knowledge and practices of palliative care directed at nurses. Method: this study is about a methodological and quantitative study that is composed of three phases: 1) elaboration of the dimensions about palliative care; 2) development of an evaluation instrument; and 3) content validation of the evaluation instrument. This research was appreciated and approved by the Research and Ethics Committee of the Federal University of Alagoas on February 22nd, 2018, received the note of number 2.508.803. Results: at the first step, at the integrative review, after the reading of the papers found, there were formulated three categories: 1- concepts, fundamentals, principles, and indications in palliative care, 2- symptom control and communication and 3- proceedings in palliative care. These categories have originated the instrument domains. At the second phase, it was built a questionnaire that has thirty items, nineteen of these evaluates the knowledge and eleven evaluates the practicing. It was submitted to the first round on the specialist panel, where twenty-eight experts nurses evaluated and made suggestions about the content of the instrument. It is worth mentioning that twenty items, or 66.67% of the questions, where modified. Four questions where excluded, that is 13.3% of the original amount. Six items, or 20% of the questionnaire, remained unaltered. At last, one question was added following specialists suggestions. Totaling twenty-seven items: sixteen evaluating the knowledge about PC and eleven the practicing. Subsequently, the questionnaire was submitted to the second round on the specialist panel, in which nineteen experts participated in evaluating and proposing improvement suggestions. After judges considerations, eleven items (40.74%) were modified, two questions (7.41%) were excluded and fourteen (51.85%) remained unaltered. Summarizing to the final instrument twenty-five items: sixteen to evaluate the knowledge and nine the practicing. Conclusion: the instrument developed in this research is considered adequate to evaluate knowledge and practicing of nurses on PC. Mentioning that the agreement percentage of specialists on the three dimensions reached values beyond the established standards, that is 80%.