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    Educação para o autogerenciamento de pacientes com câncer de cabeça e pescoço apoiada em multimídia
    (Universidade Federal de São Paulo (UNIFESP), 2017-10-26) Hortense, Flavia Tatiana Pedrolo [UNIFESP]; Domenico, Edvane Birelo Lopes De [UNIFESP]; Bergerot, Cristiane Decat; http://lattes.cnpq.br/4394065755397984; http://lattes.cnpq.br/9590895567864681; http://lattes.cnpq.br/4611985668712695; Universidade Federal de São Paulo (UNIFESP)
    Head and neck cancer (CA/HN) is among the ten most frequent in Brazil, reaching about 1.7% of the population. The treatments can result in functional and aesthetic deficiencies, depending on location and staging. Educational interventions should be developed to assist patient in the process of adaptation and generation of selfmanagement skills. Objectives: to build, validate the content of an educational program based on the principles of self-management, directed to patients with CA/HN, and to evaluate the effectiveness of this program in a comparative way, and through a reception study. Method: study of mixed nature, divided into three steps: (1) methodological study, for the construction and validation of a script for the development of learning objects, (2) experimental study, randomized and controlled, to evaluate the educational intervention based on the usual action versus the multimedia, through the instruments Functional Assessment of Cancer Therapy-Head and Neck (FACT-H & N) and Hospital Anxiety and Depression Scale (HADS) in four time points, from the beginning of the treatment to the follow-up period (12 months) and (3) qualitative study to evaluate the educational material developed on the basis of the principle of the reception study. The results were analyzed according to the study design of each step. Results: in the first step, the script was approved by 99 percent of all health professionals. The kappa free-marginal statistical test presented a value of 0.68%, giving a substantial agreement, resulting in the production of a printed manual and an educational video. In the second, the control group (GC) reported gradual decrease on the quality of life (QOL) scores over the time points, while the experiment group (GE) has increased progressively their scores. The prevalence of anxiety and depression (AD) symptoms was low in both groups, next to those described in the literature. The correlation was significant between the presence of AD symptoms and poor QOL. GC patients showed significant worsening in social/family well-being and on the prevalence of additional concerns related to CA/HN, while the GE presented decrease on anxiety symptoms and increase on emotional well-being. In the last step, the educational material was evaluated as satisfactory for the subject sequence, length, language and images used. Participants have attested that the educational materials helped in the development of skills for self-management. Conclusion: the steps adopted for the construction and validation of the content, and for the development of educational materials were effective, appropriate and capable of reproduction. The different criteria used for the educational material evaluation indicated and highlighted the benefit of this educational action. It was observed that patients have opted for a better adaptive response to the illness. In addition, the assessment routine brought indicators that guided the team working. The educational material was considered appropriate for the target population and capable of generating skills for self-management.