Validação da escala EORTC QLQ-INFO 25 para pacientes com câncer e aplicação na ação educativa
Data
2021
Autores
Bezerra, Michele
Orientadores
De Domenico, Edvane Birelo Lopes [UNIFESP]
Tipo
Dissertação de mestrado profissional
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: O câncer é considerado uma doença crônica e progressiva, que ocasiona sofrimento físico, emocional e psicoespiritual. Considerando a importância da participação efetiva do paciente no processo de adoecimento e o papel da ação educativa para o alcance desse objetivo, conhecer a qualidade da informação na perspectiva do paciente é condição essencial para ajustes necessários no plano assistencial da equipe interprofissional. Objetivos: Validar a escala da European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire EORTC QLQ Info 25 para pacientes com câncer; avaliar a qualidade de vida dos pacientes com câncer por meio da escala da EORTC QLQ C30; testar a validade e confiabilidade do módulo informação, instrumento EORTC QLQ Info 25; identificar os principais domínios que influenciam na percepção do paciente sobre as informações recebidas e correlacionar com as características sociodemográficas e clínicas; propor uma diretriz, como produto, para a educação em saúde multiprofissional ao paciente e sua família na vigência do tratamento antineoplásico baseada nos domínios do instrumento validado (conteúdo não incluído neste documento, disponível em arquivo próprio). Método: estudo metodológico, transversal, quantitativo, analítico, com validação de propriedades psicométricas de instrumento de medida. A confiabilidade foi avaliada por meio da consistência interna e da estabilidade, por meio do coeficiente alfa de Cronbach, Coeficiente de Correlação Intraclasse (ICC) e teste e reteste. A coleta de dados deu-se com 128 pacientes, utilizando-se os instrumentos: questionário com as características sociodemográficas e clínicas, EORTC QLQ-C30 com o módulo EORTC QLQ-Info 25, e o instrumento para validação convergente Supportive Care Needs Survey – Short Form 34, versão brasileira. Resultados: 60,90% dos respondentes eram do sexo feminino, 81,3% casados, 84,4% possuíam Ensino Superior completo e a prevalência da classificação socioeconômico foi B1 e 2 (86%). Em relação aos diagnósticos de câncer, o câncer de mama (44%) foi seguido do câncer colorretal (41%) e o tempo transcorrido desde o diagnóstico foi de até 12 meses para 65,7% dos respondentes. O coeficiente Alfa de Cronbach obtido foi de 0,85, indicando que o protocolo é consistente e com alta confiabilidade. Averiguou-se que não existe diferença estatística entre o teste e o reteste, indicando que o protocolo é reprodutivo. Foi analisada a estabilidade por meio do ICC e Correlação de Spearman-Brown, verificando-se que os instrumentos são concordantes. Na análise do instrumento Info-25, os participantes apresentaram nível satisfatório de informações recebidas. Entretanto, há domínios cujas médias de aprovação foram inferiores a 70%, a saber: InfoThse (Informação sobre outros serviços); InfoDifp (Informação sobre locais de cuidados), InfoHelp (Informação sobre autoajuda); e, ainda, inferior a 50%, InfoWrin (Informação escrita). Em relação às respostas dos pacientes para as questões abertas, foi evidenciado que, para os respondentes desejosos de mais informações, os conteúdos mais citados foram risco de insucesso (progressão) e/ou recidiva, sobrevivência e cuidados em casa. Em contrapartida, houve respondentes que atestaram o não desejo para a obtenção de mais informações. Conclusão: a validação do instrumento foi obtida, demonstrando ser confiável, consistente e estável nos testes psicométricos. Implicações para a prática: o instrumento permite avaliar as informações prestadas ao paciente com câncer, na perspectiva de vários domínios, evidenciando os processos que necessitam de aprimoramento para a qualificação da ação educativa em saúde. Assim, como produto, estruturou-se uma diretriz para a educação em saúde de pacientes e familiares na vigência de tratamento antineoplásico. A composição da diretriz está subdivida em caracterização do problema, plano de intervenção, atividades e responsabilização.
Introduction: Cancer is considered a chronic and progressive disease that causes physical, emotional, and psycho-spiritual suffering. Considering the importance of effective patient participation in the disease process and the role of educational action to achieve this goal, getting to know the quality of information from the patient's perspective is an essential condition for necessary adjustments in the interprofessional team´s care plan. Objectives: Validate the European Organization for Research and Treatment Cancer Core Quality of Life Questionnaire EORTC QLQ Info 25 scale for cancer patients; assess cancer patient's quality of life using the scale EORTC QLQ C30; test the validity and reliability of the information module, EORTC QLQ Info 25 instrument; identify the main domains that influence the patient's perception of the information received and correlate them with sociodemographic and clinical characteristics; to propose a guideline, as a product, for multidisciplinary health education for patients and their families during antineoplastic treatment based on the domains of the validated instrument (content not included in this document, available in the proper file). Method: methodological, cross-sectional, quantitative and analytical study, with validation of psychometric properties of measurement instrument. Reliability was assessed through internal consistency and stability, through Cronbach's alpha coefficient, Intraclass Correlation Coefficient (ICC) and test-retest. Data collection took place with 128 patients. A questionnaire was filled in with sociodemographic and clinical characteristics, EORTC QLQ-C30 with the EORTC QLQ-Info 25 module and the instrument for convergent validation Supportive Care Needs Survey – Short Form 34, Brazilian version. Results: 60.90% of respondents were female, 81.3% were married, 84.4% had completed higher education and the prevalence of socioeconomic classification was B1 and 2 (86%). Regarding cancer diagnoses, breast cancer (44%) was followed by colorectal cancer (41%) and the time elapsed since diagnosis was up to 12 months for 65.7% of respondents. The results showed a Cronbach's alpha coefficient of 0.85, indicating that the protocol is consistent and highly reliable. It was found that there is no statistical difference between the test-retest, concluding that the protocol is reproductive. Stability was analyzed using the ICC and Spearman-Brown correlation; the technique showed that both instruments are in agreement. In the analysis of the Info-25 instrument, the assessed patients presented a satisfactory level of information received. However, there are domains whose approval average was below 70%, namely: InfoThse (Information about other services); InfoDifp (Information about places of care), InfoHelp (Information about self-help); and still less than 50%, InfoWrin (Written Information). Regarding the patients' answers to the open questions, it was evidenced that for the respondents who wanted more information, the most cited contents were risk of failure (progression) and/or relapse, survival, and home care. On the other hand, there were respondents who attested to their unwillingness to obtain more information. Conclusion: instrument validation was obtained, proving to be reliable, consistent, and stable in psychometric tests. Implications for practice: the instrument allows the assessment of the information provided to cancer patients from the perspective of various domains, highlighting the processes that need improvement for the qualification of the educational action in health. Thus, as a product, a guideline for the health education of patients and families was structured in the presence of anticancer treatment. The composition of the guideline is subdivided into problem characterization, intervention plan, activities, and accountability.
Introduction: Cancer is considered a chronic and progressive disease that causes physical, emotional, and psycho-spiritual suffering. Considering the importance of effective patient participation in the disease process and the role of educational action to achieve this goal, getting to know the quality of information from the patient's perspective is an essential condition for necessary adjustments in the interprofessional team´s care plan. Objectives: Validate the European Organization for Research and Treatment Cancer Core Quality of Life Questionnaire EORTC QLQ Info 25 scale for cancer patients; assess cancer patient's quality of life using the scale EORTC QLQ C30; test the validity and reliability of the information module, EORTC QLQ Info 25 instrument; identify the main domains that influence the patient's perception of the information received and correlate them with sociodemographic and clinical characteristics; to propose a guideline, as a product, for multidisciplinary health education for patients and their families during antineoplastic treatment based on the domains of the validated instrument (content not included in this document, available in the proper file). Method: methodological, cross-sectional, quantitative and analytical study, with validation of psychometric properties of measurement instrument. Reliability was assessed through internal consistency and stability, through Cronbach's alpha coefficient, Intraclass Correlation Coefficient (ICC) and test-retest. Data collection took place with 128 patients. A questionnaire was filled in with sociodemographic and clinical characteristics, EORTC QLQ-C30 with the EORTC QLQ-Info 25 module and the instrument for convergent validation Supportive Care Needs Survey – Short Form 34, Brazilian version. Results: 60.90% of respondents were female, 81.3% were married, 84.4% had completed higher education and the prevalence of socioeconomic classification was B1 and 2 (86%). Regarding cancer diagnoses, breast cancer (44%) was followed by colorectal cancer (41%) and the time elapsed since diagnosis was up to 12 months for 65.7% of respondents. The results showed a Cronbach's alpha coefficient of 0.85, indicating that the protocol is consistent and highly reliable. It was found that there is no statistical difference between the test-retest, concluding that the protocol is reproductive. Stability was analyzed using the ICC and Spearman-Brown correlation; the technique showed that both instruments are in agreement. In the analysis of the Info-25 instrument, the assessed patients presented a satisfactory level of information received. However, there are domains whose approval average was below 70%, namely: InfoThse (Information about other services); InfoDifp (Information about places of care), InfoHelp (Information about self-help); and still less than 50%, InfoWrin (Written Information). Regarding the patients' answers to the open questions, it was evidenced that for the respondents who wanted more information, the most cited contents were risk of failure (progression) and/or relapse, survival, and home care. On the other hand, there were respondents who attested to their unwillingness to obtain more information. Conclusion: instrument validation was obtained, proving to be reliable, consistent, and stable in psychometric tests. Implications for practice: the instrument allows the assessment of the information provided to cancer patients from the perspective of various domains, highlighting the processes that need improvement for the qualification of the educational action in health. Thus, as a product, a guideline for the health education of patients and families was structured in the presence of anticancer treatment. The composition of the guideline is subdivided into problem characterization, intervention plan, activities, and accountability.