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Advisor(s)
Abstract(s)
Da literatura sobre monitorização da cicatrização de feridas crónicas demonstra que a
única escala validada para Portugal é a PUSH-PT. A evidência demonstra a
necessidade de um instrumento que seja simultaneamente fácil de aplicar mas mais
completo, pelo que a adaptação e validação para a população portuguesa do
instrumento RESVECH 2.0 – escala de monitorização de feridas crónicas tornou-se o
objetivo deste estudo, pretendendo-se estimar as propriedades psicométricas do
mesmo, nomeadamente consistência interna, validade coincidente e sensibilidade.
Com recurso a metodologia quantitativa desenhou-se uma investigação observacional
de carácter prospectivo e de provas repetidas, tendo sido cumpridas todas as etapas e
pressupostos de tradução e adaptação cultural de instrumentos de medida, sendo que
para dissipar algumas das dúvidas levantadas e por forma a imprimir melhorias na
compreensibilidade e clareza linguística/científica da escala, se constituiu um Focus
Group com 15 peritos. Após construção da versão final do instrumento e sua
retroversão, os autores da escala original avaliaram a equivalência conceptual,
semântica e cultural. O trabalho de campo decorreu nos meses de Março a Julho de
2015 e as monitorizações aconteceram em 5 momentos distintos: avaliação inicial, às
2 - 4 - 6 e 8 semanas de evolução, num total 57 feridas crónicas. Os indivíduos com
ferida apresentavam uma mediana de 80 anos, maioritariamente do género feminino
(63,64%). Em relação à etiologia de ferida: maioritariamente úlcera de pressão (74%),
16% úlceras de perna e 10% pé diabético. Cerca de 75% das lesões apresentava
tecido necrótico ou fibrinoso, mais de metade denotava bordos lesados ou espessados
e em 31,58% visualizavam-se 5 ou mais sinais de inflamação local. Os resultados do
estudo de confiabilidade permitiram concluir que a versão portuguesa da escala
RESVECH 2.0-PT apresenta boa consistência interna, com α de Cronbach de 0,786
no início do estudo, que aumentou ao longo do mesmo. Foram também observadas
associações dos itens que a compõem com o score total, tornando-se mais fortes ao
longo do estudo. A validade de critério foi avaliada por meio de uma validação
coincidente, aplicando em simultâneo a escala PUSH-PT nos mesmos participantes. O
estudo da sensibilidade à mudança foi efectuado em função de modificações
registadas nas feridas da amostra. Assim, decidiu-se estudar as mudanças ocorridas
em função em função da cicatrização final das lesões (n=12). Verificou-se que o
instrumento discriminou entre as feridas que cicatrizam e as que não cicatrizam, bem
entre as feridas do primeiro e quarto quartis, com significância estatística (p<0,001).
The existing literature on monitoring chronic wound healing shows that the only scale validated to Portugal is PUSH-PT. The evidence demonstrates the need for an instrument that is both easy to apply but more complete, so the adaptation and validation to the Portuguese population of the RESVECH 2.0 - chronic wound healing monitoring tool become our goal, aiming to estimate its psychometric properties, namely internal consistency, concurrent validity and sensitivity. Using the quantitative methodology, an observational research of prospective character and repeated evidences was designed. All the steps and principles of translation and cultural adaptation of measuring tools were accomplished. In order to clear up some previously raised doubts and aiming to improve the understanding and the linguistic/scientific accuracy of the tool, a Focus Group of 15 experts was formed. After the final version of the tool and the corresponding back translation was built, one of the authors of the original scale assessed its conceptual, semantic and cultural equivalence (content validity). Based on 44 individuals (residents in the MDR ,LDM of the UCC-A and Nursing Home as well as in UCC-B), who met the defined requirements, a sample of 57 chronic wounds was made, an average of 1,3 wounds per individual. The field work was during the months of Mars to July 2015 and the monitoring of the chronic wounds happened in 5 different moments: initial assessment - 2 - 4 – 6 and after 8 weeks of evolution. The individuals had a median of 80 years, mostly female gender (63.64%), and regarding wound etiology: mainly pressure ulcer (74%), 16% leg ulcers and 10% diabetic foot. About 75% of the lesions had necrotic or fibrinous tissue, more than half showed damaged or thickened edges; and 5 or more signs of local inflammation were seen in 31.58% of them. Results of the reliability study allowed us to conclude that the Portuguese version of the RESVECH 2.0-PT scale shows good internal consistency, Cronbach's α =0.786 at the beginning, which increased throughout the study. Associations of the items that compose it with the total score were also observed, becoming stronger throughout the study. The criterion validity was evaluated by means of a coincident validation, simultaneously applying the PUSH-PT scale in the same participants. The study of sensitivity to change was performed based on changes in the wounds of the sample. Thus, it was decided to study the changes that occurred in function as a result of the final healing of the lesions (n = 12). It was verified that the instrument discriminated between wounds that healed and those that did not heal, as well as wounds of the first and fourth quartiles, with statistical significance (p <0.001).
The existing literature on monitoring chronic wound healing shows that the only scale validated to Portugal is PUSH-PT. The evidence demonstrates the need for an instrument that is both easy to apply but more complete, so the adaptation and validation to the Portuguese population of the RESVECH 2.0 - chronic wound healing monitoring tool become our goal, aiming to estimate its psychometric properties, namely internal consistency, concurrent validity and sensitivity. Using the quantitative methodology, an observational research of prospective character and repeated evidences was designed. All the steps and principles of translation and cultural adaptation of measuring tools were accomplished. In order to clear up some previously raised doubts and aiming to improve the understanding and the linguistic/scientific accuracy of the tool, a Focus Group of 15 experts was formed. After the final version of the tool and the corresponding back translation was built, one of the authors of the original scale assessed its conceptual, semantic and cultural equivalence (content validity). Based on 44 individuals (residents in the MDR ,LDM of the UCC-A and Nursing Home as well as in UCC-B), who met the defined requirements, a sample of 57 chronic wounds was made, an average of 1,3 wounds per individual. The field work was during the months of Mars to July 2015 and the monitoring of the chronic wounds happened in 5 different moments: initial assessment - 2 - 4 – 6 and after 8 weeks of evolution. The individuals had a median of 80 years, mostly female gender (63.64%), and regarding wound etiology: mainly pressure ulcer (74%), 16% leg ulcers and 10% diabetic foot. About 75% of the lesions had necrotic or fibrinous tissue, more than half showed damaged or thickened edges; and 5 or more signs of local inflammation were seen in 31.58% of them. Results of the reliability study allowed us to conclude that the Portuguese version of the RESVECH 2.0-PT scale shows good internal consistency, Cronbach's α =0.786 at the beginning, which increased throughout the study. Associations of the items that compose it with the total score were also observed, becoming stronger throughout the study. The criterion validity was evaluated by means of a coincident validation, simultaneously applying the PUSH-PT scale in the same participants. The study of sensitivity to change was performed based on changes in the wounds of the sample. Thus, it was decided to study the changes that occurred in function as a result of the final healing of the lesions (n = 12). It was verified that the instrument discriminated between wounds that healed and those that did not heal, as well as wounds of the first and fourth quartiles, with statistical significance (p <0.001).
Description
Keywords
Cicatrização Feridas crónicas Escala Validação Healing Chronic wounds Scale Validation