doctoralThesis
Validação da escala de verificação do nível de adaptação da pessoa com estomia (ENAE) elaborada à luz do modelo de Roy
Fecha
2018-02-26Registro en:
XAVIER, Suenia Silva de Mesquita. Validação da escala de verificação do nível de adaptação da pessoa com estomia (ENAE) elaborada à luz do modelo de Roy. 2018. 127f. Tese (Doutorado em Enfermagem na Atenção à Saúde) - Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, 2018.
Autor
Xavier, Suenia Silva de Mesquita
Resumen
Ostomy is the opening of any hollow viscera to the outside of the body through a surgical
procedure, aiming to supplement the need for feeding or elimination. Having an ostomy can
restrict perspectives in life given that the physical alterations extend beyond the physiological
realm and reach the psychosocial, which demand that the individual adapt to the new reality.
It is believed that the use of an instrument developed based on a theory of caretaking that
focuses on adaptation, such as the Roy Adaptation Model, can collaborate with the
Systemization of Nursing Care Assistance and to the care of people with ostomy. Thus, this
study aims to analyze evidence of the validity of the Verification of the Level of Adaptation
Scale for People with Ostomy (ENAE – in Portuguese), based on the Roy Model. This
research is characterized as a methodological validation study of the ENAE, which was
developed in four stages: 1st – the theoretical pole constituted by two rounds of submissions
of the instrument to the judges, the carrying out of a pilot test, and lexical and grammatical
correction; 2nd – the experimental pole that involves the planning of the application of the
instrument, application and collection of data, the instrument having been applied to 200
people with ostomy at the Child and Adult Rehabilitation Center of Rio Grande do Norte; 3rd
– the analytical pole involving the carrying out of the statistical analysis, applying Cronbach’s
Alpha to analyze the internal consistency of the items, Pearson correlation, and T test to
analyze the precision of the instrument, as well as the Kruskal-Wallis test to verify the
evidence of criteria validity; 4th- the socio-demographic, clinical and health characteristics,
and the dimensions of the ENAE in which the Mann-Whitney test was used. As a result, in
the first stage, 13 items received suggestions for improvement, 3 items were unified as their
approaches were similar, and 1 item was excluded. After the adjustments were completed in
the first stage, a consensus among the judges was arrived at with regard to the
representativeness of the items and the permanence in the modes. The final version of the
instrument comprised 32 items distributed in four adaptive modes, the Cronbach’s Alpha rates
being: physiological mode (α=0,680), self-concept (α=0,889), role function (α=0,749) and
interdependence (α=0,793), with a global value of Alpha at 0,980. In the test-retest, regarding
reliability, it was observed that the correlations were between 0,723 to 0,870, all of them
strong and statistically significant (p<0,005) and with regard to the precision, it was verified
that the means of the scores were very similar between the test and the retest, therefore
without any statistically significant difference (T test). As for the criteria validity, it was
verified that a significant relationship exits (p<0,001) through the Kruskal-Wallis test. A
significant relationship was verified among sex, age, income, time of ostomy, permanence
and presence of complications and the ENAE domains. Thus, the alternate hypothesis of the
study is accepted, insofar as the instrument presented strong evidence of validity. The
expectation is that the use of an instrument developed from a theory and validated
scientifically, can contribute to the assistance practice for people with ostomy and aid in the
development of nursing as a science.