CONSTRUCTION AND VALIDATION OF AN EDUCATIONAL MANUAL FOR FAMILY CAREGIVERS OF OLDER ADULTS AFTER A STROKE

Fuhrmann, Ana Cláudia; Bierhals, Carla Cristiane Becker Kottwitz; Santos, Naiana Oliveira dos; Machado, Diani de Oliveira; Cordova, Fernanda Peixoto; Paskulin, Lisiane Manganelli Girardi

doi:10.1590/1980-265X-TCE-2019-0208

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Original Article • Texto contexto - enferm. 30 • 2021 • https://doi.org/10.1590/1980-265X-TCE-2019-0208 copy

CONSTRUCTION AND VALIDATION OF AN EDUCATIONAL MANUAL FOR FAMILY CAREGIVERS OF OLDER ADULTS AFTER A STROKE

CONSTRUCCIÓN Y VALIDACIÓN DE MANUAL EDUCATIVO PARA FAMILIARES CUIDADOSOS DE PERSONAS MAYORES TRAS ACCIDENTE CEREBRO VASCULAR

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

to construct and validate an educational manual for family caregivers of older adult dependent on care after a stroke.

Method

a methodological study with four stages: focus group with five family caregivers, to identify doubts and difficulties regarding home care for older adults with stroke; preparation of the manual by six researchers; content validation by 18 specialist nurses, and face validation by 12 family caregivers. For data analysis, thematic analysis was performed, the Content Validity Index (CVI) was calculated, and the consensus of the target population was verified.

Results

from the focus group, the experiences and challenges faced by the caregivers in caring for aged family members with a stroke were identified, which supported the elaboration of an educative manual, in the second stage. In the expert consensus, a global CVI of 0.97 was obtained and, in face validation, a consensus of 95.51% by the target population.

Conclusion

an educational manual for family caregivers of older adults after a stroke was built, which was validated in terms of content and appearance. In view of this, it can be used as complementary material to the guidelines of the professionals, enabling improvement of the care provided by family members to the older adult dependent on care after a stroke.

DESCRIPTORS
Caregivers; Older adult; Stroke; Manuals; Validation studies; Nursing

Evaluation items	N=18				CVI^\|\|
Evaluation items	I^*	ALR^†	QR^‡	ER^§	CVI^\|\|
1 - What is a Stroke? How to prevent a stroke	-	-	6	12	1.0
2 - Taking care of the caregiver	-	2	6	10	0.88
3 - Care with food	-	1	3	14	0.94
4 - Care with tracheostomy	-	-	8	10	1.0
5 - Care with medications	-	-	2	16	1.0
6 - Care with hygiene	-	-	5	13	1.0
7 - Care with eliminations	-	-	5	13	1.0
8 - Skin care	-	1	2	15	0.94
9 - Care for taking off and putting on clothes	-	-	7	11	1.0
10 - Care with positioning	-	-	3	15	1.0
11 - Care with the environment	-	-	7	11	1.0
Regarding the structure
12 - The information is relevant for a better quality of care provided by family caregivers to older adults with a stroke	-	-	5	13	1.0
13 - The structure and presentation are coherent and appropriate	-	2	5	11	0.88
14 - The information is based on updated scientific evidence	-	-	7	11	1.0
15 - There is a logical sequence in the content proposed	-	-	7	11	1.0
16 - The information is presented clearly and objectively	-	-	9	9	1.0
17 - The writing style corresponds to the level of knowledge of the target population	-	1	8	9	0.94
18 - The illustrations are expressive and enough	-	2	8	8	0.88
19 - The number of pages is adequate	-	-	9	9	1.0
Total					0.97

Evaluation items	Suggestions	How it was	Changes
2 - Taking care of the caregiver	Mention, more explicitly, the possibility of care burden, self-care, and body posture of the caregiver when performing care; include the possibilities of supporting the caregiver.		Inclusion of the following phrases: - If you did not have help from other people to care for the older adult, you may be overloaded. To prevent this from happening, you can arrange for a family gathering to establish what activities each family member can help with. - Remember to be careful with your body posture when performing some care action in the older adult so as not to cause spinal problems.
3 - Care with food	Add the need for nutritional guidance and medical prescription of a tube diet, as well as fluid intake and moistening of mucous membranes and lips in a patient on a catheter-only diet.		Inclusion of the following phrases: - It is important to have monitoring by a nutritionist and medical prescription of the diet. - If feeding is only through the probe, water must also be placed through the tube. - Moisten the older adult's lips with a cloth with water, avoiding wounds.
8 - Skin care	Include guidance on the possibility of using a pneumatic mattress and the importance of moisturizing the skin.	If possible, use a pyramidal mattress - egg box (image), which relieves the person's weight at different points where the bones are most prominent.	If possible, use a pyramidal mattress - egg box (image 1) or pneumatic air mattress (image 2), which relieve the person's weight at different points where the bones are more prominent. Inclusion of the following phrase: - Whenever possible, apply moisturizer on the skin, this helps to prevent the appearance of wounds.
13 - The structure and presentation are coherent and appropriate	Explore more information through images; improve the graphical presentation; shorter sentences.	41 images	48 images
17 - The writing style corresponds to the level of knowledge of the target population	Improve the language, so that it is easy and understandable to the caregivers.		The entire manual was reviewed and more colloquial words were used.
18 - The illustrations are expressive and enough	Include images about care with the environment; a suggestion of adequacy of the images regarding how to put diapers on.		The entire manual was reviewed, images were included and others suitable for better illustration.

Evaluation items	N=12			%
Evaluation items	Y^*	N^†	IP^‡	%
Organization
Did the cover catch your attention?	12	-	-	100%
Is the content sequence adequate?	12	-	-	100%
Is the size of the manual adequate?	10	-	2	83.33%
Writing style
Are the sentences easy to understand?	12	-	-	100%
Is the written content clear and appropriate?	12	-	-	100%
Di the text draw your attention?	12	-	-	100%
Appearance
Are the illustrations adequate?	12	-	-	100%
Do the illustrations complement the text?	11	-	1	91.66
Are the pages or sections organized?	12	-	-	100%
Motivation
In your opinion, will any caregiver of an older adult who has suffered a stroke understand this information?	10	-	2	83.33%
Did you feel motivated to read until the end?	10	-	2	83.33%
Does the manual address issues necessary for the caregiver of an older adult with stroke sequelae?	12	-	-	100%
Does the manual provide caregivers with information to develop care activities properly?	12	-	-	100%

Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Campus Universitário Trindade, 88040-970 Florianópolis - Santa Catarina - Brasil, Tel.: (55 48) 3721-4915 / (55 48) 3721-9043 - Florianópolis - SC - Brazil
E-mail: textoecontexto@contato.ufsc.br

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[1] CORRESPONDING AUTHOR
Ana Cláudia Fuhrmann ana_fuhrmann@hotmail.com