Cultural Adaptation, Content Validation, and Reliability of the SACS 2.0 Instrument for Colombian Spanish

OBJECTIVE

To realize the cultural adaptation and content validation and evaluate the reliability of the SACS 2.0 instrument in Colombian Spanish.

METHODS

The researchers conducted a methodological study with a quantitative approach. The adaptation process was carried out in five stages: translation, synthesis, reverse translation, evaluation by a committee of experts, and testing of the adapted version. In addition, the interobserver reliability was evaluated by four nurses who examined 210 stomas.

RESULTS

All of the proposed stages were carried out successfully, and an adapted version of the instrument in Colombian Spanish was obtained. During the content validation stage, the instrument obtained a content validity index of 1. The adapted version of the test showed substantial agreement for the aspect of clarity, adequacy, and understandability. In the interobserver reliability, there was agreement in 95.7% of the evaluations for the classification of the lesions according to the quadrants (κ = 0.97-0.99).

CONCLUSIONS

Authors achieved a culturally adapted, valid, and reliable instrument for the evaluation and classification of peristomal skin alterations in Colombian Spanish.

Cultural Adaptation and Validation of the Ostomy Skin Tool to the Brazilian Portuguese

PURPOSE

To adapt the Ostomy Skin Tool (discoloration, erosion, and tissue overgrowth) to the Brazilian culture and to analyze psychometric properties of the adapted version.

DESIGN

Psychometric (methodologic) evaluation of the instrument.

SUBJECTS AND SETTING

Three ostomy/enterostomal therapy nurses evaluated the extent and severity of peristomal skin conditions in a sample of 109 adults 18 years or older with peristomal skin complications. These participants were receiving care in an ambulatory care center in outpatient health services in Sao Paulo and Curitiba, Brazil. In addition, interobserver reliability was measured using a group of 129 nurse participants who attended the Brazilian Congress of Stomatherapy held from November 12 to 15, 2017, in Belo Horizonte, a city located in the state of Minas Gerais, Brazil. Nurse participants assessed the descriptions of peristomal skin complications of the Portuguese version, using the same photographs used in the original DET score, purposely placed out of original order.

METHODS

The study was performed in 2 stages. The instrument was translated into Brazilian Portuguese by 2 bilingual translators, and back-translated into English. The back-translated version was sent to one of the developers of the instrument for additional evaluation. During stage 2, content validity was evaluated by 7 nurses with expertise in ostomy and peristomal skin care. Convergent validity was evaluated by correlating the severity of peristomal skin complications to pain intensity. Discriminant validity was evaluated based on type and time of ostomy creation, presence of retraction, and preoperative stoma site marking. Finally, interrater reliability was evaluated using standardized photograph evaluation reproduced in the same sequence as the original English language version of the instrument, along with paired scores from assessment of adults living with an ostomy generated by an investigator and nurse data collectors.

RESULTS

The Content Validity Index for the Ostomy Skin Tool was 0.83. Levels of mild agreements were obtained for the nurses' observations in the evaluation of peristomal skin complications using standardized photographs (κ= 0.314). In contrast, moderate to almost perfect agreements were obtained when scores were compared in the clinical setting (κ= 0.48-0.93, according to the domains). Positive correlations between the instrument and pain intensity (r = 0.44; P = .001) indicate convergent validity of the adapted version of the Ostomy Skin Tool. In contrast, analysis of discriminant validity was mixed and definitive conclusions about this form of construct validity cannot be made based on this study.

CONCLUSION

This study supports convergent validity and interrater reliability of the adapted version of the Ostomy Skin Tool.

Elaboration and Validation of Flowchart for the Prevention and Treatment of Intestinal Peristomal Skin Complications

Objective To build and validate a flowchart for the prevention and treatment of intestinal peristomal skin complications.

Method For the construction of the algorithms, a systematic review was carried out in health sciences databases comprising the last 10 years. The evaluation of the algorithms was carried out by 38 nurses. For the validation of the algorithms, the Delphi technique was used. The statistical analysis used was the content validity index and the Cronbach alpha coefficient. The questionnaire was sent by e-mail and in person after approval by the Ethics and Research Committee.

Results In the first evaluation of the algorithms, there was no agreement among the experts. However, after making the corrections suggested by the evaluators, the algorithms were resent, with a 100% consensus among the evaluators. The questions used to validate the algorithms contributed favourably to the internal consistency and content validation of the instrument, since the respective Cronbach alpha was 0.9062 and the global content validity index (g-CVI) was 0.91 in the first validation and 1.0 in the second validation.

Conclusion After an integrative literature review, the flowcharts were built and validated by a professional with experience in the area, showing 100% agreement among the experts in the second evaluation.

Construction and validation of educational technology to prevent complications in intestinal ostomies / periestomy skin

OBJECTIVE

To build and validate an educational booklet for preventing complications in intestinal ostomy and peristomy skin.

METHODS

Methodological study developed in: 1. Survey of the clinical profile of patients; 2. Integrative review; 3. Construction of technology; 4. Validation of educational material. The Delphi technique was used, with 18 judges with expertise in the field of stomatherapy. For data treatment, the Collective Subject Discourse (CSD), descriptive analysis, Kappa Index (K), binomial test and Content Validity Index (CVI) were used.

RESULTS

The agreement rate between judges was higher than 0.61, for K p> 0.05, a proportion of 80% for the binomial test and 80% for the CVI. . The booklet showed an excellent index for K, binomial test and global content validity, becoming validated.

FINAL CONSIDERATIONS

The booklet was validated in appearance and content, being an instrument that can favor communication between professionals and people with ostomies.

Molde de recorte da placa periestomal: possibilidades de aplicação de novos produtos

Introdução: Dermatite periestomal pode ser causada por vazamentos entre placa adesiva e pele. Objetivo: Descrever o molde de recorte da placa periestomal (MRPP) para avaliação simultânea de novos produtos para tratamento de dermatite. Métodos: Relato de experiência sobre a criação de modelo de recorte, com tamanho e largura suficientes para exposição de parte da pele com dermatite, para aplicação de outro produto. O recorte, em forma trapezoidal e, em acordo com as posições 3, 6, 9 ou 12 horas, correspondendo a um dos quadrantes, foi realizado na placa de carboximetilcelulose, pectina e gelatina acoplada à bolsa para estomas. A parte íntegra da placa aderida à pele adequou-se ao produto-controle. Na análise fotográfica, utilizou-se CorelDRAW 19.0. As lesões foram mensuradas em pixels. Resultado: O recorte não interferiu na aderência da placa do dispositivo de duas peças, possibilitou a aplicação e teste simultâneo de novo produto e a comparação da cicatrização com a placa. Conclusão: O MRPP é uma nova estratégia para estudos da aplicação de outros produtos para dermatite periestomal de forma simultânea no mesmo paciente e demonstra resultados positivos em seu emprego.

Peristomal plate cut mold: possibilities for applying new products

Introduction: peristomal dermatitis can be caused by leakage between adhesive plate and skin. Objective: to describe the peristomal plate cut mold (PPCM) for simultaneous evaluation of new products for the treatment of dermatitis. Methods: experience report about creation of a cut model, with sufficient size and width to expose part of the skin with dermatitis, to apply another product. The trapezoidal cut, according to positions 3, 6, 9 or 12 hours, corresponding to one of the quadrants, it was performed on the plate of carboxymethylcellulose, pectin, and gelatine coupled to the stoma bag. The entire part of the plate adhered to the skin was adapted to the control product. In the photographic analysis, CorelDRAW 19.0 was used. The lesions were measured in pixels. Result: the cut did not interfere with the adhesion of two parts device board, it made possible the simultaneous application and testing of a new product and the comparison of the healing with the plate. Conclusion: the PPCM is a new strategy for studies of the application of other products for peristomal dermatitis simultaneously in the same patient and demonstrates positive results in its use.