Validación de modelos lógicos para el manejo del tratamiento de la tuberculosis

Linhares, Shirley Ribeiro dos Santos; Paz, Elisabete Pimenta Araújo; Cardoso, Gisela Cordeiro Pereira

doi:10.1590/0034-7167-2019-0812

Brasil

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 73 (suppl 6) • 2020 • https://doi.org/10.1590/0034-7167-2019-0812 linkcopiar

Validación de modelos lógicos para el manejo del tratamiento de la tuberculosis

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivos: describir las etapas de validación de los modelos lógicos del Tratamiento Directamente Observado y del Sistema de Información de la Estrategia Directly Observed Treatment Short-Course.

Métodos: estudio metodológico realizado de febrero a junio de 2018, en dos etapas. El contenido de los ítems que componen los modelos ha sido fundamentado en evidencias científicas y sometido a la apreciación de especialistas para validación de contenido. Se aplicó el Índice de Validez de Contenido, aceptándose el valor ≥ 0,80.

Resultados: la concordancia, cuanto a su validez, ha sido satisfactoria en los 79 ítems analizados. Los modelos lógicos han sido considerados válidos con Índice de Validez Global de 0,91 para el Tratamiento Directamente Observado y de 0,87 para el Sistema de Información.

Conclusiones: los modelos lógicos han sido considerados válidos cuanto al contenido, siendo un instrumento útil y oportuno para fundamentar los gestores en la toma de decisión.

Descriptores: Estudio de Validación; Tuberculosis; Gestión en Salud; Evaluación en Salud; Servicios de Salud

Structural component	Items analyzed Directly Observed Treatment	IVC
Input	Human Resources	1
	Standardization of conduct	0.87
	Physical structure	0.87
	Tuberculostatic drugs	1
	Information system*	1
	Computer	0.87
	Internet	1
	Printer	0.62
	Refrigerator	1
	Sputum pot	1
	Rapid HIV** test	1
	Electronic medical record	0.87
	Green Book	1
	Training of professionals in DOT***	0.87
Activities	Contacts evaluation	1
	Direct observation of medication taking	0.87
	Monthly consultations	1
	Conducting home visits	0.75
	Case notification at SINAN-RIO****	1
	Registration in the Green Book	0.87
	Proper record in the electronic medical record	0.87
	Follow-up bulletin update	0.75
	Conducting active search for missing persons	0.87
	Rapid HIV testing	1
	Rapid Test Request, BAAR *****, Culture,	1
	TS *****, chest X-ray and PPD ******	0.87
Product	No. of observations made during the attack and maintenance phase	1
	No. of consultations carried out	1
	% of home visits made per patient	0.75
	No. of cases notified at SINAN-RIO	1
	No. of cases recorded in the Green Book	0.87
	% of medical records with proper record	0.87
	% of notifications updated in the Green Book	0.75
	Number of absentees in the semester	0.62
	% of contacts evaluated	0.87
	% of patients being treated with result of HIV-RT	1
	% Rapid Test, BAAR, Culture, TS, chest radiography and PPD requested	0.75
	Improvement in the technical capacity of professionals for TB********* service	1
Immediate result	Improvement in the quality of information	1
	Reduced underreporting of TB cases	1
	Practices for diagnosis and treatment of the appropriate disease	0.87
	Reduction of treatment abandonment	1
Intermediate result	Increased adherence to treatment	1
	Increased cure rate	1
	Reduced incidence of tuberculosis	1
	Reduction of TB morbidity and mortality	1

Structural component	Items analyzed Information System	CVI
Input	Human resources	1
	Protocols	0.87
	Physical structure	0.87
	Greenbook	1
	Notification Sheets	0.87
	Computer	0.87
	Internet	1
	Printer	0.87
	TB cases follow-up bulletin	0.87
	Electronic medical record	0.87
Activities	Training of professionals in IS *	1
	Protocol for recording information	0.87
	Cleaning the SINAN database	0.62
	Registration of information in ISs *	1
	Updating and sending the follow-up bulletin	0.75
	Timely closure of the case in the Information Systems	0.87
	Monthly monitoring of records in ISs	0.87
	Periodic verification of data completeness at SINAN	0.87
	Analysis of variables 1 and 3 * of the electronic medical record	0.75
Product	No. of training courses	0.87
	Protocol for recording the information prepared	0.87
	% of qualified records	0.87
	% TB cases registered in ISs	0.87
	% notifications with updated information	0.87
	No. of cases closed timely	0.87
	Regularly monitored IS	0.87
	% of notification forms with records in all fields	0.87
	No. of new cases closed as a cure	0.62
	No. of patients computed in variable 3	0.75
Immediate result	Professionals aware of the importance of notification and proper registration of cases
Immediate result	Up-to-date and reliable information on the treatment and status of the disease	1
Intermediat eresult	Reduction of underreporting	1
Intermediat eresult	Improving the quality of filling out the notification form	1
Impact	Strengthening the actions of the Tuberculosis Control Program	1
Impact	Improvement in the analysis of the population's health situation and in the evaluation of the work developed in the PA*	1

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Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
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[TFN1] Note:** Information System: SINAN-RIO and Laboratory Environment Manager (LEM);** Acquired Immunodeficiency Syndrome (HIV); *** Directly Observed Treatment (DOT); **** Notifiable Diseases Information System - Rio (SINAN-RIO); ***** Bacillus Acid Resistant Alcohol (BAAR); ****** Sensitivity Test (TS); ******* Purified Protein Derivative Molecular Rapid Test (PPD); ********Tuberculosis (TB).