Validation of an educational manual for breast cancer patients undergoing radiotherapy

doi:10.1590/1518-8345.3197.3384

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Revista Latino-Americana de Enfermagem

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Original Article • Rev. Latino-Am. Enfermagem 28 • 2020 • https://doi.org/10.1590/1518-8345.3197.3384 copy

Validation of an educational manual for breast cancer patients undergoing radiotherapy^* * Paper extracted from doctoral dissertation “Development and assessment of education technology designed for women with breast cancer undergoing radiation therapy”, presented to Universidade de Brasília, Brasília, DF, Brazil.

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Objective:

to validate the content and appearance of an educational manual for breast cancer patients undergoing radiation therapy.

Method:

methodological research, which had the Theory of Psychometry as a theoretical-methodological reference. The minimum 80% Concordance Index was considered to ensure the adequacy of the material. The sample consisted of 17 experts in the subject area of the educational manual and 12 patients previously submitted to radiotherapy due to the diagnosis of breast cancer.

Results:

two items of the expert evaluation tool were found to have a concordance index <80%. The other items were considered adequate and/or totally adequate in the three blocks of analysis proposed for the experts: objectives - 89.07%, structure and presentation - 92.94%, and relevance - 93.13%; and good and/or very good in the five blocks of analysis proposed for the patients: objectives, organization, writing style, appearance, and motivation, all with 100% agreement rate.

Conclusion:

the educational manual, after having been perfected based on the suggestions of the sample and the scientific literature, was considered valid according to its content and appearance, suggesting its contribution to the clinical practice of nursing and to the understanding of the treatment to which patients with breast cancer are submitted.

Descriptors:
Oncology Nursing; Health Education; Nursing Care; Validation Study; Educational Technology; Breast Neoplasms

Evaluation items		n=17				%^¶ ¶ % = Concordance Index calculated by the sum of adequate and totally adequate judgments: TA+A x 100 / total of responses;
Evaluation items	I^* * I = Inadequate;	PA^† † PA = Partially adequate;	N^‡ ‡ N = Not sure;	A^§ § A = Adequate;	TA^\|\| \|\| TA = Totally adequate;
A. The material is consistent with the needs of breast cancer patients undergoing radiotherapy	0	0	0	6	11	100.00
B. It is consistent from the point of view of the treatment process (stages of radiotherapy)	0	0	0	4	13	100.00
C. It is coherent from the point of view of the health education process (it provides important and necessary information and guidance)	0	0	0	6	11	100.00
D. It is effective for the maintenance of self-care at home by the patient	0	0	2	6	9	88.23
E. Can promote changes in attitude and behavior	0	0	5	3	9	70.58
F. It can circulate in the scientific environment of oncology and radiotherapy	0	0	1	5	11	94.11
G. Meets the objectives of UNACON/HUB^ UNACON/ HUB = High Complexity Unit in Oncology of the University Hospital of Brasilia and other institutions that work with cancer and radiotherapy, and its use can be extended to other health services	0	3	2	4	8	70.58
Total	0	3	10	34	72	89.07

Evaluation items		n=17				%^¶ ¶ % = Concordance Index calculated by the sum of Adequate and Totally Adequate judgments: TA+A x 100 / total answers
Evaluation items	I^* * I = Inadequate;	PA^† † PA = Partially adequate;	N^‡ ‡ N = Not sure;	A^§ § A = Adequate;	TA^\|\| \|\| TA = Totally adequate;
A. The material is suitable for women with breast cancer who have undergone radiotherapy (target public)	0	0	0	6	11	100.00
B. The material is able to reach different socio-cultural layers	0	1	2	5	9	82.35
C. The information is presented in a clear and objective manner	0	0	0	4	13	100.00
D. The information presented is scientifically correct	0	0	0	3	14	100.00
E. There is a logical sequence in the content covered	0	1	1	2	13	88.23
F. The information is well structured in concordance and spelling	0	0	0	5	12	100.00
G. The writing style is able to reach different socio-cultural layers	0	1	2	7	7	82.35
H. The size of the title and topics is adequate	0	0	0	4	13	100.00
I. The illustrations are adequate and in sufficient amount	0	1	1	5	10	88.23
J. The amount of information and guidance is adequate	0	1	1	7	8	88.23
Total	0	5	7	48	110	92.94

Evaluation items		n=17				%^¶ ¶ % = Concordance Index calculated by the sum of Adequate and Totally Adequate judgments: TA+A x 100 / total answers
Evaluation items	I^* * I = Inadequate;	PA^† † PA = Partially adequate;	N^‡ ‡ N = Not sure;	A^§ § A = Adequate;	TA^\|\| \|\| TA = Totally adequate;
A. The topics covered portray aspects that are essential to self-care and which should be reinforced for the target audience	0	0	0	5	12	100.00
B. The manual allows the transfer and generalizations of learning in different contexts (hospital and home)	0	0	0	6	11	100.00
C. The manual is effective when it proposes to the patient to acquire knowledge to perform self-care at home	0	0	3	3	11	86.66
D. The manual is effective when it proposes to the patient the acquisition of information about the treatment process (steps of radiotherapy)	0	0	3	3	11	86.66
E. Addresses the most pertinent issues for the breast cancer patient in radiotherapy	0	0	0	9	8	100.00
F. It is suitable for use as a form of educational technology in the practice of health professionals	0	1	0	6	10	93.33
Total	0	1	6	32	63	93.13

Evaluation items	n=12					%^¶ ¶ % = Concordance Index calculated by the sum of good and very good judgments: MB+B x 100 / total
Evaluation items	B^* * B = Bad;	R^† † R = Regular;	N^‡ ‡ N = Not sure;	G^§ § G = Good;	VG^\|\| \|\| VG = Very good;
Objectives
A. The material meets the goals of women with breast cancer who undergo radiotherapy	0	0	0	2	10	100.00
B. The material brings the main needs of women with breast cancer during radiotherapy	0	0	0	2	10	100.00
C. Can help during treatment	0	0	0	2	10	100.00
D. Can help with home care	0	0	0	2	10	100.00
Total	0	0	0	8	40	100.00
Organization
A. The initial section indicates the content of the material	0	0	0	2	10	100.00
B. The size of the title and content is adequate	0	0	0	2	10	100.00
C. The topics have a logical sequence for learning	0	0	0	2	10	100.00
D. The amount of information is adequate	0	0	0	2	10	100.00
E. The topics covered portray key aspects	0	0	0	2	10	100.00
F. The material is appropriate and arouses the woman's interest in its use	0	0	0	2	10	100.00
Total	0	0	0	12	60	100.00
Writing style
A. The writing is in proper style	0	0	0	2	10	100.00
B. The text is interesting and the tone is friendly	0	0	0	2	10	100.00
C. Vocabulary is accessible and easy to understand	0	0	0	2	10	100.00
D. The theme of each session is linked to its text	0	0	0	2	10	100.00
E. The text is clear	0	0	0	2	10	100.00
F. The text is in sufficient quantity	0	0	0	2	10	100.00
Total	0	0	0	12	60	100.00
Appearance
A. The sections of the material have a logical sequence	0	0	0	2	10	100.00
B. The illustrations are simple and informative	0	0	0	2	10	100.00
C. The illustration is important to complement the text	0	0	0	2	10	100.00
D. The illustrations are realistic enough	0	0	0	2	10	100.00
E. The illustrations are in sufficient quantity	0	0	0	2	10	100.00
Total	0	0	0	10	50	100.00
Motivation
A. The material is suitable for the age, gender and culture of the target population	0	0	0	2	10	100.00
B. The material is logical	0	0	0	2	10	100.00
C. The interaction between the woman and the material is possible, encouraging actions of care	0	0	0	2	10	100.00
D. The material addresses the issues needed for women with breast cancer who undergo radiotherapy	0	0	0	2	10	100.00
E. Can help promote a change in attitude	0	0	0	2	10	100.00
F. The material offers women the opportunity to acquire the knowledge to perform self-care	0	0	0	2	10	100.00
Total	0	0	0	12	60	100.00

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding author: Paula Elaine Diniz dos Reis. E-mail: pauladiniz@unb.br