IST Nurse<sup>®</sup>: development and validity evidence of a mobile application as a support for the clinical management of Sexually Transmitted Infections

Sousa, Leilane Barbosa de; Sousa, Ismael Moreira de; Costa, Edmara Chaves; Freitas, Ana Paula Fragoso de; Santos, Lydia Vieira Freitas dos; Ferreira, Adriana Gomes Nogueira

doi:10.1590/1518-8345.7207.4317

Leilane Barbosa de Sousa

Study concept and design

Obtaining data

Data analysis and interpretation

Statistical analysis

Obtaining financing

Drafting the manuscript

Critical review of the manuscript as to its relevant intellectual content

Approved the final version of the text

Universidade da Integração Internacional da Lusofonia Afro-Brasileira, Redenção, CE, Brazil.

https://orcid.org/0000-0003-0266-6255

Ismael Moreira de Sousa

Study concept and design

Obtaining data

Data analysis and interpretation

Statistical analysis

Drafting the manuscript

Critical review of the manuscript as to its relevant intellectual content

Approved the final version of the text

Universidade da Integração Internacional da Lusofonia Afro-Brasileira, Redenção, CE, Brazil.

2 Scholarship holder at the Fundação Cearense de Apoio ao Desenvolvimento Científico e Tecnológico (Funcap), Brazil.

https://orcid.org/0000-0003-2178-867X

Edmara Chaves Costa

Data analysis and interpretation

Statistical analysis

Drafting the manuscript

Critical review of the manuscript as to its relevant intellectual content

Others (Guidance as a member of the dissertation committee)

Approved the final version of the text

Universidade da Integração Internacional da Lusofonia Afro-Brasileira, Redenção, CE, Brazil.

https://orcid.org/0000-0003-0007-6681

Ana Paula Fragoso de Freitas

Data analysis and interpretation

Statistical analysis

Drafting the manuscript

Critical review of the manuscript as to its relevant intellectual content

Approved the final version of the text

Faculdade Rodolfo Teófilo, Curso de Graduação em Enfermagem, Fortaleza, CE, Brazil.

https://orcid.org/0000-0003-1984-939X

Lydia Vieira Freitas dos Santos

Data analysis and interpretation

Obtaining financing

Drafting the manuscript

Critical review of the manuscript as to its relevant intellectual content

Others (Guidance as a member of the dissertation committee)

Approved the final version of the text

Universidade da Integração Internacional da Lusofonia Afro-Brasileira, Redenção, CE, Brazil.

https://orcid.org/0000-0003-4277-7486

Adriana Gomes Nogueira Ferreira

Study concept and design

Data analysis and interpretation

Drafting the manuscript

Critical review of the manuscript as to its relevant intellectual content

Others (Collaboration in structuring references, creating the introduction and summary)

Approved the final version of the text

Universidade Federal do Maranhão, Imperatriz, MA, Brazil.

https://orcid.org/0000-0002-7107-1151

Corresponding author: Ismael Moreira de Sousa E-mail: ismaelmsenf@gmail.com https://orcid.org/0000-0000-2178-867X

Conflict of interest:

the authors have declared that there is no conflict of interest.

Associate Editor:

Maria Lúcia Zanetti

N°	Questions	min^†	m^‡	max^§	std dev^\|\|	CVI^¶	p**
1	Does the application maintain coherence with the needs of nurses regarding clinical reasoning for the management of STI*?	4	4	4	0	1	1
2	Does the application promote systematization for the clinical management of STI*?	4	4	4	0	1	1
3	Can the application circulate in the scientific community in the area of clinical management of STI*?	4	4	4	0	1	1
4	Is the application material suitable for supporting nurses during the clinical management of STI*?	4	4	4	0	1	1
5	Is the information organized in a clear and objective way?	3	3.71	4	0.49	1	1
6	Is the information presented consistent with scientific evidence?	4	4	4	0	1	1
7	Is there a logical sequence of the proposed content?	4	4	4	0	1	1
8	Is the material appropriate in terms of the sociocultural level of the proposed target audience?	4	4	4	0	1	1
9	Is the information well-structured in terms of agreement and spelling?	2	3.29	4	0.95	0,76	0,71
10	Does the writing style match the level of knowledge of the proposed target audience?	3	3.86	4	0.38	1	1
11	Are the illustrations expressive and sufficient?	3	3.43	4	0.53	1	1
12	Is the number of steps adequate?	3	3.86	4	0.38	1	1
13	Are the size of items and topics appropriate?	3	3.86	4	0.38	1	1
14	Do the themes portray the key aspects that must be paid attention to?	3	3.86	4	0.38	1	1
15	Does the application provide nurses with sufficient requirements aimed at people with STI^* for the clinical management of STI*?	3	3.86	4	0.38	1	1
16	Is the application suitable for use by any nurse who works with care for people with STI*?	3	3.86	4	0.38	1	1

N°	Questions	min^†	m^‡	max^§	std dev^\|\|	CVI^¶	p**
1	I found it easy to insert data into this application. For example, using QR code, list of options, etc.	3	3.57	4	0.53	1	1
2	When I make a mistake, it’s easy to correct it.	3	3.57	4	0.53	1	1
3	I found the help/tips given by the application to be useful.	3	3.71	4	0.49	1	1
4	It was easy to find the information I needed.	3	3.71	4	0.49	1	1
5	I felt in command using this application.	3	3.71	4	0.49	1	1
6	I thought the time it took to complete the tasks was adequate.	3	3.71	4	0.49	1	1
7	It was easy to learn how to use this application. (To answer this question, you should only consider using the IST* Nurse^® application, not the installation process).	3	3.71	4	0.49	1	1
8	The sequence of actions in the application corresponds to the way I normally perform them, for example, the order of buttons, data fields, etc.	3	3.57	4	0.53	1	1
9	It is easy to do what I want using this application.	3	3.71	4	0.49	1	1
10	It was easy to navigate the application’s menus and screens.	3	3.86	4	0.38	1	1
11	The application meets my needs.	3	3.86	4	0.38	1	1
12	I would recommend this applicationto others.	3	3.86	4	0.38	1	1
13	Even in a hurry, I would be able to perform tasks in this application.	3	3.86	4	0.38	1	1
14	I found the application to be consistent. For example, all functions can be performed in a similar way.	3	3.71	4	0.49	1	1
15	It is easy to remember how to do things on this application.	3	3.86	4	0.38	1	1
16	I would use this application frequently.	3	3.71	4	0.49	1	1
17	The organization of menus and action commands (such as buttons and links) is logical, allowing to easily find them on the screen.	3	3.86	4	0.38	1	1
18	I was able to complete the tasks successfully using this application.	3	3.86	4	0.38	1	1
19	I enjoyed using this application.	3	3.86	4	0.38	1	1
20	The application offers all the information necessary to complete tasks in a clear and understandable way.	3	3.86	4	0.38	1	1
21	I found the application very complicated to use.	1	1	1	0	0	0
22	The symbols and items are clear and intuitive.	3	3.71	4	0.49	1	1
23	I found the texts easy to read.	3	3.86	4	0.38	1	1
24	I found the application unnecessarily complex. I had to remember, research or think a lot to complete the tasks.	1	1	1	0	0	0
25	The terminology used in texts, labels, titles, etc., is easy to understand.	3	3.71	4	0.49	1	1
26	I would need the support of a person to use this application.	1	1.29	2	0.49	0	0
27	I felt comfortable using this application.	3	3.71	4	0.49	1	1
28	The application behaved as I expected.	3	3.71	4	0.49	1	1
29	I found using this application frustrating.	1	1	1	0	0	0
30	I found the application’s various functions to be well integrated.	3	3.57	4	0.53	1	1
31	I felt very confident using this application.	3	3.86	4	0.38	1	1

N°	Questions	min^†	m^‡	max^§	std dev^\|\|	CVI^¶	p**
1	Are the available functions sufficient to carry out the tasks proposed by the application?	4	4	4	0	1	1
2	Is the language used in the application understandable?	3	3.67	4	0.58	1	1
3	Is the application consistent with the target audience it is intended for?	4	4	4	0	1	1
4	Is the amount of information placed on each screen appropriate for the target audience?	3	3.67	4	0.58	1	1
5	Are the colors used with balance, that is, are they well distributed, thus avoiding visual pollution?	3	3.67	4	0.58	1	1
6	By using the application, is it possible to obtain information to achieve your primary objective?	3	3.67	4	0.58	1	1
7	Does it invite or instigate the user to systematic reasoning?	4	4	4	0	1	1
8	Is the information contained in the application coherent?	4	4	4	0	1	1
9	Is it attractive to the user?	4	4	4	0	1	1
10	Is it easy to understand the concepts used?	4	4	4	0	1	1
11	Are the functions easy to learn to use?	4	4	4	0	1	1
12	Are the presentations of interface functions (icons, menus...) easy to understand?	3	3.67	4	0.58	1	1
13	Is it easy to operate and control the operation?	4	4	4	0	1	1
14	Is the application consistent with what is expected in relation to what is scientifically proposed?	4	4	4	0	1	1
15	In the presence of errors, does the application allow recovery of the data already provided?	3	3	3	NA^††	1	1
16	Does it prevent unauthorized, accidental or deliberate access to data programs?	3	3.5	4	0.71	1	1
17	Does it promote user integrity?	4	4	4	0	1	1
18	Is it easy to find faults when they occur?	3	3	3	NA^††	1	1
19	Is it easy to adapt to other environments without applying other actions or means than those provided for this purpose in the software considered?	3	3.67	4	0.58	1	1
20	Is the application easy to install?	3	3.67	4	0.58	1	1
21	Is it good enough to be replaced?	4	4	4	NA^††	1	1
22	Does it issue some form of feedback when the user follows a negative line of reasoning?	4	4	4	0	1	1
23	Does it offer a summary of user performance at the end of use?	4	4	4	0	1	1

Suggestion	Decision
Analysis of content evidence
Better illustrate the home screen.	Accepted. The logo was modified to better relate to the purpose of the application.
Insert more images to help the nurse better identify/suspect during management.	Accepted. New images were inserted for the presented clinic of infections.
Improve image quality.
Improve information on the conduct of syphilis management, especially regarding serological scar.	Accepted. Content was added to guide nurses regarding the need to request tests and conduct to monitor syphilis cases.
Address the immunological window in the issue of rapid tests.	Accepted. Information was inserted to request a new collection within 30 days in case of suspicion or negative results.
Improve quick test images.	Accepted. New images were inserted to assist in the interpretation of rapid test results.
Insert treatment for anogenital warts.	Accepted. The treatment indication was inserted.
Analysis of functional performance evidence
Facilitate the installation process by entering one of the stores.	Not accepted. The application will only be made available in stores after application in an effectiveness evaluation study.
Analysis of usability evidence
Insert a link in the application that leads to the notification.	Not accepted. This possibility had been considered during prototyping, but due to guidance from the software development team, it was not included.

[1] Corresponding author: Ismael Moreira de Sousa E-mail: ismaelmsenf@gmail.com https://orcid.org/0000-0000-2178-867X

Brazil

Brazil

Abstract

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