Construction and validation of an instrument to assess the care for prisoners living with HIV/AIDS

Apolinario, Fernando Henrique; Papini, Silvia Justina; Spiri, Wilza Carla

doi:10.1590/0103-11042022E713I

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ORIGINAL ARTICLE • Saúde debate 46 (spe7) • Dec 2022 • https://doi.org/10.1590/0103-11042022E713I copy

Construction and validation of an instrument to assess the care for prisoners living with HIV/AIDS

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

This study aimed to build and validate indicators for the health care of those deprived of freedom living with HIV/AIDS, being a methodological development study carried out in two stages. In the first stage, there was the construction of indicators through a literature review in national and international databases. In the second stage, the content and appearance validation were performed using the Delphi technique method; ten judges specialized in the care of the person living with HIV/AIDS and practical performance in the prison environment participated in this stage, most of them being nurses working in prison units. After that, the internal consistency analysis was performed, and the instrument was applied to 10 health managers of prison units, and the Cronbach’s alpha coefficient was calculated. The instrument resulted in five dimensions: Physical Structure; Human Resources; Work Process Organization; Health Records; and Adherence to Treatment. The instrument obtained 80% of agreement from the judges regarding content and appearance. The overall Cronbach’s alpha was 0.90. The instrument was validated in appearance, content, and consistency for the evaluation of care to those deprived of freedom living with HIV/AIDS.

KEYWORDS
Prisoners; Health care quality; Program evaluation; Acquired Immunodeficiency Syndrome; Validation studies

Evaluation criteria	EFINAPS		RHNASP		OPANASP
Evaluation criteria	Freq.	% of agreement	Freq.	% of agreement	Freq.	% of agreement
Intelligibility and Objectivity
Agree	9	90	9	90	8	80
Disagree	1	10	1	10	1	10
Do not agree nor disagree	0	0	0	0	1	10
Pertinency
Agree	9	90	9	90	8	80
Disagree	1	10	1	10	2	20
Do not agree nor disagree	0	0	0	0	0	0
Appearance
Agree	9	90	9	90	8	80
Disagree	1	10	1	10	2	20
Do not agree nor disagree	0	0	0	0	0	0
Accuracy
Agree	9	90	9	90	10	100
Disagree	1	10	1	10	0	0
Do not agree nor disagree	0	0	0	0	0	0

Evaluation criteria	PRONTNASP		ATARV
Evaluation criteria	Freq.	% of agreement	Freq.	% of agreement
Intelligibility and Objectivity
Agree	9	90	8	80
Disagree	0	0	1	10
Do not agree nor disagree	1	10	1	10
Pertinency
Agree	9	90	8	80
Disagree	0	0	0	0
Do not agree nor disagree	1	10	2	20
Appearance
Agree	10	100	9	90
Disagree	0	0		00
Do not agree nor disagree	0	0	1	10
Accuracy
Agree	10	100	10	100
Disagree	0	0	0	0
Do not agree nor disagree	0	0	0	0

General	Alpha
Considering 259 items	0,91	all items (259)
Considering 172 items	0,91	excluding items with same answers (0 or 1 in all items (152)
Per dominium
Physical Structure	0,79
HR		-
Process Organization	0,86
Medical Record of the Nucleus of Health Attendance	0,67
Adherence to the Treatment with Anti-retroviral	0,69

Centro Brasileiro de Estudos de Saúde Av. Brasil, 4036, sala 802, 21040-361 Rio de Janeiro - RJ Brasil, Tel. 55 21-3882-9140, Fax.55 21-2260-3782 - Rio de Janeiro - RJ - Brazil
E-mail: revista@saudeemdebate.org.br

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EFINASP	Question according to the instrument	Changes suggested
Intelligibility and Objectivity	Adequate room for clinical attendance, with hygiene, ventilation and privacy for the attendance?	Adequate room for clinical attendance, with hygiene, ventilation and granting privacy for the attendance?
Aspect and Accuracy	Waiting room with illumination conditions, ventilation and chairs for the users?	Separate the items in the alternative, as follows: - Illuminated waiting room - Ventilated waiting room - Chairs for user in the waiting room
RHNASP	Question according to the instrument	Changes suggested
Intelligibility and Objectivity	The penitentiary health technical team includes: clinical doctor; infectologist doctor, nurse, nurse auxiliary, nursing technician; psychologist, social worker, pharmacist; security officer; administrative assistants; buccal health assistant in the odontological office?	In theory, the security officer and the administrative assistant are not prepared to perform in the health area. Suggestion: change the question to ‘The team of the ambulatory of penitentiary health counts on…’
OPANASP	Question according to the instrument	Changes suggested
Aspect and Accuracy	Activities performed by; pharmacist, psychologist and social worker?	Include nursing, dentist and doctor
Intelligibility and Accuracy	Identification and general characteristics of the HIV/Aids service?	Place at the beginning of the questionnaire of the first matrix.
Intelligibility and Accuracy	Is there a systematic registration of the number of attendances and procedures?	Explain what is a systematic registration. Is it a weakly registration? Does it involve a form with specific/standard blank to be filled in?
Aspect		Include the characterization of CD4 number under 350 and above 350.
		Include: are there difficulties for genotyping?
		Use the word Aids the same way all over the instrument.