RESUMEN
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 reviewwas 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, theDelphi 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. (AU)
Asunto(s)
Humanos , Piel/lesiones , Algoritmos , Diseño de Software , Estomas Quirúrgicos/efectos adversos , Técnica Delphi , Cuidados de la Piel/normasRESUMEN
BACKGROUND: The reliability of homeopathic prescriptions may increase through resource to objective signs and guiding symptoms with significant positive likelihood ratio (LR). We estimated LR for six objective signs attributed to the homeopathic medicine Natrum muriaticum (Nat-m). METHODS: In this multi-centre observational assessment, we investigated the prevalence of six signs in the general patient population and among good responders to Nat-m in daily homeopathic practice. Next, we calculated LR for these six signs. RESULTS: Data from 36 good responders to Nat-m and 836 general population patients were compared. We found statistically significant positive LR (95% confidence interval) for signs such as lip cracks (1.94; 1.15 to 3.24), recurrent herpes (2.29; 1.20 to 4.37), hairline eruptions (2.07; 1.03 to 4.18), and dry hands (2.13; 1.23 to 3.69). CONCLUSIONS: Objective signs with significant positive LR might increase the reliability of homeopathic prescriptions. Further studies are warranted to confirm the validity of this approach.
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Materia Medica/normas , Adulto , Argentina , Brasil , Humanos , Materia Medica/uso terapéutico , Persona de Mediana Edad , Países Bajos , Prevalencia , Cuidados de la Piel/métodos , Cuidados de la Piel/normas , Estomatitis Herpética/tratamiento farmacológicoRESUMEN
Brazil has the third largest prison population in the world. Studies on the health status of prisoners have shown that skin diseases, especially infectious skin diseases, are prevalent in this population. Because some skin diseases can be prevented, strategies to inform and guide incarcerated persons may be helpful. PURPOSE: The purpose of this study was to develop and validate a manual of skin care for use by prisoners in the São Paulo State Prison System. METHODS: To develop the manual, a Google search to ensure originality of the concept was conducted, followed by an integrative literature search of the MEDLINE and the Latin American and Caribbean Health Science Literature, and the medical records of the prison system were reviewed for content. The Delphi technique was used to validate content; the content validity index (CVI) was determined based on the ratings of an expert panel of 10 prison employees who were health professionals and have experience providing care to prisoners. Twenty (20) target-users (prisoners) also evaluated the manual. The experts responded to questionnaires (sent by email) containing 19 items related to the manual's objective, structure and presentation, and relevance. Items were rated on a Likert-type scale where 1 = inadequate, 2 = partially inadequate, 3 = adequate, 4 = very adequate, and NA = not applicable, and participants also could provide suggestions and comments on the manual. The prisoners used a paper-and-pencil questionnaire to assess the manual that included 14 items with 3-choice answers (agree, undecided, disagree) on the utility and ability to understand the manual topics and space to write concerns and suggestions regarding the utility of the content; they also could offer their thoughts and opinions about the manual. The proportion of agreement among responses was calculated. RESULTS: The overall CVI of the first round of evaluations was 1.0. Suggested changes were to include guidelines on the proper use of medications and modify some wording. The overall CVI of the next round was 1.0 (100% agreement). The evaluation by target users showed an agreement of 98.6%. The final version of the manual has 8 topics, 12 subtopics, and 29 illustrations; topics include skin, hair, and nail care and skin diseases. A printed version is available in the prison library and an electronic copy was sent to all prisons in the State of São Paulo to be printed as needed. CONCLUSION: A manual providing guidelines on skin care for prison populations was developed and validated with the intent to improve prisoner quality of life and care. Research to examine overall manual usage and the effect of the information and guidance on healthy behaviors, prevention, and management of skin diseases is warranted.
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Prisioneros , Cuidados de la Piel/instrumentación , Adulto , Brasil , Femenino , Estado de Salud , Humanos , Masculino , Prisiones/normas , Prisiones/estadística & datos numéricos , Desarrollo de Programa/métodos , Cuidados de la Piel/métodos , Cuidados de la Piel/normas , Encuestas y CuestionariosRESUMEN
Newborn cord infections commonly lead to neonatal sepsis and death, particularly in low-resource countries where newborns may receive unhygienic cord care. Topical application of chlorhexidine to the newborn's cord has been shown to prevent infection. Such benefits may be particularly important in Haiti. We explored current cord care practices by conducting a qualitative study using five focus groups among key community stakeholders (mothers of newborns/children under age two years, pregnant women, traditional birth attendants, community health workers, traditional healers) in Petit-Goâve, Haiti. Data collection was guided by the Health Belief Model. Results suggest community stakeholders recognise that infants are susceptible to cord infection and that cord infection is a serious threat to newborns. Long-held traditional cord care practices are potential barriers to adopting a new cord care intervention. However, all groups acknowledged that traditional practices could be harmful to the newborn while expressing a willingness to adopt practices that would protect the newborn. Results demonstrate potential acceptability for altering traditional cord care practices among neonatal caretakers in Haiti. An informational campaign designed to educate local health workers and new mothers to eliminate unhygienic cord applications while promoting chlorhexidine application may be a strong approach for preventing neonatal cord infections.