Navegando por Palavras-chave "Validation Study"
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- ItemSomente MetadadadosAcurácia do teste de linguagem expressiva para identificar alterações morfossintáticas em crianças pré-escolares(Universidade Federal de São Paulo (UNIFESP), 2021) Kayanoki, Fabiana Yumi Sato [UNIFESP]; Puglisi, Marina Leite [UNIFESP]; Universidade Federal de São PauloIntroduction: The evaluation of preschool children's grammatical aspects is essential to identify the areas of major language impairments, in addition to often directing the speech rehabilitation of these children. Thus, it is necessary to develop simple, specific protocols and with reference standards. In Brazil, however, there are few instruments used to assess preschool children using statistical and psychometric analyses, especially with regard to validation in protocols in speech therapy practice. Objective: To validate, compare forms of analysis of the grammatical modality and verify the diagnostic accuracy of the Expressive Language Test (ELT) to identify children with low language performance. Methods: The ELT is an instrument created to assess the grammatical skills of preschoolers and was applied in 618 children aged 3 years and 6 months to 6 years and 1 month enrolled in Years I or II of Municipal Schools of Early Childhood Education in São Caetano do Sul. Children were individually evaluated and encouraged to describe the content of 12 scenes, based on guide questions (picture-elicited language samples). Three objective forms of grammatical analysis of responses were proposed, in which only the sentences pertinent to the content of the test figures were analyzed, pondering the obligatory context of the scenes: 1) Mean Length Utterances – words (MLU-w): mean number of words produced in a sentence; 2) Length Utterances (LU): sum of number of words produced in a sentence e 3) Percentage Grammatical Utterances (PGU): ratio of the number of grammatically correct sentences to the total number of sentences produced in the test. Then, the MLU-w_II and LU_II were computed again, but considering the entire production of the child (both the pertinent sentences and those that extrapolated the content of the figures) for all utterances produced in each item in order to verify whether these measures would also assess the child's complete response. All forms were computed and tested for construct validity by Confirmatory Factor Analysis and only those with the most fitting indicators were considered to test the accuracy. To investigate whether the TLE is sensitive to identify children with Language Disorder (LD), the vocabulary, receptive grammar and phonological working memory tests were considered as the gold standard. And the accuracy of the ELT was assessed using the ROC Curve and the sensitivity and specificity values. Results: The LU, MLU-w and PEG analyzes were considered valid to assess the grammatical skills of children. However, EME-p_II and EE_II did not show indexes of adequacy as robust as the previous ones and therefore were not validated for the ELT. In addition, the test showed 66% Positive Predictive Value (probability of a child presenting a positive result and LD) and 67% Negative Predictive Value (probability of a child presenting a negative result and not LD) for the diagnosis of LD in preschoolers. Conclusions: LU and PEG are the two recommended measures for grammatical analysis for ELT. The cutoff point of the ROC curve -0.429 showed the best prognostic accuracy for the test with a sensitivity of 70.4% and specificity of 66.6%.
- ItemSomente MetadadadosAdaptação transcultural e validação para a lingua portuguesa do Brasil do instrumento “Health Sciences Evidence Based Practice Questionnaire (HS-EBP)”(Universidade Federal de São Paulo (UNIFESP), 2021) Schwenck, Rubia Cristina Bozza [UNIFESP]; Domenico, Edvane Birelo Lopes De [UNIFESP]; Universidade Federal de São PauloINTRODUCTION: Evidence-based practice is a challenge that requires the development of individual and organizational structures, which includes understanding the factors that interfere in its use by healthcare professionals. The Health Sciences Evidence Based Practice Questionnaire – HS-ESP – assesses the different dimensions of constructing an evidence-based practice as a process to respond to situations that arise form daily clinical practice. OBJECTIVES: The aim of this study was to conduct a cross-cultural adaptation of the Health Sciences Evidence Based Questionnaire to Brazilian Portuguese. METHOD: This was a methodological, cross-sectional and quantitative study divided into two steps. The first step was the cross-cultural adaptation and validation of the instrument, both with their respective phases. The second phase included the application of the instrument in a field study with healthcare professionals. The instrument’s reliability was assessed via internal consistency using Cronbach’s alpha coefficient, and stability via test-retest. Convergent validation was measured using the Evidence Based Practice and Clinical Effectiveness Questionnaire. Pearson’s R was applied, and confirmatory factor analysis performed. RESULTS: Content validity was obtained on the third round, with the final title of Questionário HS-EBP- Prática Baseada em Evidência nas Ciências da Saúde, which was administered to 305 healthcare professionals. Of these, 53.1% were nurses, 15.7% were physical therapists, 7.9% were physicians, 7.5% were biomedics, 6.65% were dieticians, 5.6% were pharmacists, 2.3% were psychologists, and 1.3% were speech therapists. Of the participants, 85.9% had a non-degree certificate or specialization degree, 6.9% had a master’s degree, and 3% had a PhD. Most professionals were female, n:254 (83.3%), and mean age was 35 years. Reliability was verified using internal consistency, Cronbach’s alpha coefficient (0.970), similar to that of the original version, and test-retest stability via Pearson’s R (r=0.766), which indicated strong correlation. Convergent validity was assessed using Pearson’s R (r=0.683) and was positive, with moderate correlation between the instruments. The chi-squared test was significant (<0.001) for all the models obtained and all the models tested. Conclusion: The Brazilian version of the HS-EBP- Health Sciences Evidence Based Practice Questionnaire was valid and reliable for reproducibility.
- ItemSomente MetadadadosAvaliação do nível de responsividade em pacientes neurológicos sob ventilação mecânica: proposta de um novo instrumento(Universidade Federal de São Paulo (UNIFESP), 2020-07-10) Monteiro, Ana Paula Gomes [UNIFESP]; Vidotto, Milena Carlos [UNIFESP]; Universidade Federal de São PauloIntroduction: Among the demands of a patient with brain injury and changes in the level of consciousness is possible the need for invasive ventilatory support. The moment of ventilatory weaning and orotracheal extubation is a major challenge in the management of this specific group. Therefore, considering the limitations demonstrated by the available instruments, in addition to the complexity of neurological patients, it is necessary to develop new scales to assess neurological patients using invasive mechanical ventilation. Objective: To construct and validate a new instrument for assessing the level of responsiveness of neurological patients under mechanical ventilation. Method: This is a study of methodological development called validation, developed from quantitative and qualitative perspectives. The development took place in five methodological stages: In the first, an integrative literature review was carried out. The second stage covered the process of building a new instrument. In the third moment, the search and selection of judges took place through curriculum evaluation. The fourth stage involved the content validation, encompassing the verification of the content validity coefficient and the analysis of the qualitative content pointed out by the judges. Finally, the fifth step involved the adequacy review of the proposed instrument. Results: The integrative literature review had 71 articles involving instruments already available that could guide the construction of a new instrument composed of five categories. The expert consultation process included 19 judges, most of whom were physiotherapists (84,21%), doctors (68,42%) and with expertise and experience in intensive care (84,21%). Considering the content validity coefficient by categories, ocular response (CVCt = 0,95), motor response (CVCt = 0,96) and ventilatory autonomy (CVCt = 0,90) obtained excellent coefficients and cough response categories and oral automation returned the satisfactorily values of CVCt = 0,86 and CVCt = 0,88, respectively. The qualitative analysis of the content allowed the exploration of the records of the open questions of the questionnaire, involving notes pertinent to the modification, allowing the improvement in the initial proposal of the instrument. Conclusion: The instrument built and whose content was validated, considering the criteria of importance, objectivity, relevance, clarity, practicality and vocabulary. Furthermore, it demonstrates the potential to offer assistance to the multidisciplinary team to guide the TE of patients with neurological deficits, allowing an evaluation focused on relevant variables for maintaining the integrity of spontaneous breathing.
- ItemSomente MetadadadosElaboração e validação de um estudo de caso para o desenvolvimento do raciocínio diagnóstico de estudantes e enfermeiros(Universidade Federal de São Paulo (UNIFESP), 2020-09-24) Leandro, Daniela Luana Fernandes [UNIFESP]; Lopes, Juliana De Lima [UNIFESP]; Universidade Federal de São PauloIntroduction: Case studies are teaching tools that can be used for the development and improvement of diagnostic reasoning, contributing to an evidence-based nursing practice and with better health indicators for the patient. Therefore, they must be prepared based on the literature and their content must be validated. In the literature, there are few validated case studies and, to the best of our knowledge, none addressing peripheral arterial disease (PAD). Due to the high prevalence of this disease in the world population, it is relevant that nurses are able to identify the human responses common to patients with PAD. Objective: Develop and validate a case study to assist in the development of the diagnostic reasoning of students and nurses. Method: Methodological study, carried out in three stages: 1) preparation of the case study; 2) content validation of the case study and identification of the nursing diagnoses present; 3) assessment of diagnostic accuracy and establishment of priority diagnosis. This study was approved by the Unifesp Research Ethics Committee, Protocol 1550/2017. Participants: Twelve nurses specialized in Nursing Process selected according to pre-defined criteria. Results: The case study was based on a narrative review of the literature, which allowed the identification of clues related to the most frequent nursing diagnoses (ND) in patients with PAD, selected as the central health problem of the case. For the construction of the case, Lunney's eight assumptions were followed for the elaboration of case studies. The content of the case study was validated in the second evaluation round and the experts identified 18 ND with different degrees of accuracy. The most frequent diagnoses were: ineffective peripheral tissue perfusion (100%), impaired ambulation (83%), impaired comfort (50%) and chronic pain (50%). The diagnosis considered a priority by all specialists was "Ineffective peripheral tissue perfusion". Conclusion: The validated case study can be used by students and nurses to facilitate the development of diagnostic reasoning and critical thinking in the context of care practice, teaching and research.
- ItemSomente MetadadadosEvidências de validade e normatização de uma bateria de avaliação do processamento fonológico para crianças pré-escolares(Universidade Federal de São Paulo (UNIFESP), 2021) Silva, Nathane Sanches Marques [UNIFESP]; Puglisi, Marina Leite [UNIFESP]; Universidade Federal de São PauloThe aim of this study was to validate and standardize a series of evaluation of phonological processing for kids at preschool age. To validate the series, we objected to finding validation evidence of constructs in proofs that aim to evaluate the fast access to the lexical, the optional phonological memory and the phonological awareness. To achieve this, three studies were made, one for each skill of phonological processing, stemming from two samples. The sample I was composed of 582 kids between 3,6 and 6.1 years old from São Caetano do Sul and the sample II included 222 kids between 4 and 6,2 years old from São Paulo city. In both samples, the kids were enrolled at the first or second year of the Municipal Elementary School (EMEI). To test the validation of construct from each proof of the evaluation series, a confirmatory factor analysis was used; and to regulate, an specific model by age range was used. As conclusions, it was possible to make the validation of the internal structure and the proofs regulations of 1) automatic fast naming to preschoolers (NAR-Pre); 2) and Brazilin Children’s test of Pseudoword Repetition (BCPR); 3) proof of phonological awareness to preschoolers (CF-Pre). In the case of BCPR and the proof of CF-Pre, it was possible to analyze the items in terms of differentiation and difficulty. The standardization of the three proofs showed that there is a relation between the improvement of performance in proofs and aging.
- ItemSomente MetadadadosValidação externa do escore Villalta traduzido para português brasileiro em pacientes com trombose venosa profunda prévia e sintomas compatíveis com síndrome pós-trombótica(Universidade Federal de São Paulo (UNIFESP), 2021) Avila, Rafael Bernardes De [UNIFESP]; Flumignan, Ronald Luiz Gomes [UNIFESP]; Universidade Federal de São PauloObjective: We sought to systematically translate the Villalta Score from the English language into Brazilian Portuguese, and to assess the external validation when applied to a population with at least 6 months of previous diagnosis of deep vein thrombosis and with compatible symptoms of post-thrombotic syndrome; to compare the ultrasound findings with the severity of post-thrombotic syndrome; and to develop a digital informative application about the post-thrombotic syndrome. Methods: We systematically translated the original Villalta score into Brazilian Portuguese. Fifty participants who underwent two outpatient visits were evaluated using the translated Villalta Score. We assessed its intra-rater and inter-rater agreement, comparing the original Villalta Score versus Brazilian Portuguese Villalta Score; Brazilian Portuguese Villalta Score versus a widely used scale for chronic venous insufficiency, the CEAP clinical component, and the clinical post-thrombotic syndrome severity versus the duplex ultrasonography findings. Results: The intraobserver evaluation of Villalta Score grades had a simple Kappa coefficient of 0.73, and the simple Kappa coefficient interobserver for Villalta Score grades was 0.67. When Villalta Score was compared to CEAP clinical component, it established an excelent Pearson correlation of aproximately 0.9. There was difference among Villalta Score values compared to duplex ultrasonography initial deep vein thrombosis territory, with femoropopliteal showing higher values than distal veins. Higher Villalta Score values were correlated to duplex ultrasonography venous recanalization and reflux. Conclusions: There was a good interobserver and intraobserver agreement when the Brazilian Portuguese Villalta Score was applied; and when compared to CEAP clinical component, Villalta Score showed an excelent correlation. When Villalta Score grading was compared to duplex ultrasonography characteristics, there were statistical and clinical correlation, with presence of reflux and recanalization showing higher Villalta Score values. The application was developed and widely available via the internet.