Validation of a counseling guide for adherence to antiretroviral therapy using implementation science

Abstract

Objective: to determine the contents that must be included in the usual counseling to improve the adherence to antiretroviral therapy (ART) of HIV patients, according to their different levels of alcohol consumption, and to determine the validity of the Counseling Guide in improving the adherence to ART in patients who consume alcohol using Implementation Science. Method: this is an observational study with formative and validation phases. The formative phase defined the content, approach and structure of the counseling. Validation included focus groups with patients and nurses, trial process by an expert and a pilot test. The criteria evaluated based on Implementation Science were: intervention source, evidence strength and quality, relative advantage, and complexity. The following criteria were also evaluated: usefulness, practicality, acceptability, sustainability, effectiveness; content consistency and congruence; procedural compliance and difficulties, and time spent in counseling. Results: the strength of evidence of the counseling is High-IIA, with strong level of recommendation and presenting usefulness, practicality, acceptability, sustainability and effectiveness. Eight in 11 experts argued that the Guide is clear, consistent and congruent. Initial counseling takes around 24 minutes; and follow-up counseling, 21. The instruments of the Guide present reliability levels between good and high (0.65 ≥ alpha ≤ 0.92). Conclusion: the Counseling Guide is valid to improve the adherence to antiretroviral therapy in patients who consume alcohol.

Construction and validation of an instrument for classifying nipple and areola complex lesions resulting from breastfeeding

“…Current literature identifies the participation of a group of experienced judges as essential in content assessment (20)(21)(22)(29)(30)(31)(32)(33)(34)(35) . It is recognized, in this study, that the judges contributed to content adequacy, by suggesting significant adjustments and/or additions to the proposed classification, as well as their expertise and qualification, and enabled a critical and rigorous analysis of sentences.…”

“…After this assessment, a new meeting was held between the researchers, reaching a final proposal to submit to content validation. This process of development and construction of a new measurement instrument, through literature review and the clinical experience of focus groups, whether through interviews, observation of practical experience or consensus meetings, is widely used in studies of current literature (29)(30)(31)(32)(33)(34) .…”

“…A literature review showed that some authors recommend a committee composed of at least 5 and at most 10 professionals with clinical experience in the field and working at the time of the research (22) . Some studies that address content validation selected from 5 to 17 experts for the validation stage (29)(30)(31)33,(36)(37) .…”

Conteúdos representacionais de profissionais da rede de atenção à saúde sobre o HIV no aconselhamento

“…Los cambios en la forma de percibir e integrar las condiciones y elementos críticos de la vulnerabilidad, como el género, la raza, la etnia, la sexualidad, la clase social, el grupo etario y los efectos que producen en las relaciones interpersonales o intersubjetivas (23) en la práctica profesional, tienen como objetivo mejorar la atención de la salud (19)(20)(21)(22)(23)(24) . Estudios realizados en países marcados por vulnerabilidades que amenazan a mujeres y niños de África subsahariana y Asia, víctimas diarias de abuso y violencia sexual, argumentan que las pruebas y el asesoramiento deben abordar las diferentes realidades de las personas (19,25) . Un estudio realizado en México incluye la violencia y la inmigración como elementos críticos (26) .…”

Associação entre expectativa de autoeficácia e adesão ao tratamento antirretroviral em adultos com HIV

“…Esse programa previa que 90% das pessoas que vivem com HIV descobrissem seu diagnóstico, 90% das diagnosticadas recebessem o tratamento adequado e 90% das que estão em tratamento alcançassem o nível indetectável para sua carga viral (CV) (Dave et al, 2019). Esse panorama aponta a importância da adesão à TARV e da avaliação deste processo (Souza et al, 2019), para se eleger estratégias de intervenção e monitoramento (Loch et al, 2020;Musayón-Oblitas et al, 2020;Zuge et al, 2020) e melhorar os resultados clínicos do paciente (Cardoso et al, 2019).…”