Construction and validation of an instrument for the structural assessment of wards for urinary continence in older adults

Abstract

Objective: to build and validate an instrument for structural assessment of wards for the preservation of urinary continence in hospitalized older adults. Method: this is a methodological study divided into two stages. The first corresponded to an integrative literature review that guided the construction of the instrument. The second consisted of the content validation stage of the instrument, by means of expert consensus, using the Delphi technique. The selected experts were recognized in the field and authors of the articles included in the integrative review. Results: six experts participated in the content validation, which resulted in the “Instrument for Structural Assessment of Wards for the Preservation of Urinary Continence in Older Adults”, composed of 27 items, distributed in three dimensions: “physical structure”, “human resources”, and “material resources”. Two Delphi rounds were carried out for validation, resulting in a final version with 83% agreement among the experts. Conclusion: the instrument reached content validity, requiring application for clinical validation. However, it can be used by researchers and health staff in hospital settings, in order to identify structural weaknesses and guide the priority of interventions for the quality and safety of this care.

Atuação Do Enfermeiro Estomaterapeuta No Manejo Da Incontinência Urinária De Esforço

“…(10) Ainda se tratando de tecnologias assistenciais na área da Enfermagem para a IU, verificou-se a publicação de um instrumento de consulta de enfermagem para a mulher idosa com Incontinência Urinária sob a ótica da Teoria da Adaptação de Callista Roy; (11) um protocolo de avaliação e treinamento da musculatura do assoalho pélvico para atendimento à mulher com incontinência urinária (12) e um instrumento de avaliação estrutural de enfermarias para continência urinária de idosos. (13) O presente estudo utilizou um protocolo de cinesioterapia e eletroestimulação para seguimento do tratamento da IUE. Assim, destaca-se um experimento koreano que indicou a eficácia da estimulação elétrica transcutânea na melhora dos sintomas fisiológicos e satisfação psicológica das mulheres participantes.…”

Validation of the hospital resources assessment scale for the preservation of urinary continence in the elderly

“…This study focused on validating the internal structure of a scale that was constructed based on the Donabedian conceptual model and an integrative review. In the initial phase of the validation process, content validation was performed (7) . In this current study, we proceeded to evaluate the validity of the scale's internal structure, including its items and dimensions, by applying it to the target population.…”

“…However, considering the practical relevance of evaluating the physical structure of the unit, the evaluated construct, the theoretical framework used in constructing the instrument, and the achieved content validation after constructing these items (7) , it was decided to retain this dimension as a complementary checklist to the instrument. The proposed subscale in checklist format (Chart 1) was separated from the instrument, and the model, now proposed with two dimensions/factors (human resources and material resources), was re-specified and subjected to a new EFA.…”

“…Studies indicate that hospital structural factors, such as the environment and the care process itself, contribute to episodes of UI, be it temporary or persistent. Notable factors include limited encouragement of independent bathroom use, excessive bed rest restrictions, inadequate privacy, insufficient signage and guidance to bathroom locations, and indiscriminate use of urinary control devices like diapers and indwelling catheters (7)(8)(9) .…”

“…To address this gap, the "Structural Assessment Instrument for Nursing Units to Preserve Urinary Continence in Older Adults" (IAEE-CUI) was developed based on the Donabedian conceptual model and studies analyzed through an extensive literature review (4) . After the initial construction, the scale underwent content validation in Brazil in 2020 (7) through evaluation by experts experienced in the subject. Consequently, a version consisting of 24 items with a dichotomous response pattern was obtained, distributed across three dimensions: "physical structure, " "material resources, " and "human resources.…”