Análise da validação de constructo do instrumento de classificação de pacientes proposto por Perroca

Abstract

This paper starts from a research on the reliability and validity assessment of Perroca's patient classification instrument. Its purpose is to analyze the construct validity of this instrument, as well as to check its use in nursing management practice. Study participants were a hundred forty-one patients, allocated in Intensive Care and Hospitalization Units of a school hospital in the interior of São Paulo State, Brazil. Several statistical techniques were used to show the construct validity of the instrument. Research results revealed the importance of all critical indicators, each of which has its own role in determining the patient's complexity degree in relation to nursing care. Therefore, the study showed that the instrument shows evidence of validity. Hence, it is useful for nursing management practice, as a guide to the patient's care needs as well as to the nursing team's workload.

Identification of care needs of patients with and without the use of a classification instrument

“…The availability of access to information by the internal evaluator enables higher data processing, making the evaluation process more efficient. It also became clear, as a previous study (12) , the extreme categories of care (minimum and intensive) were more consistent for patients presenting demand of nursing care and easily identifiable by nurses.…”

“…A Patient Classification Instrument (PCI), developed in Brazil in the late 1990s, has been subjected, over the years, to several tests to evaluate its psychometric properties (9,(12)(13) . Although the results have shown evidence of reliability and validity of the scale and that it can be used to guide management practice in determining the workload of the nursing staff (13) , it becomes important to further investigate this instrument, even though the demand for nursing care for the patient is identified by the perception of nurses.…”

Use of patients’ classification instruments: analysis of the brazilian production of knowledge

“…Content validity (2,(7)(8)(9)22) Delphi technic (2,(7)(8)(9)22) Agreement level ≥ 70% (2,(7)(8)(9)22) Neonatology (7) Psychiatry (9) Pediatrics (8,22) Perroca new version (2) 16 areas/ 3 categories (7) ; 11 areas (8) ; 11 areas/3 categories (9) ; 5 categories (22) ; Relevance, clarity and increasing level of complexity (7) Agreement: 86-100% (9) ; 85-100 (21) ; ≥ 90 (structure) and 80-96 (care areas) (2) . Construct validity (10,(20)(21)23) Principal components (21,23) Analysis of Variance (23) Discriminant analysis (21) Pearson (22) Spearman (10) Factor analysis (20) Perroca original (21,23) Psychiatry (10) Perroca new Version (20) First two factors explained 75% of the total variation (23) Discrimination: 89.1 -95.6% (21) Importance of all areas of care (20) Agreement between instruments (24) Spearman and Weighted Kappa …”

“…The researchers used diverse tests to prove reliability and validity of the instruments: inter-rater reliability (8,10,(17)(18)(19)(20) , predictive ability (6,20) , users' opinion (21) , content validity (2,(7)(8)(9)22) and construct validity (10,(20)(21)23) . The original PCI and its new version were the most subjected to a validation process (2,6,(20)(21)(23)(24) .…”

“…The original PCI and its new version were the most subjected to a validation process (2,6,(20)(21)(23)(24) . The psychometric properties of the PCI allows the generation of legitimate and reliable data, allowing its use in clinical practice to measure the workload of the nursing staff and to guide management decisions (20) .…”