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Doctoral Thesis
DOI
https://doi.org/10.11606/T.22.2023.tde-02062023-151453
Document
Author
Full name
João Batista Moreira
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2023
Supervisor
Committee
Teixeira, Carla Regina de Souza (President)
Guimarães, Everton Tavares
Iunes, Denise Hollanda
Pereira, Marta Cristiane Alves
Title in Portuguese
Pés em dia: desenvolvimento e validação de aplicativo para o autocuidado e autoexame dos pés de pessoas com diabetes mellitus
Keywords in Portuguese
Aplicativo móvel
Autocuidado
Autoexame
Diabetes mellitus
Informática em saúde
Pé diabético
Tecnologia educativa
Abstract in Portuguese
O pé diabético é um crescente problema de saúde pública por ser uma complicação incapacitante, mas com caráter prevenível, de 50 a 70% das úlceras de pés são evitáveis, diminuindo o risco de amputações. Para tanto, requer dos profissionais da saúde vigilância constante e ensino das mudanças no comportamento de autocuidado com os pés das pessoas com diabetes mellitus. Nesta direção, há carência de recursos tecnológicos de aplicação móvel para a promoção de hábitos de autoexame e autocuidado com os pés. Desta forma, o objetivo foi o desenvolvimento do protótipo de aplicação móvel "Pés em dia" baseado na metodologia centrada no usuário a fim de apoiar a pessoa com diabetes no autocuidado e autoexame dos pés. Como também, realizar a validação de conteúdo do protótipo por peritos da área de saúde mediado pelo instrumento Suitability Assessment of Materials (SAM) e a validação de usabilidade por peritos da área de tecnologia e informática e as pessoas e familiares com diabetes mellitus mediado pelo Smartphone Usability QuestionnaiRe (SURE). Na elaboração o protótipo teve sua apresentação estrutural e virtual com 21 telas e seu conteúdo organizado em nove telas primárias no menu, doze telas na área dos usuários com os agendamentos, as checagens de autocuidado e autoexame planejados de modo individual. As telas principais oferecem: "Cuide-se" a apresentação, o funcionamento, utilização e créditos, o "Autoexame" e diferenciam as situações dos pés em "pés sem ferida" e "pés com ferida cicatrizadas". E em outra tela "Passos do Autoexame" com textos informativos, multimídias de apoio, achados no autoexame, vídeos do teste do toque para sensibilidade, imagens dos testes de circulação, recursos domésticos, e o reconhecimento das deformidades comuns no contexto da pessoa com DM. O estudo foi realizado na Escola de Enfermagem de Ribeirão Preto, e no desenvolvimento realizou grupos focais com usuários e equipe desenvolvedora para elencar as necessidades do protótipo. Utilizou-se a engenharia de software com compatibilidade para o sistema Android, a linguagem KOTLIN, a estrutura Activity e Fragments e o recurso Navigation Drawer Layout, disponível em Android Studio vídeos e elementos gráficos no Camtasia Studio e Adobe Fireworks, que foram exportados em MP4, JPG e PNG, e armazenados no banco de dados MySQL. Para a validação de conteúdo, os 22 juízes foram selecionados pela expertise e técnica de snowballing, idade média de 37,8 anos (+-7,8), a maioria era do sexo feminino 15 (68,2%), 19 (86,4%) enfermeiros, 9 (40,9%) possuíam mestrado, e 19 (86,3%) participava de grupos de pesquisas nas temáticas de interesse. As respostas dos juízes no instrumento SAM validaram como adequado o protótipo, com o total de 40,3 pontos, (91,7%), a média de 1,85 nas seis categorias, IVCt 0,98 e Alfa de Cronbach 0,936. A maior pontuação nas respostas e IVC foi nas categorias de conteúdo, estimulação/motivação do aprendizado e ilustrações. Quanto a validação de usabilidade, os 22 juízes foram selecionados pela expertise em tecnologia de informática e validação de instrumentos e a técnica de snowballing, a maioria era do sexo masculino 16 (72,7), 6 (27,3%) graduados em Tecnologia da Informática ou Sistema de Informação, 6 (27,3%) Análise de Sistemas ou Programação de Sistemas, 7 (31,8%) com especialização acadêmica, 19 (86,4%) possuíam experiência com a temática. As respostas dos juízes expertise em informática no instrumento SURE consideraram o protótipo pertinente (nível 70 e 80) pois responderam a pontuação 104,8 na média, 22 itens foram avaliados em 100% de concordância, IVCt 0,98, Alfa de Cronbach 0,867, considerado como adequado. A validação de usabilidade pelo público alvo de pessoas com diabetes e seus familiares foi selecionada pela técnica de snowballing, participaram 37 (100%) pessoas, idade média de 48,1 anos (+-13,3), sendo que dessas 21 (56,8%) eram do sexo masculino, 26 (70,3%) com diabetes, tempo médio de 11,5 anos, e 11 (29,7%) eram familiares, 35 (94,6%) não possuía algum tipo de ferida nos pés naquele momento e 24 (64,9%) responderam que não tinham costume de utilizar este tipo de tecnologia. As respostas variaram de 75% a 94,6% de concordância, Alfa de Cronbach 0,989, considerado como adequado. Desta forma, apresenta-se um protótipo móvel "Pés em dia" para promover o autocuidado e autoexame com os pés e validado com o conteúdo e usabilidade adequadas para a literatura e disponíveis gratuitamente para a sociedade.
Title in English
Feet up to date: development and validation of an application for self-care and self-examination of the feet of people with diabetes mellitus
Keywords in English
Diabetes mellitus
Diabetic foot
Educational technology
Health informatics
Mobile application
Self-care
Self-examination
Abstract in English
The diabetic foot is a growing public health problem due to its crippling complication, but with a preventable feature, 50 to 70% of the foot ulcers are preventable, decreasing the risk of amputations. Therefore, it requires constant supervision from health professionals and teaching about changes in self-care behavior with the feet of people with diabetes mellitus (DM). In this sense, there is a lack of technological resources for mobile applications to foment self-examination and self-care habits with the feet. In this way, the objective was the development of the mobile application prototype "Pés em dia" based on the user-focused methodology in order to support, with self-care and self-examination of the feet, the person with diabetes, as well as performing the content validation of the prototype by health-area experts mediated by the Suitability Assessment of Materials (SAM) tool and the usability validation by experts in technology and information technology, as well people and family members with diabetes mellitus mediated by Smartphone Usability QuestionnaiRe (SURE). In the elaboration, the prototype had its structural and virtual presentation with 21 content-organized screens in nine primary screens in the menu and twelve screens in the user's area with the schedules and self-care and self-examination checks individually planned. The mains screens offer: "Take care" as the presentation, operation, using and credits, the "Self-examination" and they differentiate the feet condition in "Feet without wounds" and "Feet with healed wounds" and in another screen "Steps of the self-examination" with informative texts and supporting multimedia and discoveries in the self-examination, touch test videos for sensitivity and images of the circulation testes, the household resources, the recognition of common deformities in the context of the person with DM. The study was conducted at the Ribeirao Preto School of Nursing. For its development, focus groups with users and the development team were carried out to list the requirements of the prototype. Software engineering with Android system compatibility was used, the KOTLIN programming language, the Activity and Fragments structure and the Navigation Drawer Layout resource, available in Android Studio, graphic and video elements in Camtasia Studio and Adobe Fireworks, in which the files were exported in MP4, JPG and PNG, and they were stored in the MySQL database. For the content validation, 22 judges were selected for their expertise and snowballing technique, average age of 37.8 years (+/- 7.8), the most were female (15 women - 68,2%), 19 nurses (86.4%), 9 had a master's degree (40,9%) and 19 (86.3%) participated in research groups on topics of interest. The answers of the judges in the SAM tool validated the prototype as adequate, with a total of 40.3 points (91.7%), an average of 1.85 in the six categories, IVCt 0.98 and Cronbach's alpha 0.936. The highest score in the responses and IVC was in the categories of content, stimulation/motivation of learning and illustrations. Regarding the usability validation, the 22 judges were selected for their expertise in computer technology and tool validation and the snowballing technique, the most of them was male (16 - 72.7%), 6 were graduated in Computer Technology or Information Systems (27,3%), 7 with academic specializations (27.3%), 19 had experience in the subject (86.4%). The answers of the computer-expert judges in the SURE tool considered the prototype relevant levels 70 and 80) as they answered to an average score of 104.8, 22 items were evaluated at 100% agreement, IVCt 0.98, Cronbach's alpha 0.867, which is considered as suitable. The usability validation by the target audience made up of people with diabetes and their families was selected by the snowballing technique, 37 people participated in (100%), average age of 48.1 (+/- 13.3), in which 21 were male (56.8%), 26 had diabetes (70.3%), average time of 11.5 years, 11 were family members (29.7%), 35 did not have any type of feet wound at the moment (94.6%)and 24 answered that they were not acquainted to this technology (64.9%). The answers ranged from 75 to 94.6% agreement, Cronbach's alpha 0.989, which was considered adequate. So, "Pés em dia" mobile prototype is presented to promote self-care and self-examination of the feet and it was validated as adequate content and usability for the literature available at no charge to society.
 
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Publishing Date
2023-06-12
 
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