Construção e validação de um instrumento de avaliação do conhecimento do paciente e do acompanhante sobre segurança do paciente

Abstract

Introduction: When considering the magnitude of adverse events in the hospital context, efforts are made to reduce errors and improve patient safety. One of the strategies is to encourage the participation of the patient and his family in the care, since they can contribute to the early identification of preventable errors. Therefore, it is essential that patients and companions have knowledge about the theme to be more involved in the identification of failures and, thus, reduce the occurrence of adverse events. Objective: To build an instrument to assess the knowledge of the patient or companion on patient safety. Methodology: Methodological study, with a quantitative approach. For the construction of the instrument, international targets for patient safety and the document of the National Health Surveillance Agency were used: “How can I contribute to increase patient safety? Orientation to patients, family members and companions”. The construction of the instrument comprised seven stages: establishment of the conceptual structure; definition of the objectives of the instrument and the population involved; construction of items, domains and response scale; selection and organization of items; structuring the instrument; content validity and pre-test. The content validity was performed by the methodological triangulation: in the quantitative approach, the instrument was sent to the judges through the eSurv online platform; and qualitatively, a focus group. Agreement rates above 90% and content validity index above 0.90 were considered, calculated by the same platform. The pretest data was entered in Excel Software version 16.0 for Windows and analyzed using descriptive statistics. Results: The instrument structure was organized in two parts: header and knowledge questionnaire on patient safety with 11 items, grouped into six domains. The content validity happened in three phases, with the participation of 26, 19 and six judges, respectively. In the first, the judges evaluated the domains and items of the questionnaire, and the agreement rate varied between 65.4% and 100%, with the inclusion of two new items, totaling 13 items of evaluation in the final version. In the second, the judges assessed the title of the instrument and its component parts, instructions for filling it out, header items, domains and questionnaire items. The content validity index varied between 0.58 and 1.00. In the third phase, the header and eight items of the questionnaire were evaluated, and the content validity index was equal to 1.00 in all evaluated items. Conclusion: It is considered that the objective of the work was achieved, through the construction of an evaluation instrument that went through the process of content validity. This is a pioneering study in the construction of an instrument for assessing knowledge, both with regard to the public, and in the scope of patient safety domains. It is expected that this work will contribute to the assessment of knowledge, as well as guide educational interventions to improve the information worked by health professionals.