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. 2023 Jun;120(6):e20220576.
doi: 10.36660/abc.20220576.

Construction and Validation of a Protocol Targeting Patients on Oral Anticoagulation with Warfarin

[Article in English, Portuguese]
Hannah Cardoso Barbosa  1 , Heloisa de Carvalho Torres  1 , João Antônio de Queiroz Oliveira  1 , Rebeca Priscilla de Melo Santos  2 , Josiane Moreira da Costa  3 , Leonardo Gonçalves Miranda  1 , Adriana Silvina Pagano  1 , Marcus Fernando da Silva Praxedes  4 , Maria Auxiliadora Parreiras Martins  1
Affiliations

Construction and Validation of a Protocol Targeting Patients on Oral Anticoagulation with Warfarin

[Article in English, Portuguese]
Hannah Cardoso Barbosa et al. Arq Bras Cardiol. 2023 Jun.

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] Arq Bras Cardiol. 2023 Dec;120(12):e20230806. doi: 10.36660/abc.20230806. Arq Bras Cardiol. 2023. PMID: 38232247 Free PMC article. English, Portuguese.

Abstract
in English, Portuguese

Background: Warfarin is an oral anticoagulant that is very useful in preventing thromboembolism, though it is considered a drug with a high risk of causing adverse events. Considering the practical challenges in controlling oral anticoagulation, the patients on warfarin could benefit from educational strategies aimed at behavioral changes, active participation in self-care, and adherence to drug therapy.

Objective: The aim was to construct and validate the EmpoderACO protocol for behavioral changes in warfarin patients.

Methods: The methodological steps were: definition of concepts and domains of self-care, identification of objectives, construction and selection of items, assessment of content validity, and pre-test in the target population.

Results: Relevance, adequacy, clarity, and internal reliability of the instrument's items were assessed by a multidisciplinary judges committee (JC) through the E-surv web platform, obtaining an average agreement of ≥0.91. The understanding of the instrument measured by the target population revealed adequate clarity with a coefficient average of 0.96.

Conclusion: EmpoderACO can aid in qualifying the communication process between medical professionals and patients, as well as in improving adherence to both treatment and clinical outcomes, and can be replicated in healthcare settings.

Fundamento: A varfarina é um anticoagulante oral útil para prevenção de tromboembolismo, embora seja considerado fármaco de alto risco de causar eventos adversos. Considerando os desafios práticos no controle da anticoagulação oral, os pacientes poderiam se beneficiar de estratégias educacionais que visem mudança de comportamento, participação ativa no autocuidado e adesão à farmacoterapia.

Objetivo: Construir e validar o protocolo EmpoderACO para mudança de comportamento em pacientes em uso de varfarina.

Métodos: As etapas metodológicas foram: definição de conceitos e domínios do autocuidado, identificação dos objetivos, construção e seleção dos itens, avaliação da validade de conteúdo e pré-teste na população alvo.

Resultados: Relevância, adequação, clareza e confiabilidade interna dos itens do instrumento foram avaliadas por comitê de juízes multiprofissional pela plataforma web E-surv, obtendo-se média de concordância ≥0,91. A compreensão do instrumento pela população-alvo teve clareza adequada com média de 0,96.

Conclusão: O EmpoderACO poderá contribuir para qualificar o processo de comunicação entre profissionais e pacientes, melhorar a adesão ao tratamento e os resultados clínicos, podendo ser replicado nos serviços de saúde.

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Conflict of interest statement

Potencial conflito de interesse

Não há conflito com o presente artigo.

Figures

Figura 1
Figura 1. – Domínios do autocuidado em anticoagulação oral. Fonte: Elaborado com auxílio do CmapTolls.
Figura Central
Figura Central. : Construção e Validação do Protocolo EmpoderACO Direcionado a Pacientes em Anticoagulação Oral com Varfarina
Figure 1
Figure 1. – Domains of self-care in oral anticoagulant treatment. Source: Created with the use of CmapTolls.
Central Illustration
Central Illustration. : Construction and Validation of a Protocol Targeting Patients on Oral Anticoagulation with Warfarin
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