EVIDENCE OF VALIDITY OF ADAPTIVE INSTRUMENT FOR THE PRE- AND POST-
OPERATIVE OF INTESTINAL STOMISES IN THE LIGHT OF THE ROY ADAPTATION MODEL
Estomy. Nursing Models. Psychological Adaptation. Data collect. Validation Studies.
Taken for therapeutic purposes, the stomies are called ileostomy and colostomy, depending on the segment to be externalized, of a temporary or definitive character. This surgically created opening divert the stool directly from the gastrointestinal tract to the outside, making it necessary to use an external collection bag to the body. The person is faced not only with the loss of an important segment, but with altered body image, gastrointestinal physiological changes, self-esteem, sexuality and daily activities. These changes require adaptive skills in all areas of life. In this perspective, nursing care in pre and postoperative care is essential. The nurse is fundamental in the process of orientation and adaptation of the stomeized and should be able to identify the level of adaptation and intervene to promote it. The process of rehabilitation of stomates, when elaborated in a holistic and systematized way, through the first stage of the PE, data collection becomes an incentive tool for adaptation. To do so, it is necessary to create instruments that facilitate the collection of data, providing a significant improvement in the quality of care. Thus, the importance of the organization of the care given to stomized patients is reinforced, based on a theory that meets the needs of this clientele. In this context, a relationship can be established with Roy's Adaptation Model, since the range of physical, social and psychological needs that affect this population function as stimuli that promote adaptive or inefficient responses. This is a quantitative methodological study carried out in three stages: the construction of the preliminary version of a nursing consultation guiding instrument based on the Roy Adaptation Model, based on the definitions of constitutive and operational, from the components of the model of Adaptation of Roy (1st stage), submission of this instrument for validation of its content to the specialists through the technique of focus group (2nd stage) and pre-test of the pilot instrument for semantic analysis performed by a sample of the population (3rd stage). To support the construction and validation of the instrument, the Theory of Psychometry was used, which is based on three poles: theoretical, experimental and analytical. For purposes of content validation, the present study was stopped at the theoretical pole. The validation process was analyzed by applying the Kappa Index, to verify the level of agreement and level of consistency of the judges in relation to the permanence or not of the items that make up the instruments, and the Content Validity Index. 09 judges were selected for the validation stage. The final version of the instrument has 34 items in total, of which 16 are patient identification, 6 are clinical history, 6 are surgical data, 67 are physiological, 15 are self-concepts, 3 are paper, 7 are interdependent. The results may have repercussions in the hospital environment, since it will enable patient data/behaviors to be obtained, guiding nurses, teachers and nursing students in the first stage of the nursing process. Finally, this study provides the technological development of nursing coming from the construction of an instrument in the light of Roy's Model of Adaptation, ratifying the systematization of nursing care. This study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, opinion 421,342 (CAAE nº 65941517.8.0000.5537).