Letramento em saúde: elaboração e validação de manual para a redução de risco de complicações dos pés de pessoas com Diabetes Mellitus

Abstract

Introduction: Health literacy aims, through reading and writing, to inform and expand the knowledge of patients and caregivers. It has proven to be a strategy to reduce the risk of foot complications in people with Diabetes Mellitus (DM), such as amputation. In the context of public health, it is a promising and simple tool for health professionals to use in educating people with diabetes. This study aligns with the research line of Quality in Adult Health Care in the Professional Master's Program in Health Sciences at ESCS. Based on professional practice, the research question is: How to develop and validate a manual for foot care for people with Diabetes Mellitus? Objectives: The study aimed to develop and validate a manual designed to reduce the risk of foot complications in people with Diabetes Mellitus. The specific objectives were: to create a manual for people with Diabetes Mellitus treated in the endocrinology outpatient clinic of the Federal District; to evaluate the information in the manual regarding content and appearance validity; and to incorporate relevant suggestions from judges into the final version of the manual. Method: This was a documentary research study for the development and validation of a manual, with information from the LILACS, PubMED, Scielo databases, CAPES journals, and grey literature. Pasquali's method was used in the manual's development process, followed by validation by ten DM specialist experts, according to Fehring's criteria, using an evaluation instrument based on the Likert scale. This method is appropriate and innovative, providing manual validation through effective criteria and scale application, and may contribute to the applicability of the obtained results. Results: The result was the development and validation of the manual, which achieved an average agreement index of 88.6% for the objective, 90% for structure and presentation, and 91.7% for relevance in the experts' evaluation. Relevant suggestions from the experts were incorporated to enrich this educational health literacy tool. The importance of applying this manual in the SUS is to ensure the principle of the right to information for the assisted people about their health. Developed Products: The products of this dissertation are the final version of the manual titled "Foot Care Manual for People with Diabetes Mellitus" and the article titled "Health Literacy: Development and Validation of a Manual for Foot Care of People with Diabetes," which was submitted to the Journal of the School of Nursing of USP (REEUSP), classified by CAPES with Qualis A2. Finally, the manual will be submitte to the website of the Federal Nursing Council (Cofen) and the Brazilian Nursing Association (Aben) for review, followed by publication and broad dissemination, and will be sent for evaluation and possible mplementation for use in the Health Department of the Federal District. The technical production has the potential to influence public and health policies, with innovation, impact on policies and practices, or education, as well as generate an impact on the lives of people with diabetes. Conclusion: The manual was positively evaluated and validated by experts, evidencing its practical applicability and relevance for health education compared to other national and international studies. The work demonstrated originality and importance for scientific, technological, cultural, social, and/or innovative development in the health and nursing field. The study contributes to public health and offers an educational tool that directly benefits people with diabetes and strengthens the SUS. The importance of conducting this research lies in the potential of the manual to provide people with diabetes a clear and accessible understanding of daily foot care to reduce the risk of complications, reinforcing the role of health literacy. The study has local, regional, national, and international applicability, and can also return results to the scientific community and health authorities. Finally, the research products' results indicate that maintaining healthy feet may contribute to the quality of life and well-being of people with DM.