Desenvolvimento do protótipo do aplicativo Diu Conecta e vídeo instrucional sobre o dispositovo intrauterino com cobre

Abstract

Introduction: The copper intrauterine device (IUD) is a non-hormonal, long-acting, reversible contraceptive method. It is practical, safe, highly effective, and works by creating local effects in the uterus to prevent pregnancy. Despite being offered for free through the Brazilian public health system (Sistema Único de Saúde), its use is limited in Brazil. This can be attributed to a lack of information and barriers to accessing the method. In May 2023, the Ministry of Health revoked its technical note that didn't recommend copper IUD insertion by nurses. In response, later that same year, the Brazilian Nursing Association – Federal District Section, offered training on IUD insertion to nurses working in primary health care. Since then, the growing number of qualified professionals has facilitated access to this contraceptive method. Based on this, we sought to learn from these nurses how to encourage greater use of this contraceptive method among women. Objective: To develop the prototype of the DIU ConecTa application and an instructional video about the copper IUD. Method: This was a methodological study for the development of technologies. The instructional design was guided by the ADDIE model, structured in the stages of definition, architecture, design, implementation, and evaluation. In the definition stage, a descriptive exploratory cross-sectional study with a qualitative approach was conducted with 14 nurses qualified to insert copper IUDs in Basic Health Units of the Federal District. The snowball technique was used to recruit the nurses. In-depth interviews were conducted, followed by transcription and textual analysis using the Iramuteq software. Thus, the research problem originated from the practice of these nurses, and in partnership with them, ideas were developed for the subsequent stages of product development for this thesis. The results of this first stage informed the definition of the products and the guiding topics for their content. In the architecture stage, we began by defining objectives, gathering sources, analyzing content/context, prototyping, and creating interface resources. In the design stage, we created images, wrote texts, and recorded the audio for the video. In the implementation stage, the textual, illustrative, and audio components were combined to create the products, followed by making adjustments. The evaluation stage will be carried out in future studies. Results: The analysis of the nurses' interviews led to the following thematic categories: (1) health education as a way to demystify the IUD; (2) structural barriers; and (3) training and professional autonomy. The basic content of the two products covered indications, contraindications, myths, side effects, information on where, when, and how the IUD insertion procedure occurs, and post-procedure care. The "DIU ConecTa" application prototype has two basic functionalities. The first is informative, with the purpose of providing clear and accessible information about the copper IUD. The second is interactive, with the goal of tracking the journey of users who utilize this contraceptive method. In this tracking, the user inputs information and the application helps with predicting menstrual cycles, monitoring signs, symptoms, and discomforts related to IUD use. The user can configure important notifications, such as reminders for the monthly self-exam of the device's strings. Regarding the video, the title was "Copper IUD: an effective choice to prevent pregnancy." It had a total duration of three minutes and seventeen seconds and was made available on YouTube via this link: https://youtu.be/9OIUCgJxKnc?si=EwoU4knyA4W9bSbi. Developed Products: Product 1: Original article titled "Intrauterine device insertion by nurses in primary health care: challenges and potential." Product 2: Prototype of the DIU ConecTa Application, “A guide that informs you and connects you to your IUD,” with a registration at the National Institute of Industrial Property (protocol no. BR 512025 000961-5). Product 3: Instructional video titled “Copper IUD: an effective choice to prevent pregnancy,” with a registration at the Brazilian Book Chamber (Document Hash: 8da02bb7e0b1785dc2ce57f24a821d0ecc4185aa5b55b29fd70cc5033b9ea5a6). Conclusions: The developed products provide the key information about the copper IUD that nurses identified as common questions from the women they assist. Consequently, these products can be used by nurses to help reduce misinformation about the copper IUD, thus promoting greater access to sexual health and reproductive rights, which is a goal of the Sustainable Development Goal for gender equality. Therefore, the developed products have the potential to influence and create a national impact on public policies, demonstrating originality and relevance for scientific, technological, and social development in the field of Nursing by returning the results to the scientific community and/or health authorities. This thesis aligns with the research line on Quality in Health Care for Women, Children, and Adolescents.