CLINICAL-CARE ALGORITHM FOR PREVENTION OF SUICIDE IN ADOLESCENTS IN THE CONTEXT OF PRIMARY HEALTH CARE
Article Sidebar
Main Article Content
Abstract
Notably, the epidemiological, biopsychosocial and family impact, associated with deaths of adolescents and young adults due to self-extermination, characterizes suicidal behavior, in this age group, as a serious public health problem. Thus, in this study, as a general objective, it was assumed to describe the construction and validation of the face and content of a clinical-care algorithm, intended for the assessment, management and follow-up of suicidal behavior, respecting the diversity of adolescence, in the context of Primary Health Care. This is, therefore, methodological research for which was adopted what is proposed by Pasquali, in an adapted form, to the construction and validation of research instruments. This study includes: planning and selection of the theoretical-methodological framework, construction of the items that make up each step proposed by the algorithm and face and content validation through a questionnaire in the Likert scale format, made available electronically to seven judges -specialists, selected for healthcare and/or academic expertise (master's degree and/or doctorate), with at least five years of experience, in the areas of Family and Community Health, Public Health, Mental Health and/or Health Education, who evaluated nine questions about the appearance, relevance and instrument's clarity. For data analysis, the IBM SPSS Statistics 28.0.1.1 software was used. Through the face and content validation process, by the committee of expert judges, the Content Validity Index found, Global CVI = 0.98, was considered satisfactory. In the semantic analysis, the instrument was considered relevant, reliable and easily understood by members of Family Health Strategy teams, with heterogeneous professional experience, who work in PHC (N=8). For the Cronbach's alpha test, when evaluating the internal consistency of the judges' responses, a value of 0.794 was found, considered substantial. Therefore, a validated Brazilian instrument for the prevention of suicide among adolescents, and which can be operationalized in an interdisciplinary way, allows the provision of viable early interventions in PHC services. The clinical algorithm presented, adapted to the specificities of adolescence, reiterates training in primary mental health care, cooperative work and preservation of life, in highly vulnerable populations. Further studies are recommended, with the evaluation of other psychometric and statistical properties, such as construct validity and exploratory factor analysis.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c). Conjuncture Bulletin (BOCA)
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
ALEXANDRE, N. M. C.; COLUCI, M. Z. O. “Validade de conteúdo nos processos de construção e adaptação de instrumentos de medidas”. Ciência e Saúde Coletiva, vol. 16, n. 7, 2011.
ARAUJO, E. T. H. et al. “Use of social networks for data collection in scientific productions in the health area: integrative literature review”. Aquichan, vol. 19, n. 2, 2019.
BAHIA, C. A. et al. “Notificações e internações por lesão autoprovocada em adolescentes no Brasil, 2007-2016”. Epidemiologia e Serviços de Saúde, vol. 29, n. 2, 2020.
BARRERA, C. A. et al. “Metodología para el desarrollo y la actualización de guías de práctica clínica: estado actual”. Revista Médica del Instituto Mexicano del Seguro Social , vol. 54, n. 1, 2016.
BARROS, J. et al. “Recognizing states of psychological vulnerability to suicidal behavior: a Bayesian network of artificial intelligence applied to a clinical sample”. BMC Psychiatry, vol. 20, 2020.
BEURS, D. et al. “A network perspective on suicidal behavior: Understanding suicidality as a complex system”. Suicide and Life ‐Threatening Behavior, vol. 51, n. 1, 2021.
BIERNACKI, P.; WALDORF, D. “Snowball sampling-problems and techniques of chain referral sampling”. Sociological Methods and Research, vol. 10, 1981.
BONETT, D. G.; WRIGHT, T. A. “Cronbach’s alpha reliability: interval estimation, hypothesis testing, and sample size planning”. Journal of Organizational Behavior, vol. 36, n. 1, 2015.
BRASIL. Boletim Epidemiológico. Brasília: Ministério da Saúde, 2022. Disponível em: . Acesso em: 14/12/2023.
CALDEIRA, C. M. H. Estratégias de coping em indivíduos que tentaram o suicídio (Dissertação de Mestrado em Psicologia Clínica e da Saúde). Évora: UE, 2015.
CAPOTE, J. C. A. et al. “Utilidad de las guías, protocolos y algoritmos en la práctica clínica”. Revista Cubana de Medicina, vol. 58, n. 1, 2019.
CASTIEL, L. D.; GUILAM, M. C. R.; FERREIRA, M. S. Correndo o risco: uma introdução aos riscos em saúde. Rio de Janeiro: Editora Fiocruz, 2010.
CRONBACH, L. J.; MEEHL P. E. “Construct validity in psychological tests”. Psychological Bulletin, vol. 52, n. 4, 1955.
DEL HIERRO, L. I. Análisis de los protocolos y guías de práctica clínica sobre el abuso sexual infantil en España (Trabalho de Conclusão de Curso de Graduação em Enfermagem). Madrid: UAM, 2018.
DRUMMOND, J. P. et al. Fundamentos da medicina baseada em evidências: teoria e prática. São Paulo: Editora Atheneu, 2014.
ERCOLE, F. F.; MELO, L. S.; ALCOFORADO, C. L. G. C. “Revisão integrativa versus sistemática”. Revista Mineira de Enfermagem, vol. 18, n. 1, 2014.
FEIJOO, A. M. L. C. “Por um núcleo de atendimento clínico a pessoas em risco de suicídio”. Revista da Abordagem Gestáltica, vol. 24, n. 2, 2018.
FUKUMITSU, K. O. “O psicoterapeuta diante do comportamento suicida”. Psicologia USP, vol. 25, n. 3, 2014.
GIL, A. C. Como elaborar projetos de pesquisa. São Paulo: Editora Atlas, 2002.
GUNNELL, D. et al. “Suicide risk and prevention during the COVID-19 pandemic”. Lancet Psychiatry, 2020.
JOBES, D. A. et al. “A stepped care approach to clinical suicide prevention”. Psychological Services, vol. 15, n. 3, 2018.
LOBIONDO-WOOD, G.; HABER, J. Nursing research: methods and critical appraisal for evidence-based practice. Saint. Louis: Elsevier, 2013.
LÓPEZ, A. G. “Narrativas del duelo en profesionales de salud mental sobrevivientes a suicidio”. Revista Sul-Americana de Psicología, vol. 9, n. 2, 2021.
MEDEIROS, R. K. S. et al. “Modelo de validação de conteúdo de Pasquali nas pesquisas em enfermagem”. Revista de Enfermagem, vol. 4, 2015.
MILLARUELO, T. J. M. “Guías de práctica clínica: una visión crítica”. Diabetes Práctica, vol. 6, n. 2, 2015.
MING-WAU, C. et al. “A decisão de tentar o suicídio sob a lente fenomenológico-existencial sartriana”. Estudos e Pesquisas em Psicologia, vol. 20, n. 4, 2020.
NASEEM. U. et al. “Graph-Based hierarchical attention network for suicide risk detection on social media”. Anais of Companion Proceedings of the Association for Computing Machinery Web Conference. New York: ACM, 2023.
PAGE, M. J. et al. “The PRISMA 2020 statement: an updated guideline for reporting systematic reviews”. British Medical Journal, vol. 372, n. 71, 2021.
PASQUALI, L. Instrumentação psicológica: fundamentos e práticas. Porto Alegre: Editora Artmed, 2010.
PASQUALI, L. Psicometria: teoria dos testes na psicologia e na educação. Petropólis: Editora Vozes, 2013
POISK, E. A. C. et al. “A constituição psíquica e sua relação com atos autoinfligidos: uma compreensão psicanalítica”. Boletim de Conjuntura (BOCA), vol. 16, n. 47, 2023.
POLIT, D. F.; BECK, C. T. (orgs.). Fundamentos de pesquisa em enfermagem: avaliação de evidências para prática de enfermagem. Porto Alegre: Artmed, 2011.
POLIT, D. F.; BECK, C. T. “The content validity index: are you sure you know what's being reported? Critique and recommendations”. Research in Nursing and Health, vol. 29, n. 5, 2006.
POLIT, D. F.; BECK, C. T.; HUNGLER, B. P. Fundamentos de pesquisa em enfermagem: métodos, avaliação e utilização. Porto Alegre: Editora Artmed, 2011.
SCHMITTMANN V. D. et al. “Deconstructing the construct: a network perspective on psychological phenomena”. ResearchGate [2011]. Disponível em: . Acesso em: 22/10/2023.
SILVA, R. M. et al. “Suicidal ideation and attempt of older women in Norther as tern Brazil”. Revista Brasileira de Enfermagem, vol. 71, 2018.
SOUZA, A. C.; ALEXANDRE, N. M. C.; GUIRARDELLO, E. B. “Propriedades psicométricas em instrumentos de avaliação de confiabilidade e validade”. Epidemiologia e Serviços de Saúde, vol. 3, 2017.
STEVENS, K. et al. “Core components and strategies for suicide and risk management protocols in mental health research: a scoping review”. BMC Psychiatry, vol. 21, n. 13, 2021.
STONE, M. B. et al. “Response to acute monotherapy for major depressive disorder in randomized, placebo controlled trials submitted to the US Food and Drug Administration: individual participant data analysis”. British Medical Journal, vol. 378, 2022.
STREINER, D. L. “Starting at the beginning: an introduction to coefficient alpha and internal consistency”. Journal of Personality Assessment, vol. 80, n. 1, 2003.
VOLDSBEKK, I. et al. “Delineating disorder-general and disorder-specific dimensions of psychopathology from functional brain networks in a developmental clinical sample”. Developmental Cognitive Neuroscience, vol. 62, 2023.
WHO - World Health Organization. Helping adolescents thrive toolkit: strategies to promote and protect adolescent mental health and reduce self-harm and other risk behaviours. Geneva: WHO, 2021.
WHO - World Health Organization. Suicide worldwide in 2019: global health estimates. Geneva: WHO, 2021.
YUSOFF, M. S. B. “ABC of content validation and content validity index calculation. Resource, vol. 77, n. 2, 2019.