Validade e confiabilidade de um instrumento de avaliação do conhecimento de médicos generalistas sobre transplante de fígado

Abstract

Liver transplantation is the only therapeutic modality that makes it possible to cure cirrhosis and its complications. Hepatic cirrhosis is the terminal stage of many chronic liver diseases. It presents clinical and social relevance due to its high prevalence and global incidence. Most cirrhotic patients present their first contact with the health system in primary care and / or in the emergency network. Therefore, the care with this patient from this first contact is of great importance. The aim of the present study was to elaborate and evaluate the validity and reliability of an instrument to evaluate the knowledge of general practitioners about liver transplantation. The following steps were followed: 1) identification of the updated source literature on the subject; 2) elaboration of the items of the questionnaire by the researchers, based on the source literature; 3) face and content validation; 4) application of the instrument for construct validation (hypothesis test); 5) internal consistency analysis and 6) temporal stability or test-retest evaluation. A total of 203 general practitioners or specialists in family and community medicine and 10 gastroenterologists participated in the validation process. The instrument elaborated in its final version with 47 items, presented a Cronbach alpha of 0.936. The hypothesis test showed that the instrument can discriminate adequately professionals with greater and lesser knowledge and the test-retest registered a concordance of over 60% for most items. The performance evaluation of general practitioners in the questionnaire results showed that the majority reached below-average scores. This study adequately concluded the elaboration of the instrument to evaluate the knowledge of general practitioners about liver transplantation, which presents good internal consistency and good reproducibility. It was possible to identify important knowledge gaps among professionals participating in the study. The final instrument should be considered as a valuable tool in the identification of knowledge gaps of general practitioners about liver transplantation and may serve as a basis in the elaboration of training and educational strategies for these physicians in different regions.