Serial album on Continuous Insulin Infusion System as an innovative educational technology in diabetes

Brilhante, Raquel Rodrigues da Costa; Moreira, Thereza Maria Magalhães; Oliveira, Sherida Karanini Paz de; Florêncio, Raquel Sampaio; Pessoa, Vera Lúcia Mendes de Paula; Cestari, Virna Ribeiro Feitosa

doi:10.1590/0034-7167-2021-0277

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 75 (5) • 2022 • https://doi.org/10.1590/0034-7167-2021-0277 copy

Serial album on Continuous Insulin Infusion System as an innovative educational technology in diabetes

Álbum en serie sobre el Sistema de Infusión Continua de Insulina como tecnología educativa innovadora en diabetes

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to build and validate a serial album content and appearance on insulin therapy using a Continuous Infusion System.

Method:

a methodological study, carried out in three stages in Fortaleza, Ceará, Brazil, from August to November 2018. The serial album construction and content and appearance validity were carried out by experts, and assessment, by the target audience. Content Validity Index and Concordance Index were calculated.

Results:

the judges considered the serial album content and appearance to be valid, which means that the material is suitable as an educational technology. Experts suggested adjustments, incorporated into the material for print production of the final version. The target audience also assessed the serial album positively.

Conclusion:

we realized that the serial album was considered an innovative educational technology in diabetes, valuable for promoting knowledge about Continuous Insulin Infusion System, with rich, updated content, combined with clarity, suitable format and explanatory illustrations.

Descriptors:
Diabetes Mellitus; Insulin Infusion Systems; Educational Technology; Validation Study; Nursing Care.

Variables	Totally agree		iCVI^a
Variables	n	%	iCVI^a
Objectives: purposes, goals or aims			0.76
1. Contemplates proposed theme	9	90	0.90
2. Suitable for the teaching-learning process	8	80	0.80
3. Clarifies doubts about the topic covered	8	80	0.80
4. Provides reflection on the topic	7	70	0.70
5. Encourages behavior change	6	60	0.60
Structuring/presentation: organization, structure, strategy, coherence and sufficiency			0.84
6. Language suitable for the target public	9	90	0.90
7. Language appropriate to educational material	8	80	0.80
8. Interactive language, allowing active involvement in the educational process	8	80	0.80
9. Correct information	4	40	0.40
10. Objective information	10	100	1.00
11. Enlightening information	8	80	0.80
12. Necessary information	10	100	1.00
13. Logical sequence of ideas	10	100	1.00
14. Current topic	9	90	0.90
15. Appropriate text size	8	80	0.80
Importance: significance, impact, motivation and interest			0.90
16. Encourages learning	8	80	0.80
17. Contributes to knowledge in the field	10	100	1.00
18. Arouses interest in the theme	9	90	0.90

Variables	Agree		Totally agree		CI^a
Variables	n	%	n	%	CI^a
1. Figures are appropriate for the target audience	4	33.3	6	50.0	0.83
2. Figures are clear and convey ease of understanding	5	41.6	5	41.6	0.83
3. Figures are in appropriate quantity and sizes on the serial album	7	41.6	5	41.6	1.00
4. Figures are related to the serial album text and elucidate the content	6	50.0	5	41.6	0.91
5. Figures’ colors and shapes are suitable for the type of material	5	41.6	5	41.6	0.83
6. Figures depict the daily life of people that use the Continuous Insulin Infusion System	4	33.3	6	50.0	0.83
7. Figure arrangement is in harmony with the text	5	41.6	7	58.3	1.00
8. Figures help in exposing the theme and are in a logical sequence	6	50.0	6	50.0	1.00
9. Figures help in insulin therapy treatment with Continuous Insulin Infusion System	4	33.3	6	50.0	0.83
10. Figures are relevant to the understanding content by the target audience	5	41.6	7	58.3	1.00
Total CI					0.90

Experts’ suggestions
Figure 1	- Modify the sentence: “This system is used externally to the body in the subcutaneous tissue, just below the skin...” for “This system is used externally to the body, with the application of a catheter in the subcutaneous...”. - Remove the word “pulse” and leave only the word “bolus”
Figure 2	- Explain that the choice of ultra-fast insulin would be due to the fact that it has an early peak of action and is more predictable than regular insulin, and not only because it causes less hypoglycemia than regular insulin. - Modify change time from 3 days to “change every 2-3 days” or “change at most every 3 days”.
Figure 5	- Review the phrase: “air bubble occlusion”. - Replace the word “insufficient” with “inappropriate” in the phrase “Infection by insufficient cleaning”. - The change to “System occlusion: by wire bending (catheter)” was performed.
Figure 6	- Change the sentence “The consumption of a snack before bed (supper) (milk or bread with cheese and ham) can help in nocturnal hypoglycemia prevention” by “Check the best snack option with your professional”. - Review the text about blood glucose values between 60-50 mg/dL that cause symptoms of hypoglycemia, as some feel at 80-70 mg/dL, depending on patients’ threshold. - Include hypoglycemia corrections: 15 g of carbohydrate with blood glucose below 70 mg/dL and with 30 g of carbohydrate, if blood glucose is below 50 mg/dL.
Figure 8	- Do not specify the type of battery to be used in CIIS, as each device model requires a specific model. - Include in the emergency kit the long-acting insulins, in case of failure in the device that prevents its operation for a longer time. - Replace the phrase “fast-acting glucose tablets” with “fast-absorbing carbohydrates” and exemplify - Include applicator figure and 70% swabs.
Figure 10	- In Medtronic’s CIIS models, the guidelines are the use of no cleaning product other than 70% alcohol.

Variables		PS^a	S^b
1	Content
1.1	Objective is evident facilitating a prompt understanding of the material	1	5
1.2	Content addresses information related to insulin pump treatment	1	5
1.2	The purpose is limited to such purposes as the viewers can reasonably understand in the time allowed.	1	5
2	Language
2.1	Reading level is suitable for readers’ understanding	1	5
2.2	Conversation style makes it easy to understand the text	-	6
2.3	Vocabulary uses common words	1	5
3	Graphic illustrations
3.1	Cover attracts attention and depicts the purpose of the material	2	4
3.2	Illustrations feature key visual messages so that readers can understand the key points alone, without distractions	2	4
4	Motivation
4.1	There is interaction of text and/or figures with readers, leading them to solve problems, make choices and/or demonstrate skills	2	4
4.2	Desired behavior patterns are modeled or well demonstrated	1	5
4.3	There is motivation for self-efficacy, i.e., people are motivated to learn because they believe that tasks and behaviors are feasible	2	4
5	Cultural suitability
5.1	The material is culturally appropriate to the target audience’s logic, language and experience	-	6
5.2	Displays culturally appropriate images and examples	-	6

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[1] Corresponding author: Raquel Rodrigues da Costa Brilhante, E-mail: raquelcosta_ce@hotmail.com