Development and validation of educational hypermedia for family members and caregivers of people with epidermolysis bullosa

Dionísio, Paulo Sérgio; Barbosa, Islene Victor; Sampaio, Luís Rafael Leite; Rolim, Karla Maria Carneiro; Seifert, Silvia Karina Moreira; Sousa, Gleison Resende; Abreu, Rita Neuma Dantas Cavalcante de; Vasconcelos, Elizete Rios de

doi:10.1590/0034-7167-2021-0856

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 75 (05) • 2022 • https://doi.org/10.1590/0034-7167-2021-0856 copy

Development and validation of educational hypermedia for family members and caregivers of people with epidermolysis bullosa

Desarrollo y validación de hipermedia educativa para familiares y cuidadores de personas con epidermólisis ampollosa

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

to develop educational hypermedia to support the care of people with epidermolysis bullosa; and validate its content, functionality, usability, and efficiency.

Methods:

methodological study, based on five phases: analysis and planning; modeling; implementation; evaluation; and distribution. Hypermedia was evaluated by expert judges, using the content validity index, index of agreement, and exact binomial distribution test, considering p > 0.05 and 0.80 agreement ratio to estimate the statistical reliability of CVI and IOA.

Results:

in the validation with the judges, hypermedia presented excellent indices of total content validity (CVIt=0.99) and agreement for functionality, usability, and efficiency (IOA=100%), with p > 0.05 in all evaluated items.

Conclusions:

the developed hypermedia was considered adequate, with good screens, descriptions, and animations, presenting itself clearly and objectively to be used by patients with epidermolysis bullosa and their family members/caregivers.

Descriptors:
Epidermolysis Bullosa; Caregivers; Educational Technology; Hypermedia; Validation Study.

Item	Agreed		CVI (%)	p
Item	Partially f(%)	Totally f(%)	CVI (%)	p
Objectives			1.00
1 - Are consistent with the practice of caring for people with EB.	1 (5.9)	16 (94.1)	1.00	0.118
2 - Are consistent with the content presented.	3 (17.6)	14 (82.4)	1.00	0.549
3 - Are suitable to be effective.	3 (17.6)	14 (82.4)	1.00	0.549
4 - Are suitable for the teaching and learning process.	3 (17.6)	14 (82.4)	1.00	0.549
Content			0.98
5 - The content accurately reaches the approach of the topic.	4 (23.5)	13 (76.5)	1.00	0.451
6 - It is suitable for the family/caregiver of people with EB.	5 (29.4)	12 (70.6)	1.00	0.242
7 - The information is current and true.	2 (11.8)	15 (88.2)	1.00	0.310
8 - The information is enlightening and necessary.	1 (5.9)	16 (94.1)	1.00	0.118
9 - The language is suitable for the target population.	4 (23.5)	11 (64.7)	0.94	0.118
Relevance			1.00
10 - The items illustrate important aspects for essential care for people with EB.	2 (11.8)	15 (88.2)	1.00	0.310
11 - The educational material is relevant and stimulates learning.	2 (11.8)	15 (88.2)	1.00	0.310
12 - It is consistent for the practice of care for people with EB.	-	17 (100.0)	1.00	0.310
Environment			1.00
13 - Hypermedia is suitable for content presentation.	5 (29.4)	12 (70.6)	1.00	0.242
14 - The resources are suitable for learning the subject.	5 (29.4)	12 (70.6)	1.00	0.242
15 - Resources propose attractive learning situations.	5 (29.4)	12 (70.6)	1.00	0.242
CVIt	-	-	0.99	-

Judge	Suggestions
J1	Add care for non-care professionals (informal). Add an Afro-descendant oriented professional.
J3	I suggest spelling and grammatical revision. On page 11 - include guidelines regarding bathing. On page 13 - specify whether the care about the bath is for children.
J4	In the first paragraph, in the definition of EB - replace “being able” (gerund) with “and may”. Insert pictures on how to put the baby diaper. Unify Topics 4 and 5 in the care in the bath section. Clarify whether the care in the bath is for children or adults.
J9	Expand the use of technology. Re-evaluate the use of some terms, making them clearer to the user.
J10	Bring scientific terms closer to their definition. Include the term “self-care”
J12	Reread to delete repetitive information. Beware of using terms inappropriate to the public.
J14	Evaluate the possibility of transforming the app in other educational technology.
J16	Available in Unified Health System (SUS). Put more humor in the photograph. Insert musical background.
J17	Use more illustrations, especially in the description of each care to be provided. Modify scientific terms that may hinder the understanding of users, especially in Figures 5 and 8. Reevaluate the illustrations - some do not match the purpose for which they are set.

	Agreed		CVI (%)	p
	Partially f(%)	Totally f(%)	CVI (%)	p
Feature
1 - Hypermedia is presented as an appropriate tool to the proposal for which it is intended.	2 (20.0)	8 (80.0)	100.0	0.302
2 - Hypermedia makes it possible to generate positive results.	1 (10.0)	9 (90.0)		0.107
Usability
3 - Hypermedia is easy to use.	1 (10.0)	9 (90.0)	100.0	0.107
4 - It is easy to learn the concepts used and their applications.	1 (10.0)	9 (90.0)		0.107
5 - Allows control of the activities presented in it, being easy to apply.	4 (40.0)	6 (60.0)		0.624
6 - Allows the user to have ease in applying worked concepts.	1 (10.0)	9 (90.0)		0.107
7 - Provides help clearly.	2 (20.0)	8 (80.0)		0.302
8 - Provides help in a complete way.	2 (20.0)	8 (80.0)		0.302
9 - Provides help quickly, not being tiring.	3 (30.0)	7 (70.0)		0.624
Efficiency
10 - Hypermedia design is suitable for your upgrade.	2 (20.0)	8 (80.0)	100.0	0.302
11 - The number of modules is consistent with the proposed time.	-	10 (100.0)		0.107
12 - The organization of thematic topics is suitable for a good understanding of the content, with easy localization of the desired topic.	1 (10.0)	9 (90.0)		0.624
13 - Resources are used appropriately.	-	10 (100.0)		0.107
14 - Resources are used efficiently and comprehensively.	-	10 (100.0)		0.107
IOAt			100.0

Judge	Suggestions
JTI2	Insert function to fill in concrete and updated user data, such as telephone number/email.
JTI4	Available on iOS and Android platforms.
JTI7	Enter a chat so that users can exchange ideas with each other. Enable follow-up with health professionals.
JTI8	Insert animations closer to the reality of the anomalies caused on the skin.
JTI9	Enter a system of interaction with some public service.
JTI10	Enter a specific information search system. Check that animations involve all age groups.

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[1] Corresponding author: Paulo Sérgio Dionísio E-mail: pdio2007@hotmail.com