Protocol for pelvic organ prolapse treatment with vaginal pessaries

Ferreira, Hellen Lívia Oliveira Catunda; Bezerra, Karrine de Castro; Freitas, Vívien Cunha Alves de; Silva, Tatiane Moura; Moura, Escolástica Rejane Ferreira; Vasconcelos, Camila Teixeira Moreira; Pinheiro, Ana Karina Bezerra; Aquino, Priscila de Souza

doi:10.1590/1982-0194201800081

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Original Article • Acta Paul Enferm 31 (6) • Nov-Dec 2018 • https://doi.org/10.1590/1982-0194201800081 linkcopy

Protocol for pelvic organ prolapse treatment with vaginal pessaries

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective To develop a clinical protocol for the conservative treatment of pelvic organ prolapse with vaginal pessaries.

Methods Developmental research conducted in the period from July 2015 to January 2016 and performed in the following steps: refinement of topics/protocol issues; establishing recommendations for research and updates; peer review. The analysis was by statistical program and the Content Validity Index (CVI).

Results The protocol was developed and evaluated by professionals of the area through the Delphi technique regarding criteria of objectives, content and presentation, and relevance. The total CVI of each domain and the overall CVI were calculated. The total Content Validity Index for the objectives domain was 1.00, for content and presentation criterion was 0.98, and for the relevance domain was 0.96. The overall Content Validity Index obtained was 0.98. Thus, there was agreement among participants of the Delphi technique with value above 0.85, and the clinical protocol was considered valid.

Conclusion When health professionals use the clinical protocol, they will have a better foundation in practice and offer a higher quality care, since this is a valid and scientifically based tool.

Pelvic floor disorders; Pelvic organ prolapse; therapy Pessaries; Protocols; Validation studies

Objectives criterion	CVI*	Content and presentation criterion	CVI*	Relevance criterion	CVI*
Item 1	1.00	Item 1	1.00	Item 1	1.00
Item 2	1.00	Item 2	1.00	Item 2	1.00
Item 3	1.00	Item 3	1.00	Item 3	0.85
Item 4	1.00	Item 4	1.00	Item 4	1.00
-	-	Item 5	1.00	-	-
-	-	Item 6	1.00	-	-
-	-	Item 7	1.00	-	-
-	-	Item 8	1.00	-	-
-	-	Item 9	1.00	-	-
-	-	Item 10	0.85	-	-
Total CVI	1.00		0.98		0.96

Overall CVI	0.98

Evaluators’ suggestions	Changes made
Reformulation of protocol considerations	The target audience of the protocol was defined as health professionals working in the area of PFD rather than in Urogynecology.
Insertion of figure	The figure of the pessary was inserted next to the explanation of each specific type
Replacement of term in English	The name of the pessary type ‘Donut’ was changed to ‘Rosca’
Insertion of table	A table was inserted with the main intercurrences in the use of pessaries and their management
Detailing/Reformulation of content	POP classifications were better detailed (POP-q); The steps for selecting and adjusting the pessary were rearranged; One more item was included in the steps for insertion of the pessary; Inclusion of the possibility of the stomatherapist nurse acting together with the physiotherapist in the conservative treatment with training of the pelvic floor musculature

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Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
E-mail: actapaulista@unifesp.br

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[TFN1001] *CVI – Content Validity Index