Recurso audiovisual na aquisição de conhecimento e redução de ansiedade de pacientes hospitalizados recém diagnosticados com HIV/AIDS: ensaio clínico randomizado

Abstract

Recently diagnosed patients with the human immunodeficiency virus (HIV), which causes Acquired Immunodeficiency Syndrome (AIDS), require appropriate, updated, and reliable guidance to acquire knowledge and contribute to reducing anxiety. Therefore, the use of technological tools in education and healthcare is necessary because lack of knowledge can trigger feelings and emotions capable of impairing adherence to proper treatment. The objective is to evaluate the effectiveness of an audiovisual resource in knowledge acquisition and anxiety reduction in newly diagnosed HIV patients at an infectious disease hospital in the capital of Rio Grande do Norte. Developed in two phases: methodological and experimental, from August to December 2023. The first phase was divided into three stages: Stage 01 - scope review, identifying and validating relevant elements for resource composition, through the participation of 22 judges, using Fehring criteria; Stage 02 - construction and validation of the script content, and Stage 03 - construction and validation of the resource interface. Delphi technique was used in Stages 02 and 03, with seven judges in both. For the construction of the script and the audiovisual resource, operational procedures of pre-production, production, and postproduction were used. In the experimental phase, a randomized controlled single-blind clinical trial was conducted, with a quantitative approach, following Consolidated Standards of Reporting Trials recommendations. Considering Cohen's size and effect of 0.50, test power of 0.88, and a 5% level, a sample of 40 patients was generated, with 20 patients in the Control Group (CG) and 20 patients in the Experimental Group (EG). The CG received standard hospital guidance, and the EG received standard guidance plus the audiovisual resource. The audiovisual resource contained information about the disease, virus characteristics, transmission and prevention methods, treatment effectiveness, and daily care. To evaluate the effectiveness of the resource, two data collection instruments were used: 1) State-Trait Anxiety Inventory (STAI); and 2) Knowledge Assessment Instrument (KAI). Data were processed using Microsoft Office Excel 2010 and Statistical Package for the Social Sciences (SPSS) version 20.0, through descriptive and inferential statistics. Chi-square test (χ²) or Fisher's exact test or Student's t-test and other necessary statistical tests were used, with p <0.05 for the relationship between variables. This research was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, with CAEE: 44714621.0.0000.5537. The developed and validated technological tool is a short film, developed by an expert team in educational video production, anchored on a YouTube® digital platform. Regarding the results, the scope review listed essential elements for script elaboration, which were subdivided into initial guidance, general care, healthy living, sexual health, and emotional support categories. After its construction, the script was appreciated and validated by 22 judges, then the resource script was developed and validated by seven specialists, who provided relevant considerations that were accepted. Subsequently, the resource construction followed and was validated by experts in infectious diseases. In this final validation, judges agreed with the proposed items, with 100% approval of the audiovisual resource interface. The experimental phase of the study, a randomized clinical trial, confirmed the effectiveness of the audiovisual resource compared to standard institution guidance in knowledge acquisition and anxiety reduction, measured based on KAI and STAI-State and STAI-Trait instruments. Regarding knowledge acquisition assessed by KAI, positive results were obtained with an average of 29% after resource application, with statistical significance in standard deviation of 6.25 in the CG and 6.80 in the EG with value-p <0.001. Regarding anxiety addressed in STAI, of the eight sub-items directly related to anxiety, a 28.5% reduction in anxiety was obtained after intervention. Thus, the alternative hypothesis is confirmed, and the proposed thesis is supported, since the findings identified in the experimental phase indicated that the interventions performed had significant post-intervention effects, with greater statistical relevance in the experimental group. Finally, it is emphasized that nurses need to adopt communication facilitating strategies, and education technologies assist and promote knowledge, enabling knowledge acquisition, better treatment adherence, better user experience in the face of diagnosis, contributing to improvements in their quality of life.