Eficácia do aplicativo móvel ostocuide® no autocuidado de pessoas com estomias intestinais: ensaio clínico randomizado

Abstract

Intestinal stomas allow the exteriorization of portions of the intestine in the abdominal wall and are routinely performed in health services. These surgeries have a significant impact on aspects of self-care. As a way of working on self-care for this population, mobile technologies are included as resources that enable easy access in different locations, rapid obtaining of information and communication. However, there is a lack of studies on the development and evaluation of the repercussions of these software on the health of the population with stomas. Thus, the objective was to analyze the effectiveness of the Ostocuide® mobile application in the self-care of people with intestinal stomas. This is a longitudinal study with a quantitative, methodological and intervention approach, carried out from March 2023 to January 2025. The research had two studies: a methodological study to validate the content and evaluate the usability of the application and an intervention study, of the randomized clinical trial type. The methodological study was carried out from March to December 2023 and involved content validation with 10 experts, via the Google Forms platform, semantic validation and usability assessment with 10 people with ostomies at the State Center for Rehabilitation and Specialized Outpatient Care, in Natal, Rio Grande do Norte. The intervention study was carried out at the State Rehabilitation Center with people with ostomies, from July 2024 to January 2025. Simple random sampling distributed the patients into the control group, which received only conventional guidance in the nursing consultation, and the intervention group, which in addition to the consultations, used the Ostocuide® application. Both groups answered the self-care development form and were monitored for 45 days, with the instrument reapplied after 15, 30 and 45 days, via telephone contact. The results of the methodological stage showed that in the first round of evaluation by the judges, all domains presented a content validity index equal to 1.0, with the exception of the font size, which obtained 0.900. In the second round, consensus was reached. In the evaluation by the patients, the item quantity of illustrations obtained 0.800 in the first round and there was consensus in the second round. The overall usability average was 92.25 points. In the intervention study, 61 people composed the sample, 30 in the intervention group and 31 in the control group. It was observed that the knowledge domain presented a statistically significant interaction effect, which demonstrated that there was an interaction between knowledge and the groups (F=7.33, p=0.00). The averages of the intervention group were higher over time compared to the control group. The differences between the groups presented statistical significance in all domains and in the overall average. There was a moderate and significant correlation (r=0.449; p=0.013) between the number of accesses and the average final self-care assessment. All participants responded that they were satisfied with the application, and three people responded that it was not easy to access. Regarding the contributions of the application, 11 (36.7%) mentioned information regarding nutrition, 6 (20.0%) mentioned hygiene and changing the collection equipment, and 4 (13.3%) mentioned laws and rights. Therefore, it was observed that Ostocuide® is effective in the selfcare of people with intestinal ostomies. Furthermore, this study contributes to the advancement of knowledge about technologies for people with ostomies and may help to improve the lifestyle of people with ostomies. It is emphasized that further studies are needed to verify the effectiveness of the application in other contexts.