Menezes, Rejane Maria Paiva deGonçalves, Rafaella Guilherme2025-10-282025-10-282025-06-30GONÇALVES, Rafaella Guilherme. Extubação paliativa: desenvolvimento e validação de tecnologia educacional digital para profissionais de saúde. Orientadora: Dra. Rejane Maria Paiva de Menezes. 2025. 168f. Tese (Doutorado em Enfermagem na Atenção à Saúde) - Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, 2025.https://repositorio.ufrn.br/handle/123456789/65946Palliative extubation is defined as the planned withdrawal of ventilatory support from patients at the end of life when such therapy is considered futile. Although it is a recognized practice, significant barriers to its implementation exist, including cultural and religious influences, lack of clear guidelines, and deficits in the training of healthcare professionals. This study aims to develop a digital educational technology, in the form of an e-book, focused on qualifying health professionals for the practice of Palliative Extubation.This methodological research, grounded in instructional design, was conducted in four stages. The first stage, called analysis, was carried out in two phases. The first phase consisted of a scoping review, which identified 44 studies, mostly published in 2023, addressing guidelines for palliative extubation practice, symptom management, time between extubation and death, institutional protocols, and emotional impact on professionals. In the second phase, a cross-sectional study was conducted with 73 healthcare professionals from two university hospitals located in the Northeast and Southeast regions of Brazil. Data were collected virtually through an electronic form and analyzed using descriptive statistics and thematic content analysis. The sample was predominantly female, with a mean age of 38.6 years, mainly composed of nurses and nursing technicians, holding specialization or master’s degrees, and an average of 7.78 years of experience in critical care units. The mean score on the knowledge test was 8.89 correct answers, with a significant association between institution and results, showing better performance among professionals from the hospital in the Southeast region (p = 0.007). The main difficulties reported included limited team qualification, lack of institutional protocols, communication failures, family resistance, and fear of legal implications. Following the analytical phase, corresponding to the second stage— design and development—an evidence-based educational e-book was developed, structured according to instructional design principles. The e-book included concepts related to palliative extubation and its technical aspects, symptom management, use of pharmacological interventions, and interactive resources. In the third stage, evaluation and validation of the educational technology, 13 expert judges participated, including six nurses, four physicians, and three physiotherapists, mostly holding doctoral degrees. The evaluators’ mean age was 42.54 years, with an average of 19 years since graduation. The obtained indices were substantial: Content Validity Index (0.95), Kappa Coefficient (0.81), and Appearance Validity Index (0.97), confirming the quality, scientific accuracy, and didactic adequacy of the technology. In the fourth and final stage - implementation - the e-book was completed and made publicly available on the eduCAPES portal in Adobe Portable Document Format. It was concluded that the educational e-book presented validated content and appearance, constituting a relevant contribution to the training of healthcare professionals by addressing palliative extubation, a topic still little explored and surrounded by taboos in critical care settings, such as Intensive Care Units.pt-BRAcesso AbertoCuidados paliativos na terminalidade da vidaUnidades de Terapia IntensivaExtubaçãoTecnologia educacionaldoctoralThesisCIENCIAS DA SAUDE::ENFERMAGEM