Desenvolvimento de um aplicativo para avaliação dos pés de pessoas com diabetes Mellitus

Abstract

Diabetes Mellitus is a complex metabolic disorder, with negative repercussions due to its high potential to cause health complications, such as the Diabetic Foot. This complication is the main cause of amputations in the lower limbs, is characterized by the presence of foot ulceration associated with neurological changes and peripheral arterial disease and requires quality multidisciplinary assistance, involving interventions in several etiological components and periodic clinical examination of the person's feet with Diabetes Mellitus. Thus, it is important to develop and implement strategies that use innovative and updated methodologies to make clinical management of diabetic foot more efficient. In this sense, the study aimed to develop an application to evaluate the feet of the person with Diabetes Mellitus. It is a descriptive study with a quantitative approach, carried out through two stages: the elaboration of the application and the evaluation of the quality of the application by experts. Extreme Programming or XP method was used to make the application, through biweekly meetings between the researchers involved, the requirements of the system were surveyed; estimated the effort and resources needed to develop the instrument; planning and construction of the first version of the tool. Then the version of the application was made available for quality evaluation by the experts and performed the analyzes through averages and Kappa Fleiss test. Four successive evaluations were performed by expert peers, with the assignment of evaluating the functionality, usability and efficiency of the application using a form with responses on a likert scale ranging from 1 - totally disagree to 5 - strongly agree. The elaboration of the application took place in the following phases: selection and organization of the indicators of the Diabetic Foot Manual; photographs and videos; screen planning; logo design and other graphic elements; application flowchart; database design; installation of the Integrated Development Environment and choice of version and, finally, application programming, which resulted in the instrument called "Foot Care", consisting of four initial screens with information about the application; 17 screens for anamnesis and evaluation including three explanatory videos; 22 screens with photographs, six screens with helping information and one screen with the risk classification. Regarding quality evaluation by peer reviewers, the study showed that in the first evaluation the level of agreement was poor, with K = 0.135 (p = 0.407), in the second and third analyzes the level of agreement was satisfactory with K = 0.621 (p = 0.002) and K = 0.631 and p = 0.006 respectively. In the fourth analysis, agreement was excellent among the expert pair with K = 1,000 (p <0.01). Finally, after the suggested adjustments, the experts considered it possible to use the "Foot Care" application in clinical practice. We can conclude, in addition to the construction of the application, that the quality of the "Foot Care" app can be verified, making it possible to use in the foot exams of people with DM, in a systematized and standardized way, making foot evaluation more attractive and appropriate.