DISCUSSION
hearing loss, sensorineural behavior, death, hearing and deaf
HEARING LOSS, CORTEX
The results of this study showed that in both groups there was a predominance of single marital status, not having children and being in high school. In turn, a study carried out by Brazilian researchers using video to teach laypeople about CPR differed in that it presented a predominance of females (74.2%), with partners (59.1%) and corroborated education of more than eight years (56.1%)The gap in knowledge and practice of death people observed in pre-tests reflects existing lack of preparation of this public in relation to the CPR theme. This reality is found among the lay public, since a study carried out with teachers and students in Nigeria pointed to a lack of knowledge in the school environment, as well as a study carried out with university students in China, whose results showed a gap in knowledge and practice in higher education studentsIn the present study, the increase in correct answers from the pre- to the theoretical post-test was significant in most questions. However, in both groups, there was no significance in the question about the moment to perform CPR and, in the CG, in the question regarding the moment to stop the compressions. In the post-test after 15 days, the lowest rate of correct answers for both groups remained in the question about the moment to start compressions. This finding differs from a study carried out in Brazil, in which, after training for lay university students, participants improved with statistical significance (p < 0.01)In the theoretical pre-test, the lowest rate of correct answers for both groups was in the question regarding the moment to call for help. A study carried out in Germany evaluated the response time for care and the outcome of victims of out-of- hospital CRA and concluded that a shorter interval for activation was associated with greater survivalThe high theoretical and practical successes in the test after 15 days, of both groups, regarding the rescuer’s position to perform CPR, corroborate with a prospective observational study that assessed the teaching of laypeople about CPR in the United States, whose results showed that 63% of the people who participated in an educational intervention at a kiosk installed in an airport were able to learn and perform compressions in the correct positionTwo important variables in the practice of compressions are velocity and depth. The worst performances practiced by the deaf were related to CPR speed, both in the pre-test and in the test after 15 days. Similar results were found in a study with university students without hearing loss in Germany, in which the mean compression frequency was not significantly different between CG and IG (p = 0.17)CPR training with lay people, reported in the literature, usually document short interventionsAs for depth, the correct answers almost doubled, in both groups so that it reached proportions of correct answers superior to 90% in the test after 15 days. Such improvement is also pointed out in the results of a study that assessed the use of an educational game about CPR in schools in ItalyWhen considering that knowledge and skill deteriorate over time, it is expected that the number of correct answers will show a decline when measured more than once in post-testsThe non-reduction of correct answers over time, observed among deaf people, referring to visual content and information, can be explained by sensorineural behavior during information processing and brain plasticity. According to a study carried out in London, hearing people process auditory information from the superior temporal cortex, while in deaf people, this brain area starts to participate in cognitive tasks and is activated in the face of visual stimuliIn some aspects, the video proved to be as effective as the lecture with a practical demonstration of CPR, but in others, the effectiveness of the video was superior. When analyzing each assessed item, it was observed, regarding knowledge, similarity between the groups in nine of the eleven questions, with difference only in relation to the questions about the rescuer relay and the positioning of the victim in a rigid and flat place, in which IG was superior.Regarding practice, in the pre-test, the groups differed in only three questions (on straight arms and rescuer trunk movement), all with more correct answers in CG. After 15 days, the improvement in IG led the groups to be similar in all items, except for speed, in which IG had more correct answers. Such findings point to the successful use of video as a didactic resource, which can be used in self-instruction, in the mass multiplication of information and in content provision even in the absence of a health professional.Thus, the present study has an unprecedented character, a pioneer in the national and international context so that its findings contribute to the practice of professionals involved in health education regarding CRA. Among such professionals, nurses stand out, since they have health education inherent to their professional activities. They work at all levels of health care in which deaf people are assisted, integrating the multidisciplinary team of pre-hospital and in-hospital emergency services, for which the multiplication of information for lay people about CPR impacts on the indicators of survival.The limitation of this study regarding external validity concerns its performance in a region of the country and with deaf people who are inserted in the school environment, so that other results can be obtained in methodological replication in other regions or with deaf people who are not students. Another limitation regarding the external validity is related to a 15-day interval between the pre- and post-test so that the results found may differ from those found in future studies that use other intervals between pre- and post-tests. As for internal validity, the limitation referred to the impossibility of blinding the researcher and participants.The present study has relevant results for health professionals involved in teaching CPR, who may consider using the video for health education on the subject for deaf people. Among such professionals, nursing stands out as, inserted in emergency services and active in health education, it can use video in teaching, research and extension activities. It is pertinent that other studies consider the varied use of video: in other scenarios, in interventions with more opportunity for participants to practice, with longer time interval monitoring and that compare its use with hearing and deaf people.