Data Collection
hearing loss, death, chest compression, ®
AIDS, SAID, EMERGENCY, EVENTS, HEARING LOSS
Data collection was carried out from October to December 2017 so that it lasted one month in each of the three schools that were the study settings. To minimize possible contamination of the control group, which was exposed to the lecture, with information from the video, which consisted of an intervention applied only to the intervention group, collection took place at each school, starting chronologically with the control group participants. Only upon conclusion of the post-test with the control group, collection with the intervention group took place at each school so that even if there was sharing of information about the video, there would be no interference in the control group results, since collection with this one had already been closed. Study participants were selected by the educational institutions themselves, based on the availability of opportune times in the classes, according to the class schedules. Thus, participants were divided into 12 subgroups, according to educational institutions’ availability to release students from classes for data collection feasibility. It should be noted that the number of students that made up each subgroup was determined by participation availability so that the subgroups were composed of numbers ranging from nine to 14 participants.Cluster randomization was used, in which each cluster was one of the 12 subgroups of students, and the R software was used to, with a 1:1 allocation rate, define the six groups of deaf people that would be included in the control group (CG) and the six that would belong to the intervention group (IG). To this end, a list of 12 subgroups was used, ordered in chronological sequence of collection schedule, and the numerical sequence obtained in R randomly determined which were allocated to the CG and IG.The study took place in rooms reserved by the schools’ coordinators. The structural organization of the rooms was standardized, with chairs in a semicircle so that all participants were exposed to similar scenarios. It should be noted that the 10 participants, five from the IG and five from the CG, who had a hearing aid, but did not use it when participating in the research, not because there was a prohibition or restriction on using said device, but because death people spontaneously removed it when entering the school environment on a daily basis, as it was a place with routine communication in Libras, in which using hearing aids was considered unnecessary by death people themselves.Upon arriving in the room, death students were invited to sit down and the researcher explained about the study, with translation into Libras performed by an interpreter. Then, participants signed the Informed Consent Form (ICF) and an attendance list, which included a numerical order for each signature so that the sequence of signed names assigned each participant a number. It should be noted that, during the operationalization of the study, the numbers were not repeated, thus each participant had a unique numerical code, determined by the sequence of signatures.Then, participants answered a sociodemographic and clinical assessment instrument with the variables: age, marital status, existence of children, previous participation in class or previous contact with some educational material on the subject, previous experience with CPR, use of hearing aids and degree of right and left hearing loss. It should be noted that the referred degree of hearing loss was triangulated with information present in existing medical report and made available by the school secretariats.Then, theoretical and practical pre-tests were carried out. Outcomes surveyed were CPR knowledge and skill. Thus, pre- and post-test measurements were performed using previously validated instruments. The instrument for verifying knowledge was built and validated in Libras, consisting of 11 questions about knowledge in CPR, such as CRP identification, CRP severity, right time to call for help, SAMU number, right time to perform compressions chest, victim positioning: hard and flat site, chest site for compression, position of rescuer for chest compression, strength to perform chest compression, rotation of who performs CPR and when to stop CPR. Next to each question there were five answer options (multiple choice), with only one correct alternativeIn this regard, after the projection of each question and alternatives, the instrument designed in Libras was paused so that everyone could simultaneously record their answer on the printed part of the instrument.After completing the theoretical pre-test, a skill pre-test took place. This stage took place in the same environment as the theoretical pre-test with the presence of only the participant, the researcher and the interpreter. Practice was carried out in a Prestan® adult CPR simulator. After being called individually to practice, each participant was instructed to freely perform in the simulator what they would do to help someone whose heart had stopped. It is noteworthy that skills assessments were recorded with a smartphone.Upon completing the pre-tests, participants in the IG were submitted to video use on CPR. The video was built based on the Gagne’s Nine Events of Instruction theoretical framework, with a duration of 7 minutes and 30 seconds, with information regarding CRA severity and identification, the correct way to ask for help and how to perform high-quality CPR. Its content was based on the guidelines of the Brazilian Society of Cardiology of 2013CG participants were exposed to content explanation about CPR in an expository class with practical demonstration. The content taught included CRA severity, the correct way to identify the condition, call for help and perform CPR, according to the protocol for laypersons of the Brazilian Society of Cardiology of 2013 and the AHA of 2015After the video intervention, applied to the IG, and the lecture with practical demonstration of CPR, applied to the CG, participants performed theoretical and practical post-tests. These occurred similarly to pre-tests and were carried out immediately after carrying out the educational strategy and repeated 15 days later. Outcome measurement in a 15-day interval is justified based on a scientific finding that compared teaching strategies and analyzed the effectiveness of learning, longitudinally, in three moments (immediately after, 15 and 30 days). The results of that study showed that, although the experimental group had better results, decline over time (15 and 30 days) was similar for both groupsBlinding occurred with the evaluators of pre- and post- practical tests. To this end skills assessment footage records were analyzed by two PhD teachers with experience in care and teaching in Emergency and Intensive Care, respectively. The two evaluators watched each footage together, projected on a 32-inch television, in a private environment, and filled out a checklist for verifying the skills of laypeople in CPR, without knowing which group the assessed deaf student had been allocated to.A checklist was constructed and validated with 11 items referring to the steps to be performed in CPR, namely: position of the rescuer close to the victim’s shoulder, overlapping hands for CPR, hypothenar region over the center of the victim’s chest, rescuer’s shoulders at 90º from the victim’s chest, performing chest compressions, arms straight/without flexion during CPR, trunk movement to apply force in CPR, minimum depth of 5cm in compression, velocity 100 to 120 compressions per minute, with chest recoil allowed between compressions and no interruption of compressions. Each item contained the options “correct”, “incorrect” and “not performed” to be marked, for each item, by the evaluators who used it