Evidências de validade da versão brasileira da “Coping and Adaptation Processing Scale” (CAPS) no perioperatório de cirurgias ortopédicass

Abstract

Introduction: In the 1970s, Callista Roy developed the Middle-Range Theory of Coping and Adaptation and the Coping and Adaptation Processing Scale, whose Brazilian version still lacks evidence of the testability of its theoretical constructs. Objective: General: To analyze the evidence of validity and psychometric reliability of the Brazilian version of the “Coping and Adaptation Processing Scale” in the perioperative orthopedic population. Specific Objectives: To verify the stability of the “Coping and Adaptation Processing Scale” at different perioperative moments in orthopedic surgeries and to estimate the internal structure of the “Coping and Adaptation Processing Scale” at different perioperative moments in orthopedic surgeries. Method: Psychometric study in accordance with Standards, 2014. The research setting was na institute specializing in medium and high complexity orthopedic surgeries in Rio de Janeiro. The sample consisted of 450 participants in the perioperative period of primary total hip and knee arthroplasty surgeries, considering 5-10 individuals per item. For statistical analysis, the FACTOR and JAMOVI programs were used. Descriptive analyses of sociodemographic, clinical, and orthopedic data were performed, through data collection from medical records, in order to characterize the participants. Subsequently, the scale was applied. The psychometric procedures consisted of stability analysis with 46 participants in the preoperative, immediate postoperative, and late postoperative periods; who were subsequently allocated to the preoperative group. Test-retest analysis was performed using non-parametric repeated measures analyses for each group, followed by ANOVA for the entire sample. To analyze the validity evidence of the internal structure considering the 450 participants, the following methods were adopted: matrix definition; sample adequacy test; determination of the number of factors; factor extraction and rotation; and bias correction. Results: The scale showed temporal stability. The scores indicated a reduction in coping strategies in the immediate postoperative period in response to surgical stimuli. FACTOR analysis identified that the five-factor model does not adequately explain the construct, suggesting unidimensionality. In the JAMOVI analysis, after the sixth round, the model found presented three dimensions, defined as input, central, and output processes, according to the theoretical proposition, absence of negative items or items with double saturation, acceptable RMSEA, solid TLI, more consistent theoretical structure, items with loadings ≥ 0.40, and overall McDonald’s Omega reliability of 0.94. Conclusions: The model found differs from the original proposed model. This is attributed to the sociocultural and linguistic particularities and the inequalities in access to healthcare present in the Brazilian population compared to developed populations. The contribution of the study lies in the possibility of rigorously investigating the factorial structure of the instrument applied to a clinical scenario permeated by complex human responses such as the orthopedic perioperative period, a context that previously lacked research references on the scale’s structure. The study strengthens the disciplinary knowledge of nursing since, through the empirical testability of a theory, it is possible to improve clinical practice and the decision-making process. The findings further reinforce the importance of new investigations aimed at verifying metric and conceptual invariance in other clinical and sociocultural contexts.