DESIGN AND VALIDATION OF A BUNDLE FOR ASSESSING GONADAL FUNCTION IN INDIVIDUALS WITH LIVER CIRRHOSIS

Liver cirrhosis (LC) constitutes the final stage of various chronic liver diseases and represents a serious public health problem. Its pathophysiology involves an inflammatory and fibrotic process that culminates in liver dysfunction and several systemic repercussions, including gonadal dysfunction with consequent hormonal alterations. Despite the clinical importance of this condition, there is a lack of studies that systematically address the assessment of gonadal function in men with LC, justifying the development of specific instruments for this purpose.

This study aimed to construct and validate a package for assessing gonadal function in men with LC.

A methodological approach divided into stages of construction and validation of the proposed instrument was used. Initially, an integrative review was conducted using 21 included articles to identify the main clinical and laboratory parameters associated with gonadal dysfunction in men with cirrhosis. These parameters formed the basis for the development of the instrument package, which is structured around three axes: clinical manifestations, laboratory tests, and management of gonadal dysfunction. The instrument underwent content validation by 11 expert judges, selected according to standardized expertise criteria. The evaluation was carried out using a single questionnaire on the Google Forms platform, where judges, based on a Likert scale, assigned scores from 0 to 4 to assess the three domains of the package: i) Objectives; ii) Structure and Presentation; iii) Relevance. Data were analyzed using SPSS 23, employing the Index of Agreement (IA), the Exact Binomial Distribution test (P>0.05), and the Intraclass Correlation Coefficient (ICC) to determine reliability.

Validation of the package showed excellent agreement among those evaluated, with a total confidence interval of 98.8% and an ICC of 0.814, demonstrating high reliability of the instrument. All evaluated domains obtained agreement greater than 80%, and the binomial distribution test indicated that the observed agreement proportion was not significantly lower than the predetermined value of 80% (P>0.05). The main suggestions from the experts focused on improving the visual and functional aspects of the material, including flowcharts, detailing the procedures, and multidisciplinary integration.

The results confirm the content validity and theoretical consistency of the instrument, establishing it as a useful environmental tool for standardizing the assessment of gonadal function in men with LC.