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O protocolo para a elabora&#231;&#227;o do manual foi composto por duas fases&#58; a primeira fase envolveu a constru&#231;&#227;o do material educativo&#44; com base na busca de artigos cient&#237;ficos em bancos de dados no per&#237;odo entre 1980 e 2019&#44; por meio dos descritores &#8220;acne&#8221;&#44; &#8220;isotretino&#237;na&#8221;&#44; &#8220;ader&#234;ncia&#8221;&#44; &#8220;efeitos adversos&#8221;&#44; &#8220;manuais de educa&#231;&#227;o em sa&#250;de&#8221;&#46; Na elabora&#231;&#227;o do conte&#250;do&#44; procurou&#8208;se utilizar frases curtas&#44; com linguagem simples&#44; cotidiana e na voz ativa&#46; O manual resultante foi denominado <span class="elsevierStyleItalic">Guia de Orienta&#231;&#227;o ao Paciente para o uso de Isotretino&#237;na</span>&#59; tem&#160;16 p&#225;ginas&#44; e seu conte&#250;do foi organizado em 11 dom&#237;nios com os seguintes subt&#237;tulos&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1&#46;</span><p id="par0015" class="elsevierStylePara elsevierViewall">O que &#233; isotretino&#237;na&#63;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2&#46;</span><p id="par0020" class="elsevierStylePara elsevierViewall">O que &#233; acne inflamat&#243;ria grave&#63;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3&#46;</span><p id="par0025" class="elsevierStylePara elsevierViewall">O que devo contar ao meu m&#233;dico antes de usar isotretino&#237;na&#63;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4&#46;</span><p id="par0030" class="elsevierStylePara elsevierViewall">Como devo tomar isotretino&#237;na&#63;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">5&#46;</span><p id="par0035" class="elsevierStylePara elsevierViewall">O que devo evitar enquanto estou usando isotretino&#237;na&#63;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">6&#46;</span><p id="par0040" class="elsevierStylePara elsevierViewall">Quais os efeitos colaterais mais comuns da isotretino&#237;na&#63;</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">7&#46;</span><p id="par0045" class="elsevierStylePara elsevierViewall">O que devo comunicar imediatamente ao meu m&#233;dico durante o uso de isotretino&#237;na&#63;</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">8&#46;</span><p id="par0050" class="elsevierStylePara elsevierViewall">Teratogenicidade</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">9&#46;</span><p id="par0055" class="elsevierStylePara elsevierViewall">Exames laboratoriais</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">10&#46;</span><p id="par0060" class="elsevierStylePara elsevierViewall">Guarda do medicamento</p></li><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">11&#46;</span><p id="par0065" class="elsevierStylePara elsevierViewall">Perguntas frequentes</p></li></ul></p><p id="par0070" class="elsevierStylePara elsevierViewall">Na segunda fase&#44; o manual educativo foi avaliado em duas etapas&#58; valida&#231;&#227;o por ju&#237;zes &#40;dermatologistas brasileiros <span class="elsevierStyleItalic">experts</span> em acne&#41; e valida&#231;&#227;o pelo p&#250;blico&#8208;alvo &#40;pacientes&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">A literatura apresenta controv&#233;rsias quanto ao n&#250;mero e qualifica&#231;&#227;o dos ju&#237;zes&#46; Lynn recomenda um m&#237;nimo de cinco e um m&#225;ximo de 10 pessoas participando desse processo&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">3</span></a> Pasquali ressalta que o n&#250;mero de seis a 20 especialistas &#233; o recomend&#225;vel para o processo de valida&#231;&#227;o&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">4</span></a> Na primeira etapa&#44; nove ju&#237;zes foram inclu&#237;dos&#44; seguindo o sistema de classifica&#231;&#227;o descrito por Joventino &#40;2010&#41;&#44; que requer escore m&#237;nimo igual a 5&#44; considerando a gradua&#231;&#227;o acad&#234;mica e a qualifica&#231;&#227;o na &#225;rea de interesse &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46; Os especialistas receberam o termo de consentimento livre e esclarecido e um question&#225;rio a ser completado <span class="elsevierStyleItalic">online</span>&#44; adaptado do instrumento de Galdino &#40;2019&#41;&#44; contendo perguntas fechadas sobre informa&#231;&#245;es presentes no manual a respeito de objetivos&#44; relev&#226;ncia&#44; estrutura e apresenta&#231;&#227;o&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">5</span></a> Na segunda etapa&#44; ap&#243;s considerar as sugest&#245;es dos ju&#237;zes&#44; uma nova vers&#227;o do manual foi criada e destinada ao p&#250;blico&#8208;alvo&#46; Trinta pacientes foram selecionados&#44; procedentes do Ambulatorio de Dermatologia Sanitaria&#44; Rio Grande do Sul e do Hospital de Clinicas de Porto Alegre&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">Os crit&#233;rios de sele&#231;&#227;o dos pacientes com acne foram&#58; idade maior ou igual a&#160;14&#160;anos&#44; em uso de isotretino&#237;na at&#233; o terceiro m&#234;s de tratamento&#44; e n&#237;vel de educa&#231;&#227;o compat&#237;vel com leitura e compreens&#227;o do material&#46; Eles deveriam assinar o termo de consentimento livre e esclarecido&#44; e responder um question&#225;rio sobre organiza&#231;&#227;o&#44; estilo da escrita&#44; apar&#234;ncia e motiva&#231;&#227;o do material educacional&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">O estudo foi aprovado pelo Comit&#234; de &#201;tica e Pesquisa das intitui&#231;&#245;es Ambulat&#243;rio de Dermatologia Sanit&#225;ria e Hospital de Cl&#237;nicas de Porto Alegre atrav&#233;s dos n&#250;meros&#160;3&#46;389&#46;244 e 3&#46;584&#46;111&#44; respectivamente&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Para realizar a interpreta&#231;&#227;o e an&#225;lise dos dados&#44; foi utilizado o &#205;ndice de Validade de Conte&#250;do &#40;IVC&#41;&#44; que mede a propor&#231;&#227;o de ju&#237;zes que est&#227;o em concord&#226;ncia sobre o instrumento e seus itens&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">6</span></a> Esse m&#233;todo utiliza uma escala tipo Likert&#44; com pontua&#231;&#227;o de 1 a 4&#46; Para avaliar a relev&#226;ncia&#47;representatividade&#44; as respostas podem incluir&#58;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">3</span></a><ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0060"><span class="elsevierStyleLabel">1&#46;</span><p id="par0095" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>n&#227;o relevante&#44; ou n&#227;o representativo&#59;</p></li><li class="elsevierStyleListItem" id="lsti0065"><span class="elsevierStyleLabel">2&#46;</span><p id="par0100" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>precisa de maior revis&#227;o para ser representativo&#59;</p></li><li class="elsevierStyleListItem" id="lsti0070"><span class="elsevierStyleLabel">3&#46;</span><p id="par0105" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>precisa de pequena revis&#227;o para ser representativo&#59;</p></li><li class="elsevierStyleListItem" id="lsti0075"><span class="elsevierStyleLabel">4&#46;</span><p id="par0110" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>relevante ou representativo&#46;</p></li></ul></p><p id="par0115" class="elsevierStylePara elsevierViewall">O &#237;ndice &#233; calculado pela soma da concord&#226;ncia dos itens marcados com &#8220;3&#8221; e &#8220;4&#8221; pelos especialistas&#44; dividida pelo n&#250;mero total de respostas&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">7</span></a> Os itens que receberam uma pontua&#231;&#227;o de &#8220;1&#8221; ou &#8220;2&#8221; devem ser revisados ou eliminados&#46; No caso de seis ou mais ju&#237;zes&#44; recomenda&#8208;se uma taxa aceit&#225;vel de concord&#226;ncia n&#227;o inferior a 0&#44;78&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">7</span></a> Na an&#225;lise dos dados julgados pelo p&#250;blico&#8208;alvo&#44; itens com n&#237;vel m&#237;nimo de concord&#226;ncia de 75&#37; foram considerados validados&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a> mostra a avalia&#231;&#227;o do manual pelos ju&#237;zes em rela&#231;&#227;o aos objetivos&#44; estrutura e apresenta&#231;&#227;o e a relev&#226;ncia do manual&#46; Todos os itens foram validados&#44; o que conferiu um IVC de 0&#44;88 para os objetivos propostos&#44; IVC de 0&#44;88 para estrutura e apresenta&#231;&#227;o e IVC de 1&#44;0 para relev&#226;ncia&#46; Houve sugest&#245;es de algumas mudan&#231;as de cor&#44; figuras e texto&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a> mostra a avalia&#231;&#227;o do manual pelos pacientes&#46; Dos 30 pacientes&#44; 63&#37; tinham idade entre 15 e 20 anos&#59; 30&#37; tinham entre 21 e 25 anos&#59; 6&#44;7&#37;&#44; entre 26 e 31 anos&#46; A maioria dos pacientes era do sexo masculino&#160;&#40;56&#44;6&#37;&#41;&#44; solteira&#160;&#40;93&#44;3&#37;&#41; e estudava havia mais de 10 anos&#160;&#40;56&#44;6&#37;&#41;&#59; apresentava acne por um per&#237;odo menor ou igual a cinco anos&#160;&#40;70&#37;&#41; e havia sido submetida a tratamento pr&#233;vio com medica&#231;&#227;o oral ou t&#243;pica&#160;&#40;56&#44;6&#37;&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0130" class="elsevierStylePara elsevierViewall">O material foi avaliado positivamente e validado pelos pacientes em todos os aspectos&#58; organiza&#231;&#227;o&#44; estilo e apar&#234;ncia da escrita e tr&#234;s itens de motiva&#231;&#227;o&#44; com IVC sempre igual ou muito pr&#243;ximo de 1&#44;0&#46; Um item relacionado &#224; motiva&#231;&#227;o apresentou menor IVC &#40;0&#44;70&#41; e n&#227;o foi validado pelos pacientes &#40;que aborda se o manual influenciaria a mudan&#231;a de comportamento durante o uso de isotretino&#237;na&#41;&#46; &#201; poss&#237;vel que a qualidade das informa&#231;&#245;es fornecidas aos pacientes pelos dois Servi&#231;os de Dermatologia em que o estudo foi realizado tenha sido a causa da n&#227;o valida&#231;&#227;o desse item&#44; pois provavelmente os pacientes j&#225; haviam recebido orienta&#231;&#245;es sobre comportamento enquanto usavam isotretino&#237;na&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">O manual&#44; com suas 16 p&#225;ginas&#44; validado por ju&#237;zes e pacientes&#44; &#233; ilustrado na <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a> em tamanho reduzido&#46; O projeto desenvolveu um material de f&#225;cil compreens&#227;o e linguagem simples&#44; abordando as quest&#245;es necess&#225;rias para orientar os pacientes em rela&#231;&#227;o &#224; isotretino&#237;na&#44; a partir de uma amostra de usu&#225;rios do SUS&#8208;Brasil&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Suporte financeiro</span><p id="par0140" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Contribui&#231;&#227;o dos autores</span><p id="par0145" class="elsevierStylePara elsevierViewall">Let&#237;cia Santos Dexheimer&#58; An&#225;lise estat&#237;stica&#59; concep&#231;&#227;o e planejamento do estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica dos casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Camila Boff&#58; Concep&#231;&#227;o e planejamento do estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Cec&#237;lia Cassal&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; concep&#231;&#227;o e planejamento do estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Renan Rangel Bonamigo&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; concep&#231;&#227;o e planejamento do estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; revis&#227;o cr&#237;tica do manuscrito&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflito de interesses</span><p id="par0165" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Como citar este artigo&#58; Dexheimer LS&#44; Boff C&#44; Cassal C&#44; Bonamigo RR&#46; Development and validation of printed educational material for isotretinoin users&#46; An Bras Dermatol&#46; 2021&#59;96&#58;504&#8211;7&#46;</p>"
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          "pt" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Manual completo&#44; ap&#243;s valida&#231;&#227;o &#40;tamanho reduzido&#41;&#46; 1&#46; Capa&#59; 2&#46; Sum&#225;rio&#59; 3&#46; O que &#233; isotretino&#237;na&#63;&#59; 4&#46; O que &#233; acne inflamat&#243;ria grave&#63;&#59; 5&#46; O que devo contar ao meu m&#233;dico antes de usar isotretino&#237;na&#63;&#59; 6&#46; Como devo tomar isotretino&#237;na&#63;&#59; 7&#46; O que devo evitar enquanto estou usando isotretino&#237;na&#63;&#59; 8&#46; Quais os efeitos colaterais mais comuns da isotretino&#237;na&#63;&#59; 9&#46; O que devo contar imediatamente ao meu m&#233;dico enquanto uso isotretino&#237;na&#63;&#59; 10&#46; Teratogenicidade&#59; 11&#46; Exames laboratoriais&#59; 12&#46; Guarda do medicamento&#59; 13&#46; Perguntas frequentes&#59; 14&#46; Contracapa&#46;</p>"
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                  <table border="0" frame="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">2 pontos&#47;tese&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 ponto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t">1&#46;1&#46; O instrumento &#233; coerente com as necessidades dos pacientes usu&#225;rios de isotretino&#237;na&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;2&#46; Pode circular no meio cient&#237;fico na &#225;rea de Dermatologia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">2&#46; Avalia&#231;&#227;o dos ju&#237;zes de conte&#250;do quanto &#224; estrutura e apresenta&#231;&#227;o do manual</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">2&#46;1 O material educativo &#233; apropriado para a orienta&#231;&#227;o dos usu&#225;rios de isotretino&#237;na&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;2 As mensagens s&#227;o apresentadas de maneira clara e objetiva&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;3 As informa&#231;&#245;es apresentadas est&#227;o cientificamente corretas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;4 H&#225; uma sequ&#234;ncia l&#243;gica do conte&#250;do proposto&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;5 O material est&#225; adequado ao n&#237;vel sociocultural do p&#250;blico&#8208;alvo proposto&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">2&#46;6 As informa&#231;&#245;es est&#227;o bem estruturadas em concord&#226;ncia e ortografia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">2&#46;7 O estilo de reda&#231;&#227;o corresponde ao n&#237;vel de conhecimento do p&#250;blico&#8208;alvo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">2&#46;8 Informa&#231;&#245;es da capa e contracapa s&#227;o coerentes&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;9 As ilustra&#231;&#245;es s&#227;o expressivas e suficientes&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">2&#46;10 O n&#250;mero de p&#225;ginas est&#225; adequado&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">2&#46;11 O tamanho do t&#237;tulo e dos t&#243;picos est&#225; adequado&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">2&#46;12 O n&#237;vel de dificuldade do conte&#250;do &#233; adequado para a compreens&#227;o do paciente&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">2&#46;13&#46; Ocorre intera&#231;&#227;o do texto e&#47;ou das figuras com o leitor&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">3&#46; Avalia&#231;&#227;o dos ju&#237;zes de conte&#250;do quanto &#224; relev&#226;ncia do manual</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t">3&#46;1 Os temas retratam aspectos chaves que devem ser refor&#231;ados aos usu&#225;rios de isotretino&#237;na&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">3&#46;2 O material prop&#245;e ao paciente adquirir conhecimento acerca do uso de isotretino&#237;na&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">3&#46;3 O material aborda os assuntos necess&#225;rios acerca dos riscos do uso da medica&#231;&#227;o&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#46;4 Est&#225; adequado para ser utilizado por qualquer profissional da sa&#250;de em suas atividades educativas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;1 A capa chamou sua aten&#231;&#227;o&#63;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;2 A sequ&#234;ncia do conte&#250;do est&#225; adequada&#63;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;3 A estrutura da cartilha educativa est&#225; organizada&#63;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">2&#46; Estilo da escrita</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;1 Quanto ao entendimento das frases&#44; elas s&#227;o&#58; f&#225;ceis&#47;dif&#237;ceis de entender&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;2 O conte&#250;do escrito &#233;&#58; claro&#47;confuso&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;3 O texto &#233; interessante&#47;desinteressante&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">3&#46; Apar&#234;ncia</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#46;1 As ilustra&#231;&#245;es s&#227;o&#58; simples&#47;complicadas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#46;2 As ilustra&#231;&#245;es servem para complementar o texto&#63; Sim&#47;N&#227;o&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;967&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">3&#46;3 As p&#225;ginas parecem organizadas&#63; Sim&#47;N&#227;o&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;933&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">4&#46; Motiva&#231;&#227;o</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">4&#46;1 Em sua opini&#227;o&#44; qualquer paciente em uso de isotretino&#237;na que ler esta cartilha vai entender do que se trata&#63;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">29&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">96&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;967&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">4&#46;2 Voc&#234; se sentiu motivado para ler a cartilha at&#233; o final&#63;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">29&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">96&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;967&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">4&#46;3 A cartilha aborda os assuntos necess&#225;rios para resolver as d&#250;vidas de quem usa isotretino&#237;na&#63;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">29&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">96&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;967&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">4&#46;4 A cartilha educativa lhe sugeriu ou orientou a agir ou a mudar algum comportamento durante o uso de isotretino&#237;na&#63;&nbsp;\t\t\t\t\t\t\n
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