INTRODUCTION

One of the approaches presented by technology and that has been positively impacting, due to its practicality and convenience, are podcasts. Podcasts are programs in audio format available on digital platforms for streaming communication through the internet freely so that everyone has access, in order to transmit some type of information⁽¹⁾.

Spotify and Deezer are examples of these platforms that provide this type of content. Spotify, launched in 2008 in Sweden, is the most popular, having about 433 million active users worldwide and there are 4.4 million podcasts distributed on the platform, while Deezer, created in 2007 in France, has 16 million users distributed around the planet. Both allow the user to have access to its contents free of charge with ads or in a paid way⁽²⁾,⁽³⁾.

Podcasts have gained a lot of space in communication and transmission of information in various areas. Among these, one that grows a lot is the dissemination of knowledge about health, well-being and human body, since many experts are invited to participate in programs to transmit information on a certain subject, which dominate and thus assist in the dissemination of quality and safe health education⁽⁴⁾.

Health education can be implemented through podcasts, which are considered Information and Communication Technologies (ICT), since it favors health promotion, especially for patients with chronic diseases and disabilities, such as people with ostomies, enabling the subject to be active in their learning process, self-care and adaptation⁽⁵⁾.

Ostomies are artificial orifices that externalize organs or tissues for therapeutic purposes, and may be drainage, elimination or nutrition. They are classified according to the length of stay (temporary or definitive) and the location of the surgical procedure⁽⁶⁾,⁽⁷⁾.

The main diseases that suggest the making of an ostomy are the neoplasms. In the world, there is a prevalence of 0.12% of people with ostomies, and it is estimated that there are among 500,000 people living under these conditions in the United States⁽⁸⁾. In Brazil, this data is inaccurate, but can be stipulated by the number of people with cancer, especially those of colon, rectum, trachea, bronchi and lung, stomach and bladder, which according to the National Cancer Institute (INCA), for the year 2020, estimated if more than 800,000 cases per 100,000 inhabitants⁽⁹⁾,⁽¹⁰⁾.

The presence of an ostomy can significantly change the life of the person and his family, since its manufacture promotes not only physical, but also psychological and social changes. The adaptive process is stressful and the individual may feel mutilated, develop self-image problems, bring feelings of contempt and difficulties in relating to people for fear of rejection^{(11) (12) (13)}.

Therefore, health education can contribute to self-care since it guides about changes in habits, clarifies doubts and brings perspectives for future life quality. Considering the use of technologies for the practice of health education of patients, it is necessary to know about the characteristics of podcasts in health, highlighting the importance of the correct production of digital audio media, considering that the lack of adequate communication and education aimed at people with ostomies interferes negatively in their adaptation to this condition⁽¹³⁾,⁽¹⁴⁾.

Thus, this study presented as a guiding question: "What are the characteristics of educational podcasts on health and nursing for people with stomas in literature and on music streaming platforms?" Thus, the study aims to analyze in the literature and digital platforms of audios the characteristics of educational podcasts on intestinal stomas.

METHODOLOGY

This is a scope review, conducted from June to September 2022, developed according to the theoretical framework provided by the Joanna Briggs Institute - JBI⁽¹⁵⁾, as a stage of technological prospection through the search in music streaming platforms.

The scope review followed the five steps recommended by the Joanna Briggs Institute (JBI): I. Identification of the guiding question; II. Mapping of relevant studies; III. Selection of studies; IV. Data analysis; V. Synthesis and presentation of data^(15)). As well as the recommendations proposed by the Checklist of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR), for scope review⁽¹⁶⁾.

Initially a search was performed in the databases Open Science Framework (OSF), Database of Abstracts of Reviews of Effects (DARE), The Cochrane Library and International Prospective Register of Ongoing Systematic Reviews (PROSPERO), during the month of to verify the existence of protocols or scoping Reviews with similar objectives to this research, so no results were found for the desired search. Thus, a research protocol was created, composed of 12 items, and registered in the database of the Open Science Framework (OSF), and can be identified through the link: https://osf.io/kyj9r/?view_only=e5a62c4f097443218f0b0565b22b321b.

The guiding question of the research, the objective and the descriptors were elaborated following the mnemonic PCC, in which P (Population): people with stomas; C (Concept): characteristics of podcasts in health; C (Context): literature and music streaming platforms. Thus, the following guiding question was elaborated: "What are the characteristics of educational podcasts on health and nursing for people with intestinal stomas in literature and music streaming platforms?".

The descriptors used in the search were selected through an initial search of the indexed terms of the Medical Subject Headings (MeSH) and Descriptors in Health Sciences (DeCS), in additionin studies available in the database Medical Literature Analysis and Retrieval System Online (MEDLINE) and Latin American and Caribbean Literature in Health Sciences (LILACS) as recommended in the manual of the Joanna Briggs Institute (JBI)⁽¹⁵⁾. Thus the terms found and used for the following search of the studies were: P - Estomia; Colostomia; Ileostomia; Estomaterapia; Ostomy; Colostomy; Ileostomy; Enterostomal Therapy; Estomía; Colostomía; Ileostomía; Estomaterapia; C - Educação em saúde; Tecnologia educacional; Educação; Health Education; Educational Technology; Education; Educación en Salud; Tecnología Educacional; Educación; and C - Webcast; Podcast; Difusión por la Web.

After the selection of descriptors and equivalences, the electronic research of the studies was carried out in the databases Medical Literature Analysis and Retrieval System Online (MEDLINE); Latin American and Caribbean Literature in Health Sciences (LILACS), Nursing Database (BDENF), Índice Bibliográfico Español en Ciencias de la Salud (IBECS), Web of Science and Scientific Electronic Library Online (SciELO). For gray literature (dissertations and theses) were used the bases of the Brazilian Digital Library of theses and dissertations (BDTD), Scientific Open Access Repository of Portugal (RCAAP), Theses Canada, DART-Europe E-Theses Portal.

The search was conducted through access to the Portal of Journals of the Coordination of Improvement of Higher Education Personnel (CAPES), from the identification through the Federated Academic Community (Cafe), during the months of July to September 2022, and adapted according to the specificities of different databases and music streaming platforms, seeking to maintain the similarities in combinations and crossings of terms.

The descriptors search strategy stage with the Boolean operators AND and OR was as follows: in Portuguese[(Estomia OR Colostomia OR Ileostomia OR Estomaterapia) AND (Educação em saúde OR Tecnologia educacional OR Educação) AND (Webcast OR Podcast)]; in English [(Ostomy OR Colostomy OR Ileostomy OR ENTEROSTOMAL THERAPY) AND (Health Education OR Educational Technology OR Education) AND (Webcast OR Podcast)] and in Spanish [(Estomía OR Colostomía OR Ileostomía OR Estomaterapia) AND (Educación en Salud OR Tecnología Educacional OR Educación) AND (Difusión por la Web)]. We also performed the crossing "(Ostomy OR Colostomy OR Ileostomy OR Stomatology) AND (Health Education OR Educational Technology OR Education)" languages in Portuguese, English and Spanish.

The criteria for inclusion of the studies for sample selection were: Research available in full, available in electronic form free of charge and that meet the objective of the study, in Portuguese, English and Spanish languages through access to the portal (CAFe). The exclusion criteria were: duplicate studies, in editorial format, letter to the editor, theoretical essays, reflection studies and opinion articles.

The search was performed by pairs between two researchers, using different computers, aiming to avoid selection biases in the studies. In cases of divergence between both, the full reading and discussion of the studies were carried out, or a third researcher assisted in the selection of the sample. No software was used to assist in the selection of studies.

The technological prospecting stage was developed through the search on music streaming platforms in June of the same year, in access to the platforms Deezer (https://www.deezer.com) and Spotify (https:/www.spotify.com). In the search field of the sites were used the terms "Ostomia", "Estomia" and "Ostomy", indexed in the Descriptors in Health Sciences (DeCS), to filter the search were selected options "Episodes" and "Podcasts" in both streams, in order to analyze the channels and published episodes related to the object of study. The choice of these platforms is justified by the easy access free of charge and by having a search tool that helps in the survey of the findings in question. It was necessary to create an account with email address and password on both platforms to access the content.

The terms were searched and then the results were added. This process was repeated on both platforms (Deezer and Spotify). Initially, 54 channels and 231 episodes were found. After this stage were selected for analysis only the channels that presented in their title and/ or in the description the terms in question ("Ostomia", "Estomia" and "Ostomy"), resulting in 14 channels, The episodes that presented subjects related to the person with intestinal ostomy and that also presented in the description the terms, with any length of time, published in any period and in the Portuguese, English or Spanish languages, were chosen for analysis. Channels and episodes repeated on both platforms and those that did not present the terms in question were excluded from the sample. At the end, 119 episodes were selected to compose the sample.

The final sample of this study was selected based on the reading of the materials in full and analysis of the podcasts channels in the music streams, performed through the data extraction strategy as: source of publication, authors, title, objective of the study, year of publication, country of origin and the characteristics of podcasts.

The data referring to the analysis of the podcasts that composed the sample of this research, were transcribed in full and organized in a spreadsheet developed in Microsoft® Office Excel for better organization and interpretation of the acquired findings, being carried out analyzes through descriptive statistics with absolute and relative frequencies.

According to Resolution 466 of 2012 of the National Council of Ethics in Research, all the requirements for the development of the research were met, there is no need to submit to the research ethics committee because it is a study conducted with data from third parties available in literature databases and digital audio platforms.

RESULTS

The search strategy established for the databases allowed to identify 745 studies, after reading the title and summary was found only one study that was about the theme and corresponded to the final sample, as presented in the flowchart (Image 1).

Source: research data, 2022.

Image 1: Study selection flowchart in data sources. Natal, RN, Brazil, 2022. 

The article found is an experience report on a health education activity, made possible by an extension group in stomatology of the Federal University of through the creation of the podcast entitled Extension Group in Stomatherapy to meet the population in need of stomatherapy care, as well as professionals and nursing students in the context of the covid-19 pandemic.

The podcast consisted of a total of 16 episodes addressing the three areas of stoma, 4 of which were focused on stomas. In the approach on stomas, the themes presented were: "definition of stoma and classification of intestinal stomas", "self-care with stomas", "exchange of the collecting bag" and "common complications in stomas". The construction of the episodes was done through the creation of a script in the Portuguese language and recorded in the interview format lasting from 1m45s to 6m7s, being available in mp3 format on the Anchor platform of Spotify.

In the technological prospection stage from the searches on the platforms of Spotify and Deezer Streamings were found 14 podcasts and 119 episodes that had the stoma theme, 13 (92.86%) of these channels were on the Spotify platform and represent a total of 108 episodes and only one (7.14%) channel on the Deezer platform with 11 episodes on the theme. The episodes of the final sample totaled 27h21min5s of audio content analyzed.

An average of 8.5 episodes per channel was observed, in relation to the most prevalent language in the episodes was English present in 12 (85.71%) channels, and Portuguese only in two (14.29%) channels, no podcasts were found in the Spanish language. The duration of episodes between channels ranged from 3m38s to 1h43m58s. The most prevalent script format was the "interview" present in eight (57.14%) of the channels, followed by "self-report" in five (35.72%) and "narrative" in only one (7.14%) channel. Regarding the participants of the episodes, it was observed a higher conFiguration of episodes composed of more guest presenters present in eight (57.14%) channels and in six (42.86%) this conFiguration was composed only of presenters.

Chart 1 shows the podcasts that were selected on these search platforms with their characteristics. All data were taken from the information present on the platforms.

Chart 1: Podcasts distributed on the Spotify and Deezer platform with the ostomy theme. Natal, RN, Brazil, 2022. 

Source: research data, 2022.

^*Number of episodes in each channel referring to the theme.

DISCUSSION

From a general analysis, many of the podcasts addressed broad themes of various subjects in the area of health, in which ostomy is included. The few episodes found in Portuguese, had characteristics about reports involving experiences of the presenters and rights of the person with ostomy, and nursing care presented by a professional nurse. It was also observed that they also discuss the prejudice experienced by people with stomas and how this fact directly impacts on the quality of life of these individuals.

It is understood that people who are more informed about the condition of having an ostomy, develop fewer complications because they take adequate care and identify possible aggravations early⁽¹⁷⁾, information transmitted correctly can be considered a protective factor for the development of complications.

An important point to be addressed is the presence of health and nursing professionals who deal with this problem daily. In which the perspective of these professionals greatly influences the treatment, self-care and the way the patient should deal with the situation. These factors contribute to the dissemination of technical and accurate information for patients, thus, from these guidelines it is possible to develop informative resources that help in the dissemination of health to these individuals⁽¹⁸⁾.

Reflecting the lower number of podcasts and episodes with the language in Portuguese, it is demonstrated that many patients who undergo procedures for making an ostomy do not have care information or even information about the type of procedure, generating negative feelings about this situation and configuring a risk factor for peristomal complications⁽¹⁹⁾. Prejudice against the person with ostomy not only results in social exclusion but also promotes a process of adaptation and more time-consuming coping, in addition to being a catalyst for the emergence of mental disorders, points that are addressed in episodes of the sample.

In English-language podcasts, the main facts that are explored by the programs are real cases, which seek to interview people who have passed or who still go through the situation of being people with ostomies and how they deal with it in their daily lives. The reports involve problems of both physical, psychological or social character, as well as stories that helped these participants overcome their difficulties. These themes can be observed in the literature, corroborating with the findings of this research^{(20) (21) (22)).}

It is necessary to take into account, in addition to the physical changes that may affect the person with stoma, psychological issues in the assessment of the well-being of the person under this circumstance. It was observed that patients in this condition end up becoming more reclusive, antisocial, with tendencies to loneliness and the possibility of developing depression, negatively impacting the relationships of these subjects^{(22) (23) (24)).}

The formats as the episodes are presented (interview and self-report) can be considered a positive factor for the listeners, according to the experiences of a support group for the person with ostomy developed in a Brazilian university hospital⁽²⁵⁾, which reveal that the integration of participants through the sharing of experiences and teachings on ostomies results in a mutual learning between professional-and help in coping with situations arising from the making of an ostomy and the challenges that this condition represents in your life.

The limitations of this study are related to the absence of bibliographical productions that allow the analysis of podcasts developed and published in the databases for the population in question, despite the broad search strategy in the literature. It is observed that there is little progress in techniques and new information on ostomy, many of the data are repetitive and little information. Bringing more specific and innovative content is necessary on the subject, using as a means of linking information podcasts, seeking an approximation of the veracity of data transmitted with scientific basis, thus assisting in obtaining quality and safe information.

It appears that the important of this analysis of podcasts is to show the dissemination of information about the stoma and also to analyze how this condition still negatively impacts people's lives and can generate discrimination. In addition, showing examples of overcoming by people with stomas help listeners understand possible problems and overcome stressful and challenging situations. The reflections present in podcasts bring the implications and problems reported in studies that analyzed the perspective of individuals⁽²⁶⁾.

The making of a stoma generates numerous transformations in the daily life of the person as well as the emergence of doubts and anxiety arising from this condition, the use of strategies that seek to meet the needs of these individuals for their rehabilitation and self-care. Health education is a dynamic tool for sharing knowledge capable of reflecting changes in the quality of life of those involved⁽²⁷⁾.

CONCLUSIONS

The analysis of the podcasts showed that there is a considerable difference in the time of the episodes and the amount of content intended for people with stomas in relation to the language of publication, Thus it can be inferred that there are no criteria for the duration of the episodes and that there is a need to create content in the Portuguese language so that health information is also propagated to patients who understand this language.

In addition, it is important to continue the production of content related to the subject in question, since the lack of clarification contributes to the processes of discrimination and prejudice against this population. Thus, podcasts are conFigured as an alternative tool for health education if they have characteristics and contents based on the literature, since they clarify doubts, demystifies prejudices and promote the inclusion of the person with ostomy in society.

It also emphasizes the importance of the social and informational character of podcasts on stomas for educational practice in health, as well as a tool that seeks to reduce prejudice against the person with ostomy. In this way, take the information not only to the target audience, but also to other listeners, so that social barriers are broken and people can be treated appropriately.