Construção e validação de Escala de Qualidade da Assistência Hospitalar no Puerpério (EQUAP)
Introduction: the puerperium is a period of physical and mental changes that begins after birth and ends when breastfeeding ends. This process of involution to the pre-pregnancy condition can cause more severe complications and evolve to death; however, 92% of maternal deaths in this phase are pr...
Na minha lista:
| Autor principal: | |
|---|---|
| Outros Autores: | |
| Formato: | doctoralThesis |
| Idioma: | pt_BR |
| Publicado em: |
Universidade Federal do Rio Grande do Norte
|
| Assuntos: | |
| Endereço do item: | https://repositorio.ufrn.br/handle/123456789/32771 |
| Tags: |
Adicionar Tag
Sem tags, seja o primeiro a adicionar uma tag!
|
| id |
ri-123456789-32771 |
|---|---|
| record_format |
dspace |
| institution |
Repositório Institucional |
| collection |
RI - UFRN |
| language |
pt_BR |
| topic |
Estudo de validação Assistência hospitalar Estudo de avaliação Período pós-parto |
| spellingShingle |
Estudo de validação Assistência hospitalar Estudo de avaliação Período pós-parto Rodrigues, Wilma Ferreira Guedes Construção e validação de Escala de Qualidade da Assistência Hospitalar no Puerpério (EQUAP) |
| description |
Introduction: the puerperium is a period of physical and mental changes that begins after birth
and ends when breastfeeding ends. This process of involution to the pre-pregnancy condition
can cause more severe complications and evolve to death; however, 92% of maternal deaths in
this phase are preventable, especially at the hospital level, when related to bleeding, puerperal
infection, and hypertension. In this context, the evaluation of the quality of puerperal hospital
care is fundamental for the monitoring of possible complications. However, the indicator that
evaluates this type of care does not contemplate the complications susceptible to complications,
nor the specific causes related to maternal deaths. Objective: to construct and validate a scale
for assessing the quality of hospital care in the puerperium. Method. a methodological study
developed in two stages: theoretical foundation and theoretical analysis. In the theoretical
foundation stage, an instrument based on the General Systems Theory, proposed by Adevis
Donabedian, and a scope review that allowed the construction of the instrument items from the
constitutive, operational and behavioral definitions were developed. The second stage began
with the evaluation of expert judges in the field. They agreed or disagreed with the items based
on the following criteria: objectivity, simplicity, clarity, relevance, accuracy, and variety. The
inclusion of expert judges was based on the following criteria: having published and researched
on the topic and being an expert in instrument construction. Those who submitted incorrect or
incomplete answers were excluded. The Content Validity Index (CVI) and the Kappa Index
were used to evaluate the level of agreement between the judges about a given item. The study's
relevance criteria were CVI>0.80 and Kappa>0.61. The sample consisted of ten judges. In
addition, the instrument was submitted to a lexical and grammatical correction in order to allow
its adaptation to another language. After lexical and grammatical analysis and validation by
expert judges, the evaluation of puerperal women (target population) was performed. They
agreed or disagreed with the items based on the following criteria: A (easy to understand), B
(medium understanding) and C (did not understand the item). This step allowed the evaluation
by the lowest cognitive stratum of the target population. Ten puerperal women admitted to the
Flávio Ribeiro Coutinho Maternity in the municipality of Santa Rita, Paraíba, were randomly
selected by convenience. Inclusion criteria for the women were: being over 18 years old,
knowing how to read and write, and being in the puerperium. The exclusion criteria were: puerperal complication, some medical contraindication and/or with suspected COVID-19. At
this stage, the Content Validity Index and Kappa Index were also used. The pertinence criterion
was CVI>0.80 and Kappa>0.61. The instrument went through a second evaluation by expert
judges to validate the final version of the instrument. The method chosen for the construction
and theoretical validation of this evaluation instrument followed Pasquali's recommendations.
It is noteworthy that this study was submitted to the Research Ethics Committee (REC) of the
Federal University of Rio Grande do Norte (UFRN), in accordance with Resolution No.
466/2012, and obtained a favorable opinion under CAAE number 18967519.6.0000.5176.
Results: At the end of this stage, eight items were removed from the instrument, 11 were
unified, and three had their wording modified. After the lexical and grammatical correction, the
scale was submitted to the analysis of the target audience, and presented CVI ≥ 0.9 in all items,
except for items 16, 24, 34, 37, 38, which presented CVI < 80, were reformulated and were not
removed. Finally, a second round was performed with the participation of judges and the scale
obtained a CVI ≥0.9 in all items. The scale for assessing the quality of hospital care provided
in the puerperium is presented with theoretical validity, mean CVI = 0.99, with 49 items in
total, 17 in the structure dimension, 23 in the process dimension, and nine in the result
dimension. It is concluded that the scale for assessing the quality of hospital care provided in
the puerperium has theoretical validity. |
| author2 |
Carvalho, Jovanka Bittencourt Leite de |
| author_facet |
Carvalho, Jovanka Bittencourt Leite de Rodrigues, Wilma Ferreira Guedes |
| format |
doctoralThesis |
| author |
Rodrigues, Wilma Ferreira Guedes |
| author_sort |
Rodrigues, Wilma Ferreira Guedes |
| title |
Construção e validação de Escala de Qualidade da Assistência Hospitalar no Puerpério (EQUAP) |
| title_short |
Construção e validação de Escala de Qualidade da Assistência Hospitalar no Puerpério (EQUAP) |
| title_full |
Construção e validação de Escala de Qualidade da Assistência Hospitalar no Puerpério (EQUAP) |
| title_fullStr |
Construção e validação de Escala de Qualidade da Assistência Hospitalar no Puerpério (EQUAP) |
| title_full_unstemmed |
Construção e validação de Escala de Qualidade da Assistência Hospitalar no Puerpério (EQUAP) |
| title_sort |
construção e validação de escala de qualidade da assistência hospitalar no puerpério (equap) |
| publisher |
Universidade Federal do Rio Grande do Norte |
| publishDate |
2021 |
| url |
https://repositorio.ufrn.br/handle/123456789/32771 |
| work_keys_str_mv |
AT rodrigueswilmaferreiraguedes construcaoevalidacaodeescaladequalidadedaassistenciahospitalarnopuerperioequap AT rodrigueswilmaferreiraguedes constructionandvalidationofahospitalcarequalityscaleinthepuerperiumequap |
| _version_ |
1773962926578728960 |
| spelling |
ri-123456789-327712021-06-24T17:32:57Z Construção e validação de Escala de Qualidade da Assistência Hospitalar no Puerpério (EQUAP) Construction and validation of a hospital care quality scale in the puerperium (EQUAP) Rodrigues, Wilma Ferreira Guedes Carvalho, Jovanka Bittencourt Leite de http://lattes.cnpq.br/4974595817934197 http://lattes.cnpq.br/6954933298962832 Dantas, Daniele Vieira http://lattes.cnpq.br/0404704679319143 Silva, Flávio César Bezerra da http://lattes.cnpq.br/2365641113875246 Araújo, Gabriela de Sousa Martins Melo de http://lattes.cnpq.br/8320620928250775 Souza, Nilba Lima de http://lattes.cnpq.br/3552543432083948 Santos, Sérgio Ribeiro dos http://lattes.cnpq.br/2057116013573850 Dantas, Stelio Henrique Martim Estudo de validação Assistência hospitalar Estudo de avaliação Período pós-parto Introduction: the puerperium is a period of physical and mental changes that begins after birth and ends when breastfeeding ends. This process of involution to the pre-pregnancy condition can cause more severe complications and evolve to death; however, 92% of maternal deaths in this phase are preventable, especially at the hospital level, when related to bleeding, puerperal infection, and hypertension. In this context, the evaluation of the quality of puerperal hospital care is fundamental for the monitoring of possible complications. However, the indicator that evaluates this type of care does not contemplate the complications susceptible to complications, nor the specific causes related to maternal deaths. Objective: to construct and validate a scale for assessing the quality of hospital care in the puerperium. Method. a methodological study developed in two stages: theoretical foundation and theoretical analysis. In the theoretical foundation stage, an instrument based on the General Systems Theory, proposed by Adevis Donabedian, and a scope review that allowed the construction of the instrument items from the constitutive, operational and behavioral definitions were developed. The second stage began with the evaluation of expert judges in the field. They agreed or disagreed with the items based on the following criteria: objectivity, simplicity, clarity, relevance, accuracy, and variety. The inclusion of expert judges was based on the following criteria: having published and researched on the topic and being an expert in instrument construction. Those who submitted incorrect or incomplete answers were excluded. The Content Validity Index (CVI) and the Kappa Index were used to evaluate the level of agreement between the judges about a given item. The study's relevance criteria were CVI>0.80 and Kappa>0.61. The sample consisted of ten judges. In addition, the instrument was submitted to a lexical and grammatical correction in order to allow its adaptation to another language. After lexical and grammatical analysis and validation by expert judges, the evaluation of puerperal women (target population) was performed. They agreed or disagreed with the items based on the following criteria: A (easy to understand), B (medium understanding) and C (did not understand the item). This step allowed the evaluation by the lowest cognitive stratum of the target population. Ten puerperal women admitted to the Flávio Ribeiro Coutinho Maternity in the municipality of Santa Rita, Paraíba, were randomly selected by convenience. Inclusion criteria for the women were: being over 18 years old, knowing how to read and write, and being in the puerperium. The exclusion criteria were: puerperal complication, some medical contraindication and/or with suspected COVID-19. At this stage, the Content Validity Index and Kappa Index were also used. The pertinence criterion was CVI>0.80 and Kappa>0.61. The instrument went through a second evaluation by expert judges to validate the final version of the instrument. The method chosen for the construction and theoretical validation of this evaluation instrument followed Pasquali's recommendations. It is noteworthy that this study was submitted to the Research Ethics Committee (REC) of the Federal University of Rio Grande do Norte (UFRN), in accordance with Resolution No. 466/2012, and obtained a favorable opinion under CAAE number 18967519.6.0000.5176. Results: At the end of this stage, eight items were removed from the instrument, 11 were unified, and three had their wording modified. After the lexical and grammatical correction, the scale was submitted to the analysis of the target audience, and presented CVI ≥ 0.9 in all items, except for items 16, 24, 34, 37, 38, which presented CVI < 80, were reformulated and were not removed. Finally, a second round was performed with the participation of judges and the scale obtained a CVI ≥0.9 in all items. The scale for assessing the quality of hospital care provided in the puerperium is presented with theoretical validity, mean CVI = 0.99, with 49 items in total, 17 in the structure dimension, 23 in the process dimension, and nine in the result dimension. It is concluded that the scale for assessing the quality of hospital care provided in the puerperium has theoretical validity. Introdução: o puerpério é um período de transformações físicas e mentais com início após o parto e término quando se encerra a amamentação. Esse processo de involução à condição prégravídica pode ocasionar complicações mais severas e evoluir para o óbito, todavia, 92% dos casos das mortes maternas nessa fase são evitáveis, principalmente em nível hospitalar, quando relacionadas a quadros de hemorragias, infecção puerperal e hipertensão. Nesse contexto, a avaliação da qualidade da assistência hospitalar puerperal é algo fundamental para o monitoramento de possíveis complicações. No entanto, o indicador que avalia esse tipo de assistência não comtempla as intercorrências passíveis de complicações, tão pouco as causas específicas relacionada aos óbitos maternos. Objetivo: construir e validar uma escala para a avaliação da qualidade da assistência hospitalar no puerpério. Método. Estudo metodológico desenvolvido em duas etapas: fundamentação teórica e análise teórica. Na etapa de fundamentação teórica, foram desenvolvidos um instrumento fundamentado na Teoria Geral dos Sistemas, proposta por Adevis Donabedian, e uma revisão de escopo que permitiu a construção dos itens do instrumento a partir das definições constitutivas, operacionais e comportamentais. A segunda etapa iniciou-se pela avaliação de juízes experts na área. Eles concordaram ou discordaram dos itens a partir dos seguintes critérios: objetividade; simplicidade; clareza; relevância; precisão e variedade. A inclusão dos juízes especialistas foi baseada nos seguintes critérios: ter publicado e pesquisado sobre o tema e ser perito na construção de instrumento. Foram excluídos aqueles que apresentaram respostas incorretas ou incompletas. Para avaliar o nível de concordância entre os juízes sobre determinado item, utilizaram-se o Índice de Validade de Conteúdo e o Índice Kappa. O critério de pertinência do estudo foram o IVC>0,80 e o Kappa>0,61. A amostra foi formada por dez juízes. Além disso, o instrumento foi submetido a uma correção léxica e gramatical a fim de propiciar a adaptação deste para outra linguagem. Após a análise léxica e gramatical e a validação dos juízes especialistas, foi realizada a avaliação de puérperas (população-alvo). Estas concordaram ou discordaram dos itens a partir dos seguintes critérios: A (de fácil entendimento), B (de médio entendimento) e C (não entendi o item). Essa etapa possibilitou a avaliação pelo menor estrato cognitivo da população-alvo. Foram selecionadas, por conveniência e de forma aleatória, dez puérperas internadas na Maternidade Flávio Ribeiro Coutinho, no município de Santa Rita, Paraíba. Os critérios de inclusão das mulheres foram: ter idade acima de 18 anos, saber ler e escrever e estar no puerpério. Elencaram-se como critérios de exclusão: complicação puerperal, alguma contraindicação médica e/ou com suspeita de COVID-19. Nessa etapa, também foram utilizados o Índice de Validade de Conteúdo e o Índice Kappa. O critério de pertinência foi IVC>0,80 e Kappa>0,61. O instrumento passou por uma segunda avaliação dos juízes especialistas para validar a versão final do instrumento. O método escolhido para a construção e validação teórica desse instrumento de avaliação seguiu as recomendações de Pasquali. Ressalta-se que este estudo foi submetido à apreciação do Comitê de Ética e Pesquisa (CEP) da Universidade Federal do Rio Grande do Norte (UFRN), em conformidade com a Resolução nº 466/2012, e obteve parecer favorável sob CAAE de número 18967519.6.0000.5176. Resultados: ao final dessa etapa, oito itens foram retirados do instrumento, 11 foram unificados e três tiveram a redação modificada. Realizada a correção léxica e gramatical, a escala foi submetida à análise do público-alvo, apresentou IVC ≥ 0,9 em todos os itens, exceto os itens 16, 24, 34, 37, 38, que apresentaram IVC<80, foram reformulados e não foram retirados. Por fim, uma segunda rodada foi efetuada com a participação de juízes e a escala obteve um IVC ≥0,9 em todos os itens. Apresenta-se a escala para avaliar a qualidade da assistência hospitalar prestada no puerpério com validade teórica, média do IVC = 0,99, com 49 itens no total, sendo 17 na dimensão estrutura, 23 na dimensão processo e nove na dimensão de resultado. Concluise que a escala para avaliar a qualidade da assistência hospitalar prestada no puerpério possui validade teórica. 2021-06-24T17:32:02Z 2021-06-24T17:32:02Z 2021-02-22 doctoralThesis RODRIGUES, Wilma Ferreira Guedes. Construção e validação de Escala de Qualidade da Assistência Hospitalar no Puerpério (EQUAP). 2021. 148f. Tese (Doutorado em Enfermagem na Atenção à Saúde) - Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, 2021. https://repositorio.ufrn.br/handle/123456789/32771 pt_BR Acesso Aberto application/pdf Universidade Federal do Rio Grande do Norte Brasil UFRN PROGRAMA DE PÓS-GRADUAÇÃO EM ENFERMAGEM |