Construção e validação de um instrumento de avaliação do conhecimento, atitude e prática de profissionais da Atenção Primária à Saúde sobre amamentação

Abstract

Breastfeeding is one of the most impactful practices for promoting maternal and child health and reducing infant morbidity and mortality, and it is recognized as a priority public health strategy. Despite advances in public policies aimed at its promotion, protection, and support, challenges persist regarding the performance of Primary Health Care professionals, including gaps in knowledge, attitudes, and practices related to breastfeeding care. This study aimed to develop an instrument to assess professionals’ knowledge, attitudes, and practices regarding breastfeeding and to provide evidence of its content validity and applicability for use in Primary Health Care. Regarding methods, this was a methodological study with a mixed-methods approach, conducted in four stages: a review of scientific literature and regulatory documents; development of the instrument’s preliminary version; content validation by experts using the Delphi technique; and a pilot application with Primary Health Care professionals in the municipality of Juiz de Fora, Minas Gerais. We assessed content validity using the Content Validity Index. The study was approved by the Research Ethics Committee (Opinion No. 7,670,334). Regarding the results, 24 specialists with experience in breastfeeding and Primary Health Care participated in the validation stage, yielding a global Content Validity Index of 0.95. The final version of the instrument comprised two sections: sociodemographic, academic, and professional characterization; and an assessment of Knowledge, Attitudes, and Practices, consisting of 37 statements distributed across seven thematic modules. Twenty-two Primary Health Care professionals—predominantly female nurses—participated in the pilot application. The overall mean percentage of correct answers was 91.5%; however, knowledge gaps were identified regarding the recognition of early infant hunger cues, the clinical assessment of breastfeeding sessions, and the Brazilian Standard for the Marketing of Foods for Infants and Young Children. Participants gave positive ratings regarding the instrument’s clarity, comprehensibility, and applicability. The instrument showed favorable evidence of content validity and applicability, making it a promising tool for identifying training needs, planning Continuing Health Education initiatives, and strengthening efforts to promote, protect, and support breastfeeding within Primary Health Care.