Validação de uma ficha clínica para a consulta de pré-natal às gestantes de risco habitual: uma proposta de enfermeiras

Abstract

The objective of this research was to adapt a medical record for nursing appointments during the regular-risk prenatal according to the Primary Healthcare and validate it as a technology for nursing appointments. The agreement level chosen for the inclusion or exclusion of the items was 80% between the experts that have participated of the study. It was a methodological research that has applied the Delphi Technique to validate the instrument. The data collection occurred through Judgmental Sampling. According to the inclusion criteria adopted, the participant of the study should be a nurse specialized in obstetrical nursing. Moreover, this specialist should be PHD who teaches in a Brazilian public university. Therefore, it was attained representatives of all regions of the country in order to validate the instrument and assure that the results would be compatible with the regional diversities. It was considered as participants the nurses with an experience of at least 02 years teaching about women healthcare. These participants were identified by their resume at the Lattes platform using the Snowball technique. The assembling of the medical record followed the rigorous review of the literature and the observation of the instruments recommended by the Latin American Center of Perinatology Women’s Health and Reproductive of the Pan American Health Organization / World’s Health Organization and Brazilian Health Ministry. As a result, the relevant information were stablished and the content that have passed by the validation process were defined. The specialists’ evaluation of the empirical indicators occurred by a platform assembled using the Google Forms, through the Internet. The specialists subjected the instrument to a form and content validation. These experts also analyzed the relevance degree of each item of the instrument; it was considered the concept, clarity and applicability/representability of the instrument. The scenery 1 and 2 of the research took place during the months of February and June of 2016. The final sample of the first scenery was composed by 18 PHD professors. However, 3 were excluded once they did not fit on the inclusion criteria. Then, the first scenery was finalized with 15 judges. Subsequently, the second scenery were attended by 13 of the 15 previous specialists. The data were tabbed using the software Microsoft Excel then; they were analyzed quantitatively by means of the Content Validity Coefficient. The inclusion of the items has respected the calculation of the Coefficient Content Validation, which has considered 80% of agreement between the experts. Furthermore, it also pondered the specialists’ suggestions, that disagreeing or requesting the inclusion of other items, assisted the systematization of the second scenery, resulting in the final validated medical record. The validation outcomes’ majority were reached at the first scenery. At the second scenery, it was performed the validation of the items which have not reached the index of 80% at the first scenery or the items that have received suggestions to be improved on the medical record. Finally, the suggestions and the items that have composed the second scenery have contributed to the delimitation of the essential information regarding the prenatal and birth context. These items contribution acts improving the quality and humanizing the nursing care. Moreover, they have the potential to reduce the neonatal and maternal morbimortality through a technology proposed by nurses that can be used by other professional categories.