Banca de DEFESA: JOYCE WADNA RODRIGUES DE SOUZA

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : JOYCE WADNA RODRIGUES DE SOUZA
DATE: 22/06/2026
TIME: 09:00
LOCAL: Google Meet
TITLE:

MANAGEMENT OF BREASTFEEDING IN PRIMARY HEALTH CARE IN BRAZIL: EVALUATION INSTRUMENTS AND KNOWLEDGE OF HEALTH PROFESSIONALS

KEY WORDS:

Breastfeeding. Surveys and questionnaires. Primary Health Care.

PAGES: 137
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

Introduction: Breastfeeding is a fundamental practice for promoting infant and maternal health and requires an approach based on best practices within Primary Health Care. This study aimed to identify breastfeeding assessment instruments in the literature and to develop and validate the AMAH-APS (Assessment of Knowledge and Management of Breastfeeding in Primary Health Care) questionnaire for evaluating Primary Health Care professionals’ knowledge and management of breastfeeding in Brazil. Methods: The research combined a scoping review of breastfeeding assessment instruments (Study 01) and a methodological study involving the development and validation of the AMAH-APS questionnaire (Study 02). Study 01: The scoping review followed the recommendations of the Joanna Briggs Institute. The search was conducted in March 2024 and updated in May 2026. Studies addressing instruments for breastfeeding assessment during the puerperium were included through independent peer review, with disagreements resolved by a third researcher. Study 02: Conducted in three stages: (1) development and content validation of the AMAH-APS questionnaire, involving a panel of nine PhD experts with at least five years of experience in the field; (2) pre-testing of the AMAH-APS with a sample of 27 PHC professionals, including nine nurses, nine physicians, and nine dentists; and (3) administration of the questionnaire to 257 higher-education health professionals involved in breastfeeding management within PHC. Results: Study 01: A total of 190 breastfeeding assessment instruments were identified in the literature. The most frequently cited instrument was the Breastfeeding Self-Efficacy Scale and its variations (67.8%). The most common setting for instrument use was hospitals and maternity wards (71%). Only 14.7% of the studies used instruments within the Primary Health Care setting. Overall, 16.3% of the studies were conducted in Brazil. The identified instruments assessed nine different constructs, with self-efficacy being the most frequent construct (10 instruments). Study 02: Following expert evaluation, the final questionnaire consisted of 24 items distributed across five domains. The pre-test demonstrated high overall agreement (ICC = 0.96; p < 0.001). In the third stage, 38 physicians (14.8%), 97 nurses (37.7%), and 122 dentists (47.5%) completed the questionnaire. Overall, the average percentage of correct responses exceeded 50% for most items. However, items related to breastfeeding duration and assessment of milk production showed correct response rates below 30%. Higher percentages of correct responses were observed among physicians and nurses and were significantly associated with participation in breastfeeding training courses, longer experience in Primary Health Care, and fewer years since graduation. Conclusion: Different breastfeeding assessment and management instruments were identified; however, they demonstrated limited applicability within the Primary Health Care setting. The findings highlight the scarcity of studies adapted to the Brazilian context. Furthermore, this thesis presents a valid instrument for assessing knowledge of breastfeeding management in Primary Health Care. The AMAH-APS may contribute to identifying professional training gaps and support the planning of policies and educational strategies aimed at improving breastfeeding care.

COMMITTEE MEMBERS:
Presidente - 3885543 - SAIONARA MARIA AIRES DA CAMARA
Interna - 2166798 - ADALA NAYANA DE SOUSA MATA
Externo à Instituição - RAMON TARGINO FIRMINO
Externa à Instituição - FERNANDA CUNHA SOARES
Externo à Instituição - MARCELO COSTA FERNANDES - UFCG