The oral ability of premature newborns for breastfeeding: proposal for evaluation instrument.
Premature newborn; Eating behavior; Breastfeeding; Validation studies; Neonatal Nursing.
In spite of the national and international organizations investments, barriers to breastfeeding in premature infants still persist due to the clinical conditions of prematurity. Therefore, it is common to start eating in an enteral way until the premature newborn it can feed orally. This process of food transition is one of the biggest challenges for the care of this newborn because it is differentiated between health services, without standardized behaviors and without the participation of the multidisciplinary team. This study aims to psychometrically build and validate an instrument to assess the oral ability of premature newborns for breastfeeding. The theoretical-conceptual context will use three theorists: the nurse Alaf Ibrahim Meleis, author of the Transition Theory; the nurse Sister Callista Roy, responsible for the Adaptation Theory; and the American psychologist Arnold Sameroff, author of the Unified Development Theory. This is a theoretical study of methodological development with a quantitative approach through the psychometric theory of data, with a sample that will be non-probabilistic obtained by criteria of convenience and intentionality having a total of 340 individuals. The methodological design will be based on three stages. The first stage has the Creation of the Theoretical Model, Operationalization of the Measure, Literature Review and the Construction of Items. The second stage has the Content Validity and Verbal Understanding. The content validity will have the analysis of 10 judges, selected from the Lattes Platform on the portal of the National Council for Scientific and Technological Development, who will analyze the relevance of a given item to a specific construct evaluated using the Kappa agreement rate. Besides the committee of judges, the verbal comprehension will be constituted by 30 undergraduate students of the nursing, medicine and speech therapy courses of the Federal University of Rio Grande do Norte in the city of Natal, with 10 students for each course. Both will evaluate the comprehension of the items calculating the content validity index. The third stage has the Construct Validation and Instrument Reliability. The construct validation will be obtained through the Item Response Theory and the Classical Test Theory and the instrument reliability will be estimated by internal consistency and equivalence. There will be 300 health professionals (nurses, doctors and speech therapists) participating in this stage, who work in Intensive Care Units and Neonatal Intermediate Care Units, directly involved in the manipulation of premature newborns working in the states of Paraíba, Rio Grande do Norte, Pernambuco, Alagoas and Ceará. The data obtained will be typed and consolidated in an Excel spreadsheet and analyzed in the Software R statistical package. The Research Ethics Committee of the Federal University of Rio Grande do Norte approved the Project under the following CAAE protocol: 21351419.0.0000.5537. We hope that the instrument to be built and validated will be able to assess the preterm oral ability early, reducing neonatal morbidity and mortality rates, length of stay and the consequences of this prolonged practice, hospital costs and early weaning.