Banca de DEFESA: TATIANA MARIA NOBREGA ELIAS

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : TATIANA MARIA NOBREGA ELIAS
DATE: 21/07/2023
TIME: 14:00
LOCAL: DEPARTAMENTO DE ENFERMAGEM (UFRN)
TITLE:

Development of an instrument for nursing
care in the prevention of congenital syphilis in Primary Health Care.2023.

KEY WORDS:

Nursing care. Prenatal care. Congenital syphilis. Syphilis.
Nursing. Primary Health Care.

PAGES: 225
BIG AREA: Ciências da Saúde
AREA: Enfermagem
SUMMARY:

Brazil faces high rates of cases of perinatal morbidity and mortality caused by
congenital syphilis since the 1990s, although actions for the promotion,
prevention and control of diseases are applicable in prenatal programs during
assistance to the binomial. Consultations for pregnant women are carried out as
a priority in Primary Health Care, accompanied by a multidisciplinary team,
including a nurse. However, despite the improvement in access to prenatal
care, important gaps persist, such as: late start of consultations, number of
consultations lower than recommended, deficit of tests performed and,
sometimes, the inefficient conduction of specific treatments and forms of
prevention of illnesses. Therefore, the objective of this study is to build and
validate an instrument for nursing care in the prevention of congenital syphilis in
Primary Health Care. For this purpose, Jean Watson's theory of nursing care
was used, constituting the application of nurses' critical thinking, in a
transpersonal perspective, enabling the recognition of care by the pregnant
woman to support her in the prevention of congenital syphilis. This is a
methodological study consisting of four phases: the first being the
operationalization of the construct, supported by the theory of transpersonal
nursing care and a scope review, containing a final sample of 35 articles that
enabled the categorization of 33 care nursing for the prevention of congenital
syphilis which, together with the ten elements of the Clinical Caritas Process,
made up the first version of the instrument, with ten dimensions and 27 items;
the second phase corresponded to content validation for the analysis of
agreement between the item-dimension and the validation of the instrument
items and its operational guide and took place in two Delphi rounds with the
participation of 12 judges; in the third phase, face validation took place, with 38
judges and a Delphi round to assess the instrument's verbal compression. Both
in the second and in the third phase, the Kappa coefficient and the Content
Validation index were used for the statistical analyses. And, finally, the fourth
phase, which consisted of validating the construct and assessing its reliability;
15 nurses who accompany the prenatal consultation and 138 pregnant women
participated in it. For construct validation, exploratory and confirmatory factor
analysis and Cronbach's alpha were used to assess the instrument's internal
consistency and thus ensure its reliability. The study complied with the ethical
prerogatives required by Resolution nº 466/2012, of the National Health Council
and its complementary ones, being approved by opinion nº. 5,632,945 and
CAAE 61762422.3.0000.5637, issued by the Ethics and Research Committee
of the Federal University of Rio Grande do Norte. From the results obtained, in

the validation of the instrument's content, an agreement between the items and
the dimensions was greater than 0.60 in the first round of Delphi in 77.78% of
the items; however, of the six items that did not show satisfactory agreement, 3
were excluded and the other 3 were adjusted in their allocation and description.
Items validated with a Kappa index of less than 1.00 were submitted to the
second Delphi round, with all of them presenting values higher than those of the
first round and greater than 0.61. Still in this phase, regarding the content
validation of the instrument and the operational guide, all items and their
respective operational descriptions obtained a CVI ≥ 0.80 and a Kappa ≥ 0.60,
giving rise to the second version of the instrument with 24 items. In face
validation, the instrument was submitted to the evaluation of verbal
compression, with all items obtaining a Kappa ≥ 0.80 and a CVI greater than
0.89, not requiring another round or adjustments, moving on to the last phase
validation, with 24 items. The construct validation was carried out through factor
analysis, where in the exploratory analysis the variables generated 9 factors
with a variance greater than 50%, which brings security to the confirmatory
analysis that obtained statistically significant values in the adequacy indices of
the final model (Ratio X2 /g.l, RMR, RMSEA, PCFI, CFI and IFI). Regarding the
verification of reliability, the instrument obtained a Cronbach's Alpha above 0.70
and below 0.90 in all items, that is, the consistency of the data is classified as
adequate. In view of these results, it is concluded that the instrument developed
for nursing care in the prevention of congenital syphilis demonstrated to have
psychometric quality and satisfactory validity to support and qualify nurses'
practice with pregnant women in Primary Health Care.

COMMITTEE MEMBERS:
Externa à Instituição - ALEXANDRA DO NASCIMENTO CASSIANO
Externa ao Programa - 3221432 - CAROLINE EVELIN NASCIMENTO KLUCZYNIK - nullExterna à Instituição - LUCIANE PAULA BATISTA ARAUJO DE OLIVEIRA
Interna - 3168491 - NILBA LIMA DE SOUZA
Presidente - 347635 - REJANE MARIA PAIVA DE MENEZES