Guia prático para acompanhamento da criança que nasceu pré-termo na atenção básica: validação de conteúdo

Abstract

Prematurity is one of the main causes of infant deaths in the first years of life. Technological advances have enabled greater survival, even in cases of extreme organic immaturity. However, survivors are at greater risk of altered growth and development. As Primary Care is a priority gateway to the health system in Brazil, it needs professionals to be trained and using appropriate tools during care. The research aimed to develop the Practical Guide for Monitoring Children who were Born Preterm in Primary Care, with content validated by expert judges. It is a methodological development research, which followed the phases proposed by Echer. In the first phase, the project was elaborated, submitted to the Ethics Committee of the Federal University of Maranhão. In the second phase, through a literature search, concepts and content were defined, so that the information was made available in an accessible language, aiming at a good evaluation of the constructed material. For the third phase, which consists of qualifying the guide (content validation), the Delphi technique was used, thus, the Practical Guide for Monitoring Children who were Born Preterm in Primary Care in PDF and the Likert-scale instrument were sent of four points to evaluate the content for 27 expert judges, of which 15 evaluated the guide in the first round and 11 in the second, from April to July 2021. The collected data were organized in an Excel spreadsheet and the validation was through of the Content Validity Index (IVC) and 5% Binomial Test. In the first phase, the research project was approved, as per opinion 4.043.100, which made it possible to establish a research protocol and increase methodological rigor. In the second phase, a literature review was carried out, which provided a theoretical basis to support the selection of the guide's content. Based on the author's findings and experience, the contents of the Practical Guide for Monitoring Children who were Born Preterm in Primary Care, with 54 pages, are organized into eight chapters: The child who was born prematurely; Growth; Nutrition; Development; Neonatal screening; Vaccines; Bond; and Secure attachment. In the third phase of the 27 judges who accepted to participate, 17 evaluated the content, of these, 15 expert judges participated in the first round, obtaining a Content Validity Index of 76.23%.The questions regarding the relevance of preparing the guide proved to be statistically positive, which is characterized by the need to elaborate the care of preterm children (p<0.001), which is important for clinical practice in AB (p<0.04); and motivation (p<0.04), suggestions and comments were analysed and, in the majority, accepted and made modifications. For the second round, in the second version of the guide, the same chapters remained, with 71 pages, later, a report of the changes was prepared and sent along with the guide for the second round, which presented four withdrawals, thus, 11 expert judges evaluated the guide that obtained IVC 96.44%. Significant values were presented in the contents referring to the chapters: Bond and Secure Attachment (p<0.02), Vitamin and Mineral Supplementation (p<0.02) and Vaccines (p<0.02), being unanimous among the judge’s experts, characterizing the end of the rounds. The content of the Practical Guide for Monitoring Children who were Born Preterm in Primary Care was prepared and validated by expert judges on the subject, obtaining a validity of 96.44% and consensus, ending the rounds. It is noteworthy that these are preliminary results of a macro-project that aims to build a guide, assistive technology, independent of medium innovative content and of low complexity. It is replicable material in different scenarios, such as academia, clinical practice and/or source of scientific research, generating positive impacts in improving the care of children who were born prematurely.