Construção de indicadores de estrutura e processo para avaliação da qualidade assistencial em aleitamento materno
Arquivos
Data
2014-12-17
Autores
Diaz, Claudia Maria Gabert 
Orientadores
D'Innocenzo, Maria
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Essa pesquisa aborda a temática da gestão em aleitamento materno. O objetivo geral foi construir indicadores de estrutura e processo para avaliar a qualidade assistencial em aleitamento materno, na área hospitalar. E, específicos, elaborar um instrumento de avaliação da qualidade assistencial em aleitamento materno, na área hospitalar; validar o conteúdo desse instrumento, por meio da Técnica de Delphi; criar um manual operacional para mensurar a qualidade assistencial. Trata-se de uma pesquisa descritiva, de abordagem metodológica com enfoque quantitativo, que segue a linha de pesquisa ?Gestão, gerenciamento e educação em enfermagem e saúde?. Para a elaboração do instrumento foram identificados os fatores e práticas que repercutem positivamente ou não, na amamentação. Estas variáveis importantes para o cuidado de enfermagem oferecido à nutriz e ao recém-nascido foram pautadas na revisão de literatura científica nacional e internacional sobre a temática, dos últimos dez anos, bem como a experiência e vivências da pesquisadora. A validação de conteúdo do instrumento, por meio da Técnica de Delphi, foi realizada em dois ciclos por experts em aleitamento materno. Dos trinta convidados, dezesseis profissionais devolveram o instrumento preenchido, confirmando a estatística de aproximadamente 50% no primeiro ciclo e treze avaliadores no segundo ciclo. O grau de concordância ou discordância com a opinião expressa pela declaração ocorreu por meio da escala psicométrica tipo LIKERT. O consenso favorável foi de 80%, porém os resultados com percentual de concordância de 75% foram revistos por meio das sugestões e/ou comentários dos experts, agrupados e analisados para serem novamente incorporadas ao instrumento. A maioria das observações foi aceita, tais como: inclusão de referências, adequação do nome parâmetro para itens de referência, o acréscimo ou alteração de palavras nas frases; readequação do cálculo de pessoal, dentre outras. O Manual Operacional contém oito indicadores assistenciais de estrutura e oito, de processo, pautados no modelo Donabediano. Considera-se que este estudo contribui para melhoria das práticas assistenciais relacionadas ao aleitamento materno. Ressalta-se a importância de estudos posteriores para sua aplicação nos cenários assistenciais em AM, consolidando-se futuramente como um importante instrumento de avaliação.
This research deals with the thematic of the management in breastfeeding. The main aim was to build indicators of structure and process to evaluate the healthcare quality in breastfeeding, in the hospital area. And, specifics, to elaborate an evaluation instrument of the healthcare quality in breastfeeding, in the hospital area; to validate the content of this instrument, through the Delphi technique; to create an operational manual to measure the healthcare quality. It is a descriptive research, of methodological approach with a quantitative emphasis, which follows the research line ?Gestão, gerenciamento e educação em enfermagem e saúde? (Management and education in nursing and health). In order to elaborate this instrument it was identified the factors and practices that have an impact positively or not, in breastfeeding. These important variables for the nursing care offered to the nursing mothers and to the newborn child were guided by the national and international scientific literature review about the theme, from the last ten years, as well as the experience of the researcher. The validation of the instrument content, through the Delphi technique, was performed in two cycles by experts in breastfeeding. From the thirty people that were invited, sixteen professionals developed the filled instrument, confirming the statistics of approximately 50% in the first cycle and thirteen evaluators in the second cycle. The degree of agreement or disagreement with the opinion expressed by the declaration occurred through the psychometric scale LIKERT type. The favorable consensus was of 80%, however the results with percentage of agreement of 75% were reviewed through the suggestions and/or comments of the experts, grouped and analyzed to be incorporated again to the instrument. The majority of the observations were accepted, such as: inclusion of references, adequacy of the parameter name to items of reference, the adding or changing of words in the sentences; readjustment of the personal calculation, among others. The Operational Manual has eight healthcare indicators of structure and eight of processes, guided by the Donabediano model. We consider that this study contributes to the improving in the healthcare practices related to the breastfeeding. We highlight the importance of further studies to its application in the healthcare scene in AM, consolidating itself in the future as an important instrument of evaluation.
This research deals with the thematic of the management in breastfeeding. The main aim was to build indicators of structure and process to evaluate the healthcare quality in breastfeeding, in the hospital area. And, specifics, to elaborate an evaluation instrument of the healthcare quality in breastfeeding, in the hospital area; to validate the content of this instrument, through the Delphi technique; to create an operational manual to measure the healthcare quality. It is a descriptive research, of methodological approach with a quantitative emphasis, which follows the research line ?Gestão, gerenciamento e educação em enfermagem e saúde? (Management and education in nursing and health). In order to elaborate this instrument it was identified the factors and practices that have an impact positively or not, in breastfeeding. These important variables for the nursing care offered to the nursing mothers and to the newborn child were guided by the national and international scientific literature review about the theme, from the last ten years, as well as the experience of the researcher. The validation of the instrument content, through the Delphi technique, was performed in two cycles by experts in breastfeeding. From the thirty people that were invited, sixteen professionals developed the filled instrument, confirming the statistics of approximately 50% in the first cycle and thirteen evaluators in the second cycle. The degree of agreement or disagreement with the opinion expressed by the declaration occurred through the psychometric scale LIKERT type. The favorable consensus was of 80%, however the results with percentage of agreement of 75% were reviewed through the suggestions and/or comments of the experts, grouped and analyzed to be incorporated again to the instrument. The majority of the observations were accepted, such as: inclusion of references, adequacy of the parameter name to items of reference, the adding or changing of words in the sentences; readjustment of the personal calculation, among others. The Operational Manual has eight healthcare indicators of structure and eight of processes, guided by the Donabediano model. We consider that this study contributes to the improving in the healthcare practices related to the breastfeeding. We highlight the importance of further studies to its application in the healthcare scene in AM, consolidating itself in the future as an important instrument of evaluation.
Descrição
Citação
DIAZ, Claudia Maria Gabert. Construção de indicadores de estrutura e processo para avaliação da qualidade assistencial em aleitamento materno. 2014. São Paulo, [137] p. Tese (Doutorado em Enfermagem) - Escola Paulista de Enfermagem (EPE), Universidade Federal de São Paulo (UNIFESP), São Paulo, 2014.