Talleres de planificación de atención primaria de salud: construcción y validación de instrumentos de evaluación

Nicola, Tainá; Weis, Alísia Helena

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Revista Brasileira de Enfermagem

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Brasil

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 73 (6) • 2020 • https://doi.org/10.1590/0034-7167-2019-0545 copiar

Talleres de planificación de atención primaria de salud: construcción y validación de instrumentos de evaluación

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

describir las etapas de construcción y validación de contenido del instrumento para evaluar los talleres de Planificación de la Atención Primaria de Salud.

Métodos:

estudio metodológico, enfocado en validar el contenido del instrumento. El instrumento desarrollado fue evaluado por un comité de expertos utilizando la técnica Delphi, en dos rondas. Para el grado de acuerdo, se utilizaron el Porcentaje de Acuerdo y el Índice de Validez del Contenido (IVC).

Resultados:

en la primera ronda, participaron seis expertos, y la tasa de acuerdo fue del 87% para mayor claridad y del 94% para la representatividad. En la segunda ronda, participaron cinco expertos, el IVC fue de 0.95 por claridad, 0.97 por representatividad y 0.96 IVC total. El instrumento final tiene 42 ítems divididos en tres bloques.

Conclusión:

el instrumento de evaluación incorporado tiene validez de contenido para evaluar los talleres de Planificación de Atención Primaria de Salud, siendo una herramienta para el uso de las administraciones estatales y municipales.

Descriptores:
Atención Primaria de Salud; Evaluación en Salud; Estudios de Validación; Evaluación de Programas y Proyectos de Salud; Apoyo a la Planificación en Salud

Agreement	First round - degree of agreement (%)		Second round - Content Validity Index (CVI)
Item	Clarity	Representativeness	Clarity	Representativeness
Chunk 1 items - Structure
1.1	100	83.3	1.00	1.00
1.2	100	100	1.00	1.00
1.3	100	100	1.00	1.00
1.4	83.3	100	1.00	1.00
1.5	100	100	1.00	1.00
1.6	83.3	100	1.00	1.00
1.7	100	100	0.80	1.00
1.8	100	83.3	1.00	1.00
1.9	100	100	1.00	1.00
Chunk 2 items - Content
2.1	100	100	1.00	1.00
2.2	100	83.3	1.00	1.00
2.3	33.3	83.3	1.00	1.00
2.4	33.3	83.3	1.00	1.00
2.5	83.3	100	1.00	1.00
Workshop I
2.6	100	100	1.00	1.00
2.7	50	100	1.00	1.00
2.8	100	83.3	1.00	1.00
Workshop II
2.9	100	100	1.00	1.00
2.10	50	100	1.00	1.00
2.11	100	83.3	1.00	1.00
Workshop III
2.12	100	100	1.00	1.00
2.13	50	100	1.00	1.00
2.14	100	83.3	1.00	1.00
Workshop IV
2.15	100	100	1.00	1.00
2.16	100	100	1.00	1.00
2.17	100	100	1.00	1.00
2.18	50	100	1.00	1.00
2.19	100	83.3	1.00	1.00
Workshop V
2.20	100	100	1.00	1.00
2.21	100	100	1.00	1.00
2.22	50	100	1.00	1.00
2.23	100	83.3	1.00	1.00
Workshop VI
2.24	100	100	1.00	1.00
2.25	50	100	1.00	1.00
2.26	100	83.3	1.00	1.00
Chunk 3 items - Applicability
3.1	83.3	66.6	1.00	1.00
3.2	83.3	100	1.00	1.00
3.3	83.3	100	1.00	1.00
3.4	100	100	0.80	0.80
3.5	100	83.3	1.00	1.00
3.6	100	100	1.00	1.00
3.7	100	100	1.00	1.00
Scope of Chunks	Coverage	Does the item remain in the chunk?	Coverage	Is the item removed or inserted?
1 Structure	100	100	1.00	Não
2 Content	83.3	100	1.00	Não
3 Applicability	83.3	100	1.00	Não
Scope of the instrument			1.00	Não
Instrument	Clarity		Representativeness
Title	0.80		-
Layout	1.00		-
Score classification	1.00		1.00
Final agreement	Degree of agreement (%)		Content Validity Index (CVI)
Total chunks	Clarity	Representativeness	Clarity	Representativeness
Total chunks	87	94	0.95	0.97
Total instrument CVI			0.96

INSTRUMENT TO ASSESS RIMARY HEALTH CARE PLANNING WORKSHOPS
City Professional category: Place of performance:
CHUNK 1. STRUCTURE

1.1 What is your general satisfaction with the structure of PHC Planning workshops? ( ) Very satisfied ( ) Satisfied ( ) Indifferent ( ) Dissatisfied ( ) Very Dissatisfied

1.2 How do you assess the organization/logistics of PHC Planning workshops (location, rooms, schedule, punctuality)? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

1.3 How do you assess the didactic material used in the six PHC Planning workshops? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

1.4 How do you assess the activities adopted during the six PHC Planning workshops (individual and group readings, group work/dynamics, dialogues, videos) ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

1.5 How do you assess the workload and number of days in PHC Planning workshops? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible Why? _________

1.6 How do you assess the number of workshops held (six)? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

1.7 How do you assess the dispersion tasks regarding the ease and operability of contents of workshops in professional practice? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

1.8 How do you assess the performance of the group of facilitators regarding mediation, dynamics, and ethics in PHC Planning workshops? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

1.9 In your opinion, could some themes be addressed through distance education? Yes ( ) No ( ) Which?

1.10 How do you assess the participation of MANAGERS (such as Health Officers) in your city in PHC Planning workshops? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

CHUNK 2 CONTENT

2.1 How satisfied are you with the content of PHC Planning w orkshops? ( ) Very satisfied ( ) Satisfied ( ) Indifferent ( ) Dissatisfied ( ) Very Dissatisfied

2.2 You consider that your understanding of the objectives of each workshop was: ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

2.3 Classify, in order of importance, the subjects of each Planning WORKSHOP, using a scale of 1 to 6, 1 being the one that LESS contributed and 6 that contributed MORE to the change and/or qualification of your work process and his team: ( ) Workshop I - Health Care Networks ( ) Workshop II - Primary Health Care ( ) Workshop III - Territorialization and Health Surveillance ( ) Workshop IV - Organization of care for acute events and chronic conditions in Primary Health Care ( ) Workshop V - Pharmaceutical Assistance and Diagnostic Support ( ) Workshop VI - Monitoring and Assessment in Primary Health Care

2.4 Classify, in order of importance, the DISPERSION activities of each Planning Workshop, using a scale from 1 to 6, 1 being the one that LESS contributed to and 6 that contributed MORE to the change and/or qualification of your process and your team: ( ) Workshop I - Health Care Networks ( ) Workshop II - Primary Health Care ( ) Workshop III - Territorialization and Health Surveillance ( ) Workshop IV - Organization of care for acute events and chronic conditions in Primary Health Care ( ) Workshop V - Pharmaceutical Assistance and Diagnostic Support ( ) Workshop VI - Monitoring and Assessment in Primary Health Care

2.5 Of the subjects covered in the six Workshops, do you think that any could be suppressed? What? ( ) Health Care Networs ( ) Primary Health Care ( ) Territorialization and Health Surveillance ( ) Organization of care for acute events and chronic conditions in Primary Health Care ( ) Pharmaceutical Assistance and Diagnostic Support ( ) Monitoring and Assessment in Primary Health Care ( ) All items need to be addressed For what reason do you think the subject could be suppressed? ______________

Workshop I - Health Care Networks

2.6 How do you assess your understanding of the functioning of the health system in Care Networks after the completion of I Planning Workshop? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible 2.7 Classify, in order of importance, each subject addressed in Workshop I (Health Care Networks), using a scale of 1 to 6, 1 being the one that LESS contributed and 6 that contributed MORE to your learning: ( ) Reasons for the contemporary crisis in health care systems ( ) Changes in the health situation in the country ( ) Ways of structuring health care systems ( ) Fundamentals of Health Care Networks ( ) Operational structure of Health Care Networks ( ) Modeling Health Care Networks 2.8 How do you assess the applicability of the subjects covered in Workshop I in your work process? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

Workshop II - Primary Health Care

2.9 How do you assess your understanding of access to Primary Health Care, based on the health situation in the city after the conclusion of II Planning Workshop? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

2.10 Classify, in order of importance, each subject addressed in Workshop II (Primary Health Care), using a scale of 1 to 5, with 1 being the one that LESS contributed and 5 that contributed MORE to your learning: ( ) Concept and constituent elements of Primary Health Care ( ) Primary Health Care crisis at the clinic's micro level ( ) Main demands of Primary Health Care ( ) Proposal for the social construction of Primary Health Care ( ) Main foundations for the organization of access in Primary Health Care. 2.11 How do you assess the applicability of the subjects covered in Workshop II in your work process? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

Workshop III - Territorialization and Health Surveillance

2.12 How do you assess your understanding of the integration of Primary Care with Surveillance in the territory after the conclusion of III Planning Workshop III? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

2.13 Classify, in order of importance, each subject addressed in Workshop III (Territorialization and Health Surveillance), using a scale from 1 to 4, 1 being the one that LESS contributed and 4 that contributed MORE to your learning: ( ) Concept of territory and territorialization, as well as its applicability in health planning ( ) Concepts of risk and vulnerability in the territories assigned to teams ( ) Situational analysis tools for planning, monitoring, and assessing actions ( ) Relationships between Health Surveillance and Primary Health Care focusing on the territory 2.14 How do you assess the applicability of the subjects covered in Workshop III in your work process? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

Workshop IV - Organization of care for acute events and chronic conditions in Primary Health Care

2.15 How do you assess your understanding of the organization of care for acute events and chronic conditions in your Primary Care work process after the conclusion of IV Planning Workshop? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

2.16 How do you assess your qualification in relation to the organization of care for acute events (reception with risk classification) in the Basic Health Unit after the completion of Planning workshops? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

2.17 How do you assess your qualification in relation to the organization of care for chronic conditions (programmed demand and risk stratification) in the Basic Health Unit after the completion of the Planning workshops? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

2.18 Classify, in order of importance, each subject addressed in Workshop IV (Organization of care for acute events and chronic conditions in Primary Health Care), using a scale of 1 to 5, 1 being the one that LESS contributed to and 5 for what MORE contributed to your learning: ( ) Current PHC organization to meet acute events and chronic conditions ( ) Model of Care for Acute Events ( ) Chronic Conditions Care Model (Modelo de Atenção às Condições Crônicas, abbreviated MACC) proposed for the Brazilian Unified Health System ( ) Organization of care for acute events in PHC (reception, risk classification) ( ) Organization of care for chronic conditions in PHC (risk stratification, schedule, agenda)

2.19 How do you assess the applicability of the subjects covered in Workshop IV in your work process? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

Workshop V - Pharmaceutical Assistance and Diagnostic Support

2.20 How do you assess your understanding of the organization and integration of pharmaceutical care in Primary Care after the completion of V Planning Workshop? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

2.21 How do you assess your understanding of the RAS Diagnostic Support System presented in Workshop V? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

2.22 Classify, in order of importance, each subject addressed in Workshop V (Pharmaceutical Assistance and Diagnostic Support), using a scale of 1 to 4, 1 being the one that LESS contributed and 4 that contributed MORE to your learning: ( ) Importance of pharmaceutical assistance as a support system for Health Care Networks ( ) The role of PHC in Pharmaceutical Assistance, especially in the execution of the stages of the logistical cycle ( ) Strategies for implementing pharmaceutical care in Primary Health Care ( ) Support systems in Health Care Networks

2.23 How do you assess the applicability of the subjects covered in Workshop V in your work process? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

Workshop VI - Monitoring and Assessment in Primary Health Care

2.24 How do you assess your understanding of monitoring and assessment to improve Primary Health Care actions and services after the conclusion of VI Planning Workshop? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

2.25 Classify, in order of importance, each subject addressed in Workshop VI (Monitoring and Assessment in Primary Health Care), using a scale from 1 to 5, with 1 being the one that LESS contributed and 5 that contributed MORE to your learning: ( ) Fundamentals of monitoring and assessment ( ) Importance of monitoring and assessing health actions in Primary Care ( ) Indicators and targets related to chronic conditions in Primary Health Care ( ) Matrix for monitoring the goals agreed in Primary Health Care ( ) Plan for operationalization of agreed goals

2.26 How do you assess the applicability of the subjects covered in Workshop VI in your work process? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

CHUNK 3 APPLICABILITY

3.1 How do you assess the contribution of PHC Planning Workshops to YOUR professional qualification? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

3.2 After completing Planning Workshops, how do you assess the achievement of the overall objective of Planning? General objective: "Supporting the induction of the organization of Primary Health Care (PHC), providing tools and strategies for programming and organizing the work process of the teams, as well as integration between the various points and levels of care". ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

3.3 How satisfied are you with the qualification of YOUR TEAM work process at the end of the Planning process? ( ) Very satisfied ( ) Satisfied ( ) Indifferent ( ) Dissatisfied ( ) Very Dissatisfied

3.4 How do you assess YOUR ability to put into practice the issues covered during the PHC Planning process? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

3.5 How do you assess the capacity of YOUR TEAM to develop a PHC intervention plan, after the dispersion activities of Planning? ( ) Great ( ) Good ( ) Regular ( ) Bad ( ) Terrible

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[1] Corresponding author: Tainá Nicola. E-mail: tainanicola@gmail.com