Instrument for evaluating child hearing health services: construction and validity

Azevedo, Suelen Brito; Lima, Maria Luiza Lopes Timóteo; Griz, Silvana Maria Sobral; Leal, Luciana Pedrosa

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Revista da Escola de Enfermagem da USP

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 52 • 2018 • https://doi.org/10.1590/S1980-220X2017036703357 copy

Instrument for evaluating child hearing health services: construction and validity ^* * Extracted from the dissertation: “Práticas dos enfermeiros na atenção à saúde auditiva infantil”, Programa de Pós-graduação em Enfermagem, Universidade Federal de Pernambuco, 2014.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To validate a matrix of indicators to assess the structure and process of child hearing health services.

Method

A study of semantic and content validation with specialists in the area of Nursing and Speech therapy. The instrument contained 20 indicators with scores to be analyzed by experts. The condition for the validity suitability of each indicator and scores were an Item-level Content Validity Index (I-CVI) of 0.80 and a Scale-level CVI (S-CVI) of 0.80.

Results

Twenty-two (22) specialists participated in the study, with 59% being nurses and 41% speech therapists, of which 32% had specializations, 45% had a Master’s degree, 18% had a Doctorate degree and 5% had a Post-doctorate degree. The mean I-CVI and S-CVI of the indicators evaluated as suitable were 0.96, while for the suggested scores the I-CVI was 0.80 and the S-CVI was 0.82.

Conclusion

The matrix of indicators was considered valid for evaluating child hearing health services.

Child Health; Hearing Loss; Primary Care Nursing; Health Evaluation; Validation Studies

Aspect: Physical structure
Dimension: Physical structure and necessary materials
Considered criteria	Indicators	I-CVI (Indicators)	Suggested scores	I-CVI (Scores)
Physical structure
Room for consultations	At least one room for the Family Health Team to carry out childcare consultations	1.00	4.4	0.86
Space for educational activities	At least one space destined for educational activities in the Health Unit	0.95	4.4	0.81
Necessary materials
Tables	Availability of a table to assist in registering childcare consultations and educational activities	0.95	4.4	0.86
Chairs	Availability of chairs for the accommodation of professionals, patients and companions.	1.00	4.4	0.90
Beds or stretchers	Availability of beds or stretchers for evaluating development milestones	0.90	4.4	0.86
Instruments and/or strategies used to emit sounds	Availability of percussion instruments (bells or rattles) and/or strategies used to evaluate hearing and language milestones	0.86	4.4	0.72
Child Health Handbook	Availability of Child Health Handbook available at the service for applying the development monitoring instrument	0.95	4.4	0.81
Registration form/child’s medical record/Child Health Handbook with the milestones	Availability of registration form/medical record/Child Health Handbook with evaluation of hearing and language milestones	0.86	4.4	0.77
Informative materials	Availability of informative materials for educational activities on children’s hearing health in the community and health staff (folders, booklets, brochures, etc.)	1.00	4.4	0.81
Aspect: Process
Dimension: Technical-scientific suitability
Considered criteria Indicators	Indicators	I-CVI (Indicators)	Suggested scores	I-CVI (Scores)
Sub-dimension: Management of risk factors for hearing loss		-	-	-
Identification of risk factors	Number of risk factors for hearing loss identified by the nurse	1.00	3.1	0.86
Association of risk factors with the development milestones	Checking the association of risk factors for hearing loss with child development milestones in professional practice	0.95	3.1	0.86
Sub-dimension: Monitoring the hearing development milestones and conduct		-	-	-
Direct hearing development milestones	Identifying at least three of the development milestones related to hearing in the described items	0.95	3.1	0.77
Indirect hearing development milestones	Identifying at least three of the development milestones indirectly related to hearing in the described items	0.95	3.1	0.77
Beginning of Hearing Assessment	Identifying the most likely age for assessment (NHS) and diagnosis of hearing loss with a qualified professional Identifying the most favorable age for hearing loss intervention/rehabilitation with a qualified professional	0.86	3.1 x 5	0.72
Newborn Hearing Screening (NHS)
Trained professional to perform the NHS
Diagnosis of hearing loss
Hearing loss intervention/rehabilitation
Sub-dimension: Monitoring hearing development milestones and conduct		-	-
Case 1	Correctly evaluating at least two cases related to the possibility of hearing loss, the child’s hearing development milestones and the adopted conduct	1.00	5.0	0.90
Case 2		1.00	5.0	0.90
Case 3		1.00	5.0	0.90
Case 4		1.00	5.0	0.90
Sub-dimension: Educational practices		-	-
Carrying out educational activities on child hearing health for the community	Carrying out at least one educational activity for the community	1.00	3.1	0.72
Continuous education on child hearing health for the health team	Carrying out at least one continuous educational activity for the Family Health Team	1.00	3.1	0.68
Dimension: Professional training
Participating in courses related to child hearing health	Participating in at least one course with content related to child hearing health	1.00	3.1	0.72
Participating in courses and/or training in child hearing healthcare	Participating in at least one course and/or training focused on child hearing healthcare	0.95	3.1	0.68
-	Total I – CVI 0.96	Total I – CVI		0.80
-	Total S – CVI 0.96	Total S – CVI		0.82

	Dimensions	Sub-dimensions	Considered criteria	Indicators	Verification Parameters (Expected scores)	Verification Parameters (Cut-off points)
Structure	Physical structure and necessary materials	-	Physical structure	-	-	-
			Room for consultations	At least one room for the Family Health Team to carry out childcare consultations	4.4	4.4 points = if the room for consultation is available 0 points = if the room for consultation is not available
			Space for educational activities	At least one space destined for educational activities in the Health Unit	4.4	4.4 points = if the space for educational activities is available 0 points = if the space for educational activities is not available
			Necessary materials	-	-	-
Structure	Physical structure and necessary materials	-	Table	Availability of a table to assist in registering childcare consultations and educational activities	4.4	4.4 points = if a table is available 0 points = if a table is not available
			Chairs	Availability of chairs for accommodating professionals, patients and companions.	4.4	4.4 points = if two or more chairs are available 0 points = if no chairs are available
			Bed, stretcher or exam table	Availability of a bed, stretcher or exam table for evaluating the development milestones	4.4	4.4 points = if a bed or stretcher is available 0 points = if no beds or stretchers are available
			Instruments and/or strategies used to emit sounds	Availability of percussion instruments (bells or rattles) used to evaluate hearing and language development milestones	4.4	4.4 points = if percussion instruments are available 0 points = if percussion instruments are not available
			Child Health Handbook	Availability of the Handbook at the service for applying the monitoring instrument for development	4.4	4.4 points = if the Handbooks are available; 0 points = if the Handbooks are not available
			Registration form / child’s medical record / Child Health Handbook with the development milestones	Availability of the registration form/medical record/Child Health Handbook with assessment of hearing and language development milestones	4.4	4.4 points = if the registration form/Handbook/child’s medical record is available 0 points = if the registration form/ Handbook/child’s medical record is not available
			Informative materials	Availability of informative materials for educational activities on child development, including those on hearing and language, aimed at the community and the health staff (folders, booklets, brochures, etc.)	4.4	4.4 points = if informative materials are available 0 points = if informative materials are not available
Process	Technical-scientific suitability	Management of risk indicators for hearing loss	Identification of risk indicators	The nurse identifies at least two risk indicators for hearing loss reported in the Child Health Handbook	3.1	3.1 points = if at least two risk indicators have been described 0 points = if at least two risk indicators have not been described
		Management of risk indicators for hearing loss	Association of risk indicators with the development milestones	Checking for hearing loss associated with child development milestones in professional practice	3.1	3.1 points = if the answer is “yes” 0 points = if the answer is “no”
		Monitoring the development of hearing milestones and conduct	Registering in the chart/medical record/Child Health Handbook the hearing development milestones	Identifying at least one chart, medical record or Child Health Handbook with the records of hearing development milestones	3.1	3.1 points = if any of the criteria is described 0 points = if none of the criteria is described
			Using instruments and/or strategies for emitting sound	Verifying the use of percussion instruments (rattles, bells, etc.) and/or strategies (clapping, snapping fingers, etc.) to evaluate hearing development milestones	3.1	3.1 points = if one of the criteria is described 0 points = if none of the criteria is described
			Direct hearing development milestones	Identifying at least three of the development milestones related to hearing in the described items	3.1	3.1 points = if all three criteria items are correct 0 points = if the three criteria items are not correct
			Reaction to sound when stimulated
			Social smile when stimulated
			Active response to social contact
			Locates sound when stimulated
			Recognizes two actions by pointing to the images when interrogated
			Indirect hearing development milestones	Identifying at least four of the development milestones indirectly related to hearing in the described items	3.1	3.1 points = if all four criteria items are correct 0 points = if the four criteria items are not correct
			Emission of sounds
			Duplication of syllables
			Production of “jargon” and/or incomprehensible conversation
			Vocalizes one word
			Vocalizes three words
			Understands sentences with two words
Process	Technical-scientific suitability	Monitoring the development of hearing and conduct milestones and conduct	Beginning of Hearing Assessment	Identifying the most likely moment for assessment (NHS) of hearing loss with a qualified professional	3.1	3.1 points = if the criterion was described 0 points = if no criterion was described
			Newborn Hearing Screening (NHS)		3.1	3.1 points = if the criterion was described 0 points = if no criterion was described
			Diagnosis of hearing loss	Identifying the most favorable moment for hearing loss intervention/rehabilitation with a qualified professional	3.1	3.1 points = if the criterion was described 0 points = if no criterion was described
			Hearing loss intervention/rehabilitation		3.1	3.1 points = if the criterion was described 0 points = if no criterion was described
			Resolution of case 1	Correctly evaluating at least two cases related to the possibility of hearing loss and child’s hearing development milestones	20	20 points = if all the affirmations of the cases are correct 5.0 points = if some of the affirmations of the cases are correct 0 points = if none of the affirmations of the cases are correct
			Resolution of case 2
			Resolution of case 3
			Resolution of case 4
		Educational practices	Carrying out educational activities in child hearing health for the community	Carrying out at least one educational activity on child hearing health for the community in the previous year	3.1	3.1 points = if the answer is “yes” 0 points = if the answer is “no”
	Professional training	-	Carrying out courses with content related to child hearing health	Participating in at least one course with content related to child hearing health	3.1	3.1 points = if the answer is “yes” 0 points = if the answer is “no”
	Professional training	-	Participating in courses and/or training in child hearing health care	Participating in at least one course and/or training focused on child hearing health care	3.1	3.1 points = if the answer is “yes” 0 points = if the answer is “no”

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Suelen Brito de Azevedo. Universidade Federal de Pernambuco, Centro de Ciências da Saúde. Av. Prof. Moraes Rego, 1235 – Cidade Universitária. CEP 50670-901 – Recife, PE, Brazil. suelenbritoazevedo@gmail.com

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Instrument for evaluating child hearing health services: construction and validity * * Extracted from the dissertation: “Práticas dos enfermeiros na atenção à saúde auditiva infantil”, Programa de Pós-graduação em Enfermagem, Universidade Federal de Pernambuco, 2014.

ABSTRACT

Objective

Method

Results

Conclusion

Instrument for evaluating child hearing health services: construction and validity ^* * Extracted from the dissertation: “Práticas dos enfermeiros na atenção à saúde auditiva infantil”, Programa de Pós-graduação em Enfermagem, Universidade Federal de Pernambuco, 2014.