Elaboração, validação e efeitos de uma intervenção educativa voltada ao controle da sífilis congênita

Abstract

This study aimed to construct and validate an educational booklet on the prevention of vertical transmission of syphilis and to assess its effects on knowledge, attitude and practice (KAP) of pregnant women before and after an educational intervention. This is a methodological study, associated with a quasi-experimental study, which was conducted in three phases: 1. Preparation of the booklet "How to prevent transmission of syphilis from mother to child? Let's learn! "; 2. Validation in terms of appearance and content of the material by 22 experts, and validation of appearance with the audience, composed by 11 pregnant or postpartum women diagnosed with syphilis, admitted to the School Maternity Assis Chateaubriand (SCAC); 3.The last phase was the evaluation of the booklet from 41 pregnant women followed in the Natural Birth Center Ligia Barros Costa (CEDEFAM) in September 2016 to verify its effects on the KAP related to the theme. The data were organized, processed and analyzed by the Statistical Package for Social Sciences (SPSS) version 20.0. To analyze the validity of the content and appearance of the booklet, it was used the Content Validity Index (CVI), the binomial test, Cronbach's alpha and agreement between each group of participants of at least 80%. The Flesch Legibility Test (FLT) was applied to check the legibility of the booklet index. The data obtained using the questionnaire SAM (Suitability Assessment of Materials) underwent a percentage analysis and they were classified as superior, appropriate or inappropriate. The KAP survey data were analyzed using descriptive statistical tests. The project was approved by the Research Ethics Committee n° 1615683. Initially, the booklet was prepared and divided into eight areas (Presentation; What is Syphilis?; How to find out if you have syphilis?; How can you avoid Congenital Syphilis?; How is the treatment of Syphilis?; What is the importance of treating the partner?; Let's summarize the booklet information through questions and answers?; Closing the booklet). It was followed the literature recommendations for language, illustration and layout. After the validation by the experts, the booklet was presented as a validated material from the perspective of appearance and content, once it presented great global CVI (0.96) and excellent homogeneity between the answers of the participants, with a total Cronbach's Alpha the booklet of 0.955. Regarding the evaluation of the experts by using the SAM it was considered a "superior" educational tool. Regarding the appearance of validation by the target public, the booklet was also evaluated very positively, reaching 100% agreement among them on the aspects clarity and relevance. It obtained an overall maximum CVI, with a value of 1.00 demonstrating that the material built is reliable and validated to apply towards pregnant women, aiming to prevent vertical transmission of syphilis. After the relevant adjustments to the validation process, it was applied the FLT and reading the fields of booklet was classified as "easy" or "very easy". In the last phase of the study, to evaluate the effects of educational intervention, it was verified an increase in the percentage of women classified with a knowledge, attitude and practice appropriate after reading the booklet. This considerable change in practice was statistically significant (p = 0.002), demonstrating that reading the booklet was effective to promote behavioral changes, especially in regard to adopt healthy sexual practice. Therefore, it is inferred that the booklet can be used as auxiliary resource in health education activities, as a facilitator educational technology in the teaching-learning process. The thesis is proved: the use of the booklet on the prevention of vertical transmission of syphilis to health education of pregnant women enables the improvement of the KAP related to the theme.