Construção e validação de escala para mensurar a autoeficácia materna na prevenção da diarreia infantil

Abstract

Mother’s confidence in their ability to provide good care to their children has proven to be relevant when it comes to maternal health promotion. This dissertation aims to construct a scale in order to measure maternal self-efficacy for preventing infantile diarrhea, by creating its items and dimensions, as well as evaluating the instrument’s psychometric aspects (validity and reliability). The following is both a research on methodology and development, having the model proposed by Pasquali on scale elaboration (1997) as our theoretical landmark. In the pre-empirical part, we carefully examined infantile diarrhea prevention as our construct of interest. The bibliographical survey searched for the keywords “children”, “prevention and control”, “diarrhea” on the PubMed, CINAHL, Cochrane and LILACS database. The first version of the scale was led by the synthesis of 82 selected papers. It had 35 items and also presented four domains: alimentary habits, domestic environment, mother behavior and child hygiene. The 35 items were evaluated by 30 mothers (who performed the semantic analysis), by 31 other mothers who participated in the scale pre-test and also by seven experts in the construct field. After calculating the Content Validity Index (CVI) and making the proper alterations suggested by the mentioned participators, the pilot test was elaborated, containing itself 25 items. In the empirical part of this paper, the selected sample was formed by 448 mothers of less than 5 years old children. Those women were all registered on one of the six Family Health Centers in which the research took place. Data collection was performed from November of 2009 to February of 2010. A questionnaire on socio-demographic elements and child health aspects was used along with the pilot test. The analytical work involved the construct validity, the criterion validity, Cronbach’s alpha and Intraclass Correlation Coeficient (ICC). Construct validity, through the factor analysis, has indicated the need for exclusion of the item seven and has also shown the existence of two factors/domains (family hygiene, formed by 15 items; and alimentary/general habits, with 9 items) in the Maternal Self-Efficacy for Infantile Diarrhea Prevention Scale (MSIDPS). Regarding the construct validity, hypotheses were tested by contrasting groups comparison. A negative correlation has been observed between the higher maternal self-efficacy for infantile diarrhea prevention scores and the previous occurrence of diarrhea in the child (p=0,001).The higher self-efficacy scores were also associated with older mothers (p=0,018). By using predictive validity, the criterion validity has shown that higher levels of maternal self-efficacy turned out to be a protective factor against infantile diarrhea, according to specificity and to Negative Predictive Value. Cronbach’s alpha of the MSIDPS was 0,84, which indicates high internal consistency. ICC, after test-retest stability analysis, was 0,45, showing the scale’s applicability throughout time. This dissertation has come to the conclusion that the scale is reliable, valid and capable of evaluating maternal self-efficacy for infantile diarrhea prevention.