Cartilha educativa e entrevista motivacional para promoção da autoeficácia materna na prevenção da diarreia infantil: ensaio clínico randomizado

Abstract

Educational technologies have being used by professionals at educational activities developed with the community. Among the types of technologies available, printed materials, such as booklets and brief motivational interview (BMI), are reinforced. The association between both technologies can be performed by nurses in primary care, aiming to stimulate healthy behaviors to prevent childhood diarrhea, since this disease remains as one of the main causes of infant morbidity and mortality. The objective of this study was to evaluate the effect of using an educational booklet alone and combined with a BMI on maternal self-efficacy in the prevention of childhood diarrhea. This study is a randomized clinical trial, developed at three health care units in Fortaleza/CE, with 181 mothers and/or caregivers of children under five years of age, which were divided into three groups: 1. Intervention A (GI A), which received an intervention with the use educational booklet; 2. Intervention B (GI B), that used the educational booklet combined with the BMI; 3. Comparison Group (GC). The data collect happened in four moments: 1st moment: Maternal Self-Efficacy Scale for the Prevention of Childhood Diarrhea (EAPDI) application and sociodemographic form in the health unit with all groups; 2nd moment: application of the technologies with GI A and GI B, being applied to EAPDI immediately after the interventions; 3rd and 4th moments: reduced form of investigation of diarrhea and EAPDI application in all groups, by telephone contact, one month and two months after the interventions, respectively. Data were exported to Statistical Package for the Social Sciences, version 20, and the analysis were performed. The project was approved by the Research Ethics Committee of the Federal University of Ceará and by the Brazilian Registry of Clinical Trials. The groups were homogeneous at baseline (p> 0.05). Intragroup analysis revealed that all groups had an increase in maternal self-efficacy in preventing childhood diarrhea, with statistically significant differences when evaluated full-scale scores and general / feeding practices scores, but only GI B presented a significant increase in family hygiene. In the intergroup analysis, no statistical difference was observed between the study moments, however, the evaluation performed immediately after the intervention revealed higher self-efficacy scores in the groups that received interventions. There was a greater predominance of participants with high self-efficacy in GI B after the application of the technologies. All the groups presented cases of infantile diarrhea, with a lower number in GI B, one month after the intervention (p = 0.025). It was found that children cared for by mothers and/or caregivers with moderate self-efficacy are more likely to have diarrhea than for those with high self-efficacy. At all times of the study self-efficacy scores were higher in GI B, as well as lower cases of childhood diarrhea in this group. It was concluded that the association between the booklet and the BMI was the most effective strategy to increase maternal self-efficacy to prevent infant diarrhea and reducing this disease's cases.