Atualização e validação de um check-list de enfermagem para a visita puerperal

Abstract

The postpartum period, or puerperium, begins after the expulsion of the placenta and extends for approximately six weeks, characterizing a time of intense physical and emotional adaptations experienced by the woman. It is a critical phase in which significant complications can arise, such as hemorrhages, infections, and postpartum depression, especially among those who faced complications during pregnancy. Within the scope of Primary Health Care, the nurse plays a fundamental role in conducting the postpartum visit, an activity that allows for the joint monitoring of the health of the mother and newborn, support for breastfeeding, early identification of risks, and the promotion of essential guidance for home care. However, the absence of systematized instruments and the short time allocated to nursing consultations can compromise the quality of care provided during this period. Given this scenario, the objective of this study was to update and validate a checklist for nursing consultations during the postpartum visit. This is a methodological research developed in the Primary Health Care setting in the municipality of Sobral-CE and conducted in four complementary stages. Initially, an integrative literature review was conducted to theoretically ground the construction of the instrument. Next, interviews were conducted with nine nurses from the Family Health Strategy, carried out at the Family Health Center itself, whose statements were analyzed according to Minayo's qualitative approach. The third stage consisted of constructing and updating the checklist, integrating the identified scientific evidence and the contributions from the interviewed professionals. Finally, the instrument's content was validated by seven specialists in the areas of women's health, child health, and public health, conducted online and using the Content Validity Index as an evaluation parameter, considering the criteria of clarity of language, practical relevance, and theoretical relevance. The study was approved by the Research Ethics Committee of the Vale do Acaraú State University, under opinion number 7.711.195 and CAAE 89565125.7.0000.5053. The analysis of the interviews revealed five central thematic axes related to the postpartum visit process: the clinical assessment of the postpartum woman and the newborn; the challenges faced by professionals during the visit; the role of the support network and the conditions of the home environment; the emotional dimension of the woman in the postpartum period; and educational demands, with emphasis on breastfeeding. Based on this evidence, the checklist was updated and now includes, in five pages, a structured set of information under the title

"Checklist for postpartum visits by nurses: Assessment of maternal and infant well- being," encompassing categories that include general data, gestational history,

maternal and neonatal anamnesis, social support, and essential health guidelines for the postpartum woman and the newborn. In the validation stage, the Total Content Validity Indices were 0.83 for clarity of language, 0.67 for practical relevance, and 0.71 for theoretical relevance. It is concluded that the updated instrument is adequate and has the potential to improve nursing consultations during postpartum visits, contributing to a more structured and safe practice. It is recommended that a new round of validation be carried out, incorporating the experts' suggestions and applying it in a clinical setting to verify its effectiveness and continuous improvement.