Patrícia Santos Prudêncio

The Cultural and Linguistic Adaptation to Brazilian Portuguese and Content Validity of the Patient Expectations and Satisfaction With Prenatal Care Instrument

BACKGROUND Patient satisfaction reflects how an individuals expectations, goals, and preferences are met by health care providers or services. Most research on patient expectations and satisfaction has been conducted in developed countries; there was no Portuguese language instrument to measure pregnant womens expectations and satisfaction with prenatal care. PURPOSE To adapt and test the Patient Expectations and Satisfaction with Prenatal Care (PESPC) instrument for use in Brazil. DESIGN We conducted a systematic cultural and linguistic adaptation of the PESPC into Brazilian Portuguese and tested the validity of the adapted instrument. RESULTS Implementation of this rigorous methodological process resulted in a valid, reliable, culturally, and linguistically appropriate instrument. IMPLICATIONS FOR PRACTICE We recommend further assessment of the Brazilian Portuguese PESPC with more diverse samples of Portuguese-speaking pregnant women in Brazil and other countries. Application of this structured approach to cultural and linguistic instrument adaptation is one way to further transcultural nursing research.Background: Patient satisfaction reflects how an individual’s expectations, goals, and preferences are met by health care providers or services. Most research on patient expectations and satisfaction has been conducted in developed countries; there was no Portuguese language instrument to measure pregnant women’s expectations and satisfaction with prenatal care. Purpose: To adapt and test the Patient Expectations and Satisfaction with Prenatal Care (PESPC) instrument for use in Brazil. Design: We conducted a systematic cultural and linguistic adaptation of the PESPC into Brazilian Portuguese and tested the validity of the adapted instrument. Results: Implementation of this rigorous methodological process resulted in a valid, reliable, culturally, and linguistically appropriate instrument. Implications for Practice: We recommend further assessment of the Brazilian Portuguese PESPC with more diverse samples of Portuguese-speaking pregnant women in Brazil and other countries. Application of this structured a...

Epidemiological research of the maternal deaths and compliance with the fifth millennium development goal

OBJECTIVE To identify and describe the epidemiological characteristics of maternal deaths that occured between 2000-2012 in a reference hospital in the state of São Paulo in order to contribute to the analysis of compliance with the fifth Millennium Development Goal. METHOD Epidemiological, retrospective and cross-sectional study with a population of 58 maternal deaths. Data were collected in the second half of 2013, through medical records and death certificates, and analyzed by SPSS version 13.0. RESULTS An average age of 29.11 years was identified, 56.9% with 1-3 previous pregnancies, 56.9% cesarean deliveries, 84.5% of maternal complications occurred during pregnancy and the postpartum period, 81% of deaths occurred in postpartum, 56.9% of deaths were classified as direct causes, with 44.8% of deaths being attributed to high blood pressure. CONCLUSION There is a need for investment in obstetric care to optimize the reduction of complications during the gestation and puerperal period, thereby influencing the reduction of maternal mortality.

Programs and public policy contributions for the improvement of maternal health

OBJECTIVE To analyze the contributions of public policies and programs to the improvement of maternal health. METHOD Historical and reflective study from the perspective of the theoretical framework of sexual and reproductive rights. RESULTS maternal health is embedded in sexual and reproductive rights, which are seen as human rights and a responsibility of the state. Many programs and policies have been developed and improved in order to bring advancements to maternal health and contribute to meeting the fifth Millennium Development Goal. CONCLUSIONS The development and enhancement of programs and policies played an important role in the organization of health systems, reflecting on improvements achieved in maternal health indicators. However, the perpetuation of high levels of maternal mortality over the years underscores the need to rethink the path trailed to date.

Pesquisa epidemiológica dos óbitos maternos e o cumprimento do quinto objetivo de desenvolvimento do milênio

OBJECTIVE To identify and describe the epidemiological characteristics of maternal deaths that occured between 2000-2012 in a reference hospital in the state of São Paulo in order to contribute to the analysis of compliance with the fifth Millennium Development Goal. METHOD Epidemiological, retrospective and cross-sectional study with a population of 58 maternal deaths. Data were collected in the second half of 2013, through medical records and death certificates, and analyzed by SPSS version 13.0. RESULTS An average age of 29.11 years was identified, 56.9% with 1-3 previous pregnancies, 56.9% cesarean deliveries, 84.5% of maternal complications occurred during pregnancy and the postpartum period, 81% of deaths occurred in postpartum, 56.9% of deaths were classified as direct causes, with 44.8% of deaths being attributed to high blood pressure. CONCLUSION There is a need for investment in obstetric care to optimize the reduction of complications during the gestation and puerperal period, thereby influencing the reduction of maternal mortality.

Investigación epidemiológica de muertes maternas como contribución del quinto objetivo del desarrollo del milenio

OBJECTIVE To identify and describe the epidemiological characteristics of maternal deaths that occured between 2000-2012 in a reference hospital in the state of São Paulo in order to contribute to the analysis of compliance with the fifth Millennium Development Goal. METHOD Epidemiological, retrospective and cross-sectional study with a population of 58 maternal deaths. Data were collected in the second half of 2013, through medical records and death certificates, and analyzed by SPSS version 13.0. RESULTS An average age of 29.11 years was identified, 56.9% with 1-3 previous pregnancies, 56.9% cesarean deliveries, 84.5% of maternal complications occurred during pregnancy and the postpartum period, 81% of deaths occurred in postpartum, 56.9% of deaths were classified as direct causes, with 44.8% of deaths being attributed to high blood pressure. CONCLUSION There is a need for investment in obstetric care to optimize the reduction of complications during the gestation and puerperal period, thereby influencing the reduction of maternal mortality.

Contribuciones programas y políticas públicas para la mejora de salude de la madre

OBJECTIVE To analyze the contributions of public policies and programs to the improvement of maternal health. METHOD Historical and reflective study from the perspective of the theoretical framework of sexual and reproductive rights. RESULTS maternal health is embedded in sexual and reproductive rights, which are seen as human rights and a responsibility of the state. Many programs and policies have been developed and improved in order to bring advancements to maternal health and contribute to meeting the fifth Millennium Development Goal. CONCLUSIONS The development and enhancement of programs and policies played an important role in the organization of health systems, reflecting on improvements achieved in maternal health indicators. However, the perpetuation of high levels of maternal mortality over the years underscores the need to rethink the path trailed to date.

Contribuições de programas e políticas públicas para a melhora da saúde materna

OBJECTIVE To analyze the contributions of public policies and programs to the improvement of maternal health. METHOD Historical and reflective study from the perspective of the theoretical framework of sexual and reproductive rights. RESULTS maternal health is embedded in sexual and reproductive rights, which are seen as human rights and a responsibility of the state. Many programs and policies have been developed and improved in order to bring advancements to maternal health and contribute to meeting the fifth Millennium Development Goal. CONCLUSIONS The development and enhancement of programs and policies played an important role in the organization of health systems, reflecting on improvements achieved in maternal health indicators. However, the perpetuation of high levels of maternal mortality over the years underscores the need to rethink the path trailed to date.

Adaptation and validation of the Patient Expectations and Satisfaction with Prenatal Care instrument among Brazilian pregnant women

OBJETIVO: adaptar para uso no Brasil e validar o instrumento Patient Expectations and Satisfaction with Prenatal Care, que contem 41 itens, divididos em dois dominios (expectativa e satisfacao). A versao adaptada foi submetida a analise da validade de constructo convergente, de grupos distintos, e dimensionalidade, alem da analise da consistencia interna (alfa de Cronbach) e estabilidade. METODO: foram entrevistadas 119 gestantes em acompanhamento pre-natal; dessas, 26 responderam duas vezes ao instrumento (reteste). A consistencia interna foi adequada (alfa de Cronbach ≥ 0,70) e o teste/reteste apresentou correlacao forte (r=0,82; p<0,001) para a expectativa e correlacao moderada (r=0,66; p<0,001) para a satisfacao. As analises realizadas confirmaram a validade da versao adaptada do instrumento no grupo estudado. RESULTADOS: os resultados indicaram fortes evidencias de validade e confiabilidade da versao adaptada do instrumento. CONCLUSAO: o instrumento necessita ser testado em grupos de gestantes com diferentes caracteristicas sociais.OBJECTIVE to adapt and validate the Patient Expectations and Satisfaction with Prenatal Care instrument for use in Brazil. It contains 41 items divided into two dimensions: expectations and satisfaction. The adapted version was submitted to analysis for stability, convergent construct validity, and internal consistency (Cronbachs alpha) for distinct groups and dimensions. METHOD 119 pregnant women receiving prenatal care were interviewed and 26 of these women answered the instrument twice (retest). Internal consistency was appropriate (Cronbachs alpha ≥ 0.70); test-retest presented strong correlation (r=0.82; p<0.001) for the domain expectations and moderate correlation (r=0.66; p<0.001) for the satisfaction domain. The analysis confirmed that the instruments adapted version is valid in the studied group. RESULTS there is strong evidence for the validity and reliability of the instruments adaptation. CONCLUSION the instrument needs to be tested in groups of pregnant women with different social characteristics.

Adaptação e validação do Patient Expectations and Satisfaction with Prenatal Care para gestantes brasileiras

OBJETIVO: adaptar para uso no Brasil e validar o instrumento Patient Expectations and Satisfaction with Prenatal Care, que contem 41 itens, divididos em dois dominios (expectativa e satisfacao). A versao adaptada foi submetida a analise da validade de constructo convergente, de grupos distintos, e dimensionalidade, alem da analise da consistencia interna (alfa de Cronbach) e estabilidade. METODO: foram entrevistadas 119 gestantes em acompanhamento pre-natal; dessas, 26 responderam duas vezes ao instrumento (reteste). A consistencia interna foi adequada (alfa de Cronbach ≥ 0,70) e o teste/reteste apresentou correlacao forte (r=0,82; p<0,001) para a expectativa e correlacao moderada (r=0,66; p<0,001) para a satisfacao. As analises realizadas confirmaram a validade da versao adaptada do instrumento no grupo estudado. RESULTADOS: os resultados indicaram fortes evidencias de validade e confiabilidade da versao adaptada do instrumento. CONCLUSAO: o instrumento necessita ser testado em grupos de gestantes com diferentes caracteristicas sociais.OBJECTIVE to adapt and validate the Patient Expectations and Satisfaction with Prenatal Care instrument for use in Brazil. It contains 41 items divided into two dimensions: expectations and satisfaction. The adapted version was submitted to analysis for stability, convergent construct validity, and internal consistency (Cronbachs alpha) for distinct groups and dimensions. METHOD 119 pregnant women receiving prenatal care were interviewed and 26 of these women answered the instrument twice (retest). Internal consistency was appropriate (Cronbachs alpha ≥ 0.70); test-retest presented strong correlation (r=0.82; p<0.001) for the domain expectations and moderate correlation (r=0.66; p<0.001) for the satisfaction domain. The analysis confirmed that the instruments adapted version is valid in the studied group. RESULTS there is strong evidence for the validity and reliability of the instruments adaptation. CONCLUSION the instrument needs to be tested in groups of pregnant women with different social characteristics.

Adaptación y validación del Patient Expectations and Satisfaction with Prenatal Care para embarazadas brasileñas

OBJETIVO: adaptar para uso no Brasil e validar o instrumento Patient Expectations and Satisfaction with Prenatal Care, que contem 41 itens, divididos em dois dominios (expectativa e satisfacao). A versao adaptada foi submetida a analise da validade de constructo convergente, de grupos distintos, e dimensionalidade, alem da analise da consistencia interna (alfa de Cronbach) e estabilidade. METODO: foram entrevistadas 119 gestantes em acompanhamento pre-natal; dessas, 26 responderam duas vezes ao instrumento (reteste). A consistencia interna foi adequada (alfa de Cronbach ≥ 0,70) e o teste/reteste apresentou correlacao forte (r=0,82; p<0,001) para a expectativa e correlacao moderada (r=0,66; p<0,001) para a satisfacao. As analises realizadas confirmaram a validade da versao adaptada do instrumento no grupo estudado. RESULTADOS: os resultados indicaram fortes evidencias de validade e confiabilidade da versao adaptada do instrumento. CONCLUSAO: o instrumento necessita ser testado em grupos de gestantes com diferentes caracteristicas sociais.OBJECTIVE to adapt and validate the Patient Expectations and Satisfaction with Prenatal Care instrument for use in Brazil. It contains 41 items divided into two dimensions: expectations and satisfaction. The adapted version was submitted to analysis for stability, convergent construct validity, and internal consistency (Cronbachs alpha) for distinct groups and dimensions. METHOD 119 pregnant women receiving prenatal care were interviewed and 26 of these women answered the instrument twice (retest). Internal consistency was appropriate (Cronbachs alpha ≥ 0.70); test-retest presented strong correlation (r=0.82; p<0.001) for the domain expectations and moderate correlation (r=0.66; p<0.001) for the satisfaction domain. The analysis confirmed that the instruments adapted version is valid in the studied group. RESULTS there is strong evidence for the validity and reliability of the instruments adaptation. CONCLUSION the instrument needs to be tested in groups of pregnant women with different social characteristics.