RESUMO

O objetivo desta pesquisa consistiu em adaptar uma ficha clnica para a consulta de enfermagem no
pr-natal de risco habitual na Ateno Primria Sade e valid-la como uma tecnologia para a
consulta de enfermagem. O nvel de concordncia adotado para incluso ou excluso dos itens foi de
80% entre os especialistas que participaram da avaliao. Tratou-se de uma pesquisa metodolgica
com emprego da Tcnica Delphi para validar o instrumento. A coleta de dados ocorreu por meio de
amostragem no probabilstica por julgamento. Os critrios de incluso para participar da pesquisa
consistiram em ser enfermeiro(a) docente e especialista em enfermagem obsttrica, grau acadmico
de Doutor, atuando em universidades pblicas do pas, de forma que se obteve representantes de
todas as regies, como requisito para validar o instrumento e garantir construtos compatveis com
as varincias regionais. Foram considerados participantes os enfermeiros(as) especialistas com, no
mnimo, 02 anos de ensino na rea de sade da mulher, identificados atravs do currculo na
plataforma Lattes e por meio da tcnica de bola de neve (snowball). A construo da ficha clnica
ocorreu aps reviso minuciosa de literatura e da observao dos instrumentos recomendados pelo
Centro Latino-Americano de Perinatologia Sade da Mulher e Reprodutiva da Organizao Pan
Americana da Sade/Organizao Mundial da Sade e Ministrio da Sade do Brasil. Dessa forma,
estabeleceram-se as informaes relevantes e definiu-se os contedos que passaram pelo processo
de validao. A avaliao dos indicadores empricos pelos especialistas ocorreu atravs de uma
plataforma construda nos formulrios do Google Docs, via internet. O instrumento foi submetido
validao de forma e contedo pelos especialistas que analisaram o grau de relevncia de cada item
do instrumento considerando os conceitos de clareza e pertinncia/ representatividade. O painel 1 e
2 ocorreu entre os meses de fevereiro e junho de 2016. A amostra final do primeiro painel foi
constituda por 18 professores doutores, porm 3 foram excludos por no se enquadrar nos
critrios de incluso, finalizando o primeiro painel com 15 juzes. J no segundo painel participaram
13 docentes dos 15 anteriores. Os dados foram tabulados com o auxlio do programa Microsoft Excel
e analisados quantitativamente por meio do coeficiente de validade de contedo. A incluso dos
itens respeitou o clculo do CVC adotado de 80% de concordncia entre os especialistas e a sugesto
de cada professor que, ao discordar ou solicitar a incluso de um item, subsidiaram a sistematizao
do segundo painel que originou a ficha final validada. A validao da maioria dos constructos foi
alcanada no primeiro painel enquanto no segundo foi realizada a validao dos itens que no
atingiram o ndice de 80 % na primeira fase ou que receberam sugestes para ser aprimorado na
ficha clnica. Os itens que compuseram o segundo painel e as sugestes contriburam para o
delineamento das informaes imprescindveis no contexto do pr-natal e nascimento, como forma
de qualificar e humanizar a assistncia, alm de ter potencial para reduzir a morbimortalidade
materna e neonatal.

Key words: Womens health; Pregnancy; Clinical record; technology; nursing care
Translation

The objective of this research was to adapt a medical record for nursing appointments during
the regular-risk prenatal according to the Primary Healthcare and validate it as a technology
for nursing appointments. The agreement level chosen for the inclusion or exclusion of the
items was 80% between the experts that have participated of the study. It was a methodological
research that has applied the Delphi Technique to validate the instrument. The data collection
occurred through Judgmental Sampling. According to the inclusion criteria adopted, the
participant of the study should be a nurse specialized in obstetrical nursing. Moreover, this
specialist should be PHD who teaches in a Brazilian public university. Therefore, it was
attained representatives of all regions of the country in order to validate the instrument and
assure that the results would be compatible with the regional diversities. It was considered as
participants the nurses with an experience of at least 02 years teaching about women healthcare.
These participants were identified by their resume at the Lattes platform using the Snowball
technique. The assembling of the medical record followed the rigorous review of the literature
and the observation of the instruments recommended by the Latin American Center of
Perinatology Womens Health and Reproductive of the Pan American Health Organization /
Worlds Health Organization and Brazilian Health Ministry. As a result, the relevant
information were stablished and the content that have passed by the validation process were
defined. The specialists evaluation of the empirical indicators occurred by a platform
assembled using the Google Forms, through the Internet. The specialists subjected the
instrument to a form and content validation. These experts also analyzed the relevance degree
of each item of the instrument; it was considered the concept, clarity and
applicability/representability of the instrument. The scenery 1 and 2 of the research took place
during the months of February and June of 2016. The final sample of the first scenery was
composed by 18 PHD professors. However, 3 were excluded once they did not fit on the
inclusion criteria. Then, the first scenery was finalized with 15 judges. Subsequently, the
second scenery were attended by 13 of the 15 previous specialists. The data were tabbed using
the software Microsoft Excel then; they were analyzed quantitatively by means of the Content
Validity Coefficient. The inclusion of the items has respected the calculation of the CVC,
which has considered 80% of agreement between the experts. Furthermore, it also pondered
the specialists suggestions, that disagreeing or requesting the inclusion of other items, assisted
the systematization of the second scenery, resulting in the final validated medical record. The
validation outcomes majority were reached at the first scenery. At the second scenery, it was
performed the validation of the items which have not reached the index of 80% at the first
scenery or the items that have received suggestions to be improved on the medical record.
Finally, the suggestions and the items that have composed the second scenery have contributed
to the delimitation of the essential information regarding the prenatal and birth context. These
items contribution acts improving the quality and humanizing the nursing care. Moreover, they
have the potential to reduce the neonatal and maternal morbimortality.
Key words: Womens health; Pregnancy; Clinical record; technology; nursing care