Elaboração e validação de instrumento para identificação de carga de trabalho do enfermeiro que atua em Centro de Atenção Psicossocial

Abstract

The objective was to develop and psychometrically validate an instrument to identify the workload of nurses working in the Psychosocial Care Center - CAPS II. This is a methodological development research with a quantitative approach that used the Psychometric Theory of Data, developed in three stages: In Step 1: the construction of the Nurse's Workload Instrument - CTENF was carried out through an Integrative Literature Review and according to the theoretical bases of Christophe Dejours, Edith Seligmann Silva, Laurell and Noriega and Joyce Travelbee. The CTENF was synthesized into six important manifest variables called domains throughout the text: Domain 1: Organization and Working Conditions, Domain 2: Nurse and User Relationship in Mental Distress, Domain 3: Nurse and Multidisciplinary Team Relationship, Domain 4: Relationship Nurse and Service Management, Domain 5: Mental Repercussions and Domain 6: Physical Repercussions with an array of 75 items. In Step 2: Content Validity was achieved through the participation of 10 expert judges, who were identified in the Lattes Platform based on the criteria proposed by Benner, Tanner and Chesla. The judges assessed the item / domain relationship at this stage and their agreement was assessed using Kappa, thus obtaining: in domains 1, 2, 3, 4, 5 and 6 concordances above (0.80) in all items among the evaluators, in addition, the general Kappa by domains was calculated: (0.84; 0.92; 0.80; 0.80; 0.98 and 0.84) and the general Kappa of the CTENF of 0.86. CTENF Face Validity was also carried out with expert judges and students enrolled in the Nursing Course at the Federal University of Rio Grande do Norte-UFRN Campus Natal-RN. With a General Kappa value of 1 in this validity. In Stage 3: The Construct Validity was carried out with 300 nurses who work at the Psychosocial Care Centers II in the Northeast Region. In this phase of the research, the data were analyzed using the Item Response Theory (IRT) with two parameters (a) and (b) for the evaluation of the latent traits of professionals working in the Psychosocial Care Center - CAPS II. For this, the Gradual Response Model (MRG) was applied, in which the Likert scale was fixed between 1 and 5, representing satisfaction, adequacy and frequency in relation to the item. According to the results of the IRT, all items had a satisfactory power of discrimination and it was possible to identify the items of greatest importance to differentiate professionals with different levels of the latent trait studied. From the TCT, the Confirmatory Factor Analysis (AFC) of the psychometric structure of the instrument scale (CTENF) was performed. In addition, the quality of the fit in the model was verified through the parameters χ2 / G.L., CFI, TLI, GFI and RMSEA, indicating a good or reasonable adjustment of the fixed structure. Confirmatory factor analysis was able to confirm the pre-defined structure of CTENF since all adjustment indexes were satisfactory. Its final version has 58 items divided into six domains. This study obtained a favorable opinion from the Ethics Committee of the Federal University of Rio Grande do Norte - UFRN under opinion No. 3,640,801 / 2019. Therefore, the “The Nurse's Workload (CTEnf) instrument that works in the Psychosocial Care Center - CAPS II” demonstrated to have satisfactory and reliable psychometric qualities, which can be used to generate a score for the workload of nurses working in CAPS II.