Menezes, Rejane Maria Paiva deCavalcante, Tatiana Maria Nóbrega Elias2023-10-202023-10-202023-07-21CAVALCANTE, Tatiana Maria Nóbrega Elias. Desenvolvimento de instrumento para o cuidado de enfermagem na prevenção da sífilis congênita na Atenção Primária à Saúde. 2023. 225f. Orientadora: Dra. Rejane Maria Paiva de Menezes. Tese (Doutorado em Enfermagem na Atenção à Saúde) - Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, 2023.https://repositorio.ufrn.br/handle/123456789/55050Brazil faces high rates of cases of perinatal morbidity and mortality caused by congenital syphilis, although prevention and control actions for these conditions are applicable in the prenatal program. However, despite the improvement in access for pregnant women, important gaps persist, such as inefficient driving for disease prevention. Therefore, the objective of this study is to build and validate an instrument for nursing care in the prevention of congenital syphilis in Primary Health Care (PHC). To this end, Jean Watson's theory was used, enabling the recognition of care by the pregnant woman to support her in the prevention of congenital syphilis. This is a methodological study with 4 phases: the first, the operationalization of the construct, supported by the theory of transpersonal care and by a scope review, with a final sample of 35 documents that enabled the categorization of 33 nursing care for prevention of congenital syphilis which, together with the 10 elements of the Clinical Caritas Process, composed the first version of the instrument with 10 dimensions and 27 items; the second corresponded to content validation for the analysis of agreement between the item-dimension and the validation of the instrument items and its operational guide, in two Delphi rounds with 12 judges; the third, face validation, had 38 judges and a Delphi round to assess the instrument's verbal understanding. In the second and third phases, the Kappa coefficient and the Content Validation Index (CVI) were used for statistical analyses. And the fourth phase, the validation of the construct and evaluation of its reliability, had the participation of 15 nurses and 138 pregnant women. For construct validation, exploratory and confirmatory factor analysis and Cronbach's alpha were used to assess the instrument's internal consistency. The study complied with ethical prerogatives, being approved by opinion no. 5,632,945 and CAAE 61762422.3.0000.563, issued by the Ethics and Research Committee of the Federal University of Rio Grande do Norte. From the results, it was obtained, in the content validation of the instrument, an agreement between the items and dimensions ≥ 0.60 in the first round of Delphi in 77.78% of the items; however, of the 6 items that did not show satisfactory values, 3 were excluded and 3 were adjusted. Items with Kappa less than 1.00 were submitted to the second Delphi round, all of which presented values greater than those of the first round and ≥ 0.60. Still in this phase, in the content validation of the instrument and the operational guide, all items and their operational descriptions obtained a CVI ≥ 0.80 and a Kappa ≥ 0.60, giving rise to the second version of the instrument with 24 items. In the face validation, the instrument was submitted to the evaluation of verbal compression, with all items having obtained Kappa ≥ 0.80 and CVI ≥ 0.89. In the construct validation, in the exploratory analysis, the variables generated 9 factors with a variance greater than 50% and the confirmatory analysis obtained statistically significant values in the adequacy indices of the final model (Ratio X2/g.l, RMR, RMSEA, PCFI, CFI and IFI ). Regarding the verification of reliability, the instrument obtained a Cronbach's Alpha above 0.70 and below 0.90 in all items, classifying the internal consistency as adequate. Given these results, it is concluded that the instrument developed for nursing care in the prevention of congenital syphilis demonstrated satisfactory psychometric quality and validity to support and qualify the practice of nurses with pregnant women in PHCAcesso AbertoCuidados de enfermagemcuidado pré-natalsífilis congênitaenfermagemAtenção Primária à Saúde - APSestudos de validaçãonursing careprenatal carecongenital syphilisprimary ealth caredoctoralThesisCNPQ::CIENCIAS DA SAUDE