Avaliação de guidelines para atenção pós-parto na Atenção Primária: revisão sistemática

Abstract

Resumo Introdução O cuidado após o parto, denominado de pós-natal, pós-parto ou puerpério, é um importante período para desenvolvimento de estratégias de atenção à saúde das mulheres para redução da morbimortalidade. Com o aumento de publicações de diretrizes clínicas, há preocupações quanto à qualidade delas. Objetivo Avaliar a qualidade de guidelines sobre a atenção às mulheres no pós-parto na Atenção Primária à Saúde. Método Revisão sistemática de guidelines publicados entre 2008 e 2017, nas bases de dados Lilacs e PubMed, e página da internet do National Guideline Clearinghouse, National Institute for Health and Care Excellence e Google®. A ferramenta Appraisal of Guidelines for Research and Evaluation II foi utilizada para avaliação da qualidade dos guidelines nos domínios: escopo e finalidade; envolvimento das partes interessadas (stakeholders); rigor do desenvolvimento; clareza e apresentação; aplicabilidade; e independência editorial. Resultados Foram analisados dez guidelines que apresentaram escore médio geral de avaliação de 77%, com melhor avaliação para “escopo e finalidade” (92%) e pior para “aplicabilidade” (57%). Conclusão Os guidelines apresentaram boa qualidade geral com necessidade de melhorar sua elaboração no domínio aplicabilidade.

Implementation of postpartum care for women in primary care in the South of Brazil

“…This is a normative study, which addressed the implementation level of postpartum care in PHC and analyzed favorable and unfavorable aspects in the operationalization of this intervention, 11 which was carried out from February to June 2019, in a quantitative and qualitative approach. 13 It was developed through a study of multiple cases 14,15 by answering the following research question: How is postpartum women's care implemented in PHC?…”

“…The instruments for collection were developed based on the theory of the postpartum care program for women in PHC.17A pilot case study was conducted in a city that was not part of this study. 14 The Matriz de Análise e Julgamento (MAJ) (Analysis and Judgment Matrix) was designed, consisting of dimensions and sub-dimensions, 13 defined through the Teoria do Programa 17 (Theory Program) and validated by the consensus conference technique 18 with experts in the field and stakeholders (interested in the evaluation), being: four women representatives for women's movement, five professionals in PHC area and management in women's health in Paraná, Santa Catarina and Rio Grande do Sul States, in addition to three professionals with experience in PHC.…”

“…19 The individual analysis of cases was carried out through thematic analysis 20 with triangulation of data from different sources of evidence, using a pre-defined list of codes 20 according to the MAJ design, with the aid of NVivo software, version 11. From the thematic analysis, a judgment value was held based on the rationale 13 of each criterion/indicator and discussed among the authors to attribute the score in each case. In order to perform the imbricated analysis, a thorough examination of the dimensions and sub-dimensions was carried out, verifying the convergences, divergences, favorable and unfavorable aspects among them.…”