Construção e validação de um instrumento para avaliação dos serviços públicos de saúde bucal na atençao primária à saúde sob a ótica dos usuários (ASBAP-usuário)

• Ano de defesa: 2013
• Autor(a) principal: Heriberto Fiuza Sanchez
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; UFMG
• Palavras-chave em Português: Estudos de validação; Atenção primária à saúde; Usuários; Avaliação de serviços de saúde; Saúde bucal; Cuidados primários de saúde; Odontologia em saúde pública; Saúde pública; Serviços básicos de saúde
• Link de acesso: http://hdl.handle.net/1843/ZMRO-9D2NAX

The Unified Health System is under constant building through the participation of different stakeholders, including users. The evaluation of the system, through the use of questionnaires, is one possible way of contribution in the process of consolidation of national health policy. On oral health this situation is not different and, with the example of what occurs in health care, the participation of users is essential in this process. However, there is a scarcity of tools specifically aimed at the evaluation of oral health from the perspective of users in primary health care. Integrality holds different meanings that can contribute to the change of the model of care and can serve as a theoretical framework for the construction of a new instrument. The aim of this study was to construct and validate an instrument, in the form of a questionnaire, able to assess the oral health in primary health care in the perspective of users. It was initially defined the theoretical framework, and the proposals made by Starfield (2002), directed to evaluate primary health care and Silva Jr. and Mascarenhas (2008), aimed at assessing integrality in primary health care were chosen. An evaluation model was built and served as a script for a focus group conducted with users of the health system, when categories able to assess the oral health in primary care from ntegrality were obtained. A first version of the instrument had 43 items assessed on a Likert scale with four response options (yes / always, sometimes, not / never and do not know), was drawn from these categories. This first version was submitted to experts committee, which included a total of five participants, at which it was made the content validation of the instrument. Some changes were made in the questionnaire, based on contributions made by the experts committee and the instrument was administered twice to a group of users of the public health system, when it was possible to obtain the face validation. To calculate the number of users needed to construct validation and verification of reliability was used the proportion of 4:1 (participants / instrument items), and the result was divided equally by the number of health districts in the municipality of Belo Horizonte and applied in volunteers. Reliability was calculated using the kappa coefficient to assess the temporal stability and Cronbach's alpha was used for internal consistency. Factor analysis was used for construct validation. It was used SPSS 17.0 for statistics. The validated questionnaire has 20 questions, divided in 5 dimensions. The highest score given to oral health services in primary health care can present (a situation of satisfaction by the user) is 60 points, corresponding to a situation in which all alternatives "yes/always" are indicated by the user. The use of the questionnaire by the users can be a stimulus to citizen participation in the directions of health services and the results obtained in the questionnaire may sensitize managers to improve health services and professional practices and, ultimately, become reality the building of a public health system at the height of its existence, which are the users themselves.