EDUCATIONAL INTERVENTION WITH NURSES REGARDING CHILDCARE CONSULTATION: A MIXED METHOD STUDY

Vieira, Daniele de Souza; Soares, Anniely Rodrigues; Guedes, Anna Tereza Alves; Santos, Luciano Marques dos; Toso, Beatriz Rosana Gonçalves de Oliveira; Vaz, Elenice Maria Cecchetti; Collet, Neusa; Reichert, Altamira Pereira da Silva

doi:10.1590/1980-265X-TCE-2023-0132en

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Special Section • Texto contexto - enferm. 32 • 2023 • https://doi.org/10.1590/1980-265X-TCE-2023-0132en copy

EDUCATIONAL INTERVENTION WITH NURSES REGARDING CHILDCARE CONSULTATION: A MIXED METHOD STUDY

INTERVENCIÓN EDUCATIVA CON ENFERMERAS EN LA CONSULTA DE PUERICULTURA: UN ESTUDIO DE MÉTODO MIXTO

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to determine the effect and influence of an educational intervention on childcare consultation on nurses’ knowledge and practice.

Method:

a mixed research method was adopted, with a sequential explanatory design, characterized by a stage with a quantitative approach, developed in a quasi-experimental study, with 30 nurses, followed by a qualitative one, carried out by in-depth interview, with 11 nurses working in the Family Health Units of João Pessoa, Paraíba, Brazil. In quantitative analysis, descriptive statistics and proportion test were used, and in qualitative analysis, thematic analysis was used.

Results:

the effect of the educational intervention was statistically significant in the consultation dimensions: consultation frequency; child nutrition; physical examination; growth assessment; development assessment; and health education. In the qualitative stage, the influence of the intervention in expanding knowledge and changing some nurses’ practices in the aforementioned dimensions was understood, with agreement between the data found.

Conclusion:

the positive effect of the educational intervention on nurses’ knowledge and practice in childcare consultations was evident, enabling them to reflect on the content covered and promote changes in their daily lives.

DESCRIPTORS:
Child care; Growth and development; Nurse; Education continuing; Primary health care

Dimension	Knowledge section		p-value^*	Practice section		P valor^*
Dimension	Before	After	p-value^*	Before	After	P valor^*
Consultation frequency	16	60	< 0.001	55	56	0.999
Child nutrition	32	45	0.026	53	56	0.999
Physical examination	12	37	< 0.001	49	53	0.481
Growth assessment	54	69	0.030	126	140	0.034
Development assessment	114	116	0.897	102	138	< 0.001
Health education	26	28	0.704	137	167	<0.001
Violence	25	26	0.999	6	6	0.999
CSHCN	23	28	0.184	35	37	0.856

Dimensions	Statements
Knowledge section
Growth assessment (p=0.030)	[…] the issue that I find very interesting is that sometimes we get confused and put height, but, in fact, it was length. (N1) […] this monitoring of a premature baby that I had a lot of doubts about and I wanted to know about [...] I am already planning to receive a premature child. I kept thinking, “If this girl were here and I was going to help her, I would do everything wrong because I no longer remembered [...] how I would calculate her age, weight, the corrected calculation”. (N9)
Consultation frequency (p < 0.001)	[…] in reality, I didn’t make that first visit in five days, because I have a very large area and I have four uncovered areas that I don’t have feedback from the health agents in those areas. So, I didn’t do this five-day visit (visit in the first week of life). Now I’m trying to do it, so much so that when someone who isn’t from my area arrives, I give them my private phone number so that when they have a baby, when they get home, they can contact me. (N2) [...] It improved in terms of me seeking more childcare patients [...] as I had a bigger deficit [...], it opened my mind more to involve my team even more, so we can do more and more childcare. Bring a child so we can see about the issue of the handbook, everything apart from the guidelines we have given to parents. (N7)
Nutrition (p=0.026)	[…] the issue of food was a question I had a lot. So, I thought this part was very good and it is part of growth and development. (N7)
Physical examination (p< 0.001)	[…] there’s no point in just filling it out, just staying here on paper and not examining it, doing the clinical exam, which is very important. Sometimes I didn’t do a complete clinical examination. We thought we did it, but I learned a lot [...], it’s putting into practice a better clinical examination. I really sinned, I needed to improve, I needed to perfect. (N1) [...] I didn’t know that (in the simplified physical examination) the ideal was to focus on the mother’s complaint and not waste so much time on other things, paying more attention to this other side of development [...]. (N9)
Practice section
Growth assessment (p=0.034)	[...] the part about following the graph, which I told you, was a big difficulty, I didn’t know how to do the body mass index, that was also very good. I am able to register in the medical record and in the handbook. (N6) […] the issue of premature babies’ graphics and calculating the newborn’s corrected age was new. I learned a lot from you because we didn’t do that. I knew I needed it, there was something strange, you know, [...] but it was very interesting. (N10)
Development assessment (p< 0.001)	[...] I managed to improve my ideas on this issue (how could we identify any changes in the child) [...] because I had in mind that they would have very specific characteristics, you know? But then, after the training, I was able to observe that just by identifying the absence of those milestones, in one month, in another month, it already characterizes a change, be it autism or something else. (N4) […] I, for example, was very doubtful about how far I could go on my own and how far I could go to the doctor or specialists. [...] The development table, which you said that we assess the previous ones too (development milestones), I only assessed that month, understand? (N5)
Health education (p< 0.001)	[…] with this training, I know how to distinguish, [...] pay more attention, listen, praise (the mother), who I praised like that, but a lot of things I learned to explain, to give guidance. Then I help, explain, show here this little book (Children’s Handbook) that I use as a model [...] I ask the person to read it, paying close attention, everything is very, very useful. (N6) […] the (danger signs), right?! People only know this, but with the training I became more confident in talking to the mother, because I already did that for the child’s records, those... yeah... the milestones. (N3) [..] I never worried about providing so much information to them (mothers), I just said it was within the parameters. When it was heavier, I said it was, but explained it above, but through the questions on the test (instrument), I realized that there is a real importance of providing her with this information about what is happening in that consultation. (N11)

Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Campus Universitário Trindade, 88040-970 Florianópolis - Santa Catarina - Brasil, Tel.: (55 48) 3721-4915 / (55 48) 3721-9043 - Florianópolis - SC - Brazil
E-mail: textoecontexto@contato.ufsc.br

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[1] CORRESPONDING AUTHOR
Daniele de Souza Vieira daniele.vieira2015@gmail.com