Instrument about knowledge, attitudes, and practices of pregnant women about the hypertensive disease of pregnancy

Objective: to elaborate and validate an instrument to evaluate the knowledge, attitudes, and practices of pregnant women regarding the hypertensive disease of pregnancy. Methods: methodological research, to develop and validate an instrument about the knowledge, attitudes, and practices of pregnant women regarding said disease. The stages of the design were: elaboration, content validation, and semantic analysis with the target audience. Results: to elaborate the instrument, the following items were adopted: definition, classification, signs and symptoms, risk factors, consequences, prevention and treatment of the hypertensive disease of pregnancy. The instrument was submitted to a validation by specialists. Its dimensions presented a Content Validity Index of 0.85, 0.89 for pertinence, 0.81 for clarity, and 0.86 for scope. The variable attitudes was below 0.8 in all dimensions. Conclusion: the instrument was considered to be valid and can be used to direct educational interventions, aimed to prevent the disease or its complications from surfacing. Descriptors: Hypertension, Pregnancy-Induced; Health Knowledge, Attitudes, Practice; Validation Study; Nursing. RESUMO Objetivo: elaborar e validar instrumento para avaliação do conhecimento, da atitude e prática de gestantes acerca da síndrome hipertensiva gestacional. Métodos: pesquisa metodológica, com desenvolvimento e validação de instrumento sobre conhecimento, atitude e prática de gestantes em relação à síndrome. As etapas do delineamento foram: elaboração, validação de conteúdo e análise semântica com o público-alvo. Resultados: para elaboração do instrumento, adotaram-se os itens: definição, classificação, sinais e sintomas, fatores de risco, consequências, prevenção e tratamento da síndrome hipertensiva gestacional. Mediante construção, este foi submetido à validação por especialistas, e as dimensões do instrumento apresentaram Índice de Validade de Conteúdo total de 0,85, sendo 0,89 para pertinência; 0,81, para clareza; e 0,86, para abrangência. A variável atitude foi inferior a 0,8 em todas as dimensões. Conclusão: o material foi considerado válido e poderá ser utilizado para direcionar intervenções educativas, com vistas a prevenir surgimento ou complicações da síndrome. Descritores: Hipertensão Induzida pela Gravidez; Conhecimentos, Atitudes e Práticas em Saúde; Estudo de Validação; Enfermagem. *Extracted from the thesis “Efeito de intervenção educativa para prevenção das complicações da Síndrome Hipertensiva Gestacional: ensaio clínico randomizado”, Universidade Estadual de Campinas, 2019. 1Universidade Estadual de Campinas. Campinas, SP, Brazil. Corresponding author: Lia Maristela da Silva Jacob Avenida Modesto Fernandes, 284, CEP: 13084-190, Campinas, SP, Brazil. E-mail: lia_maristela@hotmail.com EDITOR IN CHIEF: Ana Fatima Carvalho Fernandes ASSOCIATE EDITOR: Renan Alves Silva Lia Maristela da Silva Jacob1 Maria Helena Baena de Moraes Lopes1 Antonieta Keiko Kakuda Shimo1 How to cite this article: Jacob LMS, Lopes MHBM, Shimo AKK. Instrument about knowledge, attitudes, and practices of pregnant women about the hypertensive disease of pregnancy. Rev Rene. 2021;22:e60040. DOI: https://doi.org/10.15253/2175-6783.20212260040 Jacob LMS, Lopes MHBM, Shimo AKK Rev Rene. 2021;22:e60040. 2 Introduction The number of maternal deaths in a country is one of the most important indicators of its social reality. In addition to biological factors, it reflects the socioeconomic level, the quality of health care, the inequality between genders, and the political determinations with regard to promoting public health. As a result, the need to diminish the indicators of maternal mortality becomes clear(1). Hypertension in pregnancy is an important complication, significantly associated to maternal and fetal morbidity and mortality. The main issue in the management of this complication is reaching a balance between benefits for the mother, which result from a better control of arterial pressure, and the fetal risks that result from the toxicity iof the medication, in addition to a possible uterine-placental hypoperfusion(2). The hypertensive disturbances of pregnancy are still an enormous international and national health problem for maternal and neonatal health. In the United states, pre-eclampsia, whether in isolation or superimposed on pre-existing chronic hypertension, is a great risk. There are still grave cases of morbidity and mortality among mothers and fetuses, although adequate prenatal care, with the detection of signs of pre-eclampsia and births to put an end to the problem, reduced the number and the extension of negative outcomes(3). In Brazil, in 2015, 20.7% of deaths were due to hypertensive disorders during pregnancy, labor, and puerperium; 17.5% were due to complications in labor and childbirth; and 13.2%, due to complications that were mainly related to the puerperium(4). However, for some pregnant women, the hypertensive disease may not represent a problem that demands surveillance and control, since many of them lack the knowledge about the complications of this disease, especially those with low incomes. In addition, it stands out that health workers who offer prenatal care must reflect, trying to achieve a more incisive conduct targeted at preventing complications that take place during pregnancy, labor, and puerperium(5). In the meantime, the role of nurses is paramount, since these professionals follow up the pregnant women throughout the pregnancy-puerperium cycle, facilitating an early identification of alterations, be them normal or otherwise. It stands out that the assistance provided by nurses to hypertensive pregnant women should stand out for their critical nature and autonomy, in addition to technical-scientific knowledge, and need to be strengthened by a problem-solving and dynamic multiprofessional team(3). Therefore, it is important to elaborate new health strategies targeted at an early identification of health problems during prenatal care, prioritizing an individualized follow up and an adequate treatment, as prescribed by public policies of health care to high-risk pregnant women, which have been implemented recently(6). With regard to that, the application of instruments in the health care services that attend to the health of pregnant women is an effective alternative, considering that, through surveys, it is possible to detect a reality, such as the presence of health problems that were not expected in a pregnancy. Also, this is an effective way to analyze the knowledge of pregnant women with regard to the theme, aiding professionals in the planning of educational interventions targeted at the shortcomings found. Educational interventions are essential and must be a part of prenatal consultations and family planning. With regard to the hypertensive disease of pregnancy, it is a complication that has the potential to damage the mother-fetus entity, increasing the chance of mortality(4-5). The level of knowledge of the pregnant women about it should be analyzed still in the first trimester, and activities of education in health should be developed based on the shortcomings detected. These are efficient attitudes to prevent complications and protect this entity(7). The use of instruments in health care is paramount. However, they must be submitted to a process of validation by specialists, to guarantee the reliability of the content addressed in the technology. For this study, the theme hypertensive disease of pregnancy was chosen, since it was a gap in knowledge attested