Construção e validação de um inventário de problemas éticos vivenciados por enfermeiras no atendimento pré-hospitalar móvel

Abstract

General objective: To construct and validate an instrument for the identification and measurement of the occurrence of ethical problems experienced by nurses in Mobile Pre hospital Care. Specific objectives: To map the ethical problems experienced by nurses in mobile pre-hospital care; To describe the items and dimensions of the Instrument of type Inventory of ethical problems experienced by nurses in pre-hospital care to analyze evidence of content validity of the Instrument of type Inventory of ethical problems experienced by nurses in Mobile Pre-hospital Care. To analyze evidence of validity of the internal structure of the Inventory of ethical problems experienced by nurses in Pre-hospital Care to analyze evidence of reliability of the Instrument of type Inventory of ethical problems experienced by nurses in Mobile Pre-hospital Care. Methodology: Cross-sectional study, which brings together psychometric techniques. Operationalized in four stages: Step 1 – Procedures for construction of the items and dimensions of the IPE-APH through a scope review, literature review and online research with 19 nurses of the target population, for the identification of ethical problems experienced in the daily routine of mobile pre-hospital care; Step 2 – Procedures to identify evidence of content validity through the evaluation of 22 judges with expertise in the area; analysis of the content validity index through the CVR; Step 3 – Procedures to perform the pre-test in 32 nurses who work in the intervention of the Mobile Emergency Service, for semantic and operational adequacy of the instrument; Step 4 – Procedures for evidence of internal structure of the IPE-APH that occurred with self application of the version of the instrument, through an online questionnaire, in a sample of 250 participants. Exploratory Factor Analysis and Confirmatory Analysis were used to obtain the internal structure of the instrument. The reliability indexes used were Cronbrach’s alpha and McDonald’s omega indicators. The software SPSS, JASP, Factor and MPLUS were used to perform the statistical analysis. Results: The instrument was built with an initial version containing 55 items distributed in four dimensions, evaluated by 22 judges of the country, and through the pre-test conducted with 32 nurses from the five regions showed evidence of content validity. A critical CVR > 0.45 was used for the panel of judges and individual analysis of dimensions and items, obtaining a version with 44 items. With the evaluation of the evidence of the internal structure, an instrument composed of 29 items was verified. The IPE-APH presented a two-dimensional model structured in two factors, with satisfactory loads, good model adjustment indexes and reliability. Conclusion: An instrument of measurement was obtained with sources of validity evidence that can support the early identification of the occurrence of ethical problems, as well as dialogical and ethical meetings between nurses and quality of care and ethical decision-making in the APHM practice scenario.