Elaboração e investigação das propriedades psicométricas da Escala de Estresse Hospitalar para Crianças (EEH-C)

Abstract

During the hospitalization process, children are exposed to numerous stressors that can negatively affect their recovery and healthy development. Measuring stress levels during hospitalization is necessary to ensure the identification and efficient management of stress and its repercussions. The objective of this dissertation was to develop and investigate the psychometric properties of the Hospital Stress Scale for Children (HSS-C). The dissertation is part of the completion of the Professional Master's Degree in Health Psychology in the research line Human Development and Educational Practices in Health and is composed of three independent articles that contributed to all stages of the development of the scale. Article 1: Scoping review to identify the procedures used to assess stress in hospitalized children. The results showed that, although there is a diversity of procedures for measuring stress, many of them are unfeasible for routine use due to cost and lack of practicality. In addition, there is a gap in the literature regarding the existence of specific psychological instruments for assessing hospital stress in children. Article 2: The aim of this study was to understand the hospital experience of children and their potential stressors and protectors. Ten hospitalized children aged between six and 12 years participated in the study. The data were manually analyzed using Bardin's content analysis. The categorization of the categories listed by the researchers independently had a high degree of agreement (0.88) with p < 0.001, and six categories were found. Stressors include: admission to the hospital unit, physical discomfort, bed restriction, submission to medical/hospital procedures, limitations imposed by the clinical condition and hospital rules and routines, separation from family and friends, and deprivation of access to recreational activities. Article 3: In the third study, a scale was developed and validated to measure stress resulting from the hospitalization process of children. Content validity was verified with the participation of three professionals, with good agreement between the criteria, Intraclass Correlation Coefficient (ICC) 0.74 in criterion A, 0.67 in criterion B and 0.75 in criterion C, with p> 0.001. The adequacy of the items was tested in 10 children, resulting in adjustments in items 2, 3, 4, 22, 24, 25, 26 and 33. The validity and reliability analysis was performed with 202 children, showing good internal structure and reliability (Cronbach's alpha > 0.80). Divergent validity was confirmed with the significant correlation between the EEH-C and the Child Stress Scale (r = 0.48, p < 0.01). Preliminary results suggest that the EEH-C is a promising tool for measuring childhood hospital stress. Technical/technological product: The EEH-C consists of a presentation and application procedure that allow for age-appropriate interaction, establishing objective communication about how the child is feeling in the face of hospital stressors.