Construção e validação de um cenário de simulação realística sobre identificação e manejo da violência obstétrica

Abstract

Introduction: The term obstetric violence, is currently used to typify and group together various forms of violence, aggression and omissions practiced during pregnancy, childbirth and the puerperium, including abortion. Considering that obstetric violence is a relevant public health problem, there is a need to address this issue during the training of health professionals, not just in a theoretical and occasional way, but by putting them in practical situations. Realistic simulation emerges in this scenario as a powerful tool for training health academics who are more aware and prepared to identify and combat this problem. Objective: Building and contentvalidating a realistic simulation scenario on obstetric violence for nursing students. Materials and Method: Methodological study, carried out between April 2023 and December 2024 in two phases: construction of a clinical simulation scenario on teaching the identification and management of obstetric violence to undergraduate nursing students, guided by the National League Nursing Jeffries Simulation Theory model, and content validation of this scenario. The statistical analysis carried out in this study was based on a variety of statistical methods, including descriptive measures and hypothesis testing, to describe the characteristics of the variables and provide summary information on the data collected. To analyze the data, the Content Validity Index (CVI) and the Content Validity Coefficient (CVC) were calculated, and to verify the significance of the CVC, a one-sided t-test was used comparing the observed value of the CVC with the reference value of 0.8. In addition, the binomial exact test was used to assess the hypothesis of non-inferiority, with a predefined cut-off value of 0.8. All the analyses were carried out using version 4.4.2 of the R software. A significance level of 5% (α=0.05) was adopted to reject the null hypotheses. Results: A simulated clinical scenario on the identification and management of obstetric violence was constructed and subjected to a validation process. Initially, nine judges evaluated elements such as the preparation of the participants, the conduct of the debriefing, the vignette, the script and the actors' actions. Based on the judges' suggestions, the scenario was improved and re-evaluated in a second round, in which one judge did not take part. The results of the second round showed a high degree of consensus among the judges in relation to all the items assessed, with the content validity and consensus indices reaching the established values, which confirms the quality and relevance of the scenario for simulation teaching. Conclusion: The results of this study show that the scenario constructed is viable for teaching the subject in nursing courses. It is hoped that the product of this research will be useful in reinforcing the importance of clinical simulation as a teaching strategy in training health professionals who are better prepared to identify and intervene in cases of obstetric violence.