Avaliação da qualidade da atenção ao aborto: subsídios para aprimoramento do questionário Qualiaborto-Pt.

Abstract

The criminalization of abortion leads women to perform unsafe practices of terminating pregnancy, which forces them to seek health services later to deal with complications resulting from the procedure. The attention to these women, however, is based on technicality and impersonality, with reports of mistreatment and discrimination, distancing attention from that recommended by international and national standards based on scientific evidence. Evaluating this assistance is essential to identify problems and indicate measures to improve care. In Brazil, the evaluation of abortion care remains a gap in the national scientific production. In 2020, one survey “GravSus-NE” carried out in 19 public health services in three cities in the northeast evaluated the care through a structured instrument applied through face-to-face interviews with women hospitalized for abortion, spontaneous and induced. The instrument was submitted to a psychometric assessment that indicated changes. The present study aimed to propose adjustments to the QualiAborto-Pt prototype and test it after adjustments. After reviewing the scientific literature on indicators of the quality of abortion care from the perspective of women, in which items to be added to the instrument were identified, it was subjected to three pre tests. The original instrument was initially tested. After insertion of new questions and adjustments in the text of the questions poorly understood, two more pre-test steps were performed. In the three stages, 77 women with abortion were interviewed, with a similar profile to the original study. In the first stage, one item presented comprehension problems, in the second stage, 26 new items were included based on the suggestions of the psychometric analysis, literature review and expert opinion, of which seven presented problems and were readjusted; in the third testing stage, two items presented comprehension problems. The readjusted QualiAborto-Pt instrument was well evaluated and may be useful for studies evaluating abortion care. New tests are suggested to validate the instrument, so that it can be applied to larger samples and diverse populations.