Validade e confiabilidade da Survey of Well-Being of Young Children (SWYC) para crianças de 1 à 65 meses do sertão central do Ceará

Abstract

The integral development in early childhood is ahead of a healthy life. The evaluation of child development through instruments that have gone through cross-cultural translation, that are validated and reliable for the Brazilian population is an important factor for the detection of delays in children. In Brazil, we have few options for instruments with good psychometric qualities, which becomes justifiable research on the Survey of Wellbeing of Young Children (SWYC). The SWYC is an American questionnaire directed to the parents of children from one to 65 months old, divided into three subsections: development ("Developmental milestones" and "Parental observations about social interaction-POSI"), behavior ("List of Symptoms BPSC" and "List of Pediatric Symptoms-PPSC") and family risk factors ("Questions about the Family"). It is quick and easy to apply, free of charge, has evidences of validity and reliability, being feasible for use in primary care. Objectives: To contribute to the process of cross-cultural adaptation and validation of the SWYC for Brazilian children, verifying their reliability and validity for children in Brazilian northeastern. Methodology: Initially the SWYC was applied to ten mothers in the region of Ceará, to verify the understanding of the questionnaire, in the same period an expert panel was held with nine experts. Confirming the adequacy of the translation of the questionnaire, a methodological, cross-sectional and observational study was carried out in Basic Health Units. Six hundred forty-five children up to five years old were recruited in primary care of Quixadá and SWYC was applied by the ACS, and the main researcher performed a test retest reliability with 97 mothers / caregivers. Initially the parents answered a Structured Questionnaire, prepared by the researchers themselves, to obtain data on risk factors and socioeconomic conditions of the families, and then answer to SWYC. In the present study, four items were added with simple answers, in which the parents/caretakers indicated their opinion about the questionnaire, whether they liked to respond, whether it was easy, and whether they felt constrained by any question from SWYC. At the end, an item was added for the CHAs to rate their degree of confidence in the child caregiver's responses. Results: More than half (52.9%) of the children were male, living in the urban area (83.7%), with a predominance of low-income families, D-E classes (63.7%), receiving family allowance (70%). Reliability indexes of SWYC developmental and behavioral questionnaires were high (> 0.75). Test-retest reliability indices for developmental and behavioral questionnaires as well as for individual items of SWYC family questions were high (> 0.75), however, total internal consistency ranged from 0.56-0, 97. The mean interview time for SWYC application was 18,54 (±10,11) minutes. The mothers / caregivers (95.8%) liked to respond to the questionnaire, which was considered easy to answer by 85.7% of respondents, and 79.1% of the interviewers reported a high degree of confidence regarding mothers '/ caregivers' responses. Two cutoff points, US original and Brazilian estimate, were used to identify developmental delay by the Developmental Questionnaire, with a prevalence of delay of 40% and 19.3%, respectively. Low economic level, high level of parental concern about development and day care attendance were related to the suspicion of developmental delay, which adds support to the instrument's construct validity. Conclusion: it can be concluded that SWYC, a cross-culturally adapted questionnaire for Brazilian Portuguese, is easy and quick to apply, has good acceptance by parents / caregivers, showing high test-retest reliability, acceptable level of internal consistency and evidence of validity. supports its utility in primary care to identify suspected developmental delay