Validação de um instrumento de avaliação no estudo de avaliabilidade dos Centros de Especialidades Odontológicas (CEO) do Brasil

Abstract

Evaluation can be defined as a judgment in which a value is transmitted to assist in decision making. The Evaluation Study (ES) is a pre-evaluation study that precedes the evaluation of a service. In 2004, the Brazilian National Oral Health Policy was instituted and, in order to comply with the principle of integrality, secondary oral health care was strengthened and the Dental Specialty Centers (DSC) were implemented. After 16 years of implementing this service, it is necessary to evaluate it to identify its strengths and weaknesses and thus correct possible failures and establish new goals. In 2016, the ES of DSC started in the Professional Master's Program in Public Health Dentistry of UFMG. This work corresponds to the continuation of the ES, referring to the last phase of the study, the validation process of the evaluation tool. Thus, this work aimed to validate an evaluation tool of the Dental Specialty Centers (DSC) in Brazil, through an ES. This is a methodological study with a qualitative and quantitative approach developed between 2019-2020. The conceptual alignment of the measurement and analysis matrix, previously developed in the first stage of the ES, was carried out through a consensus workshop. From the consensual matrix, the DSC's evaluation tool was developed, a questionnaire with multiple-choice evaluative questions. The questionnaire was validated in appearance and content using the Delphi Technique, according to the criteria of relevance, objectivity and clarity. Nineteen key informants / judges, experts in the study area, participated in the whole process, such as university professors, DSC professionals, PMAQ-CEO (in English, National Program for Improving Access to and Quality of Dental Specialty Center) evaluators and public service professionals. Data were analyzed qualitatively and quantitatively. For quantitative analysis, SPSS Statistics software versão 23.0 was used. To identify the degree of agreement between the experts, the Content Validity Index (CVI) was used. The questions that did not reach consensus above 75%, in at least one of the three criteria, were reformulated. The questionnaire, created from the final version of the measurement and analysis matrix, was validated through two evaluation rounds. Altogether, three questions were excluded and six others were reformulated. In the first round, the mean CVI for the criteria of clarity, objectivity and relevance were, respectively, 78.7%, 86.9% and 92.1%. In the second round, they were 88.5%, 85.0% and 91.0%. The final version of the questionnaire had 57 questions. As a technical product of this study, a document was prepared with the questionnaire and a tutorial for completing it, which is under discussion with the Health Departments of Belo Horizonte city and of Minas Gerais State, with a view to incorporating the product with the secondary oral health care services. In summary, the DSC's evaluation tool has been validated in this ES and may favor the self-assessment, planning and monitoring processes of this service's actions, with possible positive implications for the work process.