Partofobia em gestantes no contexto sociocultural e clínico-obstétrico da população brasileira

• Autor(a) principal: Nunes, Rodrigo Dias
• Data de Publicação: 2020
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Universitário da Ânima (RUNA)
• Texto Completo: https://repositorio.animaeducacao.com.br/handle/ANIMA/15173
• topic: Transtornos Fóbicos; Parto Obstétrico; Diagnóstico; Inquéritos e Questionários; Estudo de Validação

Introduction: Tokophobia is pathological fear or avoidance of childbirth and affects 5% to 20% of the female population, negatively influencing the life of the pregnant woman and/or her newborn. There are still no specialized instruments in the Portuguese language and in the Brazilian cultural context, making therapeutic guidance difficult. Objectives: To develop and validate an instrument for evaluating partophobia that includes in its context of Brazilian socio-cultural and clinical-obstetric construction. Methods: A research comprised three distinct methodological protocols. Study I - Systematic review and meta-analysis of factors associated with tokophobia in pregnant women, using PICOS search strategy, according to the Preferred Reporting Items for Systematic Reviews and MetaAnalysis. Study II - Identification of perspectives of prenatal care managers and providers regarding tokophobia, based on the Standards for Reporting Qualitative Research. Study III - Development and evaluation of the psychometric properties of an instrument to measure tokophobia in pregnant women, based on the Consensus-based Standards for the Selection of Health Measurements Instruments. Results: The risk factors identified with the meta-analysis for the development of tokophobia were physical violence, anxiety or depression, lack of emotional support, multiparity, unplanned pregnancy, previous instrumental delivery, emergency cesarean section and negative birth experience. A qualitative stage identified some aspects as the key variables of tokophobia, however, or ours include perceptions of the motivation for fear of childbirth, phobic or not. As an analysis of the psychometric properties of the developed instrument, he identified Pearson's correlation coefficient of 0.766, intraclass correlation coefficient of 0.856, central dispersion between the difference and the mean of the two applications of the instrument in almost the entire sample, general Cronbach's alpha of 0.935, Kappa index of 0.444 and Pearson's correlation coefficient with the Depression, Anxiety and Stress Scale of 0.607. An exploratory factor analysis identified six factors and an item response theory demonstrated for all items. Conclusion: The Questionário de Avaliação da Partofobia developed for the Brazilian population is a reliable and valid instrument, composed of 25 items, allowing to consolidate the possibility of showing these conditions in pregnant women.