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Previous issue date: 2016-07-22 === Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq) === A atua??o das equipes multiprofissionais de sa?de ? fundamental para a preven??o e a identifica??o precoce de situa??es de viol?ncia. Entretanto, observa-se que ainda existe grande dificuldade entre os profissionais quanto ao rastreamento de abusos contra crian?a. Assim, observa-se a necessidade de um instrumento validado que possa ser utilizado por profissionais de sa?de, de maneira pr?tica e objetiva, no rastreamento de neglig?ncia e maus tratos em infantes no cotidiano da pr?tica cl?nica. Neste sentido, esta pesquisa objetivou elaborar e validar o conte?do de um instrumento para identifica??o de viol?ncia contra crian?a. Trata-se de estudo metodol?gico composto por duas etapas: a primeira foi a elabora??o do instrumento, a partir de revis?o da literatura; a segunda, de valida??o de conte?do, mediante a avalia??o do instrumento por 25 especialistas, na primeira fase, 22 ju?zes na segunda, e 21 na terceira rodada. Para an?lise, adotaram-se coeficiente Kappa ?0,61 e ?ndice de validade de conte?do ?0,75. Na primeira rodada, 39 (62,90%) apresentaram Kappa ?0,61 e ?ndice de Validade de Conte?do ?0,79. Nos demais itens (n=23; 37,10%), foram encontrados baixos ?ndices de concord?ncia Kappa e, por isso, receberam reformula??es. O instrumento recebeu avalia??o geral de Kappa de 0,62 e ?ndice de Validade de Conte?do de 0,85, que s?o considerados bons resultados. No que diz respeito ? segunda rodada, ap?s as altera??es sugeridas pelos especialistas, o instrumentou passou a possuir 50 itens. Destes, 49 apresentaram ?ndice de Validade de Conte?do entre 0,81 e 1,00, e Kappa entre 0,61 e 0,99. Apenas um item teve Kappa >0,61 (K=0,50; IVC=0,81). A insufici?ncia de concord?ncia entre os especialistas ocasionou na exclus?o dele, em uma terceira rodada. O instrumento foi avaliado de forma positiva, obtendo Kappa igual a 0,85 e ?ndice de Validade de Conte?do de 0,95, na segunda fase Delphi. Por fim, na ?ltima etapa, os ?ndices gerais de Kappa e de IVC do instrumento foram 0,98 e 0,99, respectivamente O instrumento apresentou ?ndice de validade de conte?do satisfat?rio e pode ser utilizado para identificar os sinais de suspeita de viol?ncia e auxiliar os profissionais de sa?de na assist?ncia ? crian?a. === The role of multidisciplinary health teams is key for the early prevention and identification of situations of violence. However, there is still great difficulty among professionals regarding the tracking of child abuse. Thus, there is need for a validated instrument that can be used by health professionals in a practical and objective way in the tracking of neglect and ill-treatment in infants in routine clinical practice. The aim of this study was to develop and validate the contents of an instrument for identifying violence against children. This is a methodological study consisting of two stages: the first was the development of the instrument from the literature review; the second was the content validation with evaluation of the instrument by 25 experts in the first phase, 22 in the second, and 21 in the third phase. In order to promote a multidimensional investigation of violence through a comprehensive understanding of human beings and contextualized in the phenomenon, was used the bio-ecological theory of human development. In this sense, the objective of the questionnaire is to track signs of abuse and ill-treatment of the four natures of violence - physical, psychological, sexual, neglect/abandonment - by means of the following dimensions: behavioral signs of the child; signs of physical violence; Munchausen syndrome by proxy (induction of symptoms and diseases in children by parents/caregivers); signs of sexual violence; and signs of neglect. For analysis, were adopted Kappa coefficient ?0.61 and content validity index (CVI) ?0.75. In the first round, of the 62 items, 39 (62.90%) showed Kappa ?0.61 and content validity index ?0.79. In the others (n = 23; 37.10%) were found low Kappa indexes, hence there were reformulations. The instrument received Kappa overall evaluation of 0.62, and content validity index of 0.85, which are considered good results. In the second round after the adjustments suggested by the experts, the instrument included 50 items in total. Of these, 49 had content validity index between 0.81 and 1.00, and Kappa between 0.61 and 0.99. Only an item had Kappa >0.61 (K = 0.50; CVI = 0.81). The lack of agreement among experts resulted in the exclusion of this item in a third round. The instrument was evaluated positively, reaching Kappa of 0.85, and content validity index of 0.95 in the second Delphi phase. In the last phase, the overall indices of Kappa and content validity of the instrument were 0.98 and 0.99, respectively. The instrument presented satisfactory content validity index and can be used to identify signs of suspected violence and help health professionals in child care.
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