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TECNOLOGIAS EDUCATIVAS PARA AUTOEFICÁCIA DA AMAMENTAÇÃO E PRÁTICA DO ALEITAMENTO MATERNO EXCLUSIVO: SCOPING RE= VIEW

EDUCATIONAL TECHNOLOGIES FOR SELF-EFFI= CACY FOR BREASTFEEDING AND PRACTICE OF EXCLUSIVE BREASTFEEDING=

Thayse Gabrielle Via= na Lima[1] * Maria Clara Barradas Leão[2] * Polyana Norberta Mendes<= span style=3D'font-size:12.0pt;line-height:107%;font-family:"Times New Roman",se= rif; mso-fareast-font-family:"Times New Roman";color:black;mso-fareast-language: PT-BR'>[3]* Carla Danielle Araújo Feitosa<= span style=3D'font-size:12.0pt;line-height:107%;font-family:"Times New Roman",se= rif; mso-fareast-font-family:"Times New Roman";color:black;mso-fareast-language: PT-BR'>[4]

RESUMO=

Objetivo: identificar na literatura científica as tecnologias educativas para autoeficácia para amamentar e prática do aleitamento materno exclusivo de mulheres adultas. Método: é uma revisão de escopo reali= zada em quatro bases de dados indexadas na Biblioteca Virtual em Saúde e na Nati= onal Library of Medicine/ Pubmed. A análise dos resultados ocorreu na forma descritiva. Resultados: Foram incluídos 16 estudos, publicados em periódicos nacionais e internacionais, com predomínio de estudos metodológi= cos de validação das tecnologias de educação em saúde. Os tipos de tecnologia são: folder, cartilhas, flip chart, litera= tura de cordel, vídeos e álbum seriado. Todas as tecnologias se mostraram viáveis, no entanto, deve-se atentar ao contexto em que estão sendo aplicad= as Conclusão: A grande maioria dos estudos foram de construção e validação da tecnologia = que comprovou a eficácia do uso e ressaltou alternativas que potencializem o manejo da tecnologia para autoeficácia materna para amamentar.

Palavras chave: Aleitamento Materno; Tecnologia Educacional; Cuid= ados de Enfermagem.

 

ABSTRACT

Objective: To identify, in the scientific literature, educational technologies= for self-efficacy for breastfeeding and the practice of exclusive breastfeeding= for adult women. Method: It is a scope review carried out in the LILACS, BDENF, MEDLINE and IBECS databases via the Biblioteca Virtual da Saúde (BVS) and PubMed. The analysis of the results took place in a descriptive way. Results: 16 studies were included, published in national and international journals, with a predominance of methodological validation studies of health education technologies. The types of technology are: folder, booklets, flip chart, co= rdel literature, videos and serial album. All technologies proved to be viable, = however, attention should be paid to the context in which they are being applied. Conclusion: The vast majority of studies were of construction and validation of the tec= hnology that proved the effectiveness of its use and highlighted alternatives that enhance the management of the technology for maternal self-efficacy in breastfeeding.

Keywords: Breastfeeding; Educational Technology; Nursing Care.

 


INTRODUÇÃO=

 

O aleitamento materno é uma estratégia de vínculo, afeto, proteção e nutrição para a cria= nça e uma eficaz intervenção para a redução nos indicadores de morbimortalidade= infantil. (1) Destaca-se para este fim, o aleitamento materno exclusivo como aq= uele composto apenas de leite materno e, quando necessário, medicamentos, sendo indicado até os seis meses de idade.(2)

A amamentação = traz benefícios a curto e longo prazo para a criança, parturiente e para a famíl= ia. O contato pele a pele do bebê com a mãe auxilia= na formação do vínculo, reduz o risco de infecções, além de reduzir os riscos maternos de hemorragia pós-parto e ser um importante fator de proteção para= o câncer de mama. (2)  Já = para a família e a sociedade, a criança em aleitamento materno exclusivo tem menos chances de ter problemas de saúde, que por sua vez terá a necessidade de menos atendimentos médicos, hospitalizações e gastos com medicamentos devido a problemas de saúde. (3)

Mesmo com tant= os benefícios, a taxa do aleitamento materno exclusivo em menores até os seis meses em nível mundial é cerca de 39%. Sendo no Brasil a prevalência de 36%= . (4) As estatísticas dão visibilidade a problemática, amamentar não é = algo fácil para muitas mulheres. Além da questão biológica, o ato de amamentar e= stá atrelado a diversos fatores, com diferentes efeitos sobre a dimensão psíqui= ca e social das partes envolvidas. (5)

O aleitamento materno encontra algumas barreiras, como a volta da mulher ao trabalho, fat= ores psicossociais como a insegurança e o medo, além da depressão pós-parto e separação clínica- hospitalar entre a mãe e o bebê. (6-9) Nesse aspecto, uma rede de cuidado e atenção direcionado a mulher desde o pré-nat= al é uma ferramenta que pode contribuir de forma positiva para a autoeficácia do= ato de amamentar.

Diante disso os profissionais de saúde devem sempre buscar inovações que se aproximem dos problemas identificados, a fim de criar ferramentas que possam contribuir c= om a superação dos impasses, desempenhando ações de promoção da saúde desde o pr= é-natal até a visita puerperal, utilizando-se das consultas para gerar oportunidade= s de incentivar a prática do aleitamento esclarecendo dúvidas e benefícios de tal prática. (10)

O enfermeiro torna-se facilitador para a adaptação da mulher a esse processo, intervindo quando for necessário, afim de garantir que a mãe esteja em boas condições = de saúde, física e emocionais, utilizando como ferramenta de ajuda as tecnolog= ias educacionais ao seu favor, a fim de repercutir de forma positiva nessa prát= ica tão importante que é o aleitamento materno. (11)

As tecnologias educativas em saúde são resultantes dos conhecimentos científicos para a produção de bens materiais, ou não, usados durante a intervenção em casos p= ráticos, buscando a resolução de problemas humanos e estruturais relacionados a saúd= e. (12)

Neste contexto= , o objetivo do estudo é identificar na literatura científica as tecnologias educativas = para autoeficácia da amamentação e prática do aleitamento materno exclusivo de mulheres adultas.

 

MÉTODO

Trata-se de um= a revisão de escopo (scoping review).  Este estudo é uma revisão de escopo (= scoping review), que buscou mapear, rapidamente, os conceitos-chave, as princip= ais fontes e os tipos de evidências disponíveis, principalmente, para estudos em que o material é de difícil localização, encontrando, assim, brechas nos estudos. (13) Cinco etapas foram percorridas: identificação da questão de pesquisa; busca por estudos relevantes; seleção de estudos; extr= ação dos dados e agrupamento, resumo e apresentação dos resultados. (13)  O estudo foi conduzido em cinco etapa= s. O Preferred Reporting Items for Systematic Reviews and Meta-Analyz= es extensions for Scoping Reviews (PRISMA-ScR) foi usado para guiar e repo= rtar os itens essenciais desta revisão. (14)

A construção da questão de pesquisa baseou-se na estratégia PCC  (P – população; C –Conceito; C - contexto), em que População (P): Mulheres adultas em aleitamento materno exclus= ivo; Conceito (C): Tecnologias educativas= ; Contexto (C): Cuidado de enfermagem p= ara autoeficácia materna.(15) No desenvolvimento de= ssa estratégia, considerou-se a seguinte pergunta: Quais as tecnologias educati= vas utilizadas pelo Enfermeiro para a autoeficácia da amamentação e prática do aleitamento materno exclusivo?

As buscas foram realizadas nas bases de dados LILACS, BDENF, MEDLINE e IBECS via Biblioteca Virtual da Saúde (BVS) e PubMed, em janeiro de 2021. Além da busca secundár= ia no Google Scholar e análise da lista de referências dos estudos primários incluídos, com vistas a identificar outros estudos relevantes que pudessem = ser recuperados. O processo de busca, na literatura, é ilustrado utilizando-se o fluxograma PRISMA. (16)

Os descritores controlados utilizados foram: P (Aleitamento Materno, Breast Feeding);  C(Tecnologia Educacional, Materiais de Ensino, Estudo de Validação, Educational Technology, Teaching Materials, Validation St= udy);  C (Autoeficácia, Enfermagem, Self Efficacy, Nursi= ng ). Os descritores não controlados foram: P (Aleitamento materno exclusivo; amamentação); C (Material de Ensino, Estudos de Validação= ).

A estratégia p= ara busca dos estudos atendeu as especificidades de cada base e foi composta pe= la combinação de descritores controlados (indexados nas respectivas bases de dados) e descritores não controlados. Os descritores controlados foram selecionados por meio dos Descritores em Ciências da Saúde (DeCS) e Medical  Subject  Headings  (MeSH Terms). De modo a ampliar a estratégia de busca, realizou-se a combinação dos descritores controlados e não controlados, por intermédio de operadores booleanos AND e OR. As expressões de busca resultantes foram apr= esentadas no Quadro 1.


 

Quadro 1- Expressões de busca obtidas nas bases de dados. Teresina, PI, Brasil, 2021<= o:p>

Bases de dados

Expressões de busca=

LILACS, BDENF, MEDL= INE e IBECS via BVS

(("Aleitamento Materno") OR ("aleitamento materno exclusivo") OR ("B= reast Feeding")) AND (("Tecnologia Educacional") OR ("Educational Technology")) AND ((autoeficácia) OR (enfermagem)= OR ("Self Efficacy nursing"))=

(("Aleitamento= Materno") OR ("aleitamento materno exclusivo") OR ("Breast Feeding")) AND ((materiais de ensino) OR (material de ensino) OR (te= aching materials)) AND ((autoeficácia) OR (enfermagem) OR ("Self Efficacy nursing"))

(("Aleitamento Materno") OR ("aleitamento materno exclusivo") OR ("B= reast Feeding")) AND (("Estudo de Validação") OR ("Estudos = de Validação") OR ("Validation Study")) AND ((autoeficácia) OR (enfermagem) OR ("Self Efficacy nursing"))

(("Aleitamento Materno") OR ("aleitamento materno exclusivo") OR ("Breast Feeding")) AND (("Tecnologia Educacional") OR ("Materiais de Ensino") OR ("Estudo de Validação")) A= ND ((autoeficácia) OR (enfermagem) OR ("Self Efficacy nursing"))

PUBMED

(("Breast Feeding"[MeSH Terms]) AND ((("Educational Technology"[MeSH Terms]) OR ("Teaching Materials"[MeSH Terms])) OR ("Valida= tion Study"[MeSH Terms]))) AND (("Self Efficacy"[MeSH Terms]) OR (Nursing[MeSH Terms]))=

Fonte: Autoria das pesquisadoras. Teresina-PI, 2021

 


Os critérios de inclusão foram estudos nos idiomas português, espanhol e inglês, que aborda= m a temática de interesse e publicados nos últimos dez anos. Optou-se por esse recorte temporal para resgatar as produções científicas mais recentes. Foram excluídos artigos de revisão de literatura, editoriais, teses, dissertações, resumos de congresso e estudos primários que tenha como participante adoles= centes. Optou-se por reunir estudos primários com foco nas intervenções, tecnologia= s e boas práticas em saúde, de modo a obter uma síntese das evidências validada= s e testadas que possam ser replicadas. Não foram identificados outros estudos = de revisão durante a seleção da amostra. Em razão da complexidade que envolve a gestação na adolescência, e suas implicações sociais, emocionais, os estudo= s com adolescentes não foram incluídos.  =

Inicialmente, = realizou-se a leitura dos títulos e resumos, onde foram excluídos os estudos duplicados= e os que não atendiam aos critérios de inclusão. Em sequência a leitura na íntegra dos artigos.

Após a leitura= na íntegra, realizou-se a extração dos dados, mediante instrumento elaborado p= elos autores, que incluía informações quanto ao autor principal, periódico, ano = de publicação, país, base de dados, desenho metodológico, amostra, instrumento= s de coleta de dados utilizados, desfechos e intervenção. Para extração dos dado= s, elaborou-se um quadro, por meio do Microsoft Word®, para sintetizar os dados dos estudos incluídos.

Os estudos for= am selecionados e identificados por dois revisores (T e M.A), que realizaram a= busca de forma independente. As divergências entre revisores foram avaliadas por = meio de discussão com terceiro revisor (P.N.M).

Os dados foram analisados, descritivamente, por dois revisores e validados por todos os autores. Quadr= os e temas analíticos foram elaborados para apresentar os principais achados des= ta revisão.

 

RESULTADO<= /span>

 

 Identificaram-se 377 publicaçõ= es, das quais, após aplicação dos critérios de inclusão e exclusão, foram selecionados para a amostra desta revisão 16 artigos, sendo 3 na MEDLINE, 5= na LILACS, 5 na BDENF e 3 na PUBMED. Não foram incluídos outros estudos após o processo de busca manual, conforme Figura 1.


 

 

 

Figura 1 – Fluxograma de seleção dos resultados elaborados a partir da recomendação PRISMA, Teresina, PI, Brasil, 2021

 

=    Fonte: Os autores             

=  <= /o:p>


Analisando-se a amostra de artigos incorporados nesta revisão, os estudos foram, em sua maioria, desenvolvidos Brasil  (n= =3D11, 68,75%) ,seguidos dos Países da Europa (n=3D2, 12,5%), África(n=3D1, 6,25%), Singap= ura(n=3D1, 6,25%) e Índia(n=3D1, 6,25%). Quanto ao id= ioma, os estudos foram publicados em português (n=3D11, 68,75%) e inglês (n=3D5, 31,= 25%).

Devido à atualidade do tema abordado, todas as publicações são datadas dos anos de 2= 020 (n=3D2, 12,75%), 2019(n=3D2, 12,75%), 2018(n=3D2, 12,75%), 2017(n=3D1, 6,25= %), 2015(n=3D2, 12,76%), 2013(n=3D4, 25%), 2012(n=3D1, 6,25%), 2011(n=3D2, 12,75%).

Houve presença= de periódicos com diferentes especialidades médicas, destacando-se as revistas= da enfermagem: Acta Paul Enferm (n=3D2, 12,5%), co= mo também foram identificas publicações nas revistas  Enferm Ufpe On Line (n=3D2, 12,5%), Rev = Esc Enferm USP (n=3D2, 12,5%), Rev. Latino-Am. Enfermagem onl= ine  (n=3D1, 6,25%), Texto Contexto Enf= erm (n=3D2, 12,5 e Rev Min Enferm(n=3D1, 6,25%) Revi= sta RENE (n=3D1, 6,25%)  . Como cadernos de saúde pública: Revista  Conecte-se BMC Health Serv. Res (n= =3D1, 6,25%), Revista Community Pract (n=3D1, 6,25%). E as revistas temáticas materno-inf= antil: Revista J Matern Fetal Neonatal Med (n=3D1, 6,25%), Revista Meternal and ch= illd nutrition (n=3D1, 6,25%), Revista Pract Midwife (n=3D1, 6,25%), desta forma, n= ão se limitando apenas à ginecologia e obstetrícia, o que demonstra a importância= de se abordar a temática por variadas áreas. As características dos estudos incluídos encontram-se detalhadas no Quadro 2.

No que concern= e ao delineamento metodológico empregado nos registros incluídos neste estudo, os desenhos concentraram-se em: estudo metodológico (n:6 ;37,5%), estudo de intervenção (n:3; 18,75%), estudo de avaliação (n:2 ;12,5%), relato de experiência (n:2; 12,5%), estudo de validação (n:1 ;6,25%), estudo experime= ntal (n:1, 6,25%), estudo descritivo (n:1 ;6,25%). Dos 16 estudos analisados apenas um (2,0%) fundamentou a construção da tecnolog= ia educacional em um referencial teórico, sendo ele “o modelo da psicometria” A população dos estudos, em sua maioria eram as puérperas (n:7; 43,75%) e ape= nas (n: 6,25 %) as gestantes no terceiro trimestre de gestação.


 

Quadro 2 – Registros incluídos pela revisão de escopo, segundo título, periódico e p= aís de origem. Teresina, PI, Brasil, 2021.

Título do artigo

Título abreviado do periódico

País

Ano

Meeting The Challenge Of Delivering High-Quality Breastfeeding Training For All.<= o:p>

Pract Midwife

Europa

2011

Discussion Of The Health Benefits Of Breastfeeding Within Small Groups.

Community Pract

Europa

2011

Validação De Álbum Seriado Para Promoção Do Aleitamento Materno

Acta Paul Enferm.

Brasil

2012

Álbum Seriado Sobre Aleitamento Materno: Intervenção Educativa Com Nutrizes No Pós-Parto Imediato

Rev Enferm Ufpe On Line

Brasil

2013

Validação de um álbum seriado para promoção da autoeficácia em amamentar.

Acta paul. enferm

Brasil

2013

Construção e validação de manual educativo para a promoção do aleitamento materno.

Rev. RENE

Brasil

2013

Avaliação De Tecnologia Educativa Na Modalidade Literatura De Cordel Sobre Amamenta= ção

Rev Esc Enferm USP

Brasil

2013

Estudo experimental de uma intervenção educativa para promov= er a autoeficácia materna na amamentação.

Revista latino-americana de enfermagem (Online)

Brasil

2015

Efficacy of e‐technologies in improving breastfeeding outcomes among perinat= al women: a meta‐analysis

Meternal and cjild nutrition

Singapura

2015

Postnatal counseling on exclusive breastfeeding using video - experience from a ter= tiary care teaching hospital, south India

J Matern Fetal Neonatal Med

India

2017

Efeitos De Uma Tecnologia Educativa Na Autoeficácia Para Amamentar E Na Prática Do Aleitamento Materno Exclusivo

Rev Esc Enferm USP

Brasil

2018

Tecnologia assistiva sobre amamentação para pessoas com deficiência visual: comparaç= ão Brasil e Portugal

Texto & contexto enferm

Brasil

2018

Tecnologia educacional para empoderamento materno na autoeficacia em amamentar.=

Rev. enferm. UFPE on line

Brasil

2019

The Philani MOVIE study: a clusterrandomized controlled trial of a mobile vid= eo entertainment-education intervention to promote exclusive breastfeeding in South Africa

Health Services Research

Africa

2019

Construção E Validação De Cartilha Educativa Para Sala De Apoio À Amamentação

Rev Min Enferm

Brasil

2020

Construção E Validação De Cartilha Educativa Para Dispositivos Móveis Sobre Aleitame= nto Materno

Texto & contexto enferm

Brasil

2020

Fonte: Os autores


O Quadro 3 apresenta os tipos de tecnologias educacionais desenvolvidas para a promoçã= o da autoeficácia para o aleitamento materno exclusivo, além dos objetivos e desfecho de cada estudo.



Quadro 3 – Síntese dos artigos da revisão, segundo objetivo do estudo, tecnologia educacional e desfecho. Teresina, PI, Brasil, 2021

Categoria

(Tecnologia educacional)

Autor, ano

País

Objetivo

Desfecho

Álbum seriado

JAVORSKI et al., 2018 (16)

 Brasil

Avaliar os efeitos do uso de um álbum seriado sobre a autoeficácia materna na amamentação e suas repercussões no aleitamento materno exclusivo (AME) nos primeiros 2 meses de vida da criança.

O álbum seriado funcionou de forma positiva no índice de autoeficácia do aleitamento materno exclusivo.

Cartilha educativa para dispositivos moveis.

MELLO et al., 2020(17)

 Brasil

Validar uma cartilha educativa para uso em dispositivos móveis sobre aleitamento materno para familiares, cuidadores de recém-nascidos e lactentes.

A cartilha educativa foi validada, e teve índices satisfatórios, sendo considerada uma tecnologia de apoio aos profissionais de saúde a fim de reforçar ensinamentos sobre a amamentação.

Cartilha educativa para a sala de apoio à amamentação

LIMA et al., 2020(18)

Brasil

Construir e validar uma cartilha educativa para a sala de apoio à amamentação.=

A cartilha foi validada e teve índices satisfatórios, podendo ser utilizada pelos profissionais de saúde e pelos familiares, cuidadores de recém-nasc= idos e lactentes visando à promoção do aleitamento materno e, consequentemente= , à diminuição dos índices de desmame precoce.

Literatura de cordel

DE OLIVEIRA et al., 2013(19)

Brasil

Descrever o processo de avaliação de tecnologia educativa, com relação aos aspectos= de conteúdo e literatura de cordel sobre amamentação.

Observaram-se resultados positivos, pois a referida tecnologia foi construída e avaliad= a no polo teórico quanto ao seu conteúdo e no formato de literatura de cordel, segundo o Modelo da Psicometria

Álbum seriado

DODT et al., 2012(20)

Brasil

Validar um álbum seriado a respeito da autoeficácia em aleitamento materno quanto= ao conteúdo e à aparência

O álbum seriado pode ser utilizado nos diversos campos de atuação da enferm= agem, inclusive no alojamento conjunto.

Álbum seriado

DODT et al., 2013 (21)

Brasil

Relatar a experiência da utilização de um álbum seriado sobre amamentação, em uma intervenção educativa com nutrizes.

Facilitou a comunicação entre profissional de saúde e a nutriz, favorecendo o proce= sso de aprendizagem a partir das necessidades da nutriz.

Ferramenta chamada Breastfeeding Treasure= Box

CLARCKSON, DU PLESSIS et al.,2011 (22)

Europa

Examinar a utilidade de uma sessão de gru= po interativa projetada para explorar os benefícios da amamentação para a sa= úde.

Há potencial para um maior desenvolviment= o da ferramenta para refletir os benefícios de saúde específicos identificados pela Iniciativa Amiga da Criança, embora as mensagens sobre os benefícios= da amamentação ainda precisem ser reforçadas em todas as oportunidades usando outros recursos.

Livro de exercícios e DVD

WALLACE et al., 2011 (23)

Europa

Oferecer treinamento em amamentação de alta qualidade para todos

 

Os participantes acolheram bem o programa= como uma forma de garantir que a equipe usasse a prática baseada em evidências= de forma consistente

Flip-chart

DODT et al., 2015 (24)

 

 

Brasil

Construir, validar e avaliar uma intervenção educacional usando o = flip chart intitulado "Eu posso amamentar meu filho"

A intervenção foi benéfica porque as mães= do grupo de intervenção apresentaram maiores escores de autoeficácição, mais mães continuaram aleitamento materno e as mães tiveram maior duração de a= leitamento materno exclusivo, tanto no momento da alta hospitalar quanto no segundo = mês pós-parto, com associações estatisticamente significativas.

Literatura de cordel

DE OLIVEIRA et al., 2018 (25)

Brasil

Descrever o resultado da validação aparente e de conteúdo da tecnologia assistiva "Amamentação em ação", junto a pessoas com deficiência visual de duas realidades, de Portugal e Brasil.

Houve excelentes avaliações com alguns tópicos analisados diferentemente nos do= is países. Os participantes gostaram da Tecnologia Assistiva, mas para validar utilizando o sintetizador, precisou-se de tempo, e mesmo ass= im, muitas vezes, foi complexo. 

Manual educativo

COSTA et al, 2013 (26)

Brasil

Construir e validar manual educativo para promo= ção do aleitamento materno.

O uso deste manual tanto durante o período pré-natal quanto puerp= eral facilitará a prática da enfermagem

Flip-chart

RODRIGUES et al, 2013 (27)

Brasil

Validar o conteúdo e a aparência de um flipchart intitulado "Eu posso amamentar meu filho" entre mulheres puerpe= rais internadas em uma ala de obstetrícia.

Todas as ilustrações foram consideradas claras e abrangentes. No entanto, o quadro 6 teve uma relevância de 85,7%= em comparação com 90% a 100% para as demais fotos.

Folder explicativo

FRANCO et al, 2019 (28)

Brasil

Descrever a experiência da elaboração e aplicaç= ão de uma tecnologia educativa como forma de promover a autoeficácia materna em amamentar no período pós-parto.<= /span>

Propiciou-se, por meio da tecnologia educativa, um ambiente favorável para o = empoderamento das puérperas. Utilizou-se o folder "Toda mulher é capaz de amamentar!", que favoreceu a interatividade, o conhecimento&nbs= p;e o debate a respeito da autoeficácia materna para amamentar, criando um ambiente propício ao diálogo acerca = de fatores que podem intervir negativamente para a instituição e manutenção do aleitamento materno no período pós-parto.

Vídeo educativo

ADHISIVAM et al, 2017 (29)

Índia

Avaliar o impacto de um programa de educação em saúde baseado em v= ídeo pós-natal na promoção do aleitamento materno exclusivo entre as mães prim= íparas.

Melhorou o conhecimento sobre o aleitamen= to materno exclusivo entre as mães primíparas no pós-natal, melhor do que ap= enas com o aconselhamento de lactação de rotina.

Vídeo educativo

ADAM et al, 2019 (30)

South África

Medir o efeito causal de uma intervenção baseada em vídeo, desenvolvida usando princípios de design centrados no homem, sobre comportamentos de alimentação infantil em comunidades sul-africanas sem recursos.

Destinado a apoiar a capacitação para uma "próxima geração" de educação em saúde digital, materno-infanti= l, uma geração de ferramentas educacionais inovadoras, enraizadas nas necessidades e contextos dos públicos que pretendem atender.

Vídeo educativo

LAU et al, 2016 (31)

Singapura

Sintetizar o melhor das evidências disponíveis, realizando uma meta‐análise para avaliar se as tecnologias eletrôni= cas tiveram algum efeito na melhoria dos desfechos de aleitamento materno ent= re as mulheres perinatais.

Melhorou o conhecimento sobre o aleitamen= to materno exclusivo entre as mães primiparas.

Fonte: Os autores


 DISCUSSÃO

 

Esta revisão da literatura revelou que= as tecnologias desenvolvidas para a educação em saúde para a autoeficácia do aleitamento materno foram, principalmente, vídeos (29-31), álbuns seriados (16, 20-21), cartilhas educativas (17-18) e folders (28). Mas identificaram-se ainda outros tipos de tecnolo= gia. Diante disso é possível perceber que o ato de amamentar não é tão simples, o que estimula alguns pesquisadores na busca por pesquisas e métodos para aux= iliar no aleitamento de forma desenvolta e segura.

O desenvolvimento de tecnologias educativas estruturadas a partir de um referencial teórico, possibilita o u= so de princípios e teorias que dão suporte e alcance ao objetivo educacional q= ue se espera. Dentre os estudos analisados, foi percebido que apenas um dos tr= abalhos descreve o referencial teórico utilizado: o modelo da psicometria. A psicom= etria representa uma forma importante de avaliação objetiva dos fenômenos psicológicos que são estruturados no desenvolvimento de pesquisas clínicas desde o século XIX. (32) Desta forma, pontua-se a necessidade de= os estudos descreverem com clareza o referencial teórico que norteia o desenvolvimento do método.

Todos os estudos incluídos nesta revis= ão utilizaram ao menos um tipo de tecnologia educacional como ferramenta para = o método de cuidado educativo com mães que passavam ou passarão pelo processo de amamentação, com objetivo de fomentar o aprendizado em saúde de forma signi= ficativa.

Na categoria cartilhas educativas, dois artigos descreveram o uso dessa tecnologia. (17-18) Um dos estud= os relatou sobre a importância da cartilha para a sala de apoio a amamentação.= O trabalho é um dos motivos que mais leva ao desmame precoce, desta forma é importante a sala de apoio a amamentação no ambiente de trabalho, assim com= o, a cartilha como forma de esclarecer possíveis dúvidas e realçar o incentivo a esta prática tão importante na vida da criança e da mãe. (18) O outro estudo, abordou a importância da cartilha educativa para dispositivos= moveis. O estudo foi validado tanto por juízes como pelo público-alvo e aprovado co= mo um tema relevante, visto que a tecnologia, com destaque para os dispositivos móveis, são um dos meios em que mais se tem a procura por informações.= (17)

Em comparação a outros estudos que tiv= eram também como instrumento a cartilha educativa, percebeu-se que esse modelo é autoexplicativo, devido a presença de imagens, o que favorece o processo ensino-aprendizagem, podendo ser utilizada por diversos profissionais de sa= úde, não somente o enfermeiro. Dessa forma configura-se um material simples e de baixo custo, na qual tem mostrado resultados. (33)

Tem-se o manual educativo para o aleitamento materno. Ele foi considerado pertinente e de alta relevância, e= por possuir muitas ilustrações, chamou ainda mais a atenção do público. O manual apresentava as dúvidas mais comuns entre as mulheres, desta forma, colabora= com o papel dos enfermeiros diante da necessidade de proporcionar as nutrizes autoeficácia para amamentar. (26) A ferramenta se torna lúdica, = pois é visivelmente ilustrativa e expõe de forma detalhada todos os aspectos e dificuldades que as mães em aleitamento materno experienciam. É de suma importância a criação de métodos que facilitem a autoeficácia na amamentaçã= o, melhorando assim os índices de aleitamento materno exclusivo até os seis me= ses de idade.

Outra categoria é o álbum seriado. A construção do álbum seriado “eu posso amamentar meu filho” foi descrita em = três dos trabalhos que compõe a amostra do presente estudo, sendo um relato de experiência, uma pesquisa metodológica, e o estudo de validação. (20,2= 1,27) Ambos os artigos abordaram o álbum seriado como uma tecnologia de fácil ace= sso e compreensão. Ele é visto como algo com conteúdo atraente, pois é composto= de ilustrações e pontos importantes sobre a temática, sendo esclarecedor de mu= itas dúvidas e um facilitador do diálogo educativo entre as nutrizes.=

Destaca-se também o uso do folder expl= icativo com o objetivo de promover a autoeficácia materna em amamentar no período pós-parto, o folder foi utilizado de forma individual por mulheres que recentemente haviam começado a amamentação e que estavam em alojamento conjunto. O desfecho do uso foi positivo, pois criou um ambiente favorável para o empoderamento das puérperas, além de abrir espaço para o debate a respeito da autoeficácia materna p= ara amamentar. (28) O uso de diversos tipos de tecnologia pode beneficiar a nutriz de forma a ter uma variedade de opções e ser muito mais fácil o acesso a informação, portanto o uso do folder por exemplo, juntamen= te com o uso de vídeos educativos podem trazer essa confiança de forma mais am= pla.

O modelo de tecnologia flip-chart foi descrito em dois estudos. A tecnologia foi eficaz, pois identificou-se que = as mães participantes obtiveram pontuações mais elevadas de autoeficácia, cont= inuaram a amamentar, além de apresentar uma duradoura amamentação exclusiva, tanto = no momento da alta hospitalar como no segundo mês pós-parto. (24,27)

Na categoria Literatura de Cordel, um = dos estudos procurou descrever a avaliação do uso da literatura de cordel sobre amamentação, dentre mulheres que amamentam, encontrando resultados positivo= s, como seu recurso lúdico, papel como ferramenta didática, além de um meio de comunicação em saúde e facilitador do processo ensino-aprendizagem. (3= 4) Foi visto que o cordel pode ser uma tecnologia que pode proporcionar o vínc= ulo dessas mães, de forma a fazerem a leitura em conjunto e dessa forma obter informações necessárias, no entanto a tecnologia deve ser avaliada quanto a questão do tamanho, não devendo ser tão longa. (19)  

Outro estudo também optou pelo modelo = de literatura de cordel, no contexto de participantes com deficiência visual, homens e mulheres, de diferentes faixas etárias e escolaridade com a finali= dade de avaliar o conhecimento dessas pessoas acerca do aleitamento materno. Deu= -se com o uso de computadores como sintetizador de voz e sistema de leitura de tela do computador para cegos, e se tratou de um estudo de validação, cujo objetivou era descrever o resultado da validação aparente e de conteúdo da&= nbsp;tecnologia assistiva. Obteve-se resultados positivos, pois os participantes do estudo = demonstraram gostar do método do estudo, resultando em excelentes avaliações. No entanto relata-se a necessidade de mais tempo para validar-se o estudo efetivamente= . (19)

Na África do Sul, as taxas de aleitame= nto materno exclusivo permanecem baixas e a promoção do aleitamento materno é u= ma prioridade nacional para a saúde, desta forma o vídeo se mostrou uma alternativa eficaz neste contexto. Pôde-se inferir que o grupo que teve amb= as as metodologias de suporte para o aleitamento, tiveram resultados satisfató= rios na autoeficácia para o aleitamento materno exclusivo até os seis meses de i= dade. O vídeo foi pensado com uma intervenção de entretenimento e desenvolvido baseado nos princípios de designer centrado no = ser humano e comunidade. Ao desdobramento do estudo, percebeu-se o desenvolvimento da capacidade para a formação de “uma nova geração” de uma educação digital em saúde materno-infantil, gerando ferramentas educacionais inovadoras, atreladas às necessidades do contexto público. (30)<= o:p>

Ferramentas também utilizadas, considerados recursos tradicionais de ensino, foram o livro e o DVD. As mulheres responderam a um questionário com 50 questões a respeito da temáti= ca, em seguida participaram de uma breve discussão sobre o tema e assistiram a um vídeo para fixação do conteúdo. O estudo foi aprovado pelo comitê de ética e teve como objetivo fornecer serviços que apoiam a amamentação e trabalhar a autoeficácia nesse momento tão importante. (23)

O vídeo é uma tecnologia muito utiliza= da. No entanto, observa-se que os resultados identificados revelam melhora pouco significativa se comparado as mães que tiveram apenas um diálogo educativo = com o profissional de saúde. (29) Diante disto considera-se essencia= l a junção do diálogo e da tecnologia afim de potencializar o conhecimento e aumentar os números de pessoa que realizam o aleitamento materno exclusivo = até os seis meses de idade da criança.

Outro estudo sobre construção e valida= ção de vídeo educativo para o ensino da ressuscitação cardiopulmonar por pessoas surdas revelou que a tecnologia foi avaliada pelo público participante como ferramenta que incentiva ao aprendizado e pode resultar em vidas salvas em = um determinado momento. (35)

Descreve-se também o uso das ferrament= as grupais, como a treasure box. Fez-se uso da tecnologia em uma sessão de gru= po interativa projetada para explorar os benefícios da amamentação para a saúd= e. Porém, percebeu-se a necessidade de um maior desenvolvimento da ferramenta = para refletir os benefícios de saúde específicos, como o reforço das mensagens s= obre os benefícios da amamentação em todas as oportunidades usando outros recurs= os. (22) Desta forma, eviden= cia-se a necessidade de associação de uma ou mais alternativas de intervenção.

 

CONCLUSÃO<= /span>

 

O estudo atendeu ao objetivo proposto = de identificar as tecnologias educacionais a fim promover a autoeficácia para o aleitamento materno. Trata-se de materiais diversos, impressos e digitais, utilizados, individualmente ou em associação, para a consulta individual ou atendimento grupal. A grande maioria dos estudos foram de construção e validação da tecnologia que comprovou a eficácia do uso e ressaltou alternativas que potencializem o manejo da tecnologia para autoeficácia mat= erna para amamentar.

       Apontam-se como lacunas a escassez de estudos que descreva= m o referencial teórico utilizado para construção e validação, pois este dá consistência e confiabilidade a pesquisa. Sugere-se a valorização da temáti= ca como forma de ampliar o conhecimento de nutrizes sobre o aleitamento materno proporcionando a elas uma autoeficácia e obtendo com isto o aleitamento mat= erno exclusivo até os seis meses de idade, sendo as tecnologias uma aliada ao incentivo desta prática tão importante. Por isso o investimento em estudos = que proporcionem a criação de novas ferramentas afim de impulsionar e assistir a prática do aleitamento materno é um ponto relevante e necessário para que se possa alcançar níveis satisfatórios no processo de amamentar.

 

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34.  de Couto.; B. M. V.; Alves, B. M. M.; da Silva, B. M. C. = C.; de Souza, D. S.; de Lima, E. M. A.; Jatobá, J. D. A. V. N.; Neto, W. B. Con= strução de uma cartilha educativa acerca do processo cirúrgico pediátrico: experiên= cia utilizando literatura de cordel Res., Soc. Dev. [internet] 2021 [acesso em = 04 de Abr de 202]; v. 10, n. 3, p. e38110313379-e38110313379. Disponível em: http= s://rsdjournal.org/index.php/rsd/article/view/13379

 

35.  Galindo-Neto. N. M., Alexandre.; A. C. S., Barros.; L. M.= , Sá.; G. G. D. M., Carvalho.; K. M. D.; Caetano, J. Á. Construcción y validación = de un vídeo educativo para sordos acerca de la reanimación cardiopulmonar.&nbs= p;Rev. latinoam. enferm [internet] 2019 [acesso em 04 de abr de 2021]; v. 27 e 3130. Disponível em: https://doi.o= rg/10.1590/1518-8345.2765.3130

 

Autor corr= espondente=

Thayse Gabrielle Viana Lima, rua delegado felix dias, número 7527, bairro loteamento porto alegre

Cep: 64039-050, 86 9572-3813 e thaysegabrielle0@gmail.com

&nbs= p;

Submissão: 2021-08-03=

Aprovado: 2021-09-07



[1]= Discente no Centro Universitário Santo Agostinho-UNIFSA, Teresina (P= I), Brasil. ORCID: https://orcid.org/0000-00= 02-9570-6211

[2]= Discente no Centro Universitário Santo Agostinho-UNIFSA, Teresina (P= I), Brasil. ORCID:  https://orcid.org/0000-0002-= 3554-4185

[3]= Docente no Centro Universitário Santo Agostinho-UNIFSA, Teresina (PI= ), Brasil. ORCID: https://or= cid.org/0000-0002-2765-0236

[4]= Doutorando no Programa de  Pós-graduação em Enfermagem da Universidade Federal do Piauí, Teresi= na (PI), Brasil. ORCID: http= s://orcid.org/0000-0001-7347-6972

 

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https://doi.org/10.31011/reaid-2021-v.95-n.35-art.1194  Rev Enferm A= tual In Derme  v. 95, n. 35, 2021  = e-021138                 1

 

 

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https://doi.org/10.31011/reaid-2021-v.95-n.35-art.1194 Rev Enferm Atual In Derme  v. 95, n. 35, 2021  e-021136                  1

 

 

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