Programa de Pós-Graduação em Ciências da Saúde/Saúde da Criança e do Adolescente, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
J Pediatr (Rio J). 2010 Jan-Feb;86(1):33-9. doi: 10.2223/JPED.1968.
To evaluate the implementation of the kangaroo mother method in hospitals trained by the Brazilian Ministry of Health.
Cross-sectional study, evaluating 176 (60.1%) out of 293 hospitals that were trained by the Brazilian Ministry of Health from 2000 to 2003 in Brazil. This study was conducted in two phases. The first phase consisted of sending a questionnaire to 293 hospitals; in the second phase an in loco visit was made in a sample of 29 among those hospitals. The instrument for data collection was sent to all hospitals by mail, fax or e-mail through the Ministry of Health and they addressed the three dimensions of the normative assessment: structure, processes, and results. The second phase consisted of an evaluation of the process, using a structured guide of non-participant observation. To estimate the reliability of the variable "deployment of the steps of the method" between questionnaire and site visit, we used the kappa test.
The first stage of the kangaroo mother method was implemented in 84.9% of the hospitals, but only 47.3% of them implemented the three stages according to the Brazilian norm. The kappa test results indicated a moderate agreement for the first stage, and substantial for the second and third stages of the method.
Hospital training was important for triggering the implementation process of the kangaroo mother method. However, they were not enough to promote the implementation of the three phases of the method.
评估经巴西卫生部培训的医院实施袋鼠式护理方法的情况。
这是一项横断面研究，评估了 2000 年至 2003 年期间巴西卫生部培训的 293 家医院中的 176 家（60.1%）。该研究分为两个阶段。第一阶段向 293 家医院发送问卷；第二阶段在其中 29 家医院进行现场访问。数据收集工具通过卫生部以邮件、传真或电子邮件的方式发送给所有医院，并评估规范评估的三个维度：结构、过程和结果。第二阶段采用非参与式观察的结构化指南对过程进行评估。为了评估问卷和现场访问之间“方法步骤的实施”变量的可靠性，我们使用了 Kappa 检验。
84.9%的医院实施了袋鼠式护理方法的第一阶段，但只有 47.3%的医院按照巴西规范实施了三个阶段。Kappa 检验结果表明，第一阶段的一致性为中度，第二和第三阶段的一致性为高度。
医院培训对于启动袋鼠式护理方法的实施过程很重要。然而，这还不足以促进该方法三个阶段的实施。
