Manejo inicial do acidente vascular cerebral na atenção primária: elaboração e validação de um instrumento para avaliação da infraestrutura

Abstract

Stroke is one of the leading causes of mortality and functional disability in Brazil, requiring effective and integrated healthcare organization. In this context, the Stroke Care Pathway established by the Brazilian Ministry of Health provides guidance for the organization of healthcare services, including Primary Health Care, which plays a strategic role in the early recognition and timely referral of suspected cases. Given the need to assess the structural preparedness of Primary Health Care Units for the initial management of this health condition, this study aimed to develop and validate an instrument for assessing the physical infrastructure and availability of equipment required for the initial care of adults with acute stroke in Primary Health Care. This is a methodological, descriptive study with a mixed-methods approach, developed in two stages: the development of the pilot version of the instrument, based on the Stroke Care Pathway established by the Brazilian Ministry of Health and a narrative literature review; and content validation using the Delphi method, with the participation of specialists with experience in emergency and urgent care. The pilot version consisted of 49 items distributed across seven care domains. In the first round, 46 items (93,9%) reached the minimum established consensus level of 80%. The participation of the specialists resulted in 19 suggestions for new items, of which ten reached consensus and were incorporated into the set of validated items, while the remaining items were excluded, totaling 56 items validated throughout the process. Subsequently, during the organization of the items into a checklist format, seven duplicate items were identified and removed, resulting in the final version of the Instrument for Assessing Infrastructure for Initial Stroke Care, comprising 49 items arranged in alphabetical order. It is concluded that the validated instrument provides evidence of contente validity and has the potential to support the assessment of the availability of resources required for the initial care of stroke in Primary Health Care, contributing to the identification of structural needs and the planning of actions aimed at improving healthcare delivery, thereby promoting more timely, safe, and effective care.