Episiotomy in Southern Brazil: prevalence, trend, and associated factors

OBJECTIVE To identify and analyze the prevalence, trend, and factors associated with episiotomy in Rio Grande, in the state of Rio Grande do Sul, Southern Brazil. METHODS A single, standardized questionnaire was applied to all pregnant women, residents in the municipality of Rio Grande, who had children in local hospitals between January 1 and December 12 of the years 2007, 2010, 2013, 2016 e 2019. Demographic and socioeconomic characteristics were investigated, as well as the assistance received during pregnancy and delivery. Chi-square test was used to compare proportions and Poisson regression with robust variance adjustment was used for multivariable analysis. Prevalence ratio (PR) was used as effect measure. RESULTS Among the 12,645 births that occurred in the five years, 5,714 (45.2%) were vaginal delivery. Of these mothers, 2,930 (51.3%; 95%CI: 50.0%–52.6%) underwent episiotomy. Over this period, the episiotomy rate decreased from 70.9% (68.4–73.5) in 2007 to 19.4% (17.1–21.7) in 2019. Adjusted analysis showed a high PR of episiotomy occurrence among women who were young (PR = 2.23; 95%CI: 1.89–2.63), had higher education (PR = 1.21; 95%Cl: 1.03–1.42), had a higher family income (PR = 1.25; 95%CI: 1.10–1.41), were primiparous (PR = 3.41; 95%CI: 2.95–3.95), had prenatal care in the private sector (PR = 1.25; 95%CI: 1.07–1.46), had oxytocin-induced labor (PR = 1.18; 95%CI:1.09–1.27), underwent forceps (PR = 1.32; 95%CI: 1.16–1.50), and whose newborn weighed 4,000 g or more (PR = 1.43; 95%CI: 1.14–1.80). CONCLUSION Although the prevalence of episiotomy fell sharply within the studied period, its occurrence is more likely among women at lower risk of birth complications

Initial stage of cross-cultural adaptation to Portuguese of Brazil of the HIV Knowledge Questionnaire (HIV-K-Q)

Modelo do estudo: Transversal. Objetivo do estudo: Adaptar o HIV Knowledge Questionnaire (HIVK-Q) do inglês para o português do Brasil. Metodologia: A Adaptação Transcultural seguiu os passos metodológicos definidos por Reichenheim e constou das seguintes etapas: equivalência conceitual e de itens, equivalência semântica e equivalência operacional. A validade aparente e a validade de conteúdo foram avaliadas por seis juízes. A validade de conteúdo foi calculada pelo Coeficiente de Validade de Conteúdo de cada item (CVCc) e para o questionário como um todo (CVCt). Foi realizada uma aplicação dialogada por meio de grupos focais com 15 universitários e 15 usuários de centros comunitários. Resultados: Dos 45 itens do instrumento original, quatro apresentaram baixa validade de conteúdo (CVCc<0,80), sendo que dois itens (25 e 31) foram retirados. O CVCt foi 0,82 para clareza da linguagem, 0,93 para pertinência prática e 0,90 para relevância teórica. Para os critérios de amplitude e equilíbrio foram iguais a 0,90. Os itens que apresentaram problemas de compreensão foram devidamente retificados de acordo com as sugestões dos juízes e dos grupos focais. Conclusão: A versão proposta apresenta itens satisfatórios e apropriados para utilizações em avaliações psicométricas futuras, as quais permitirão demonstrar dados sobre a aplicabilidade do questionário para avaliar o conhecimento sobre o HIV/AidsStudy design: cross-sectional. Objective: to adapt the HIV Knowledge Questionnaire (HIV-KQ) from English to Portuguese of Brazil. Methodology: the Cross-Cultural Adaptation followed the methodological steps defined by Reichenheim and consisted of the following steps: conceptual and items equivalence, semantic equivalence and operational equivalence. The apparent validity and content validity was assessed by six judges. The content validity was calculated by Content Validity coefficient for each item (CVCc) and for all questionnaire (CVCt). The dialogued application was carried out by focus groups with 15 college students and 15 users of community centers. Results: Of the 45 items of the original instrument, four present lower content validity (CVCc <0.80), being that two items (25 and 31) were removed. The CVCt was 0.82 to clarity of language, 0.93 to practice relevance and 0.90 theoretical relevance. For amplitude and balance criteria were equal to 0.90. Items that showed understanding problems were corrected according to suggestions of judges and focal groups. Conclusion: The proposed version presents satisfactory items and suitable for use in psychometric assessments in the future, which will demonstrate data about the applicability of the questionnaire to evaluate the knowledge about HIV/AID