[Adherence to best care practices in normal birth: construction and validation of an instrument]. / Adesão às boas práticas na atenção ao parto normal: construção e validação de instrumento.

OBJECTIVE: To describe the stages of construction and validation of an instrument in order to analyze the adherence to best care practices during labour and birth. METHOD: Methodological research, carried out in three steps: construction of dimensions and items, face and content validity and semantic analysis of the items. RESULTS: The face and content validity was carried out by 10 judges working in healthcare, teaching and research. Items with Content Validity Index (CVI) ≥ 0.9 were kept in full or undergone revisions as suggested by the judges. Semantic analysis, performed twice, indicated that there was no difficulty in understanding the items. CONCLUSION: The instrument with three dimensions (organization of healthcare network to pregnancy and childbirth, evidence-based practices and work processes) followed the steps recommended in the literature, concluded with 50 items and total CVI of 0.98.

[Development and validation of an instrument for evaluating the ludicity of games in health education]. / Desenvolvimento e validação de instrumento para avaliar a ludicidade de jogos em saúde.

OBJECTIVE: Developing and validating an instrument to evaluate the playfulness of games in health education contexts. METHODOLOGY: A methodological, exploratory and descriptive research, developed in two stages: 1. Application of an open questionnaire to 50 graduate students, with content analysis of the answers and calculation of Kappa coefficient for defining items; 2. Procedures for construction of scales, with content validation by judges and analysis of the consensus estimate by Content Validity Index(CVI). RESULTS: 53 items regarding the restless character of the games in the dimensions of playfulness, the formative components of learning and the profiles of the players. CONCLUSION: Ludicity can be assessed by validated items related to the degree of involvement, immersion and reinvention of the subjects in the game along with the dynamics and playability of the game.

[Factors associated with home care: support for care management within the SUS]. / Fatores associados à atenção domiciliária: subsídios à gestão do cuidado no âmbito do SUS.

The identification of variables associated with the type of home care (HC) of the users of the Unified Health System (UHS) contributes to the management of care in the Health Care Network (HCN). The objective was to identify variables associated with HC users in Basic Health Units (BHU) selected from Belo Horizonte. It was a transversal study in two BHU with all users (n=114) in HC in the covered area. We used a multiple logistic regression analysis for selection (stepwise) of significant variables. Greater clinical involvement of users (OR=27.47), a sad emotional state (OR=24.36), risk for pressure ulcer bythe Braden scale (OR=7.6) and semidependence by the Katz ADL index (OR=63.8) were obtained and were strongly associated with the type of HC (p<0.05). Variables based on the social, family and clinical context of the subjects subsidized the integral approach and decision-making of the healthcare team.

Caring to deny, confront, shiver: negativity as a critique of the "natural caregiver" stereotype in nursing.

To discuss, based on Adorno's philosophy, the negativity of care in confronting the "natural caregiver" discourse in the profession and exercise discursive analysis of this stereotype based on the negative trihedron of care (deny, confront, shiver). Theoretical study that articulates negative dialectic with the biopolitics of caring for the body. Negativity of care, as an immanent criticism that emerges from the dialectic between help and power, aims to shiver at bodily suffering, a residue of nature violated by cultural discursive practices. We applied the methodological framework of care to deny, confront, and shiver in label analysis to highlight non-identity between nursing reality and natural caregiver affirmation. We confronted the injustices made invisible in the prejudice that women are naturally predestined to provide for others' well-being. We reflected on the contradictions and suffering of women, nurses or not, invisible in the vaunted loving care. We proposed shiver as a metaphor for deny, a critical negativity that opens to the strange coerced and mutilated in the human body.

Validation of Ludic-Quest to the playfulness of health games: gameplay and emotions on the field.

OBJECTIVE: to validate Ludic-quest construct and reliability to assess game playfulness, through latent factors in gameplay, perception of learning and emotions in the game. METHODS: a cross-sectional study to validate the instrument's psychometric properties. 247 people responded to the questionnaire after a match in the game Violetas. Exploratory Factor Analysis, using KMO (>0.7), Bertlett (p=0.005), Varimax and factor loading (>0.6). Reliability by Cronbach's alpha (>0.6). RESULTS: in gameplay/learning, KMO=0.859, Bertlett significant. The eigenvalue indicated four factors (reflections; immersion; challenges; aesthetics), 10 retained variables. In the factor analysis of emotions: KMO=0.817; Bartlett p=0.000. Extraction of four factors (pleasure; ostraenie; tension; fun), 10 retained variables. The 20 validated variables contain reliability (Cronbach's alpha=0.716). CONCLUSIONS: the eight validated factors centralize playfulness in health game production, composing a reliable playfulness assessment instrument for use in research.

The limitations and possibilities of nurses' work in the family health strategy: in the search for autonomy. / Limites e possibilidades do trabalho do enfermeiro na estratégia saúde da família: em busca da autonomia.

UNLABELLED: The paper addresses how nurses can contribute to the consolidation of the Family Health Strategy (FHS) within the Brazilian National Health System (Sistema Único de Saúde - SUS), in the search for professional autonomy. OBJECTIVES: To discuss the limitations and possibilities of nursing work in the FHS aimint at the consolidation of the SUS; evaluate the available nursing appointments carried out by the FHS in Belo Horizonte (BH); reflect on the political aspects of nurses' autonomy on job positions. This is a quanti-qualitative stud study. We evaluated the availablitiy of nursing appointments in basic Health Units (BHs) based on secondary data and official parameters as indicators of autonomy. Subsequently, through focal groups, we analyzed nurses' autonomy in the FHS. Nurses can strengthen the FHS for the consolidation of the SUS, as long as they improve their understanding of the socio-historical context of nursing, the ambiguity of power relationships and social practice of the profession, improving it criticism, collectively and creatively.

Gameplay, learning and emotions in the board game Violets: cinema & action in combating violence against women. / Jogabilidade, aprendizados e emoções no jogo Violetas: cinema & ação no enfrentamento da violência contra a mulher.

The board game Violets: cinema and action in combating violence against women was developed prioritising the liberating features of play to offer a setting for struggles to secure citizenship. The objective of the article was to examine the gameplay of Violets as regards players' understanding of the rules and engagement, and the game's mechanics and design; and to evaluate gameplay, emotions and learning comparatively as dimensions of play. This mixed method study proceeded in stages: a) perfecting gameplay: a workshop with 12 experts, usability tests with 33 participants and content analysis; and b) evaluating play: questionnaires for 78 participants and non-parametric Mann-Whitney U-test comparing groups of variables. Agreement among participants on aspects of gameplay was high. The group of gameplay variables returned values equal to those of the learning group; both differed significantly from the group for emotions felt while playing. In Violets, the interweave of gameplay with the formative, learning components set up a challenging, affective, symbolic field where players' imagination, interaction, tension and interest were expressed during play.

O jogo de tabuleiro Violetas: cinema & ação no enfrentamento da violência contra a mulher, forjado a partir da priorização das características libertárias do lúdico, ambienta lutas para a conquista da cidadania. O objetivo do artigo foi analisar a jogabilidade do Violetas quanto ao entendimento das regras, ao envolvimento das(os) jogadoras(es), à mecânica e ao design do jogo; e avaliar comparativamente as dimensões da jogabilidade, das emoções e da aprendizagem como expressões da ludicidade. Pesquisa de métodos mistos, em etapas: a) aperfeiçoamento da jogabilidade: oficina com 12 especialistas; testes de usabilidade (33 participantes); análise de conteúdo; b) avaliação da ludicidade: questionários a 78 participantes, teste não paramétrico U de Mann-Whitney para comparação dos grupos de variáveis. Os aspectos da jogabilidade obtiveram graus de concordância elevados entre as/os participantes. As variáveis da jogabilidade assumiram valor igual em relação ao grupo da aprendizagem, ambos significativamente diferentes de um grupo 2, das emoções sentidas na partida. No Violetas, o entrelaçamento da jogabilidade com os componentes formativos da aprendizagem viabilizam a criação de um campo simbólico, desafiador e afetivo em que a imaginação, a interação, a tensão e o interesse das(os) jogadoras(es) se manifestam durante as partidas.

[Analysis of managed-care in the Family Health Program: the methodologic and theory referential]. / Análise da gestão do cuidado no Programa de Saúde da Família: referencial teórico-metodológico.

UNLABELLED: The theoretical-methodological referential is questioned on the possibility of its use to analyze the potential of the Care autonomy in the working process of the Family Health Program. The premise is that the analysis of the health working process, centered on the contradictions of care management contributes for unveiling emancipating potentialities. OBJECTIVES: to discuss contradictions, possibilities and challenges to the care management changes in the Family Health Program/Primary Care/National Health System, and to propose a theoretical-methodological referential for the analysis of the care management in the working process of Family Health Program. It is concluded that there should be used referential which explain if the health care tends more to the authoritarian dominium or to power sharing among the subjects, understanding them as complementary.

Caring to deny, confront, shiver: negativity as a critique of the "natural caregiver" stereotype in nursing / Cuidar para descuidar, confrontar, enfriar: la negatividad como crítica al estereotipo del "cuidador natural" en enfermería / Cuidar para descuidar, confrontar, arrepiar: negatividade como crítica do estereótipo da "cuidadora natural" na enfermagem

ABSTRACT To discuss, based on Adorno's philosophy, the negativity of care in confronting the "natural caregiver" discourse in the profession and exercise discursive analysis of this stereotype based on the negative trihedron of care (deny, confront, shiver). Theoretical study that articulates negative dialectic with the biopolitics of caring for the body. Negativity of care, as an immanent criticism that emerges from the dialectic between help and power, aims to shiver at bodily suffering, a residue of nature violated by cultural discursive practices. We applied the methodological framework of care to deny, confront, and shiver in label analysis to highlight non-identity between nursing reality and natural caregiver affirmation. We confronted the injustices made invisible in the prejudice that women are naturally predestined to provide for others' well-being. We reflected on the contradictions and suffering of women, nurses or not, invisible in the vaunted loving care. We proposed shiver as a metaphor for deny, a critical negativity that opens to the strange coerced and mutilated in the human body.

RESUMEN Discutir, a partir de la filosofía de Adorno, la negatividad del cuidado frente al discurso del "cuidador natural" en la profesión; Ejercer el análisis discursivo de este estereotipo a partir del triángulo negativo del cuidado (descuido, confrontación, escalofrío). Estudio teórico que articula la dialéctica negativa con la biopolítica del cuidado del cuerpo. La negatividad del cuidado, como crítica inmanente que emerge de la dialéctica entre ayuda y poder, pretende hacer que la gente se estremezca ante el sufrimiento de lo corpóreo, un residuo de la naturaleza violado por prácticas discursivas culturales. Aplicamos el marco metodológico del cuidado para descuidar, confrontar y estremecer en el análisis de la etiqueta para resaltar la no identidad entre la realidad de la enfermería y la afirmación del cuidador natural. Nos enfrentamos a las injusticias que se vuelven invisibles debido al prejuicio de que las mujeres están naturalmente predestinadas a velar por el bienestar de los demás. Reflexionamos sobre las contradicciones y el sufrimiento de las mujeres, enfermeras o no, invisibles en el cacareado cuidado amoroso. Proponemos el escalofrío como metáfora del descuido, una negatividad crítica que se abre a lo extraño coaccionado y mutilado en el cuerpo humano.

RESUMO Discutir, a partir da filosofia de Adorno, a negatividade do cuidado no enfrentamento do discurso da "cuidadora natural" na profissão; exercitar a análise discursiva desse estereótipo a partir do triedro negativo do cuidar (descuidar, confrontar, arrepiar). Estudo teórico que articula a dialética negativa com a biopolítica do cuidar no corpo. A negatividade do cuidado, como crítica imanente que emerge da dialética entre ajuda e poder, visa ao arrepio diante do sofrimento do corpóreo, resíduo da natureza violentada por práticas discursivas culturais. Aplicamos o referencial metodológico do cuidar para descuidar, confrontar, arrepiar na análise do rótulo para aflorar a não identidade entre a realidade da enfermagem e a afirmação da cuidadora natural. Confrontamos as injustiças invisibilizadas no preconceito de que as mulheres seriam naturalmente predestinadas a prover o bem-estar dos outros. Refletimos sobre as contradições e os sofrimentos de mulheres, enfermeiras ou não, invisibilizados na alardeada amorosidade do cuidado. Propomos o arrepio como metáfora ao descuidado, uma negatividade crítica que se abre ao estranho coagido e mutilado no corpo humano.

Good practices in normal childbirth: reliability analysis of an instrument by Cronbach's Alpha.

OBJECTIVES: to analyze the internal consistency of the evaluation instrument of the adherence to the good practices of childbirth and birth care in the professionals, through Cronbach's Alpha Coefficient for each of the dimensions and for the total instrument. METHOD: this is a descriptive and cross-sectional study performed in obstetric centers of eleven public hospitals in the Federal District, with a questionnaire applied to 261 professionals who worked in the delivery care. RESULTS: The study was attended by 261 professionals, 42.5% (111) nurses and 57.5% (150) physicians. The reliability evaluation of the instrument by the Cronbach Alfa resulted in 0.53, 0.78 and 0.76 for dimensions 1, 2 and 3, after debugging that resulted in the exclusion of 11 items. CONCLUSIONS: the instrument obtained Cronbach's alpha of 0.80. There is a need for improvement in the items of dimension 1 that refer to attitudes, knowledge, and practices of the organization of the network of care to gestation, childbirth, and birth. However, it can be applied in the way it is used to evaluate practices based on scientific evidence of childbirth care.

[Reconstructing myths of nursing through the emancipatory quality of care]. / Pela reconstruiação dos mitos da enfermagem a partir da qualidade emancipatória do cuidado.

This theoretical study focuses on the influence of myths and historical traditions of Nursing in professional practice, and is based on the emancipatory trihedron of care: to know in order to better care, to care in order to confront, to care in order to emancipate. The analysis of nurses' political fragility unveiled conservative and positivist tendencies that have been historically associated with the profession, leading to a theoretical reflection on conservative discourses about Nursing. Through the emancipatory care perspective, the study aims at pointing out possibilities for the reconstruction of historical practices of health care, adding dimension to social practices. Additionally, Nursing should take these myths and rituals as rich contradictions of reality, reflexively demystifying them through the politics of care (mediation between help and power to create autonomy).

Validation of Ludic-Quest to the playfulness of health games: gameplay and emotions on the field / Validación de Ludic-Quest a la ludicidad de los juegos de salud: jugabilidad y emociones en el campo / Validação do Ludic-Quest à ludicidade de jogos na saúde: jogabilidade e emoções em campo

ABSTRACT Objective: to validate Ludic-quest construct and reliability to assess game playfulness, through latent factors in gameplay, perception of learning and emotions in the game. Methods: a cross-sectional study to validate the instrument's psychometric properties. 247 people responded to the questionnaire after a match in the game Violetas. Exploratory Factor Analysis, using KMO (>0.7), Bertlett (p=0.005), Varimax and factor loading (>0.6). Reliability by Cronbach's alpha (>0.6). Results: in gameplay/learning, KMO=0.859, Bertlett significant. The eigenvalue indicated four factors (reflections; immersion; challenges; aesthetics), 10 retained variables. In the factor analysis of emotions: KMO=0.817; Bartlett p=0.000. Extraction of four factors (pleasure; ostraenie; tension; fun), 10 retained variables. The 20 validated variables contain reliability (Cronbach's alpha=0.716). Conclusions: the eight validated factors centralize playfulness in health game production, composing a reliable playfulness assessment instrument for use in research.

RESUMEN Objetivo: validar el constructo y la confiabilidad del instrumento Ludic-Quest para evaluar la lúdica de los juegos, a través de factores latentes en la jugabilidad, percepción del aprendizaje y emociones en el juego. Métodos: estudio transversal para validar las propiedades psicométricas del instrumento. 247 personas contestaron el cuestionario después de un partido de Violetas. Análisis Factorial Exploratorio, utilizando KMO (>0,7), Bertlett (p=0,005), Varimax y carga factorial (>0,6). Confiabilidad por Alfa de Cronbach (>0.6). Resultados: en jugabilidad/aprendizaje, KMO=0,859, Bertlett significativo. El valor propio indicó cuatro factores (reflexiones; inmersión; desafíos; estética) y 10 variables retenidas. En el análisis factorial de las emociones: KMO=0,817; Bartlett p=0,000. Extracción de cuatro factores (placer; ostraenie; tensión; diversión) y 10 variables retenidas. Las 20 variables validadas contienen confiabilidad (Alfa de Cronbach=0,716). Conclusiones: los ocho factores validados centralizan la ludicidad en la producción de juegos de salud, componiendo un instrumento de evaluación de la ludicidad confiable para uso en investigación.

RESUMO Objetivo: validar o constructo e a confiabilidade do instrumento Ludic-Quest para avaliação da ludicidade de jogos, por meio de fatores latentes à jogabilidade, percepção da aprendizagem e às emoções na partida. Métodos: estudo transversal de validação das propriedades psicométricas do instrumento. 247 pessoas responderam ao questionário após uma partida do jogo Violetas. Análise Fatorial Exploratória, com uso do KMO (>0,7), Bertlett (p=0,005), Varimax e carga fatorial (>0,6). Confiabilidade pelo Alfa de Cronbach (>0,6). Resultados: na jogabilidade/aprendizagem, KMO=0,859, Bertlett significativo. O autovalor indicou quatro fatores (reflexões; imersão; desafios; estética) e 10 variáveis retidas. Na análise fatorial das emoções: KMO=0,817; Bartlett p=0,000. Extração de quatro fatores (prazer; ostranênie; tensão; diversão) e 10 variáveis retidas. As 20 variáveis validadas contêm confiabilidade (Alfa de Cronbach=0,716). Conclusões: os oito fatores validados centralizam o lúdico na produção de jogos na saúde, compondo um instrumento de avaliação da ludicidade confiável à utilização em pesquisas.

Politicy of care in the criticism towards gender stereotypes. / A politicidade do cuidado na crítica aos estereótipos de gênero.

OBJECTIVES:: analyze gender inequalities among Brazilian women in Portugal and in contemporary nursing based on care politicity in the light of gender; disclose oppression of the female produced by the stereotypes that look upon women as natural caregivers; point out politicity to deconstruct gender stereotypes. METHOD:: theoretical reflection with narrative review of literature to analyze classic references in the feminist epistemology combined with the care politicity thesis. RESULTS:: the similarities between the stereotypes of the Brazilian Eves and the Portuguese Maries as either the sexualized or sanctified nurse are inserted in the Jewish-Christian moral genealogy that reaffirms the subservience of the female to the male. CONCLUSION:: by attaching priority to care that needs non-care to expand the possibilities of care giving, the theoretical assumption of politicy of care can contribute to subvert the stereotypical images of Brazilian women in Portuguese lands and in contemporary nursing.

Jogabilidade, aprendizados e emoções no jogo Violetas: cinema & ação no enfrentamento da violência contra a mulher / Gameplay, learning and emotions in the board game Violets: cinema & action in combating violence against women

Resumo O jogo de tabuleiro Violetas: cinema & ação no enfrentamento da violência contra a mulher, forjado a partir da priorização das características libertárias do lúdico, ambienta lutas para a conquista da cidadania. O objetivo do artigo foi analisar a jogabilidade do Violetas quanto ao entendimento das regras, ao envolvimento das(os) jogadoras(es), à mecânica e ao design do jogo; e avaliar comparativamente as dimensões da jogabilidade, das emoções e da aprendizagem como expressões da ludicidade. Pesquisa de métodos mistos, em etapas: a) aperfeiçoamento da jogabilidade: oficina com 12 especialistas; testes de usabilidade (33 participantes); análise de conteúdo; b) avaliação da ludicidade: questionários a 78 participantes, teste não paramétrico U de Mann-Whitney para comparação dos grupos de variáveis. Os aspectos da jogabilidade obtiveram graus de concordância elevados entre as/os participantes. As variáveis da jogabilidade assumiram valor igual em relação ao grupo da aprendizagem, ambos significativamente diferentes de um grupo 2, das emoções sentidas na partida. No Violetas, o entrelaçamento da jogabilidade com os componentes formativos da aprendizagem viabilizam a criação de um campo simbólico, desafiador e afetivo em que a imaginação, a interação, a tensão e o interesse das(os) jogadoras(es) se manifestam durante as partidas.

Abstract The board game Violets: cinema and action in combating violence against women was developed prioritising the liberating features of play to offer a setting for struggles to secure citizenship. The objective of the article was to examine the gameplay of Violets as regards players' understanding of the rules and engagement, and the game's mechanics and design; and to evaluate gameplay, emotions and learning comparatively as dimensions of play. This mixed method study proceeded in stages: a) perfecting gameplay: a workshop with 12 experts, usability tests with 33 participants and content analysis; and b) evaluating play: questionnaires for 78 participants and non-parametric Mann-Whitney U-test comparing groups of variables. Agreement among participants on aspects of gameplay was high. The group of gameplay variables returned values equal to those of the learning group; both differed significantly from the group for emotions felt while playing. In Violets, the interweave of gameplay with the formative, learning components set up a challenging, affective, symbolic field where players' imagination, interaction, tension and interest were expressed during play.

[Politicity of care as an emancipatory reference for nursing: getting to know to care better, delivering care to confront, delivering care to emancipate]. / Politicidade do cuidado como referência emancipatória para a enfermagem: conhecer para cuidar melhor, cuidar para confrontar, cuidar para emancipar.

UNLABELLED: Politicity of care deals with the intelligent and disruptive handling of help-power. Such notion can mainly be expressed by the trihedron getting to know to care better, delivering care to confront, delivering care to emancipate which, when adapted to the work process in health, may become emancipatory. This theoretical-philosophical reflection explores the ambiguous aspect of care, expressed by being solidary and becoming political. OBJECTIVES: a- to reflect about the politicity of care, as management of help-power, which is capable of emancipatory subversion; b- to discuss the way capitalist societies deal with health care; c- to point out disruptive dynamics to nurses, based on the emancipatory trihedron of care. The main idea of this article is to indicate applicabilities for the conception of politicity of care in the sphere of the nursing work process, signaling emancipatory potentialities.

BANFISA and (IN) DICA-SUS in health undergraduate education: playing and learning construction.

OBJECTIVES: To analyze the learning built during the matches of the games by students of the subject Gestão de Políticas Públicas em Saúde at the Universidade de Brasília. METHOD: Exploratory, descriptive research, in a qualitative approach, with 26 students from various graduation courses in health, using a questionnaire and participant observation. RESULTS: Participants reinvented rules, related issues addressed in the games to the reality, interacted with colleagues and had fun throughout the match. Comparing the games in relation to ludicity, the BANFISA was more attractive than the (IN) DICA-SUS, although they are complementary. CONCLUSIONS: Learning constructed by the students goes beyond the content of the subject; involve the active participation in group and creativity.

The Care management Information system for the home Care Network (SI GESCAD): support for care coordination and continuity of care in the Brazilian Unified health system (SUS).

The present article describes the development of the initial version of the Brazilian Care Management Information System for the Home Care Network (SI GESCAD). This system was created to enhance comprehensive care, care coordination and the continuity of care provided to the patients, family and caretakers of the Home Care (HC) program. We also present a reflection on the contributions, limitations and possibilities of the SI GESCAD within the scope of the Home Care Network of the Brazilian Unified Health System (RAS-AD). This was a study on technology production based on a multi-method protocol. It discussed software engineering and human-computer interaction (HCI) based on user-centered design, as well as evolutionary and interactive software process (prototyping and spiral). A functional prototype of the GESCAD was finalized, which allowed for the management of HC to take into consideration the patient's social context, family and caretakers. The system also proved to help in the management of activities of daily living (ADLs), clinical care and the monitoring of variables associated with type 2 HC. The SI GESCAD allowed for a more horizontal work process for HC teams at the RAS-AD/SUS level of care, with positive repercussions on care coordination and continuity of care.

Safety culture in the operating room of a public hospital in the perception of healthcare professionals.

OBJECTIVE: To evaluate the perception of healthcare professionals about the safety culture in the operating room of a public hospital, large-sized, according to the domains of the Safety Attitudes Questionnaire (SAQ). METHOD: Descriptive, cross-sectional and quantitative research, with the application of the SAQ to 226 professionals. Descriptive data analysis, instrument consistency and exploratory factor analysis. RESULTS: Participants were distributed homogeneously between females (49.6%) and males (50.4%); mean age of 39.6 (SD±9.9) years and length of professional experience of 9.9 (SD ± 9.2) years. And Cronbach's α of 0.84. It was identified six domains proposed in the questionnaire: stress perception (74.5) and job satisfaction (70.7) showed satisfactory results; teamwork environment (59.1) and climate of security (48.9) presented scores below the minimum recommended (75); unit's management perceptions (44.5), hospital management perceptions (34.9) and working conditions (41.9) presented the lowest averages. CONCLUSIONS: The results showed that, from the perspective of the professionals, there is weakness in the values, attitudes, skills and behaviors that determine the safety culture in a healthcare organization.

Good practices in normal childbirth: reliability analysis of an instrument by Cronbach's Alpha / Boas práticas no parto normal: análise da confiabilidade de um instrumento pelo Alfa de Cronbach / Buenas prácticas en el parto normal: análisis de la confiabilidad de un instrumento por el Alfa de Cronbach

ABSTRACT Objectives: to analyze the internal consistency of the evaluation instrument of the adherence to the good practices of childbirth and birth care in the professionals, through Cronbach's Alpha Coefficient for each of the dimensions and for the total instrument. Method: this is a descriptive and cross-sectional study performed in obstetric centers of eleven public hospitals in the Federal District, with a questionnaire applied to 261 professionals who worked in the delivery care. Results: The study was attended by 261 professionals, 42.5% (111) nurses and 57.5% (150) physicians. The reliability evaluation of the instrument by the Cronbach Alfa resulted in 0.53, 0.78 and 0.76 for dimensions 1, 2 and 3, after debugging that resulted in the exclusion of 11 items. Conclusions: the instrument obtained Cronbach's alpha of 0.80. There is a need for improvement in the items of dimension 1 that refer to attitudes, knowledge, and practices of the organization of the network of care to gestation, childbirth, and birth. However, it can be applied in the way it is used to evaluate practices based on scientific evidence of childbirth care.

RESUMO Objetivo: analisar a consistência interna do instrumento de avaliação da adesão dos profissionais às boas práticas de atenção ao parto e nascimento por meio do Coeficiente Alfa de Cronbach para cada uma das dimensões e para o instrumento total. Método: estudo descritivo e transversal, realizado em centros obstétricos de onze hospitais públicos do Distrito Federal, com aplicação de questionário a 261 profissionais que atuavam na atenção ao parto. Resultados: participaram do estudo 261 profissionais, sendo 42,5% (111) enfermeiros e 57,5% (150) médicos. A avaliação da confiabilidade do instrumento pelo Alfa de Conbrach resultou em 0,53, 0,78 e 0,76 para as dimensões 1, 2 e 3, após depurações que resultarama na exclusão de 11 itens. Conclusões: o instrumento obteve Alfa de Cronbach de 0,80. Há necessidade de aperfeiçoamento nos itens da dimensão 1 que se referem a atitudes, conhecimentos e práticas de organização da rede de atenção à gestação, parto e nascimento. Todavia, pode ser aplicado na forma como está para avaliação das práticas baseadas em evidências científicas de atenção ao parto.

RESUMEN Objetivos: analizar la consistencia interna del instrumento de evaluación de la adhesión de los profesionales a las buenas prácticas de atención al parto y nacimiento, por medio del Coeficiente Alfa de Cronbach para cada una de las dimensiones y para el instrumento total. Método: estudio descriptivo y transversal, realizado en centros obstétricos de once hospitales públicos del Distrito Federal, con aplicación de cuestionario a 261 profesionales que actuaban en la atención al parto. Resultados: Participaron del estudio 261 profesionales, siendo 42,5% (111) enfermeros y 57,5% (150) médicos. La evaluación de la confiabilidad del instrumento por el Alfa de Conbach resultó en 0,53, 0,78 y 0,76 para las dimensiones 1, 2 y 3, después de depuraciones que resultaron en la exclusión de 11 ítems. Conclusiones: el instrumento obtuvo Alfa de Cronbach de 0,80. Hay necesidad de perfeccioamiento en los ítems de la dimensión 1 que se refieren a actitudes, conocimientos y prácticas de organización de la red de atención a la gestación, parto y nacimiento. Todavía puede ser aplicado en la forma como está para evaluación de las prácticas basadas en evidencias científicas de atención al parto.

Recriar-se lúdico no desenvolvimento de jogos na saúde: referências teórico-metodológicas à produção de subjetividades críticas / Recrearse lúdico en el desarrollo de juegos en la salud: referencias teórico-metodológicas en la producción de subjetividades críticas / Ludic reinvention in the development of games in health: theoretical-methodological frameworks for the production of critical subjectivities

RESUMO Objetivo: refletir sobre a centralidade do lúdico na reinvenção de subjetividades críticas na área da saúde; apresentar, com base no referencial elaborado e nos relatos de experiência em pesquisa, as técnicas, os instrumentos e as triangulações utilizadas na metodologia Recriar-se Lúdico. Método: reflexão teórica e relato de experiência em pesquisa com o propósito de fundamentar o referencial teórico-metodológico do Recriar-se Lúdico na produção de tecnologias lúdico-educativas para a saúde. Resultados: a perspectiva agonista do Recriar-se Lúdico na produção de subjetividades críticas contrapõe-se às concepções positivistas presentes na produção científica e tecnológica dos jogos voltados para a saúde e para o mercado dos games. Conclusão: a metodologia do Recriar-se Lúdico, fundamentada no agon como um princípio de combate engajado em favor da imaginação e da abundância de vida, contribui para experiências plenas de sentidos que se expressam em subjetividades múltiplas, relacionais, descentradas e interpretativas nas/os jogadoras/es.

RESUMEN Objetivo: reflexionar sobre la centralidad del recreo lúdico en la reinvención de subjetividades críticas en el área de la salud; con base en el referencial elaborado y en los relatos de experiencia en investigación, las técnicas, los instrumentos y las triangulaciones utilizadas en la metodología del Recrearse Lúdico. Método: reflexión teórica y relato de experiencia en investigación con el propósito de fundamentar el referencial teórico-metodológico del Recrearse Lúdico en la producción de tecnologías lúdico-educativas para la salud. Resultados: la perspectiva agonista del Recrearse Lúdico en la producción de subjetividades críticas se contrapone a las concepciones positivistas presentes en la producción científica y tecnológica de los juegos volcados para la salud y para el mercado de los juegos. Conclusión: la metodología del Recrearse Lúdico, fundamentada en el agon como un principio de combate comprometido en favor de la imaginación y de la abundancia de vida, contribuye a experiencias plenas de sentidos que se expresan en subjetividades múltiples, relacionales, descentradas e interpretativas en las/os de las jugadoras/es.

ABSTRACT Objective: to reflect on the centrality of the ludic in the reinvention of critical subjectivities in the area of health; to present, based in the framework elaborated and in the reports of experience in research, the techniques, instruments and triangulations used in the Ludic Reinvention methodology. Method: theoretical reflection and experience report in research with the aim of basing the theoretical-methodological framework of Ludic Reinvention in the production of game-based educational technologies for health. Results: the agonist perspective of Ludic Reinvention in the production of critical subjectivities opposes the positivist conceptions present in the scientific and technological production of games geared towards health and the games market. Conclusion: the methodology of Ludic Reinvention, based in the agon as a principle of disputation engaged in favor of the imagination and the abundance of life contributes to experiences which are full of feelings which are expressed in multiple, relational, de-centred and interpretive subjectivities in the players.