Expectativa e satisfação sobre o pré-natal na atenção primária à saúde durante a pandemia de Covid-19

Abstract

This study aimed to evaluate the expectations and satisfaction of pregnant women regarding the quality of routine prenatal care in the Primary Health Care of the Unified Health System during the COVID-19 pandemic. Thus, the research was conducted in two stages: a scoping review and in the second stage, a non-experimental, crosssectional study with a quantitative approach. The scoping review followed the recommendations of the Joanna Briggs Institute Manual – Manual for Evidence Synthesis. The acronym PCC was used, with Population = pregnant women who received prenatal care in primary health care; Concept = patient expectations and satisfaction; and Context = during the COVID-19 pandemic. The research was carried out in indexed databases such as Web of Science, PubMed, LILACS, Scopus, EMBASE, CINAHL, PsycINFO, BDENF, and grey literature on Google Scholar and BDTD. The sample for the scoping review consisted of 18 studies, of which 9 addressed the expectations of pregnant women regarding prenatal care, and all pointed to satisfaction. For the cross-sectional study, two instruments were used: a questionnaire with personal, demographic, and obstetric identification data, followed by the Brazilian version of the Patient Expectations and Satisfaction with Prenatal Care instrument, applied to pregnant women receiving prenatal care in 10 health units in the municipality located in the interior of the State of São Paulo. Fisher's exact test and Chi-square test were used to verify the association between social variables and the domains of expectation and satisfaction. Ninety-nine pregnant women participated, with an average age of 27.3; 52 had completed high school; 70 were white; 40 were cohabitating; 35 had a monthly household income between one and two minimum wages; 49 were first-time mothers; 81 women started prenatal care in the first trimester; and 84 reported not having participated in health education practices. In the expectation domain, there was a predominance of low expectations with a mean of 55.2 (SD=13.2), and in the satisfaction domain, there was a predominance of high satisfaction across all subscales, with a mean of 88.7. The results of the association tests for the expectation domain showed that educational attainment in the Comprehensive Care subscale had statistical significance with a p-value < 0.05 (p=0.014), and for the satisfaction domain, only the household income variable in the System Characteristics subscale showed association and statistical significance (p=0.014). Evaluations of prenatal care have been conducted with the potential to contribute to the planning of health managers and improve the quality of prenatal assistance. Thus, the evaluation performed during the COVID-19 pandemic may provide information to support the establishment of necessary coping strategies for maintaining prenatal care in the event of discontinuity of the usual SUS service due to other public health emergencies. Consequently, this study aimed to contribute to a mode of evaluation of prenatal assistance, with the goal of supporting the implementation of evidence-based practices to enhance managerial and care processes. Regarding the domains of expectation and satisfaction, the main results indicated low expectations and high satisfaction with routine prenatal care during the COVID-19 pandemic.