Acuerdo entre tres evaluadores y un experto en la detección de riesgo relacional en el posparto entre la madre y su recién nacido, Temuco, IX región, Chile, 2010

摘要

Introduction: It is advisable to assess the bonding between the mother and the newborn in order to identify abnormalities in this interaction and plan for early interventions to facilitate attachment. The examiner must make reliable observations for diagnosis and this requires training and experience. Objective: To describe inter-observer agreement among three examiners and one expert in the detection of mother-infant attachment risk between, applying the Kimelman attachment assessment guide. Materials and methods: Cross-sectional study. Mother-infant pairs were assessed during their stay at Hospital Hernán Henríquez Aravena in Temuco, a referral centre for the Araucanía region in southern Chile. Mothers of hospitalized infants were excluded. A non-probabilistic sample was used for convenience. Inter-observer agreement was measured in relation to the diagnosis of the risk of poor interaction and the variables of the Kimelman attachment guide. Kappa statistics was used for the analysis and inter-observer observations were considered acceptable when the kappa value was greater than 0.5. Results: Overall, 71 mother-infant (M-I) pairs were assessed during the period between March 1st and March 30th, 2010. Agreement regarding the items that assess the interaction between the mother and the newborn is in the range of 0 to 1. Items that assess the degree of acceptance are between 0.59 and 0.86. The rating for interaction harmony is above 0.57; affective tone is between 0.42 and 0.83; the diagnosis of high as well as low relational risk ranges between 0.43 and 0.91. Conclusion: We emphasize the importance of training based on the theory of attachment, the characteristics of the dyadic interaction, and the development of interviewing and systematic observation competencies in order to be certain about observed behaviours.