Experiences of mothers with early weaning: a grounded theory

OBJECTIVE

To understand the experiences of mothers with early weaning.

METHOD

Qualitative research with a theoretical-methodological contribution from Grounded Theory (Straussian perspective), carried out in the context of primary health care in a medium-sized municipality in the northeast of Brazil. 19 collaborators participated by theoretical sampling. Data collection took place between April and September 2018, with in-depth interviews, and was analyzed in three stages: open and axial coding, and integration.

RESULTS

The central category "Women experiencing guilt and overload due to early weaning" was supported by three categories: a) conditions: "Showing the factors that limit breastfeeding"; b) actions/interactions: "Trying to balance motherhood and work during breastfeeding" and "Insufficient social support to keep exclusive breastfeeding"; and c) consequences: "Introducing formula and complementary foods before six months" and "Blaming oneself for the early weaning".

FINAL CONSIDERATIONS

The theoretical model can give support to managers and health professionals to advocate for longer maternity leaves and confront gender disparities and inequities, professional performance with conflicts of interest, and abusive marketing regarding the use of formula.

Representações sociais da maternidade para mulheres em privação de liberdade no sistema prisional feminino

Resumo Neste artigo, objetivou-se analisar as representações sociais da maternidade de mulheres gestantes, lactantes e que vivenciaram a gestação em privação de liberdade no sistema prisional. Trata-se de estudo qualitativo, ancorado nos pressupostos do Paradigma Teórico das Representações Sociais, realizado com 42 mulheres. As participantes eram, em maioria, jovens entre 18 e 39 anos de idade (90,5%; n=38) e se encontravam solteiras (50,0%; n=21); 61,9% (n=26) relataram duas ou mais gestações e 47,6% (n=20) referiram um ou mais abortamentos. A possível representação do ser mãe na prisão se cristalizou, em termos semânticos, principalmente pelos termos “separação” (f=27; OME: 2,9), “tristeza” (f=18; OME: 2,3), “horrível” (f=16; OME: 2,1) e “dor” (f=12; OME: 2,8). Na zona de substituição e de descontextualização, as representações foram objetivadas pelos termos “separação” (f=18; OME: 3), “tristeza” (f=13; OME: 2,5), “medo” (f=11; OME: 2,2) e “horrível” (f=10; OME: 1,5). Evidenciou-se que a centralidade das representações sociais para as participantes do estudo reflete o sofrimento vivenciado pela separação da díade mãe-filho.

Social representations of motherhood for women deprived of liberty in the female prison system

Abstract This paper aimed to analyze the social representations of motherhood of pregnant women, breastfeeding women, and those who experienced pregnancy in deprivation of liberty in the prison system. This qualitative study was conducted with 42 women and is grounded on the assumptions of the Theoretical Paradigm of Social Representations. Most participants were young women aged 18-39 (90.5%; n=38) and single (50.0%; n=21); 61.9% (n=26) reported two or more pregnancies and 47.6% (n=20) reported one or more miscarriages. The possible representation of being a mother in prison was crystallized, in semantic terms, mainly by the terms “separation” (f=27; OME: 2.9), “sadness” (f=18; OME: 2.3), “horrible” (f=16; OME: 2.1) and “pain” (f=12; OME: 2.8). In the substitution and decontextualization zone, representations were objectified by the terms “separation” (f=18; OME: 3), “sadness” (f=13; OME: 2.5), “fear” (f=11; OME: 2.2) and “horrible” (f=10; OME: 1.5). It was evident that the centrality of social representations for the study participants reflects the suffering experienced by the separation of the mother-child dyad.

Saúde mental, arte e desinstitucionalização: um relato estético-poético-teatral de uma ocupação da cidade

Resumo Objetivou-se relatar a experiência de uma produção estética, poética e teatral de ocupação da cidade a partir de um dispositivo da Rede de Atenção Psicossocial, com vistas a oferecer espaço de sociabilidade, produção e intervenção cultural. Trata-se de um relato de experiência a partir do Centro de Convivência e Cultura (CECCO) de Natal, Rio Grande do Norte, Brasil, dentro do campo da desinstitucionalização da loucura e da saúde mental. A intervenção urbana “O Pequeno Príncipe ocupa a Ribeira” foi inspirada na obra do escritor Saint-Exupéry. Os atos artísticos e criativos relatados aconteceram em dezembro de 2019. Experimentamos nessa intervenção os alcances de uma clínica-estética que, ao se abrir para a rua e para a arte, se amplia e se tece no território, instrumentalizado pelo teatro, dança, poesia, percussão, artesanato e ocupação da cidade. O movimento gerou no coletivo um “descer do palco” em direção à rua e se conecta com a desconstrução do modelo manicomial e produção da clínica dos afetos que buscamos sustentar no cotidiano do serviço.

HUMANIZAÇÃO DA ASSISTÊNCIA NO PROCESSO PARTURITIVO: INSTRUINDO MULHERES EM UMA MATERNIDADE ESCOLA

Introdução: Ao longo dos séculos, o ato de parir passou por diversas transformações. Um processo doméstico, cujo principal sujeito era a parturiente, passou a ser hospitalizado, acompanhado por profissionais de saúde e protagonizado pela figura médica. Objetivo: Compreender o nível de entendimento das puérperas sobre o conceito de humanização no trabalho de parto, bem como sobre boas práticas na atenção ao parto e nascimento. Método: Nota Prévia decorrente de Pesquisa exploratória, descritiva e qualitativa em desenvolvimento em uma maternidade de Natal, Rio Grande do Norte desde janeiro de 2021. As participantes são mulheres que se encontram no puerpério imediato. As transcrições das entrevistas têm sido codificadas e analisadas pela técnica de análise de conteúdo, na modalidade de análise temática conforme Bardin. Resultados Esperados: A partir das respostas das participantes será possível elaborar um Guia de Boas Práticas no intuito de servir como estratégia adicional de acolhimento e esclarecimento às parturientes.

Analysis of the effects of the age-period-birth cohort on cervical cancer mortality in the Brazilian Northeast

Cervical cancer (CC) is a public health problem with a high disease burden and mortality in developing countries. In Brazil, areas with low human development index have the highest incidence rates of Brazil and upward temporal trend for this disease. The Northeast region has the second highest incidence of cervical cancer (20.47 new cases / 100,000 women). In this region, the mortality rates are similar to rates in countries that do not have a health system with a universal access screening program, as in Brazil. Thus, this study aimed to analyze the effects of age, period and birth cohorts on mortality from cervical cancer in the Northeast region of Brazil. Estimable functions predicted the effects of age, period and birth cohort. The average mortality rate was 10.35 deaths per 100,000 women during the period analyzed (1980–2014). The highest mortality rate per 100,000 women was observed in Maranhão (24.39 deaths), and the lowest mortality rate was observed in Bahia (11.24 deaths). According to the period effects, only the state of Rio Grande do Norte showed a reduction in mortality risk in the five years of the 2000s. There was a reduction in mortality risk for birth cohorts of women after the 1950s, except in Maranhão State, which showed an increasing trend in mortality risk for younger generations. We found that the high rates of cervical cancer mortality in the states of northeastern Brazil remain constant over time. Even after an increase in access to health services in the 2000s, associated with increased access to the cancer care network, which includes early detection (Pap Test), cervical cancer treatment and palliative care. However, it is important to note that the decreased risk of death and the mortality rates from CC among women born after the 1960s may be correlated with increased screening coverage, as well as increased access to health services for cancer treatment observed in younger women.

The human condition of the nursing worker from the perspective of Hannah Arendt

ABSTRACT Objective: This study intends to analyze how the human condition of the nurse is established in the context of Psychosocial Care Centers (Caps). Method: theoretical-reflexive study, anchored in three essential parts: 1) Theoretical and philosophical conception of the human condition from Hannah Arendt’s perspective; 2) The nurse’s work in the Caps; and 3) Human condition to think about the work of the nurse. Results: in the context of the Caps, the work can be represented by the psychic significations; the work, through the production of nurses’ practice of care; and the action by the relations established between worker and institution, worker and user. Final considerations: the understanding of the vita activa allows to reflect on the human condition of the nurse in their work context and (re) considers a better understanding about the impact of the work on the life of these mental health workers in the contemporaneity.

Características maternas de partos prematuros

Objetiva-se dentifi car o perfi l das condições de saúde de mães de partos prematuros. Trata-se de um estudotransversal, desenvolvido em uma maternidade pública da região nordeste, do Brasil. A coleta de dados se deu noperíodo de abril a setembro de 2015, com 109 mães de partos prematuros. Os resultados apontam que 62,96%referem eventos estressantes na gestação; gravidez não planejada em 59,63% e indesejada em 21,10%. Quanto aoestilo de vida apenas 43,12% praticavam alguma atividade física antes de engravidar; durante a gestação 8,26%utilizaram drogas ilícitas, 9,17% fi zeram uso do tabaco e 11,01% de bebidas alcoólicas. Com isso, 42,20% dasmães apresentavam-se obesas no fi nal da gestação e 32,11% com pressão arterial elevada. Conclui-se que asgestações dos bebês prematuros estão ocorrendo em situações de vida desfavoráveis à saúde materno-infantil, poishá carência de gestação planejada, com eventos estressantes, sedentarismo desde antes da gestação, obesidade econsumo de drogas lícitas e ilícitas.Palavras-chave: Gravidez; Prematuro; Enfermagem Materno-Infantil; Cuidado Pré-natal; Estilo de vida. ABsTRAcTThe aim is to identify the profi le of premature birth mothers. This is a cross-sectional study, developed in apublic hospital in the northeast region of Brazil. Data collection occurred from April to September 2015 with109 mothers of premature births. The results showed that 62.96% reported stressful events during pregnancy;unplanned pregnancy in 59.63% and 21.10% in unwanted. Regarding the lifestyle only 43.12% practiced somephysical activity before pregnancy; 8.26% during pregnancy used illegal drugs, 9.17% used tobacco and 11.01%of alcohol. Thus, 42.20% of mothers presented themselves obese in late pregnancy and 32.11% with high bloodpressure. It concludes that pregnancies whose outcomes are premature babies are taking place in unfavorable lifesituations to maternal and child health, because there is a lack of planned pregnancy, stressful events, physicalinactivity since before pregnancy, obesity and consumption of licit and illicit drugs.Keywords: Pregnancy; Premature; Maternal-Child Nursing; Prenatal Care; Life Style.

Nursing in adherence to treatment of tuberculosis and health technologies in the context of primary care

Abstract Objective: To describe and analyze the relationships between adherence to tuberculosis treatment and health technologies in the context of nursing action in Primary Care. Method: Contextual reflection, using the theoretical reference of Hinds, Chaves and Cypress. Results: They were categorized according to the conceptual perspective of each context, in an immediate, specific, general and metacontext, respectively: nursing actions in Primary Care and adherence to treatment of tuberculosis; nurses' performance through personal and environmental factors, health technologies and adherence to treatment; influence of nurses' beliefs about adherence to treatment and overall health status, and use of health technologies and shared views of patients and nurses on adherence to treatment as a responsibility for preventive action. Conclusion and Implications for practice: Adherence to the treatment of tuberculosis is directly linked to the substantial performance of the nurse, which presents potentialities to contribute to greater articulation between actions necessary to the success of the treatment, reducing the weaknesses in its operationalization. The technologies in the context of nursing action can favor praxis, especially in the incentive to join, and can subsidize new strategies appropriate to the reality of services.

The presence of the father in the kangaroo method

ABSTRACT Objective: To reflect about the father’s experience close to the premature son using the kangaroo method under the referential of Merleau-Ponty. Method: Theoretical-reflexive study based on the phenomenology of perception and behavior proposed by Merleau-Ponty and relevant literature. Results: To live the prematurity with the son using the kangaroo method, provides for the father to recognize himself as a being in the world. His intentions regarding the care are demonstrated through the skin to skin contact and the associated care for the newborn child. From the lived experiences, the father can exert the fullness of his paternity. Conclusion and implications for practice: By comprehending the father’s way of being, acting and reacting using the kangaroo method, it will be possible to reflect upon his attitudes as caregiver and get him closer to the newborn child. Therefore, it is possible to strengthen the behaviors between father and son with the purpose of creating an emotional bond, thus allowing the inherent care regarding prematurity. Understanding the paternal behavior in the care of the premature child in the Kangaroo Method and their perceptions about care neonatal, can benefit nursing praxis from the perspective of promoting neonatal health, as well as in the prevention of diseases in relation to morbidity and Infant mortality.

Predisposing Factors For Incidence Of Congenital Syphilis

The study aims to synthesize the knowledge produced in articles about the predisposing factors for the incidence of Congenital Syphilis. An integrative review was conducted in May and June 2014. Three databases were consulted and all publications available at the pre-established time frame were collected. The descriptors congenital syphilis, incidence and causality in Portuguese, English and Spanish were used, resulting in 1723 articles, of which 23 were selected. The results show deficiency in prenatal care; poor diagnosis; inadequante care of the disease; unequal socioeconomic conditions; difficult access to health services; and poor guidelines. The increasing number of new cases of congenital syphilis is due to several factors that can be prevented through quality prenatal care. Therefore, care actions during pregnancy and puerperium need to be redirected so that they are based on early diagnosis, immediate treatment of the couple and health education.

Clinical Complications In Pregnancy And The Relationship With Low Birth Weight And Prematurity Of The Newborn

Study in order to know the results of prenatal care related to clinical complications of pregnancy, newborn’s low birth weight and prematurity in the context of the users of the service. Descriptive, exploratory research with quantitative approach developed with 305 users who underwent prenatal care in primary care in the city of Mossoró-RN. The data collection occurred from the application of a validated questionnaire, the IPR-PRENATAL index. The results indicate that over 50% of pregnant women had some type of complication during their pregnancy process, among intercurrent diseases in pregnancy, and experienced by users, the urinary tract infection was the most prevalent (28.0%), followed by anemia (19.3%) and hypertension (15.7%). Hypertension and anemia were the only events that interfere with the newborn’s weight, which showed that the existence of complications contributes in three times to the occurrence of low birth weight. In this sense, the quality of prenatal care can minimize that type of complication.

Influences of Non-Accession to Exclusive Breastfeeding: Understanding of Feminine Subjectivity

Objective: To investigate the difficulties experienced by mothers, that influence the failure of Exclusive Breast Feeding. Method: qualitative study, exploratory and descriptive. There were semi-structured interviews with 14 women. The data treatment occurred by means of the content analysis, in the form of thematic analysis. Results: Mammary complications; negative influences of familiar; job out of home and various household duties; insufficient information and weaknesses in communication among professionals of prenatal care; insertion of artificial teats (bottles) in the hospital. Conclusions: it was found that breastfeeding transcends biological concept, because it suffers social and cultural interference. Furthermore, woman as a social being is inserted in a context permeated by values which directly interfere in their attitudes.

Empirical Indicators of Psychobiological Needs of Pregnant Women: Integrative Review

Introduction: Pregnancy is a natural phenomenon whose evolution requires routine monitoring in order to promote well-being and comfort to the woman and her family. Objective: To analyze the scientific literature on empirical indicators of the pregnant woman needs. Method: This is an integrative review considering publications between years 2005 and 2014. Databases consulted were Cochrane, CINAHL, Lilacs, Pubmed, Scopus and Journal of Midwifery. It was used as inclusion criteria articles published in full that dealt indicators related to the need of women during pregnancy. In 36 articles selected 64 indicators were identified consistent to the physiological needs of pregnant women. Results: The results show imbalances especially eating habits, physical activity, depression and anxiety. It was found low supply of treatments and tests relating to prenatal program. Conclusion: The reviewed publications indicate the existence of gaps in the psychobiological level of the pregnant woman. This situation is worrying when it is assumed that pregnant women not getting their needs met, they are predisposed to injuries to their health and of the conceptus and of the household as a social cell.

Using acupressure to minimize discomforts during pregnancy

OBJECTIVE

To describe responses issued by pregnant women, and the improvement of the gravidic discomforts after the use of the acupressure technique.

METHOD

Qualitative and descriptive study conducted with 15 pregnant women between November 2013 and February 2014 in a Basic Health Unit in Natal, RN, Brazil. The data were collected through unstructured interviews and depositions that were then transcribed and treated according to Minayo's operative proposal, carefully read, compared and organized into two groups.

RESULTS

The categories that resulted were: Positive effects of acupressure, and the recommended use of acupressure. According to pregnant women, the discomforts of pregnancy cramps, fatigue in the legs, lower back pain and headaches decreased with the use of acupressure.

CONCLUSIONS

Based on the results, acupressure should be introduced by the nurse in pre-natal care as a therapeutic resource for the pregnant woman's well-being.

AS GESTÕES MUNICIPAIS E O USO DAS INFORMAÇÕES NO PACTO PELA SAÚDE NO ESTADO DO RIO GRANDE DO NORTE

O Pacto pela Saúde vem sendo para as gestões municipais uma experiência de grande relevância, em que uma nova forma de planejamento e avaliação tem sido proposta, com grande necessidade de utilização das informações em saúde. Este trabalho teve como objetivo analisar o uso das informações no planejamento e execução das ações de saúde. Foram selecionados onze municípios de diferentes portes populacionais e de diferentes regiões do Estado. As opiniões foram coletadas através de entrevistas semiestruturadas e analisadas em quatro categorias. As opiniões foram coletadas através de entrevistas semiestruturadas e analisadas em quatro categorias. Constatou-se que existe por parte dos gestores municipais uma avaliação positiva do processo de implantação do Pacto pela Saúde. Eles reconhecem a importância do uso das informações nos processos decisórios da gestão e aceitam as determinações impostas como naturais, sendo uma oportunidade de articulação e maior responsabilização. Identificaram, ainda, os principais problemas como propositivos, apresentando estratégias para superação dos mesmos para sua qualificação.

Domestic maternal experience with preterm newborn children

OBJECTIVE

Exploring maternal experience with premature newborn children in a domestic environment.

METHODS

The study was qualitative and used focus group interviews with 24 women who had had preterm deliveries in a public maternity hospital located in Northeast Brazil during June and October 2005. The mothers returned to the hospital facility at least 30 days after the newborn were discharged to share their experiences in caring for a premature infant at home.

RESULTS

Interview data was analysed for content, four thematic nuclei being identified: hospital discharge, preparing the family for discharge, caring for a premature baby at home and life changes arising from the premature birth. The greatest difficulties reported by the mothers in caring for their premature children at home were related to feeding and feelings of insecurity and fear were expressed which showed the need for a support network for the families following discharge.

CONCLUSIONS

The mothers care of premature infants at home represented changes for parents in everyday family life, work and social life, thus showing the need for a support network for them during the transition from hospital to home when considering premature children.

Representação social de pais sobre o filho prematuro na unidade de terapia intensiva neonatal

Pesquisa qualitativaa que teve como objetivo conhecer a representação social do pai diante do filho prematuro. Os dados foram coletados no período de maio a junho de 2008 por meio de entrevista semi-estruturada, junto a 17 pais cujos filhos prematuros estavam internados na UTIN de duas instituições públicas de natal-RN. Os depoimentos foram tratados e analisados com base na teoria das representações sociais (TRS). Os resultados revelaram que os pais ao estarem com seus filhos internados vivenciam emoções que são traduzidas por medo, angústia, ansiedade, solidão e se entremeiam a fé, alegria e esperança. Para o pai a UTIN representa um ambiente assustador, mas necessário aos cuidados especializados requeridos pelas condições do recém nascido prematuro.

Representações de mães sobre hospitalização do filho prematuro

Estudo qualitativo que objetivou conhecer as representações de mães sobre a hospitalização do filho prematuro na Unidade de Terapia Intensiva Neonatal (UTIN). Inclui dezoito mães de prematuros internados na UTIN de um hospital escola em Natal (RN). Utilizou-se a entrevista semi-estruturada e na análise dos dados evidenciou-se que a hospitalização do filho é representada pelas mães por significados, sentimentos, dificuldades e incertezas. Considera-se que a prematuridade representa um desafio materno desde o momento da constatação do parto pré-termo, prosseguindo com os percalços inerentes a hospitalização e requer conhecimento, escuta e diálogo dos profissionais de saúde de forma efetiva para fortalecimento da adequação materna a prematuridade.