Experience of Vulnerable Women Narrated through the Body-Mapping Technique.

Vulnerable women are considered a priority in public policies and research agendas. It is necessary to understand better the specificities of their daily lives and the meanings they attribute to their experiences, as this undoubtedly contributes to more grounded and culturally appropriate practices. Additionally, innovative techniques in qualitative research are demanded in academia. This narrative research study was carried out with fourteen women from a Brazilian socioeconomically vulnerable neighborhood. We used the body-mapping technique to investigate the experiences of women with mental health disorders or psychosocial distress. The aim was to analyze the self-perception about daily stressors and discuss the feasibility of this technique to facilitate this group's storytelling. Data collection was performed through focus groups, guided by the body-mapping technique steps, and supplemented with individual interviews. Interpersonal conflicts and violence were the main stressors. These strongly impacted the well-being of these women and their children. Some important personal qualities and resilience were identified. Body-mapping played a fundamental role in facilitating storytelling. It amplified the linguistic possibilities for participants to express their feelings and promoted reflections about the present, past, and glimpses into the future.

Aspectos sociodemográficos e obstétricos da morbidade materna grave / Aspectos sociodemográficos y obstétricos de la morbilidad materna grave / Sociodemographic and obstetric aspects of severe maternal morbidity

RESUMO Objetivo: Identificar os aspectos sociodemográficos, obstétricos e de saúde de mulheres com experiência de morbidade materna grave em um hospital de nível terciário. Material e método: Estudo descritivo, transversal, de base hospitalar realizado em 78 mulheres. A coleta de dados realizou-se por meio de entrevistas estruturadas e revisão de prontuários e os dados foram analisados mediante estatística descritiva. Resultados: Das partici pantes 24,4% foram gestantes e 75,6% puérperas, a idade média foi de 28,8 anos. 35,9% foram primigestas e os principais diagnósticos foram as síndromes hipertensivas, 83,3 e 16,7% outras morbidades. Destaca-se que 15,4% das participantes atendiam a mais de um critério durante o tempo de internação e 73,0% tiveram seis ou mais consultas de pré-natal. Conclusão: As síndromes hipertensivas foram as primeiras causas de morbidade materna grave, e ressalta-se a assistência pré-natal prestada. Os resultados fornecem implicações para o financiamento de mecanismos de assistência às mulheres que sofreram os eventos da morbidade materna grave associados aos aspectos obstétricos e sociodemográficos das mesmas. Existe a necessidade de caracterizar e monitorar a morbidade materna grave na atenção obstétrica para desenvolver ações de promoção e melhorar os cuidados de saúde prestados a essas mulheres. O conhecimento dos principais diagnósticos apresentados por mulheres com morbidade materna grave são importantes para a prática dos enfermeiros que atuam nessa área, pois permite instrumentalizar mudanças no modelo de assistência à mulher e sua família, com vistas a que se atinja a maternidade segura em nosso país.

ABSTRACT Objective: Identify sociodemographic, obstetric and health aspects of women who experienced severe maternal morbidity in a tertiary care hospital. Method: A descriptive study, cross-sectional and hospital-based involving 78 women. Data collection was carried out through structured interviews and review of medical records and data were analyzed using descriptive statistics. Results: 24.4% of participants were pregnant and 75.6% were in the postpartum period, the average age was 28.8 years. 35.9% were primiparous and primary diagnoses were hypertensive disorders, 83.3% and 16.7% other morbidities. It is noteworthy that 15.4% of participants met more than one criterion during the time of admission and 73.0% had six or more prenatal consultations. Con clusion: Hypertensive syndromes were the first causes of severe maternal morbidity, and prenatal care provided was highlighted. The results provide implications for the funding of mechanisms to assist women who have suffered from severe maternal morbidity events associated with obstetric and sociodemographic aspects. There is a need to characterize and monitor severe maternal morbidity in obstetric care to develop actions to promote and improve the health care provided to these women. Knowledge of the mains diagnosis presented by women with severe maternal morbidity are important for the practice of nurses working in this area, because it allows for the implementation of changes in the care model for women and their families, with a view to the attain ment of safe motherhood in our country.

RESUMEN Objetivo: Identificar los aspectos sociodemográficos, obstétricos y de salud en mujeres con experiencia de mor bilidad materna grave en un hospital de nivel terciario. Material y método: Estudio descriptivo, transversal, realizado en hospital con 78 mujeres. La recolección de datos se realizó mediante entrevistas estructuradas y revisión de historias clínicas, los datos fueron analizados mediante estadística descriptiva. Resultados: De las participantes 24,4% fueron gestantes y 75,6% puérperas, la edad media fue de 28,8 años, el 35,9% fueron primigestas. Los principales diagnósticos fueron: síndromes hipertensivos (83,3%), otras morbilidades 16,7%; se destaca que el 15,4% de las participantes presentaban más de un criterio durante el tiempo de internación y el 73% tuvo seis o más consultas de prenatal. Conclusión: Los síndromes hipertensivos fueron las primeras causas de morbilidad materna grave, y se resalta la asistencia prenatal prestada. Los resultados proporcionan implica ciones para la financiación de mecanismos de asistencia a las mujeres que sufrieron los eventos de morbilidad materna grave asociados a los aspectos obstétricos y sóciodemográficos de las mismas. Existe la necesidad de ca racterizar y monitorizar la morbilidad materna grave durante la atención obstétrica para desarrollar acciones de promoción y mejorar los cuidados de salud prestados a estas mujeres. El conocimiento del perfil de diagnósticos presentados en las mujeres con morbilidad materna severa es importante para la práctica de los enfermeros que trabajan en esta área, ya que permite dotar a los cambios en el modelo de atención de la mujer y su familia, con miras al logro de una maternidad segura en nuestro país.

Mental health of women who suffer intimate partner violence during pregnancy.

OBJECTIVE: To identify the relationship between intimate partner violence (IPV) during pregnancy and mental disorders in women in the pregnancy-puerperal cycle. METHODOLOGY: A review was conducted of papers published in Portuguese, English and Spanish regarding the study theme. The databases explored were PubMed, CINAHL, LILACS and PsycINFO. RESULTS: The 17 included papers studied the relationship between IPV and: pre- and postpartum depression (41%); pregnancy anxiety (23%) and pregnancy posttraumatic stress disorder (12%). None of the studies investigated the association between IPV and suicidal ideation. CONCLUSION: IPV against women during the pregnancy-puerperal cycle causes negative impacts on mental health. Concrete actions shall be proposed regarding the prevention, identification and treatment of women exposed to IPV during their pregnancy period.

Continuing education in nursing as a factor associated with knowledge on breastfeeding / Formación continuada en enfermería como un factor asociado al conocimiento en lactancia materna / Formação continuada na enfermagem como um fator associado ao conhecimento em aleitamento materno

Objective. Identifying the knowledge about breastfeeding of the nurses of the Family Health Program, and possible associations between the knowledge and personal, professional and self evaluation aspects. Methodology. Observational and cross-sectional study conducted in family health units of a city in Minas Gerais, Brazil, with 85 nursing professionals. Data were collected through a questionnaire. We used the Student t-test for differences between means and Pearson correlation analysis. Results. The mean score of the professionals on the knowledge test was 6.6 and was higher in the group that attended courses on breastfeeding. Conclusion. There is a need for continuing education, providing reflective and critical mobilization, the questioning of reality and identification of users needs.

Objetivo. Identificar el conocimiento de los profesionales de enfermería de la Estrategia de Salud de la Familia sobre la lactancia materna y las posibles asociaciones entre el conocimiento y los aspectos personales, profesionales y de autoevaluación. Metodología. Estudio observacional de tipo transversal, desarrollado en unidades de salud de la familia de un municipio de Minas Gerais, Brasil, con 85 profesionales de enfermería. Los datos fueron recolectados mediante un cuestionario. Resultados. La media de aciertos de los profesionales en este test de conocimiento fue de 6.6 y fue mayor en el grupo que participó en cursos sobre lactancia materna. Conclusión. Se precisa una educación permanente, proporcionando movilización reflexiva y crítica, una problematización de la realidad y la identificación de las necesidades de los usuarios.

Objetivo. Identificar o conhecimento de profissionais de enfermagem da Estratégia de Saúde da Família sobre aleitamento materno e possíveis associações entre o conhecimento e aspectos pessoais, profissionais e de auto avaliação. Metodologia. Estudo observacional e transversal, desenvolvido em unidades de saúde da família de um município de Minas Gerais, Brasil, com 85 profissionais de enfermagem. Os dados foram coletados por meio de um questionário. Utilizou-se o teste t-Student para a diferença entre médias e a análise de correlação de Pearson. Resultados. A média de acertos dos profissionais no teste de conhecimento foi de 6.6 e foi maior no grupo que participou de cursos sobre aleitamento materno. Conclusão. Há a necessidade de educação permanente, proporcionando mobilização reflexiva e crítica, a problematização da realidade e a identificação das necessidades dos usuários.

Women's feelings about early contact with their infants on the labour ward.

OBJECTIVES: to identify women's feelings after early contact with their newborn infants in the delivery room, and to identify how health professionals involved in mother and infant care behave in the intrapartum setting. DESIGN: a qualitative approach using semi-structured interviews and observation. Content analysis was used to derive the three themes that emerged from the interviews. SETTING AND PARTICIPANTS: 23 postpartum women and their caregivers in a public maternity hospital in Ribeirão Preto, Brazil. FINDINGS: three thematic categories emerged from the interviews: heightened fear, severe pain and intense conflict. The professionals' actions revealed that they have theoretical and practical abilities for humanisation of care, but their actions are fragmented. FINAL CONSIDERATIONS: women can feel lonely, fearful and conflicted in the delivery room, and they also experience pain. Giving birth is a major event in a woman's life, so it is important to facilitate a positive experience. Health professionals were found to display interventionist and impersonal attitudes; these influenced the potential choices of women at their first contact with their infant. IMPLICATIONS FOR PRACTICE: the focus of health care needs to extend beyond the institution. This means fewer normative actions performed by health professionals, enabling women to enjoy their early contact with their newborn infants.