Cross-cultural nursing care for immigrant women during pregnancy and childbirth: experiences and vulnerabilities.

OBJECTIVE: To understand the experiences and vulnerabilities for cross-cultural nursing care for immigrant women during pregnancy and delivery. METHOD: Exploratory, qualitative research, in the light of the Theory of Diversity and Universality of Cultural Care, in Foz do Iguaçu, Brazil, through interviews with eight postpartum woman and 18 nurses, between February and September 2022. The interpretation of meanings was adopted for analysis. RESULTS: The categories of analysis emerged: Experiences, vulnerabilities and acculturation of immigrant women during pregnancy and delivery; Cross-cultural care and vulnerabilities experienced by immigrants in Brazilian health services. Vulnerabilities were identified in Cultural and Social Structure Dimensions expressed in access to work, low socioeconomic conditions, lack of family and social support and specific services for this population. The potentialities experienced included good care provided by health services, quality of the multidisciplinary team and appreciation of professional knowledge, however, the understanding of expectations and cultural aspects needs to be deepened. FINAL CONSIDERATIONS: Understand that immigrant women experience situations of vulnerability in pregnancy and childbirth, in the Brazilian context, mainly related to social and programmatic dimensions. However, potentialities were also experienced, evidenced by positive aspects in cross-cultural nursing care in Brazil.

Translation, cross-cultural adaptation and validity study of the "Play Nicely Program: The Healthy Discipline Handbook" for use in Brazil.

OBJECTIVE: to describe the translation, cross-cultural adaptation and validity process of the "Play Nicely Program: The Healthy Discipline Handbook" for use in Brazil. METHODS: a methodological study that followed the translation, back-translation, expert committee assessment, and pre-test steps. The Content Validity Index (CVI) was calculated for both the judge population and the pre-test population. Four translators, seven expert judges in the field of child health and thirty participants in the pre-test, including parents, teachers and healthcare professionals, participated in the study. RESULTS: in experts' analysis (98.4%), a value of 100% of adequate assessments was obtained, and in the target population's analysis (89.5%), there were 100% of adequate assessments. In both analyses, suggested adaptations were made. CONCLUSIOS: cross-cultural adaptation and content validity into Brazilian Portuguese of the "Play Nicely Program: The Healthy Discipline Handbook" were considered adequate for application in the target population.

[Meaning the process of living the coronary artery bypass graft surgery: changes in lifestyle]. / Significando o processo de viver a cirurgia de revascularização miocárdica: mudanças no estilo de vida.

The study aimed to understand how patients mean your experience process of living after surgical revascularization. Will be presented in this article, a category and seven subcategories that represent significant changes from that experience, that is, the "consequences" component of the paradigm model, according to Grounded Theory, method of study. Participated in data collection 23 subjects The interviews were semi-structured and took place from October 2010 to August 2011. Significant changes are related to aspects of social and sexual life, work diet physical activity and drug treatment. We conclude that surgical revascularization experience encourages the reflection and the (re) think the lifestyle, it has limitations and difficulties that challenge changes in daily habits of patients and families to live a healthier process.

Continuity of care for children with chronic conditions after discharge: a constructivist grounded theory.

OBJECTIVES: to understand the meaning of continuity of care for children with chronic conditions through transitional care from hospital to home. METHODS: this is a qualitative study, conducted from a Constructivist Grounded Theory perspective. Purposive and theoretical sampling were used to recruit 35 participants, including nurses, professionals from the interprofessional hospital team, and actors responsible for healthcare in the home context. The research was conducted at two large hospitals, between March and September 2019. Semi-structured interviews were conducted. Data analysis was carried out using initial and focused coding, according to constructivist grounded theory. RESULTS: the substantive theory that emerged from this study was named "Postponing the next hospitalization". Eight categories-concepts and 18 elements were derived from the data to support the substantive theory. FINAL CONSIDERATIONS: transitional care from hospital to home acts as a reminder for the resumption of continuity of care after discharge.

Multiple relationships of nursing care: the emergence of care "of the us".

The aim of this qualitative study was to comprehend the relationships of the care of the self, of care of the other, and of care "of the us" in the different dimensions of care, through an educational/reflexive/interpretative process with nursing professionals in a University Hospital, using the complexity perspective. The data were collected through workshops and submitted to content analysis. The following categories emerged: reflecting upon the meaning of care of the self, care of the other, and "of the us" for the "I - human being", and for the "I - nursing professional"; and reflecting and (re)constructing the meanings of the relationships of care for the self, care for the other, and care "for the us". The care "for the us" is an emerging theme, in construction, and impels a concern for the collective, as well as remits to the comprehension of the multiple and unending phenomenon of constant movement among the beings and between them and their environment, modifying, altering, and causing to be altered the networks of existent relationships.

[Peripherally inserted central catheter: description of its use in neonatal and pediatric ICU]. / Cateter central de inserção periférica: descrição da utilização em UTI neonatal e pediátrica.

The purpose of this descriptive, retrospective, documental study is to describe the use of peripherally inserted central catheters (PICC) in a neonatal and pediatric intensive care unit regarding their insertion, maintenance, and removal. This study also characterized the population which received the catheter through descriptive and statistical analysis of 176 instruments filled out by nurses, in a two year period. The population attended consisted of 125 patients, mainly premature (43.2%) and male (60%). The basilic and cephalic (43.2%) veins were primarily used for the insertion of a 1.9Fr (85.8%) catheter. The success rate was 98.9% in the punctures, but anticipated removal occurred due to obstruction (25%), infiltration (18%), suspected contamination (16.6%), traction (13.9%), rupture (11.2%), accidental removal (8.3%), phlebitis (4.2%), cyanosis (1.4%), and migration (1.4%), with an average period of permanence of 14.5 days. In order to maintain the catheter professional education and preparation are required to qualify care.

(Dis)continuation of care of the pre-term newborn at the border.

OBJECTIVES: to understand how continuation of care for the preterm newborn in the health care network at the border. METHODS: the Grounded Theory was the methodological framework. Data were collected through 17 semi-structured interviews between July 2016 and March 2017. RESULTS: "Describing the structure and functioning of the Child Nutrition Center" represents the context; "Experiencing and signifying premature birth" are the causal conditions; "Identifying conditions that intervene in the process of continuation of care for the preterm newborn" are the intervening conditions; "Ensuring continuation of care for the preterm newborn" are strategies; "Identifying (dis)continuation of care flows for the preterm newborn at the border" are the study's consequences and phenomenon. FINAL CONSIDERATIONS: there is a need to plan referral and counter-referral flows of the preterm newborn and the commitment of public health managers to ensure continuation of care.

[Caring for the self, for another, and for 'us' within a complexity perspective]. / Cuidando de si, do outro e 'do nós' na perspectiva da complexidade.

This study is an experience report of a reflective practice developed with nursing professionals in a public hospital in Santa Catarina, Brazil about the problem of relationships in caring for one's self, another, and for 'us', in different dimensions, within the perspective of the Complexity paradigm. Five workshops were organized and carried out, encompassing three meetings each, with previously chosen themes. From the systematic analysis of the participants' speech content, some units of meaning emerged. This practice brought comprehension concerning established iterations and associations in the I-other-us relationship closer together, as human beings, in the I-other-us-environment relationship, and in the relationship each human being has with him/herself, based on the mobilization/undulations/private and reciprocal exchanges of living and living with others in a complex world/scenario.

[Understanding care dimensions in an emergency hospital unit]. / Compreendendo as dimensões de cuidado em uma unidade de emergência hospitalar.

The objective of this qualitative study was to comprehend the meaning of the nursing care relationships in an emergency unit from the perception of the human receiving care and to provide theoretical subsidies in order to think about the care relationships established in day-to-day nursing work. Nineteen (19) subjects were interviewed in an emergency hospital unit in Santa Catarina, Brazil. The data was submitted to content analysis and interpreted according to complex thought. The care dimensions, presented in six categories, mobilize and articulate the multiple human competencies and techniques of/by caring beings in the comprehension of the nursing care process, from the perspective of those who receive care, including rethinking nursing practice itself and the multiple conditions of the environment as a space for care.

Interferências na atenção primária às puérperas em região de fronteira durante a pandemia da covid-19 / Interferences in primary care for puerperal women in a border region during the covid-19 pandemic / Interferencias en la atención primaria a mujeres puerperales en una región fronteriza durante la pandemia covid-19

RESUMO: Objetivo: identificar fatores que interferiram na atenção puerperal em uma região de fronteira na vigência da pandemia da COVID-19. Método: pesquisa qualitativa, tendo como referencial metodológico a Teoria Fundamentada nos Dados. Desenvolvida na atenção primária, em região de tríplice fronteira, Brasil, Argentina e Paraguai, com 30 participantes entre puérperas, profissionais de saúde e gestores. Coleta e análise de dados entre agosto de 2021 e maio de 2022, seguindo as etapas de codificação aberta, axial e seletiva, conforme a perspectiva straussiana. Resultados: identificaram-se quatro subcategorias: "acessando as unidades de saúde", "entendendo a visita domiciliar e a busca ativa", "tendo insuficiência de compartilhamento de informações na rede de atenção" e "evidenciando um sistema de saúde sobrecarregado". Conclusão: constatou-se que a maioria dos fatores que interferiu no atendimento das puérperas já existia, sendo agravados pela pandemia. Recomenda-se instituição de medidas que garantam compartilhamento de informações e contrarreferência em tempo oportuno.

ABSTRACT Objective: To identify factors that have interfered with puerperal care in a border region during the COVID-19 pandemic. Method: qualitative research, using Grounded Theory as a methodological reference. It was developed in primary care in the triple border region of Brazil, Argentina, and Paraguay, with 30 participants, including puerperal women, health professionals, and managers. According to the Straussian perspective, data collection and analysis were collected between August 2021 and May 2022, following the stages of open, axial, and selective coding. Results: four subcategories were identified: "accessing health units", "understanding home visits and active search", "having insufficient information sharing in the care network" and "showing an overloaded health system". Conclusion: it was found that most of the factors that interfered with puerperal women's care already existed and were aggravated by the pandemic. It is recommended that measures be put in place to guarantee the sharing of information and timely counter-referrals.

RESUMEN: Objetivo: identificar factores que interfirieron en la atención posparto en una región fronteriza durante la pandemia de COVID-19. Método: investigación cualitativa, utilizando como marco metodológico la Teoría Fundamentada. Desarrollado en atención primaria, en una región de la triple frontera, Brasil, Argentina y Paraguay, con 30 participantes entre mujeres puerperales, profesionales de la salud y directivos. Recopilación y análisis de datos entre agosto de 2021 y mayo de 2022, siguiendo las etapas de codificación abierta, axial y selectiva, según la perspectiva straussiana. Resultados: se identificaron cuatro subcategorías: "acceso a las unidades de salud", "comprensión de las visitas domiciliarias y búsqueda activa", "intercambio de información insuficiente en la red de atención" y "evidencia de un sistema de salud sobrecargado". Conclusión: se encontró que la mayoría de los factores que interfirieron en el cuidado de las mujeres puerperales ya existían, siendo agravados por la pandemia. Se recomienda implementar medidas que garanticen el intercambio de información y la contrarreferencia de manera oportuna.

Cross-cultural nursing care for immigrant women during pregnancy and childbirth: experiences and vulnerabilities / Cuidado transcultural de enfermería para la mujer inmigrante durante el embarazo y el parto: experiencias y vulnerabilidades / Cuidado transcultural de enfermagem à mulher imigrante na gestação e parto: experiências e vulnerabilidades

ABSTRACT Objective: To understand the experiences and vulnerabilities for cross-cultural nursing care for immigrant women during pregnancy and delivery. Method: Exploratory, qualitative research, in the light of the Theory of Diversity and Universality of Cultural Care, in Foz do Iguaçu, Brazil, through interviews with eight postpartum woman and 18 nurses, between February and September 2022. The interpretation of meanings was adopted for analysis. Results: The categories of analysis emerged: Experiences, vulnerabilities and acculturation of immigrant women during pregnancy and delivery; Cross-cultural care and vulnerabilities experienced by immigrants in Brazilian health services. Vulnerabilities were identified in Cultural and Social Structure Dimensions expressed in access to work, low socioeconomic conditions, lack of family and social support and specific services for this population. The potentialities experienced included good care provided by health services, quality of the multidisciplinary team and appreciation of professional knowledge, however, the understanding of expectations and cultural aspects needs to be deepened. Final considerations: Understand that immigrant women experience situations of vulnerability in pregnancy and childbirth, in the Brazilian context, mainly related to social and programmatic dimensions. However, potentialities were also experienced, evidenced by positive aspects in cross-cultural nursing care in Brazil.

RESUMEN Objetivo: Comprender las experiencias y vulnerabilidades de la atención de enfermería transcultural a mujeres inmigrantes durante el embarazo y parto. Método: Investigación cualitativa, exploratoria, basada en la Teoría de la Diversidad y Universalidad del Cuidado Cultural, realizada en Foz do Iguazú, Brasil, a través de entrevistas con ocho madres y 18 enfermeras, entre febrero/septiembre de 2022. Se adoptó la interpretación de significados para el análisis. Resultados: Emergieron las categorías de análisis: Experiencias, vulnerabilidades y aculturación de mujeres inmigrantes durante el embarazo y parto; Atención transcultural y vulnerabilidades vividas por inmigrantes en los servicios de salud brasileños. Se identificaron vulnerabilidades en las Dimensiones de Estructura Cultural y Social expresadas en acceso al trabajo, bajas condiciones socioeconómicas, falta de apoyo familiar y social y de servicios específicos para esta población. Las potencialidades vividas incluyeron: buena atención en los servicios de salud, calidad del equipo multidisciplinario y valoración del conocimiento profesional, sin embargo, es necesario profundizar la comprensión de las expectativas y los aspectos culturales. Consideraciones finales: Se entendió que las mujeres inmigrantes vivieron situaciones de vulnerabilidad durante el embarazo y el parto, en el contexto brasileño, principalmente relacionadas con dimensiones sociales y programáticas. Sin embargo, también se experimentaron potencialidades, evidenciadas por aspectos positivos en la atención de enfermería transcultural en Brasil.

RESUMO Objetivo: Compreender as experiências e as vulnerabilidades para o cuidado transcultural de enfermagem à mulher imigrante na gestação e parto. Método: Pesquisa exploratória, qualitativa, à luz da Teoria da Diversidade e Universalidade do Cuidado Cultural, realizada em Foz do Iguaçu, Brasil, mediante entrevistas com oito puérperas e 18 enfermeiros,entre fevereiro e setembro de 2022. Adotou-se, para análise, a interpretação de sentidos. Resultados: Emergiram as categorias: Experiências, vulnerabilidades e aculturação da mulher imigrante na gestação e parto; Cuidado transcultural e vulnerabilidades experienciadas pela imigrante em serviços de saúde brasileiros. Vulnerabilidades foram identificadas nas Dimensões Culturais e de Estrutura Social expressas no acesso ao trabalho, baixas condições socioeconômicas, falta de suporte familiar, social e serviços específicos para essa população. As potencialidades experienciadas incluíram: bom atendimento nos serviços de saúde, qualidade da equipe multiprofissional e valorização do saber profissional; entretanto a compreensão das expectativas e dos aspectos culturais precisam ser aprofundados. Considerações finais: Compreendeu-se que as mulheres imigrantes experienciaram situações de vulnerabilidade na gestação e parto, no contexto brasileiro, principalmente relacionadas às dimensões sociais e programáticas. Contudo, potencialidades também foram experienciadas, evidenciadas pelos aspectos positivos no cuidado transcultural de enfermagem no Brasil.

Imunização da gestante em tempos de pandemia da COVID-19 / Inmunización de mujeres embarazadas en tiempos de pandemia de COVID-19 / Immunization of pregnant women in times of the COVID-19 pandemic

Objetivo: analisar e comparar a imunização de gestantes no período da pandemia da COVID-19 no Oeste do Paraná. Método: pesquisa analítica e transversal, realizada na nona e décima regionais de saúde do Paraná. Participaram 823 puérperas, a coleta de dados foi conduzida por inquérito e informações do prontuário entre setembro a dezembro de 2021. Utilizaram-se análise descritiva e teste de qui-quadrado com nível significância de 5%. Resultados: a nona regional apresentou melhor desempenho na imunização contra Hepatite-B, Influenza, Difteria, Tétano e Coqueluche em comparação à décima regional. A vacinação contra COVID-19 teve baixa adesão em ambas as regionais, cujos motivos foram: medo, opção própria, orientação médica e desejo de esperar o filho nascer. Conclusão: são necessárias novas estratégias e campanhas de sensibilização para aumentar o índice vacinal entre gestantes, sobretudo para a vacina contra COVID-19, considerando as complicações para a saúde materno-infantil.

Objective: analyze and compare the immunization of pregnant women during the COVID-19 pandemic in western Paraná. Method: this is an analytical, cross-sectional study carried out in the ninth and tenth regional health departments of Paraná. A total of 823 puerperal women took part, and data was collected using a survey and information from medical records between September and December 2021. Descriptive analysis and the chi-square test were used, with a significance level of 5%. Results: the ninth region performed better in immunization against Hepatitis-B, Influenza, Diphtheria, Tetanus and Pertussis compared to the tenth region. Vaccination against COVID-19 had low uptake in both regions, the reasons for which were: fear, own choice, medical advice and the wish to wait for the child to be born. Conclusion: new strategies and awareness campaigns are needed to increase the vaccination rate among pregnant women, especially for the COVID-19 vaccine, considering the complications for maternal and child health.

Objetivo: analizar y comparar la inmunización de mujeres embarazadas durante la pandemia de COVID-19 en el Oeste de Paraná. Método: investigación analítica y transversal, realizada en la novena y décima región sanitaria de Paraná. Participaron 823 puérperas. La recolección de datos se realizó mediante encuesta e información de historias clínicas entre septiembre y diciembre de 2021. Se utilizó análisis descriptivo y prueba de chi cuadrado con un nivel de significancia del 5%. Resultados: la novena región presentó mejor desempeño en inmunización contra Hepatitis B, Influenza, Difteria, Tétanos y Tos Ferina en comparación con la décima región. La vacunación contra la COVID-19 tuvo baja adherencia en ambas regiones y los motivos fueron: miedo, elección personal, consejo médico y deseo de esperar a que nazca el niño. Conclusión: son necesarias nuevas estrategias y campañas de sensibilización para aumentar la tasa de vacunación entre las mujeres embarazadas, especialmente de la vacuna contra la COVID-19, considerando las complicaciones para la salud materna e infantil.

[Understanding care dimensions in an emergency hospital unit]. / Compreendendo as dimensões de cuidado em uma unidade de emergência hospitalar.

The objective of this qualitative study was to comprehend the meaning of the nursing care relationships in an emergency unit from the perception of the human who receives the care and to provide theoretical subsidies in order to think about the care relationships established in daily nursing work. Nineteen subjects were interviewed in an emergency hospital unit in Santa Catarina, Brazil. The data was submitted to content analysis and interpreted according to complex thought. The care dimensions, presented in six categories, mobilize and articulate the multiple human competencies and techniques of/by caring beings in the comprehension of the nursing care process, from the perspective of those who receive care, including rethinking nursing practice itself and the multiple conditions of the environment as a space for care.

Atenção puerperal em uma região de fronteira: fragilidades agravadas pela pandemia de COVID-19 / Atención puerperal en una región fronteriza: debilidades agravadas por la pandemia de la COVID-19 / Puerperal care in a border zone: fragility aggravated by the COVID-19 pandemic

Resumo Objetivo Compreender a atenção à saúde de puérperas em uma região de fronteira na vigência da pandemia por COVID-19. Método Pesquisa qualitativa do tipo Teoria Fundamentada nos Dados, vertente straussiana, realizada em região de fronteira, na atenção primária à saúde, com 30 participantes, que formaram três grupos amostrais entre mulheres, profissionais de saúde e gestores, por meio de entrevistas semiestruturadas, realizadas por chamada de voz e de forma presencial entre agosto de 2021 a maio de 2022. Resultados Identificaram-se cinco categorias, conforme modelo paradigmático, sendo elas: Identificando serviços de atenção ao puerpério; retornando para a atenção primária à saúde no puerpério; identificando fatores que interferiram no atendimento à puérpera; apontando estratégias para promoção da saúde no puerpério; e tendo uma atenção puerperal frágil. Conclusão e implicações para a prática Fragilidades existentes foram agravadas no curso da pandemia por COVID-19. Recomenda-se qualificar a contrarreferência para garantir a continuidade da atenção puerperal em tempo oportuno; o teleatendimento para viabilizar o acompanhamento, quando condições epidemiológicas forem de risco para a saúde materna; políticas públicas podem fortalecer a assistência a estrangeiras e migrantes em região de fronteira.

Resumen Objetivo Comprender la atención a la salud de puérperas en una región fronteriza durante la presencia de la pandemia por COVID-19. Método Investigación cualitativa del tipo Teoría Fundamentada, vertiente straussiana, realizada en una región fronteriza, en atención primaria de salud, con 30 participantes, que conformaron tres grupos muestrales entre mujeres, profesionales de la salud y directivos, a través de entrevistas semiestructuradas, realizadas por llamada de voz y personal directivo entre agosto de 2021 y mayo de 2022. Resultados Se identificaron cinco categorías, de acuerdo con el modelo paradigmático: Identificar los servicios de atención al puerperio; volver a la atención primaria de salud en el puerperio; identificar los factores que interfirieron en la atención puérpera; señalar estrategias para la promoción de la salud en el puerperio; teniendo un cuidado puerperal frágil. Conclusión e implicaciones para la práctica las debilidades existentes fueron exacerbadas en el curso de la pandemia por COVID-19. Se recomienda calificar la contrarreferencia para asegurar la continuidad de la atención puerperal en tiempo y forma; el teleservicio para permitir el seguimiento, cuando las condiciones epidemiológicas representen un riesgo para la salud materna; Las políticas públicas pueden fortalecer la atención a los extranjeros y migrantes en la región fronteriza.

Abstract Objective To understand the health care of puerperal women in a border region during the COVID-19 pandemic. Method Grounded Theory qualitative research, straussian strand, conducted in a border region, in primary health care, with 30 participants, who formed three sample groups among women, health professionals, and managers through semi-structured interviews conducted by voice call and in-person between August 2021 and May 2022. Results Five categories were identified, according to the paradigmatic model, namely: Identifying postpartum care services; returning to primary health care in the postpartum; identifying factors that interfered in the care of postpartum women; pointing out strategies for health promotion in the postpartum period; and having fragile postpartum care. Conclusion and implications for practice Existing weaknesses were exacerbated during the pandemic by COVID-19. It is recommended to qualify the counter-referral to ensure continuity of postpartum care on time; teleservice to enable follow-up when epidemiological conditions pose a risk to maternal health; public policies can strengthen assistance to foreign women and migrants in the border region.

Introduction of the School Health Program in the city of Cascavel, Paraná State: report of nurses.

OBJECTIVE: to understand the introduction of the School Health Program in the city of Cascavel, Paraná State, as opposed to the report of nurses. METHOD: a qualitative study with fifteen participants. The data were collected from April to August 2015, through semi-structured interviews, analyzed by content analysis and thematic modality. RESULTS: the category "Introduction process" of the School Health Program integrates the subcategories "Identified health problems" and the "Challenges of intersectoriality". The program was implemented quickly, with a fragile training of professionals to perform in the phases that compose it. Structural conditions of schools, human and material resources, and emerging intersectoral interaction were identified obstacles. The integration of the health, school, and family constitutes the program's potentiality. FINAL CONSIDERATIONS: it is understood that the actions of the program were based on health assessments of students, and it is necessary for professionals and managers to discuss and analyze the obstacles identified to achieve all the proposed objectives.

Continuidade do cuidado da criança na Atenção Primária à Saúde em região de fronteira / Continuity of care for children in Primary Health Services in a border region / Continuidad del cuidado del niño en la Atención Primaria de la Salud en región de frontera

Resumo Objetivou-se compreender a continuidade do cuidado da criança na Atenção Primária à Saúde em região de fronteira por meio de um estudo qualitativo, realizado em Foz do Iguaçu, Paraná, Brasil, com mães de crianças de 0 a 24 meses e enfermeiras. A coleta de dados foi feita com entrevista semiestruturada e registros das cadernetas infantis, entre março de 2018 e junho de 2019. A análise temática de conteúdo orientou a análise dos dados. A continuidade do cuidado infantil se faz principalmente por meio da puericultura, atrelada à Educação em Saúde, da imunização e do teste do pezinho. São requeridas políticas públicas nacionais e regionais que contemplem especificidades de saúde da criança nas fronteiras, bem como acordos entre gestores em saúde dos países fronteiriços, para garantia da continuidade do cuidado, particularmente a crianças brasileiras residentes no Paraguai.(AU)

Abstract The aim of this study was to understand the continuity of care for children in primary health services in a border region. We conducted a qualitative study with the mothers of children aged 0-24 months and nurses in Foz do Iguaçu, Paraná, Brazil. Data were collected using semi-structured interviews and from care notes between March 2018 and June 2019. The data were analyzed using thematic analysis. Continuity of care consists mainly of postnatal care in conjunction with health education, immunization and the heel prick test. National and regional policies focusing on the specific context of children living in border regions and agreements between health authorities in the respective border countries are needed to ensure the continuity of care, particularly for Brazilian children living in Paraguay.(AU)

Resumen El objetivo fue comprender la continuidad del cuidado del niño en la atención primaria de la salud en región de frontera por medio de un estudio cualitativo realizado en Foz de Iguazú, Paraná, Brasil, con madres de niños de cero a 24 meses y enfermeras. La colecta de datos se realizó por medio de entrevista semiestructurada y registro de las cartillas infantiles, entre marzo de 2018 a junio de 2019. El análisis temático del contenido orientó el análisis de los datos. La continuidad del cuidado infantil se realiza principalmente por medio de la puericultura vinculada a la educación en salud, de la inmunización y de la prueba del talón. Se requieren políticas públicas nacionales y regionales que incluyen especificidades de salud del niño en las fronteras, así como acuerdos entre gestores en salud de los países fronterizos para garantía de la continuidad del cuidado, particularmente a niños brasileños residentes en Paraguay.(AU)

Perfil sociodemográfico e clínico-obstétrico de gestantes com diagnóstico de COVID-19 e desfecho após nascimento / Sociodemographic and clinical-obstetric profile of pregnant women diagnosed with COVID-19 and outcome after birth

Descrever o perfil sociodemográfico e clínico-obstétrico de gestantes com diagnóstico de COVID-19, bem como o desfecho, após o nascimento, das gestantes e dos recém nascidos atendidos no Hospital Universitário do Oeste do Paraná. Pesquisa quantitativa, descritiva, documental, retrospectiva. Coleta de dados realizada por roteiro estruturado, com base em prontuários de gestantes atendidas na instituição do estudo. As variáveis foram sobre características sociodemográficas, clínico-obstétricas, complicações, puerpério e dados do recém-nascido. Os dados foram analisados mediante análise descritiva simples. As mulheres estavam, principalmente, na faixa etária de 20 a 39 anos, assintomáticas, diagnosticadas com COVID-19 na admissão, idade gestacional a termo, prevalência de cesárea; dentre as complicações, a respiratória foi maior. Das causas de internação dos recém-nascidos em unidade de tratamento intensivo, preponderaram prematuridade e desconforto respiratório. Recomenda-se ampla imunização da população materna para prevenção de complicações e consequente redução das taxas de morbimortalidade por essa doença.

To describe the sociodemographic and clinical-obstetric profile of pregnant women diagnosed with COVID-19, as well as the outcome, after birth, of pregnant women and newborns-seen at the University Hospital of the West of Paraná. A quantitative, descriptive, documentary, retrospective research. Data collection was performed by a structured script, based on medical records of pregnant women seen at the study institution. The variables concerned sociodemographic and clinical-obstetric characteristics, complications, puerperium and newborn data. The data were analyzed using a simple descriptive analysis. Thewomen were mainly in the age group of 20 to 39 years, asymptomatic, diagnosed with COVID-19at admission, gestational age at term, and prevalence of cesarean section; among the complications, respiratory was the highest one. Of the causes of hospitalization of newborns in an intensive care unit, prematurity and respiratory discomfort deserved highlight. It is recommended that widespread immunization of the maternal population is recommended to prevent complications and a consequent reduction of morbidity and mortality rates due to this disease.

Repercussões da pandemia da covid-19 na assistência à parturiente: olhar da enfermagem / Repercusiones de la pandemia de covid-19 en la asistencia a la parturienta: perspectiva de enfermería / Repercussions of the covid-19 pandemic in the assistance to the parturient woman: nursing gaze

RESUMO Objetivo: identificar as repercussões da pandemia da COVID-19 na assistência à parturiente pelo olhar da enfermagem. Método: pesquisa qualitativa com profissionais de enfermagem atuantes em centro obstétrico de um hospital-escola do Paraná, realizada por meio de entrevistas semiestruturadas, por WhatsApp, entre maio e julho de 2020, com análise de conteúdo temática. Resultados: evidenciaram-se mudanças no fluxo de atendimento obstétrico, com ambiente exclusivo para gestantes com suspeita de infecção viral, e influência na via de parto. Houve retrocessos na assistência obstétrica, dificuldades no acesso a informações sobre o parto e nascimento devido à suspensão dos grupos de gestantes. A ausência do acompanhante no período parturitivo comprometeu o estado emocional das parturientes e elevou os sentimentos de ansiedade, tristeza e insegurança das mulheres. Para suporte emocional às parturientes, foram utilizadas estratégias para a aproximação da família, como o uso de chamadas por vídeo do celular. Os profissionais de enfermagem realizaram um cuidado sensível e empático, embora com aumento da demanda de trabalho e cercados de medo da contaminação viral. Considerações finais: Adequações institucionais foram realizadas, novas demandas de assistência precisaram ser atendidas pelos profissionais de enfermagem, concomitante ao retrocesso de outras, aumentando os desafios para planejar e realizar a assistência à parturiente.

RESUMEN Objetivo: identificar las repercusiones de la pandemia de COVID-19 en la asistencia a la parturienta por la perspectiva de la enfermería. Método: investigación cualitativa con profesionales de enfermería actuantes en centro obstétrico de un hospital-escuela de Paraná-Brasil, realizada por medio de entrevistas semiestructuradas, por WhatsApp, entre mayo y julio de 2020, con análisis de contenido temático. Resultados: se evidenciaron cambios en el flujo de atención obstétrica, con ambiente exclusivo para gestantes con sospecha de infección viral, e influencia en la vía de parto. Hubo retrocesos en la asistencia obstétrica, dificultades en el acceso a informaciones sobre el parto y nacimiento debido a la suspensión de los grupos de gestantes. La ausencia del acompañante en el período del parto comprometió el estado emocional de las parturientas y elevó los sentimientos de ansiedad, tristeza e inseguridad de las mujeres. Para apoyo emocional a las parturientas, se utilizaron estrategias para la aproximación de la familia, como el uso de llamadas por video del celular. Los profesionales de enfermería realizaron un cuidado sensible y empático, aunque con aumento de la demanda de trabajo y rodeados de miedo a la contaminación viral. Consideraciones finales: adaptaciones institucionales fueron realizadas, las nuevas demandas de asistencia necesitaron ser atendidas por los profesionales de enfermería, concomitante al retroceso de otras, aumentando los desafíos para planificar y realizar la asistencia a la parturienta.

ABSTRACT Objective: to identify the repercussions of the COVID-19 pandemic on parturient care from the perspective of nursing. Method: qualitative research with nursing professionals working in an obstetric center of a teaching hospital in Paraná, carried out through semi-structured interviews, via WhatsApp, between May and July 2020, with thematic content analysis. Results: there were changes in the flow of obstetric care, with an exclusive environment for pregnant women with suspected viral infection, and influence on the mode of delivery. There were setbacks in obstetric care, difficulties in accessing information about labor and birth due to the suspension of groups of pregnant women. The absence of a companion during the parturition period compromised the emotional state of the parturients and increased the women's feelings of anxiety, sadness and insecurity. For emotional support to parturients, strategies were used to approach the family, such as the use of cell phone video calls. Nursing professionals provided sensitive and empathetic care, although with increased work demand and surrounded by fear of viral contamination. Final considerations: institutional adjustments were made, new care demands had to be met by nursing professionals, concomitantly with the setback of others, increasing the challenges to plan and carry out care for the parturient woman.

Cuidado cultural em região de fronteira: perspectiva de enfermeiros da atenção primária à saúde / Cultural care in a border region: perspective of primary health care nurses / Cuidado cultural en una región fronteriza: perspectiva de enfermeros de la atención primaria de salud

Objetivo: conhecer a perspectiva de enfermeiros sobre cultura e cuidado cultural em município de fronteira e sua formação para realizar o cuidado culturalmente congruente. Método: estudo exploratório-descritivo, conduzido à luz da Teoria Transcultural do Cuidado. Realizadas entrevistas com 18 enfermeiros da atenção primária de Foz do Iguaçu-PR, entre janeiro de 2020 e janeiro de 2021, submetidas à análise de conteúdo. Resultados: as categorias de análise mostraram que, para os enfermeiros, o indivíduo traz consigo sua cultura, apreendida em seu meio, ao nascimento e passa de geração em geração. Considerações finais: ser profissional em região de fronteira interfere na perspectiva das diferenças culturais, as quais se relacionam num processo de interculturalidade, tornando-se relevante conhecer a população, seus hábitos e crenças para preservá-los nas ações de cuidado. Enfermeiros migrantes na região do estudo buscam conhecer a população, seus hábitos e crenças para preservá-los nas ações de cuidado(AU)

Objective: to know the perspective of nurses on culture and cultural care in a border town and their training to provide culturally congruent care. Method: exploratory-descriptive study, conducted in the light of the Transcultural Theory of Care. Interviews were conducted with 18 primary care nurses in Foz do Iguaçu-PR, between January 2020 and January 2021, submitted to content analysis. Results: the analysis categories showed that, for nurses, the individual brings with him his culture, apprehended in his environment, at birth and passed from generation to generation. Final considerations: being a professional in a border region interferes with the perspective of cultural differences, which are related in an intercultural process, making it relevant to know the population, their habits and beliefs to preserve them in care actions. Migrant nurses in the study region seek to know the population, their habits and beliefs to preserve them in care actions(AU)

Objetivo: conocer la perspectiva de los enfermeros sobre la cultura y el cuidado cultural en una localidad fronteriza y su formación para brindar un cuidado culturalmente congruente. Método: estudio exploratorio-descriptivo, realizado a la luz de la Teoría del Cuidado Transcultural. Se realizaron entrevistas junto a 18 enfermeros de atención primaria en Foz do Iguazú-Paraná, entre enero de 2020 y enero de 2021, y se sometieron al análisis de contenido. Resultados: las categorías de análisis mostraron que, según los enfermeros, el individuo lleva consigo su cultura, aprehendida en su entorno al nacer y transmitida de generación en generación. Consideraciones finales: ser profesional en una región fronteriza interfiere con la perspectiva de las diferencias culturales, que se relacionan en un proceso intercultural y se vuelve relevante conocer a la población, sus hábitos y creencias para preservarlos en las acciones de cuidado. Los enfermeros migrantes en la región de estudio tratan de conocer a la población, sus hábitos y creencias para preservarlos en las acciones de cuidado(AU)

Cross-cultural care in primary health care nurses' experience in border territories / El cuidado transcultural en la experiencia de enfermeras de atención primaria de salud en territorios fronterizos / Cuidado transcultural na experiência de enfermeiros da atenção primária à saúde em território de fronteira

ABSTRACT Objective: identify cross-cultural nursing care, based on the Sunrise model, based on primary care nurses' experiences in border territories. Method: this is qualitative research, carried out in Foz de Iguaçu, Brazil, with 18 nurses through semi-structured interviews, in person and remotely, between January 2020 and January 2021, and data analyzed by thematic analysis. Results: the factors influencing individuals' care and health were identified, according to their social, cultural structure and worldview, and the decisions and actions of transcultural care by nurses, through consultations or home visits. The Sunrise model components emerged empirically in primary care nurses' practice. Conclusion: it is recommended that health managers adopt the Transcultural Care Theory to guide culturally efficient nursing care practice, particularly in border territories.

RESUMEN Objetivo: identificar cuidados de enfermería transcultural, con base en el modelo Sunrise, a partir de las experiencias de enfermeras de atención primaria en territorios fronterizos. Método: investigación cualitativa, realizada en Foz de Iguaçu, Brasil, con 18 enfermeros a través de entrevistas semiestructuradas, presenciales y a distancia, entre enero de 2020 y enero de 2021 y datos analizados por análisis temático. Resultados: fueron identificados los factores que influyen en el cuidado y la salud de los individuos, de acuerdo con su estructura social, cultural y cosmovisión, y las decisiones y acciones de cuidado transcultural de los enfermeros, a través de consultas o visitas domiciliarias. Los componentes del modelo Sunrise surgieron empíricamente en la práctica de las enfermeras de atención primaria. Conclusión: se recomienda la adopción de la Teoría del Cuidado Transcultural por parte de los gestores de salud para orientar la práctica del cuidado de enfermería culturalmente eficiente, particularmente en territorios de frontera.

RESUMO Objetivo: identificar o cuidado de enfermagem transcultural, fundamentado no modelo Sunrise, a partir de experiências de enfermeiros da atenção primária em território de fronteira. Método: pesquisa qualitativa, realizada em Foz de Iguaçu, Brasil, com 18 enfermeiros por meio de entrevista semiestruturada, de forma presencial e remota, entre janeiro de 2020 a janeiro de 2021 e dados analisados pela Análise Temática. Resultados: identificou-se os fatores influenciadores do cuidado e da saúde dos indivíduos, conforme sua estrutura social, cultural e visão de mundo, e as decisões e ações de cuidado transcultural pelos enfermeiros, por meio de consultas ou visitas domiciliares. Os componentes do modelo Sunrise surgiram empiricamente na prática dos enfermeiros da atenção primária. Conclusão: recomenda-se a adoção da Teoria do Cuidado Transcultural por gestores de saúde, para balizar a prática do cuidado de enfermagem culturalmente eficiente, particularmente em território de fronteira.