Access to Contraceptives in Countries With Restrictive Abortion Laws: The Case of Brazil.

We aimed to determine whether current contraceptive use is affected by a history of abortion for women from a country with abortion-restricted laws. This is an analysis of 2006 Brazil Demographic and Health Survey. Nonpregnant women whose first pregnancy occurred in the previous 5 years were selected for this study (n = 2,181). We used propensity score matching to compare current contraceptive use among women with induced or spontaneous abortion and women with no abortion. We found differences in the use, but women with a history of abortion did not report more effective contraceptive than women with no abortion, as we expected.

Contraceptive use following spontaneous and induced abortion and its association with family planning services in primary health care: results from a Brazilian longitudinal study.

BACKGROUND: Although it is well known that post-abortion contraceptive use is high when family planning services are provided following spontaneous or induced abortions, this relationship remains unclear in Brazil and similar settings with restrictive abortion laws. Our study aims to assess whether contraceptive use is associated with access to family planning services in the six-month period post-abortion, in a setting where laws towards abortion are highly restrictive. METHODS: This prospective cohort study recruited 147 women hospitalized for emergency treatment following spontaneous or induced abortion in Brazil. These women were then followed up for six months (761 observations). Women responded to monthly telephone interviews about contraceptive use and the utilization of family planning services (measured by the utilization of medical consultation and receipt of contraceptive counseling). Generalized Estimating Equations were used to analyze the effect of family planning services and other covariates on contraceptive use over the six-month period post-abortion. RESULTS: Women who reported utilization of both medical consultation and contraceptive counseling in the same month had higher odds of reporting contraceptive use during the six-month period post-abortion, when compared with those who did not use these family planning services [adjusted aOR = 1.93, 95 % Confidence Interval: 1.13-3.30]. Accessing either service alone did not contribute to contraceptive use. Age (25-34 vs. 15-24 years) was also statistically associated with contraceptive use. Pregnancy planning status, desire to have more children and education did not contribute to contraceptive use. CONCLUSIONS: In restrictive abortion settings, family planning services offered in the six-month post-abortion period contribute to contraceptive use, if not restricted to simple counseling. Medical consultation, in the absence of contraceptive counseling, makes no difference. Immediate initiation of a contraceptive that suits women's pregnancy intention following an abortion is recommended, as well as a wide range of contraceptive methods, including long-acting reversible methods, even in restrictive abortion laws contexts.

Experiences and daily life attitudes of women with severe mental disorders: integrative review of associated factors.

OBJECTIVE: The objective is to identify the factors that influence the experiences and daily life attitudes of women with severe mental disorders (SMD). METHOD: A search for studies published from 2000 to 2014 was conducted in electronic databases. All relevant primary studies were screened using integrative methods. Findings were synthesized thereafter. RESULTS: Fifteen articles were included. A total of 21 factors were identified as being associated with experiences and daily life attitudes of women with SMD. These factors consisted of the following five categories: strengths and limitations regarding self-care behavior and healthcare delivery, unmet healthcare needs, psychosocial vulnerabilities underlying SMD, gains and challenges of motherhood, and adoption of coping strategies. CONCLUSIONS: Healthcare providers can greatly contribute to improving the quality of healthcare for women with SMD, but several barriers need to be overcome.

Self-esteem of adult women living in a peripheral area of São Paolo city, Brazil.

Our purpose was to determine the level of self-esteem (SE) and its associations with women's sociodemographic characteristics and social status. Adult women (N = 120) living in a peripheral area of Sao Paulo City in Southeastern Brazil were randomly included in our study. We found significant associations between higher SE scores and higher schooling (p =.02), participation in religious meetings in the church (p =.022), and practice of leisure activities (p <.001). The inclusion of a broader range of activities should be provided in health care and educational settings aiming at the improvement of women's SE levels.

Use of medicinal plants by black women: ethnography study in a low-income community.

Objective To explore beliefs, values and practices related to the use of medicinal plants among low-income black families. Method The research method was ethnography and the participant observation process was done in a low-income community in the peripheral area of the City of São Paulo. Twenty black women were interviewed. Results Two cultural sub-themes, I do use medicines that I learned to make with my mother and with religious practitioners to care for diseases and Home medicines are to treat problems that are not serious, and the cultural theme I do use home medicines to treat simple diseases because I always have them at my disposal, they are free and I don't need a medical prescription represent beliefs, values, and practices related to the use of medicinal plants among low-income black families. Conclusion The development of such practices, which can hide ethnic and social vulnerability, reveals the resilience of low-income black women in the process of confronting problems during the health-illness process.

[Integrative review: concepts and methods used in nursing]. / Revisão integrativa: conceitos e métodos utilizados na enfermagem.

UNLABELLED: Integrative review (IR) has an international reputation in nursing research and evidence-based practice. This IR aimed at identifying and analyzing the concepts and methods recommended to undertaking IR in nursing. Nine information resources,including electronic databases and grey literature were searched. Seventeen studies were included. The results indicate that: primary studies were mostly from USA; it is possible to have several research questions or hypotheses and include primary studies in the review from different theoretical and methodological approaches; it is a type of review that can go beyond the analysis and synthesis of findings from primary studies allowing exploiting other research dimensions, and that presents potentialities for the development of new theories and new problems for research. CONCLUSION: IR is understood as a very complex type of review and it is expected to be developed using standardized and systematic methods to ensure the required rigor of scientific research and therefore the legitimacy of the established evidence.

Improvement of older women's sexuality through emancipatory education.

The purpose of this action research (AR) was to explore the ways in which sexuality is experienced daily and to improve the expression of older women's sexuality. The pedagogy of autonomy as proposed by the Brazilian educator Paulo Freire theoretically supported this AR, with the participation of six older adult women living in a rural setting in southwest Brazil. The older women's experiences regarding sexuality, their concerns, and their educational demands could be summarized through five phrases: the improvement of self-esteem as a way to promote sexuality; sexuality impaired by loneliness and lack of affection; men's sexual satisfaction seen as a woman's obligation; women's sexuality controlled by the society; and relinquishment of the companion to attend to the expectations of family members. Dialogical and participative educational approaches and continuous observation-participation strategies were performed to support the women's care and educational requirements.

Psychosexual perspectives of the husbands of women treated with an elective hysterectomy.

The purpose of this study was to explore the psychosexual perspectives of a group of Brazilian men whose wives underwent an elective hysterectomy. A qualitative design based on the narrative analysis method was used to interview 22 husbands. Results showed similarities and differences among husbands regarding the support provided to their wives, the notion of sexual absence in the postsurgical period, the notion of sexual pleasure after the hysterectomy, and feelings regarding the impossibility of having children. The authors conclude that personal care requirements should be identified and satisfied to provide comprehensive and meaningful care.

Brazilian registered nurses' perceptions and attitudes towards adverse events in nursing care: a phenomenological study.

AIM: To describe the perceptions and attitudes of registered nurses (RNs) towards adverse events (AEs) in nursing care. BACKGROUND: The professionals' subjective perspectives should be taken into account for the prevention of AEs in care settings. METHOD: Schütz's social phenomenology was developed. Interviews were conducted with nine Intensive Care Unit RNs. RESULTS: The following five descriptive categories emerged: (1) the occurrence of AEs is inherent to the human condition but provokes a feeling of insecurity, (2) the occurrence of AEs indicates the existence of failures in health care systematization, (3) the professionals' attitudes towards AEs should be permeated by ethical principles; (4) the priority regarding AEs should be the mitigation of harm to patients, and (5) decisions regarding the communication of AEs were determined by the severity of the error. CONCLUSIONS: The various subjective perspectives related to the occurrence of AEs requires a health care systematization with a focus on prevention. Ethical behaviour is essential for the patients' safety. IMPLICATIONS FOR NURSING MANAGEMENT: Activities aimed at the prevention of AEs should be integrated jointly with both the professionals and the health care institution. A culture of safety, not punishment, and improvement in the quality of care provided to patients should be priorities.

Pregnancy planning: prevalence and associated aspects. / Planejamento da gravidez: prevalência e aspectos associados.

The aims were to know the prevalence of and associated aspects to the planned pregnancy. Using the Brazilian version of the London Measure of Unplanned Pregnancy, we classified the pregnancy of 126 women who had a positive urine pregnancy test in primary health centers in the city of Marília, São Paulo. The prevalence of planned pregnancy was 33.3% [25.2%-42.3%]. We found that age, partners age, living with a partner, having a previous pregnancy and a previous abortion or miscarriage were positively associated to the planning of the pregnancy. We conclude that planning a pregnancy is not frequent yet and is mainly determined by personal and relational contexts of a woman's life as well as by their reproductive history and not simply by contraception use or schooling, as it has been traditionally considered.

Religiosity and sexuality: experiences of Brazilian Catholic women.

The purpose of this study was to describe the experiences of a group of Catholic women related to the orientations received from priests and parents and their influence on sexual attitudes. The oral history method was used to interview 17 Catholic women. Three categories summarize women's experiences: orientations about sexuality received from priests; lack of orientation or existence of open dialogue about sexuality: distinct experiences in the family context; adherence or repudiation; and distinct attitudes toward orientations received. Health professionals systematically should seek knowledge about women's religious principles, because this is essential for meaningful and ethical health care.

Counseling regarding sexual and reproductive behavior: principles and practices of catholic priests.

Considering and respecting religious beliefs and values is vital for delivering integral health care. This study describes the religious principles and guidance provided by Catholic priests on sexuality and reproduction. The oral history method was used. Interviews were carried out between August 2007 and May 2008 and were analyzed in an inductive and interpretive manner to acquire a deep focus on the theme. Thirteen Catholic priests from the city of São Paulo, SP, Brazil were interviewed. Counseling provided by the priests has a traditional and conservative character and is based on principles of Catholic doctrine. Health education and promotion activities involving aspects related to sexuality and reproduction should be relevant and permeated with ethical considerations from the perspective of health care services' users, including religious perspectives.

[The experience of paternity during adolescence in a low-income Brazilian community]. / Vivencias de la paternidad en la adolescencia en una comunidad brasileia de baja renta.

There are gaps in the knowledge related to paternity during adolescence. This investigation had the purpose to explore the experiences of paternity during adolescence. The investigation method was the thematic oral history, with 19 members of a low-income Brazilian community being interviewed. The categories describing the experience were: a) Gaps in sexual education, lack of attention to contraceptive methods and the desire for fatherhood contributed for the occurrence of paternity during adolescence; b) The adolescents were surprised by pregnancy and assumed the paternal responsibilities as best as they could; c) Paternity during adolescence meant a faster process of maturation and having their lives transformed; d) Regret or happiness: distinct results of paternity in adolescence. Interventions focused on adolescents must be performed in safe, ethical and contextualized ways.

Adolescent maternity in a low income community: experiences revealed by oral history.

Adolescent maternity involves relevant factors associated with each family, culture and society. This research aimed to describe the experiences in the trajectory of adolescent maternity. The oral history method was used, obtaining the narratives of 21 adolescent mothers living in a low income community located in São Paulo City, Brazil. The following descriptive categories emerged from the narratives: Pregnancy: an event in the initial phase of the relationship; Insufficient knowledge and access to contraceptives, gender inferiority and God's will: the ways to look at pregnancy; To escape from family problems and define the life course: the personal meanings attributed to pregnancy; More gain than pain: the balance of adolescent maternity. Adolescent maternity in low income contexts involves very complex factors and requires an integral, integrated, personal and family centered care.

Illness care at home or in health institutions: the decision process in a low income community.

The aim of this research was to describe the experiences of a group of women about the decision making process related to illness care at home or in health care institutions. The thematic oral history method was applied. The descriptive categories were: a) The poor have their own way of taking care of health and illness; b) The main support to fight the illness is belief in God; c) Medical care is the last resource, when healing resources are not enough and the illness is dangerous. In low income families, the cultural background, associated to the socioeconomic conditions, permeate the decision with regard to taking care of the illness at home or to seek institutionalized medical care. This knowledge is essential for meaningful health care from the perspective of individuals and families.

Women's experiences of induced abortion resulting from unplanned pregnancy: a qualitative systematic review protocol.

REVIEW QUESTION/OBJECTIVE: The objective of this review is to synthesize qualitative evidence on the experiences of women undergoing an induced abortion resulting from an unplanned pregnancy.More specifically, the review question is: how do women experience induced abortions resulting from an unplanned pregnancy?

[Action-research as a strategy to develop pregnant women group: the participants' perception]. / Pesquisa-ação como estratégia para desenvolver grupo de gestantes: a percepção dos participantes.

The aim of this study was to verify the perception of participants regarding the use of the action-research methodology in the development of a group of pregnant women. The group was sponsored by the University of São Paulo's Hospital Universitário. Individual interviews were conducted in order to obtain data from the group's 12 participants. The action-research strategy brought benefits to the development of the group, stimulated participation, promoted the mutual identification of the group members, and responded to specific necessities. Some limitations imposed by the use of the strategy were mentioned and suggestions for improvement were cited. Based on the group members' positive evaluation, the use of the action-research strategy is encouraged.

[Body techniques in a group of pregnant women: the experience of the subjects]. / Técnicas corporais em Grupo de Gestantes: a experiência dos participantes.

The objective this study was evaluate the effectiveness of the use of the body techniques in a group of pregnant women according to the experience of the subjects. They were all interviewed before the end of the group developed in a University Hospital. The descriptive categories of the experience were: the body techniques relieved the pregnancy discomforts, had encouraged the participation in the sessions and had been evaluated positively; the use of body techniques in a group of pregnant women promoted selfcare of the members; body techniques intensified the link among the couples and gave conditions for the integration of the members; there are limitations in use of the body techniques in a group of pregnant women and in its applicability at home. The positive evaluation of the use of body techniques in a group of pregnant women justifies its recommendation.

[Spontaneous and induced abortion: feelings experienced by men]. / Aborto espontâneo e provocado: sentimentos vivenciados pelos homens.

The insertion of male perspective in reproductive health is an international recommendation. The aim of this research was to know the men's feelings related to the abortion shared with their partners. The narrative analysis was the research method. The narratives of seventeen men were analysed. The spontaneous abortion related feelings were the loss related anguish and, the provoked abortion, the culpability related feelings and its consequences. Men who share the abortion experience with their partners require sensibility and professionals involvement. Their main care demands were related to the desire of favorable reception, to get emotional support as well as a whole and correct information about the process.

The process of seeking and undergoing surgical contraception: an ethnographic study in a Brazilian community.

The purpose of this research is to describe the process of seeking and undergoing surgical contraception by women of a low-income community in the city of Sao Paulo, Brazil. The ethnonursing research method was followed and data were collected with seven key and 11 general informants. The three cultural categories described (a) the difficulties women encountered with nonsurgical contraceptive methods, (b) the obstacles and barriers to obtaining surgical contraception for low-income women, and (c) beliefs and values of and about women who have undergone tubal ligation procedures. The cultural theme was that "being operada was the realization of a great dream." Leininger's sunrise model provided a framework for the discussion of the findings and implications for socially and culturally congruent nursing care.