Sexualidade durante todas as fases da gravidez: experiências de gestantes / Sexualidad durante todas las fases del embarazo: experiencia de gestantes / Sexuality throughout all the stages of pregnancy: Experiences of expectant mothers

Resumo Objetivo Explorar e compreender as experiências sexuais de gestantes durante a gravidez. Métodos O estudo foi realizado em dois centros de saúde no Distrito Sanitário de Almería, sul da Espanha. Os participantes incluíram gestantes que receberam atendimento pré-natal e/ou educação para maternidade. Os critérios de inclusão foram estar grávida, manter atividade sexual e concordar em participar do estudo. Os critérios de exclusão foram ter limitações na atividade sexual por prescrição médica. A amostra foi composta por 15 gestantes selecionadas por meio de amostra de conveniência, das quais cinco participaram de grupo focal (GF) e 10 de entrevistas em profundidade (EP). Os dados foram coletados entre os meses de junho e dezembro de 2016. Os participantes foram contatados pelo pesquisador principal e foi realizada uma consulta para conduzir o GF ou EP. Resultados Três categorias principais emergiram: Falsas crenças e uma abordagem holística da sexualidade durante a gravidez, que está relacionada ao conceito de sexualidade, falsas crenças e aconselhamento sexual limitado durante a gravidez. Limitações: Do medo no início à dificuldade física no final, referindo-se às flutuações no desejo sexual, bem como às mudanças físicas que limitam a atividade sexual. Adaptação às mudanças: práticas seguras e satisfação com a imagem corporal, que engloba preocupações com os riscos e a relação entre imagem corporal e autoestima. Conclusão A falta de aconselhamento sexual durante a gravidez leva à criação de falsas crenças, que, juntamente com mudanças físicas, preocupações com o risco e flutuações no desejo e interesse sexual, provocam uma diminuição na atividade sexual. Mas a sexualidade permanece um aspecto importante da gravidez, em relação ao qual os participantes devem adotar uma abordagem mais ampla e não limitada ao ato sexual, além de adotar práticas adaptadas às mudanças físicas e emocionais que ocorrem durante esse período.

Resumen Objetivo Explorar y comprender las experiencias sexuales de gestantes durante el embarazo. Métodos Estudio realizado en dos centros de salud del Distrito Sanitario de Almería, Sur de España. Dentro de los participantes se incluyó a gestantes que recibieron atención prenatal y/o educación para la maternidad. Los criterios de inclusión fueron: estar embarazada, mantener actividad sexual y aceptar participar del estudio. Los criterios de exclusión fueron tener limitaciones de actividad sexual por prescripción médica. Muestra compuesta por 15 embarazadas seleccionadas mediante muestra de conveniencia, cinco de las cuales participaron del grupo focal (GF) y 10 de entrevistas en profundidad (EP). Datos recolectados entre junio y diciembre de 2016. Las participantes fueron contactadas por el investigador principal, realizando una consulta para incluirlas en el GF o en el EP. Resultados Surgieron tres categorías principales: Falsas creencias y un abordaje holístico de la sexualidad durante el embarazo, relacionada al concepto de sexualidad; falsas creencias y asesoramiento sexual limitado durante el embarazo. Limitaciones: Del miedo inicial a la dificultad física al final, refiriéndose a las fluctuaciones en el deseo sexual, así como a los cambios físicos limitantes de la actividad sexual. Adaptación a los cambios: prácticas seguras y satisfacción con la imagen corporal, que incluye preocupaciones con los riesgos y la relación entre imagen corporal y autoestima. Conclusión La falta de asesoramiento sexual durante el embarazo lleva a crear falsas creencias, que, conjuntamente con los cambios físicos, preocupaciones por riesgos y fluctuaciones del deseo e interés sexual, provocan una disminución de la actividad sexual. Pero la sexualidad continúa siendo un aspecto importante del embarazo, respecto del cual los participantes deben adoptar un abordaje más amplio y no limitado al acto sexual, además de adoptar prácticas adecuadas a los cambios físicos y emocionales típicos del período.

Abstract Objective To explore and understand the sexual experiences of expectant mothers during their pregnancy. Methods The study was carried out in two healthcare centers in the Almería Health District, in southern Spain. The participants included pregnant women who received prenatal care and/or maternity education. The inclusion criteria were being pregnant, maintaining sexual activity and agreeing to participate in the study. The exclusion criteria were having limitations on sexual activity by medical prescription. The sample consisted of 15 expectant women selected using a convenience sample, of which 5 took part in a focus group (FG) and 10 in in-depth interviews (IDI). Data was collected between the months of June and December 2016. Participants were contacted by the main researcher and an appointment was made to carry out the FGs or the IDIs. Results Three main categories emerged: False beliefs and a holistic approach to sexuality during pregnancy, which is related to the concept of sexuality, false beliefs, and limited sexual counseling during pregnancy. Limitations: From fear at the beginning to physical difficulty at the end, referring to the fluctuations in sexual desire as well as the physical changes that limit sexual activity. Adapting to changes: safe practices and satisfaction with one's body image, which encompasses concerns about the risks and the relationship between body image and self-esteem. Conclusion A lack of sexual counseling during pregnancy leads to the creation of false beliefs, which, together with physical changes, concerns about the risk, and fluctuations in sexual desire and interest, bring about a decrease in sexual activity. But sexuality remains an important aspect of pregnancy, toward which the participants must adopt a broader approach, not limited to intercourse, and adopt sexual practices that are adapted to the physical and emotional changes that happen during this time.

Efectos de un programa de ejercicio físico y relajación en el medio acuático en pacientes con espondiloartritis: ensayo clínico aleatorizado / Effects of an exercise and relaxation aquatic program in patients with spondyloarthritis: A randomized trial

Fundamento y objetivo: La espondiloartritis hace referencia a un conjunto de enfermedades reumáticas crónicas que comparten diversas características clínicas, genéticas, radiológicas y epidemiológicas. La presentación clínica de las espondiloartritis se caracteriza por compromiso del esqueleto axial y articular periférico. El objetivo de este estudio fue evaluar la eficacia de un programa de entrenamiento físico más relajación en el medio acuático en personas con espondiloartritis. Pacientes y método: Estudio clínico aleatorizado de simple ciego en el que 30 personas con espondiloartritis fueron asignadas al azar a un grupo experimental o control. Durante 2 meses al grupo experimental se le aplicó un programa de entrenamiento físico en el medio acuático más relajación (3 sesiones por semana), y al grupo control se le realizaron las evaluaciones los mismos días que al experimental sin que participaran en ningún programa de ejercicio físico supervisado. Los datos obtenidos al inicio del estudio e inmediatamente después de la aplicación de la última sesión fueron: Bath Ankylosing Spondylitis Functional Index («Índice de funcionalidad para las espondiloartritis»), Bath Ankylosing Spondylitis Disease Activity Index («Índice de actividad de la enfermedad del grupo de Bath»), Cuestionario de Salud SF-12 y pulsómetro Sigma PC3® (Sigma-Elektro GmbH, Neustadt, Aemania). Resultados: La prueba U de Mann-Whitney mostró diferencias estadísticamente significativas para la calidad de vida (función física [p = 0,05]), Bath Ankylosing Spondylitis Functional Index (p = 0,015), Bath Ankylosing Spondylitis Disease Activity Index (fatiga [p = 0,032], dolor de cuello, espalda y caderas [p = 0,045], dolor o inflamación en otras articulaciones [p = 0,032] y rigidez matutina la despertar [p = 0,019]). Conclusiones: Los resultados del presente estudio muestran que los tratamientos de ejercicio físico unidos a la relajación aportan beneficios a los pacientes con espondiloartritis y son recomendables como parte del tratamiento de la enfermedad (AU)

Background and objective: Spondyloarthritis is a general term referring to a group of chronic rheumatic illnesses that share clinical, genetic, radiological and epidemiological features. The clinical presentation of spondyloarthritis is characterized by the compromise of both the axial and peripheral articular skeleton. We aimed to evaluate the efficacy of an aquatic exercise plus relaxation program in patients with spondyloarthritis. Patients and method: This was a randomized single blind study including 30 patients with spondylitis who were randomly assigned to an experimental or control group. For 2 months, the experimental group underwent an aquatic fitness plus relaxation program (3 sessions per week). Evaluations were also performed in the control group the same days as the experimental group but they did not participate in any supervised exercise program. The following data were obtained at baseline and immediately after application of the last session: Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Disease Activity Index, Health Questionnaire SF-12 and Sigma PC3® (Sigma-Elektro GmbH, Neustadt, Germany) Heart Rate Monitor. Results: The Mann-Whitney test showed statistically significant differences in the quality of life (physical function [P = .05]), Bath Ankylosing Spondylitis Functional Index (P = .015), Bath Ankylosing Spondylitis Disease Activity Index (fatigue [P = .032], neck pain, back and hips [P = .045], pain or swelling in other joints [P = .032] and in waking morning stiffness [P = .019]). Conclusions: The results of the present study suggest that therapy with physical exercise plus relaxation provides benefits to spondyloarthritis patients and these are advised as a part of their usual treatment (AU)

[Effects of an exercise and relaxation aquatic program in patients with spondyloarthritis: A randomized trial]. / Efectos de un programa de ejercicio físico y relajación en el medio acuático en pacientes con espondiloartritis: ensayo clínico aleatorizado.

BACKGROUND AND OBJECTIVE: Spondyloarthritis is a general term referring to a group of chronic rheumatic illnesses that share clinical, genetic, radiological and epidemiological features. The clinical presentation of spondyloarthritis is characterized by the compromise of both the axial and peripheral articular skeleton. We aimed to evaluate the efficacy of an aquatic exercise plus relaxation program in patients with spondyloarthritis. PATIENTS AND METHOD: This was a randomized single blind study including 30 patients with spondylitis who were randomly assigned to an experimental or control group. For 2 months, the experimental group underwent an aquatic fitness plus relaxation program (3 sessions per week). Evaluations were also performed in the control group the same days as the experimental group but they did not participate in any supervised exercise program. The following data were obtained at baseline and immediately after application of the last session: Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Disease Activity Index, Health Questionnaire SF-12 and Sigma PC3(®) (Sigma-Elektro GmbH, Neustadt, Germany) Heart Rate Monitor. RESULTS: The Mann-Whitney test showed statistically significant differences in the quality of life (physical function [P=.05]), Bath Ankylosing Spondylitis Functional Index (P=.015), Bath Ankylosing Spondylitis Disease Activity Index (fatigue [P=.032], neck pain, back and hips [P=.045], pain or swelling in other joints [P=.032] and in waking morning stiffness [P=.019]). CONCLUSIONS: The results of the present study suggest that therapy with physical exercise plus relaxation provides benefits to spondyloarthritis patients and these are advised as a part of their usual treatment.

Comparación entre biodanza en medio acuático y stretching en la mejora de la calidad de vida y dolor en los pacientes con fibromialgia / Comparison between aquatic-biodanza and stretching for improving quality of life and pain in pations with fibromyalgia

Objetivo: Comparar qué grado de mejoría pueden alcanzar los pacientes con fibromialgia en las variables dolor, impacto de la fibromialgia y depresión, mediante la biodanza acuática frente al stretching. Diseño: Ensayo clínico aleatorio en ámbito comunitario, con 2 grupos de intervención. Emplazamiento: Cinco centros de salud (Almería). Pacientes: Contactamos con 82 pacientes entre 18 y 65 años con fibromialgia según los criterios de American College of Rheumatology. Doce declinaron participar. La muestra restante fue distribuida aleatoriamente en 2 grupos de 35 pacientes (biodanza acuática y stretching). Excluimos a quienes no participaron en al menos 14 sesiones o efectuaron cambios en su tratamiento farmacológico durante el estudio, constituyéndose una muestra final de 19 mujeres en biodanza acuática y 20 en stretching. Son limitaciones del diseño la evaluación no cegada de los resultados y el reducido tamaño muestral agravado por los abandonos. Mediciones principales: Recogimos datos sociodemográficos y medimos impacto (Cuestionario de Impacto de Fibromialgia), dolor (cuestionario McGill-Melzack y Escala Visual Analógica), algometría por presión (algómetro Wagner FPI10) y depresión (Inventario de Beck), realizadas antes, y tras 12 semanas de terapia. Resultados: La edad media de la población fue 55,41 años. El período medio desde el diagnóstico fue de 13,44 años. Toda la muestra estuvo formada por mujeres, en su mayor parte amas de casa. Se obtuvieron diferencias significativas entre ambos grupos en dolor (p < 0,01), en impacto de fibromialgia (p < 0,01) y depresión (p < 0,04) tras el tratamiento. Conclusiones: El tratamiento mediante biodanza acuática produjo una disminución del dolor y un aumento en la calidad de vida de los pacientes con fibromialgia(AU)

Objective: To determine the level of improvement, as regards pain, impact on fibromyalgia and depression, achieved by patients with fibromyalgia by comparing aquatic biodanza and stretching exercises. Design: Randomised controlled trial with two intervention groups. Location: Five health centres (Almeria). Patients: A total of 82 fibromyalgia patients between 18 and 65 years old, diagnosed by American College of Rheumatology criteria, were included, with 12 patients declining to take part in the study. The 70 remaining patients were randomly assigned to two groups of 35 patients each: aquatic biodanza and stretching exercises. Those who did not attend in at least 14 sessions or changed their treatment during the studio were excluded. The final sample consisted of 19 patients in aquatic biodanza group and 20 in stretching group. The limitations of the study included, the open evaluation design and a sample size reduced by defaults. Main measures: The outcome measures were sociodemographic data, quality of life (Fibromyalgia Impact Questionnaire), pain (McGill-Melzack questionnaire; and Visual Analogue Scale), pressure algometry (Wagner FPI10 algometer) and depression (Beck Inventory). These were carried out before and after a 12-week therapy .Results: The mean age of the sample was 55.41 years. The mean period from diagnosis was 13.44 years. The sample consisted mainly of housewives. There were significant differences (P<0.05) between groups, in pain (P<0.01), fibromyalgia impact (P<0.01), and depression (P<0.04) after the treatment. Conclusions: The biodanza aquatic exercises improve pain and quality of life in fibromyalgia patients(AU)