Sociodemographic determinants associated with breastfeeding in term infants with low birth weight in Latin American countries.

BACKGROUND: A progressive decrease in exclusive breastfeeding (BF) is observed in Latin America and the Caribbean compared with global results. The possibility of being breastfed and continuing BF for > 6 months is lower in low birth weight than in healthy-weight infants. AIM: To identify factors associated with BF maintenance and promotion, with particular attention to low- and middle-income countries, by studying geographic, socioeconomic, and individual or neonatal health factors. METHODS: A scoping review was conducted in 2018 using the conceptual model of social determinants of health published by the Commission on Equity and Health Inequalities in the United States. The extracted data with common characteristics were synthesized and categorized into two main themes: (1) Sociodemographic factors and proximal determinants involved in the initiation and maintenance of BF in low-birth-weight term infants in Latin America; and (2) individual characteristics related to the self-efficacy capacity for BF maintenance and adherence in low-birth-weight term infants. RESULTS: This study identified maternal age, educational level, maternal economic capacity, social stratum, exposure to BF substitutes, access to BF information, and quality of health services as mediators for maintaining BF. CONCLUSION: Individual self-efficacy factors that enable BF adherence in at-risk populations should be analyzed for better health outcomes.

Relación entre sexualidad e infarto agudo de miocardio desde una perspectiva fenomenológica / Relationship between sexuality and acute myocardial infarction from a phenomenological perspective

Introducción: La sexualidad ha estado presente a lo largo de la vida del ser humano e incluye aspectos como actividad sexual, identidad, roles, orientación, erotismo, etc. Para personas que han sufrido un infarto agudo de miocardio (IAM), la sexualidad se ve afectada por factores psicológicos, físicos e incluso sociales. Por ello, el objetivo de la presente investigación es describir el significado de la sexualidad para la persona que ha sufrido IAM desde una perspectiva fenomenológica. Material y método: Estudio cualitativo con enfoque fenomenológico, cuya muestra estuvo conformada por 19 personas que sufrieron infarto agudo de miocardio y que fueron atendidas por el servicio de urgencias o medicina interna de una institución de cuarto nivel de complejidad en la ciudad de Bucaramanga (Colombia). Se aplicaron entrevistas a profundidad que fueron codificadas mediante el programa Atlas.ti versión 6.1 y su análisis se llevó a cabo mediante el modelo Colaizzi. Resultados: La sexualidad para la persona que ha sufrido infarto agudo de miocardio se asocia a múltiples situaciones que no solo se relacionan con el acto sexual, sino que también involucran además las relaciones afectivas, compartir con su pareja, familia y amigos, entendiéndose que de esta experiencia se desencadenan aspectos negativos y positivos que afectan la expresión de la sexualidad o la potencializan. Conclusión: El significado de la sexualidad para la persona con infarto agudo de miocardio está dado por las emociones, cuidados, educación, creencias y cambios en la sexualidad, lo cual impacta en el proceso de recuperación de su enfermedad y calidad de vida. (AU)

Introduction: Sexuality has been present throughout the life of the human being including aspects such as sexual activity, identity, roles, orientation, eroticism, etc. People who have suffered an Acute Myocardial Infarction (AMI) sexuality is affected by psychological, physical and even social factors. Therefore, the main purpose of this research is to describe the meaning of sexuality from someone has suffered AMI from a phenomenological perspective. Method: Qualitative study with a phenomenological approach, which sample consisted of 19 people who suffered acute infarction of the myocardium and who were treated by the emergency department or internal medicine of an institution of fourth level of complexity in the city of Bucaramanga (Colombia). In-depth interviews were applied and coded using the Atlas.ti 6.1 version. The analysis was carried out using the Colaizzi model. Results: The sexuality of the person who has suffered an acute infarction of the myocardium is associated with multiple situations that are not only related to the sexual act. It is also linked with the emotional relationships such as, sharing with their partner, family, and friends. It shall be understood that this experience triggers negative and positive aspects that could affect the sexual expression or enhance it. Conclusions: The meaning of sexuality for a person who has suffered acute infarction of the myocardium is given by emotions, care, education, beliefs and changes in sexuality, which impact patient’s process of recovery from their disease and their quality of life. (AU)

Significado para las enfermeras de cuidar a las mujeres en duelo perinatal / Meaning for nurses of caring for women in perinatal bereavement

Objetivo: Describir el significado que tiene para las enfermeras cuidar a las mujeres en duelo perinatal, en los servicios de Ginecoobstetricia y Unidad de Cuidado Intensivo Neonatal, de una institución de cuarto nivel de la ciudad de Floridablanca. Metodología: una investigación de tipo cualitativo descriptivo con enfoque fenomenológico, mediante el abordaje Colaizzi; se realizaron 10 entrevistas a profundidad previo consentimiento informado que se grabaron y se trascribieron, en formato PDF se organizaron en el programa Atlas Ti 7.5. Resultados: la experiencia expresada por las enfermeras se codificó, para posteriormente organizarse en 22 subcategorías que se consolidaron en 12 categorías lo que permitió describir el significado así: la enfermera ante el duelo, percepciones de la enfermera, expectativas frente a capacidades de la enfermera, cuidados en duelo, experiencia, sentimientos de la enfermera, familia, interdisciplinariedad, formación académica, limitaciones, la mujer afronta el duelo y mujer adolescente en duelo. Análisis comparado: para las enfermeras cuidar a las mujeres en duelo perinatal está dado por la importancia que tiene para ellas brindar cuidados, pero hay ocasiones en que es difícil intervenir a la mujer, por el dolor que les genera la pérdida, reconociendo la necesidad de brindarle los cuidados y el interés de abordar, comunicar, ser amable, establecer una comunicación bidireccional, escuchar, guiar, apoyar, y colocarse en el lugar de la otra persona, que son características similares con los estudios encontrados, en el grupo de mujeres adolescentes se observó soledad y tristeza, quizá porque es un embarazo no deseado y la actitud tomada frente al cuerpo del feto o bebé fallecido, les generaba llanto y tristeza, distantes, desprendidas, y sin manifestaciones de afecto, aparentemente porque no alcanzan a ver la magnitud de la situación. Conclusión: el "significado para las enfermeras de cuidar a las mujeres en duelo perinatal" es un momento de gran tristeza para la mujer, por lo cual ella se involucra directamente en su cuidado brindando especialmente acompañamiento, escucha activa y empática, apoyándola a ella y su familia. La enfermera, reconoce que son importantes la experiencia profesional y la formación desde el pregrado en relación al duelo, pues fortalecen su desempeño, además, se necesita de todo el equipo interdisciplinario para intervenir a la mujer pero hay limitaciones de infraestructura y políticas de la clínica que interfieren en el cuidado.

Objective: describe what taking care of women during perinatal grief means for nurses in Obstetrics and Neonatal Intensive Care Unit, in a fourth level institution of Floridablanca city. Methodology: a descriptive qualitative research with a phenomenological approach, using the Colaizzi's path; 10 profound interviews were done after getting informed consent. They were recorded and transcribed to PDF format and organized using Atlas Ti 7.5 program. Results: the experience expressed by the nurses was coded. Afterwards it was organized into 22 subcategories that were consolidated into 12 categories which allowed to describe the meaning as follows: the nurse before the grief, perceptions of the nurse, expectations regarding the capabilities of the nurse, grief care, experience, feelings of the nurse, family, interdisciplinarity, academic training, limitations, the woman faces the grief and the teenage woman in mourning. Comparative analysis: for nurses, taking care of women in perinatal grief is due to the importance of providing care for them. There are times when it is difficult to intervene those women, due to the pain generated by the loss, recognizing the need to provide care and interest to address, communicate, be friendly, establish a twoway communication, listen, guide, support, and put yourself in the place of another person, which are similar characteristics related to the studies found. In the group of adolescent women, loneliness and sadness were observed, perhaps due to an unwanted pregnancy and the attitude taken against the body of the deceased fetus or baby. This situation generated tears and sadness, remoteness, detachment, and affectionless manifestations, apparently because they can not see the magnitude of the situation. Conclusion: the "Meaning of taking care of women in perinatal grief, for nurses", is a moment of great sadness for the woman, so she gets involved directly in your care especially providing accompaniment, active and empathic listening, supporting her and her family . The nurse recognizes that are important professional experience and training from the undergraduate in relation to grief because strengthen their performance also needs all the interdisciplinary team to intervene women but there are infrastructure constraints and political clinic that interfere with care.