Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 6.698
BMC Pregnancy Childbirth ; 20(1): 754, 2020 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-33267785


BACKGROUND: The effect of SARS-CoV-2 infection in pregnant women and newborns is incompletely understood. Preliminary data shows a rather fluctuating course of the disease from asymptomatic or mild symptoms to maternal death. However, it is not clear whether the disease increases the risk of pregnancy-related complications. The aim of the study is to describe the maternal and neonatal clinical characteristics and outcome of pregnancies with SARS-CoV-2 infection. METHODS: In this retrospective national-based study, we analyzed the medical records of all pregnant women infected with SARS-CoV-2 and their neonates who were admitted to New-Jahra Hospital (NJH), Kuwait, between March 15th 2020 and May 31st 2020. During the study period and as part of the public health measures, a total of 185 pregnant women infected with SARS-CoV-2, regardless of symptoms, were hospitalized at NJH, and were included. Maternal and neonatal clinical manifestations, laboratory tests and treatments were collected. The outcomes of pregnancies included miscarriage, intrauterine fetal death (IUFD), preterm birth and live birth were assessed until the end date of the outcomes follow-up (November 10th 2020). RESULTS: A total of 185 pregnant women infected with SARS-CoV-2 were enrolled with a median age of 31 years (interquartile range, IQR: 27.5-34), and median gestational age at diagnosis of SARS-CoV2 infection was 29 weeks (IQR: 18-34). The majority (88%) of these women had mild symptoms, with fever (58%) being the most common presenting symptom followed by cough (50.6%). At the time of the analysis, out of the 185, 3 (1.6%) of the pregnant women had a miscarriage, 1 (0.54%) had IUFD which was not related to COVID-19, 16 (8.6%) had ongoing pregnancies and 165 (89%) had a live birth. Only 2 (1.1%) of these women developed severe pneumonia and required intensive care. A total of 167 neonates with two sets of twins were born with median gestational age at birth was 38 (IQR: 36-39) weeks. Most of the neonates were asymptomatic, and only 2 of them tested positive on day 5 by nasopharyngeal swab testing. CONCLUSIONS: In this national-based study, most of the pregnant women infected with SARS-CoV-2 showed mild symptoms. Although mother-to-child vertical transmission of SARS-CoV-2 is possible, COVID-19 infection during pregnancy may not lead to unfavorable maternal and neonatal outcomes.

/epidemiologia , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Complicações Infecciosas na Gravidez/epidemiologia , Diagnóstico Pré-Natal/estatística & dados numéricos , Adulto , Feminino , Humanos , Recém-Nascido , Kuweit , Bem-Estar Materno/estatística & dados numéricos , Pandemias/estatística & dados numéricos , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Resultado da Gravidez , Estudos Retrospectivos , Adulto Jovem
Przegl Epidemiol ; 74(2): 276-289, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33112124


Around the end of December 2019, a new beta-coronavirus from Wuhan City, Hubei Province, China began to spread rapidly. The new virus, called SARS-CoV-2, which could be transmitted through respiratory droplets, had a range of mild to severe symptoms, from simple cold in some cases to death in others. The disease caused by SARS-CoV-2 was named COVID-19 by WHO and has so far killed more people than SARS and MERS. Following the widespread global outbreak of COVID-19, with more than 132758 confirmed cases and 4955 deaths worldwide, the World Health Organization declared COVID-19 a pandemic disease in January 2020. Earlier studies on viral pneumonia epidemics has shown that pregnant women are at greater risk than others. During pregnancy, the pregnant woman is more prone to infectious diseases. Research on both SARS-CoV and MERS-CoV, which are pathologically similar to SARS-CoV-2, has shown that being infected with these viruses during pregnancy increases the risk of maternal death, stillbirth, intrauterine growth retardation and, preterm delivery. With the exponential increase in cases of COVID-19 throughout the world, there is a need to understand the effects of SARS-CoV-2 on the health of pregnant women, through extrapolation of earlier studies that have been conducted on pregnant women infected with SARS-CoV, and MERS-CoV. There is an urgent need to understand the chance of vertical transmission of SARS-CoV-2 from mother to fetus and the possibility of the virus crossing the placental barrier. Additionally, since some viral diseases and antiviral drugs may have a negative impact on the mother and fetus, in which case, pregnant women need special attention for the prevention, diagnosis, and treatment of COVID-19.

Betacoronavirus , Infecções por Coronavirus/epidemiologia , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Coronavírus da Síndrome Respiratória do Oriente Médio , Pneumonia Viral/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Síndrome Respiratória Aguda Grave/epidemiologia , Feminino , Humanos , Bem-Estar Materno/estatística & dados numéricos , Pandemias , Gravidez
Int J Gynaecol Obstet ; 151(1): 17-22, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32698245


OBJECTIVE: To review what is known about COVID-19 and highlight gaps in the context of Nigerian obstetric practice. Research data on COVID-19 are understandably sparse in Africa. Nigeria, like most African countries, is battling a disease she is poorly equipped to fight. METHODS: The current available literature on COVID-19 was reviewed in relation to obstetric practice in the Nigerian context, gaps were identified, and recommendations were made to improve the handling of the COVID-19 pandemic in Nigerian obstetric practice. RESULTS: In and out of hospital, both the obstetrician and the obstetric patient are constantly being put at risk of exposure to the coronavirus because testing and preventive measures are either ineffective or non-existent. CONCLUSION: The pandemic has exposed the gross inadequacies in Nigeria's healthcare system and is therefore a wake-up call to the need for a complete overhaul of infrastructure and services. The government will do well to increase the budget allocation for health from the current paltry 4.14% to the recommended 15% of the total budget. The Nigerian obstetrician stands a high risk of exposure due to inadequate preventive measures, and testing and diagnostic challenges.

/prevenção & controle , Controle de Infecções/organização & administração , Serviços de Saúde Materna/organização & administração , Complicações Infecciosas na Gravidez/prevenção & controle , Prevenção Primária/organização & administração , /epidemiologia , Assistência à Saúde , Feminino , Humanos , Bem-Estar Materno/estatística & dados numéricos , Nigéria , Gravidez , Complicações Infecciosas na Gravidez/terapia
BMC Public Health ; 20(1): 1001, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32586374


BACKGROUND: This study aimed to establish whether changes in the socioeconomic context were associated with changes in population-level antenatal mental health indicators in Vietnam. METHODS: Social, economic and public policies introduced in Vietnam (1986-2010) were mapped. Secondary analyses of data from two cross-sectional community-based studies conducted in 2006 (n = 134) and 2010 (n = 419), involving women who were ≥ 28 weeks pregnant were completed. Data for these two studies had been collected in structured individual face-to-face interviews, and included indicators of antenatal mental health (mean Edinburgh Postnatal Depression Scale Vietnam-validation (EPDS-V) score), intimate partner relationships (Intimate Bonds Measure Vietnam-validation) and sociodemographic characteristics. Socioeconomic characteristics and mean EPDS-V scores in the two study years were compared and mediation analyses were used to establish whether indicators of social and economic development mediated differences in EPDS-V scores. RESULTS: Major policy initiatives for poverty reduction, hunger eradication and making domestic violence a crime were implemented between 2006 and 2010. Characteristics and circumstances of pregnant women in Ha Nam improved significantly. Mean EPDS-V score was lower in 2010, indicating better population-level antenatal mental health. Household wealth and intimate partner controlling behaviours mediated the difference in EPDS-V scores between 2006 and 2010. CONCLUSIONS: Changes in the socioeconomic and political context, particularly through policies to improve household wealth and reduce domestic violence, appear to influence women's lives and population-level antenatal mental health. Cross-sectoral policies that reduce social risk factors may be a powerful mechanism to improve antenatal mental health at a population level.

Bem-Estar Materno/estatística & dados numéricos , Saúde Mental/estatística & dados numéricos , Complicações na Gravidez/prevenção & controle , Adulto , Estudos Transversais , Violência Doméstica/prevenção & controle , Desenvolvimento Econômico , Feminino , Humanos , Bem-Estar Materno/psicologia , Pobreza/estatística & dados numéricos , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/psicologia , Escalas de Graduação Psiquiátrica , População Rural/estatística & dados numéricos , Vietnã/epidemiologia
Physis (Rio J.) ; 30(4): 1-19, 2020. tab
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1143443


Resumo Este artigo tem por objetivo tratar do sofrimento materno no contexto do home care pediátrico. Nele se conta a história de duas mães de crianças que nasceram a termo e tiveram desenvolvimento normal até sofrerem um acidente no domicílio e passarem a necessitar de aparato tecnológico e de equipe de atendimento em casa para sobreviver. É um estudo de natureza qualitativa no qual se desenham duas vinhetas clínicas, para investigar psicanaliticamente a capacidade de resiliência dessas mulheres, e como se dá a (res)significação da dor materna a partir do sentido do cuidado, no contexto de internação domiciliar. Utilizaram-se a Escala de Sobrecarga do Cuidador e a exibição do documentário "Um dia especial" para complementação da análise. O trabalho tem como referencial teórico os estudos da Saúde Coletiva e da Psicanálise nos quais os conceitos de trauma, cuidado e resiliência se destacam. A narrativa das mães vincula as experiências individuais e o contexto social de sua ocorrência. Os resultados demonstraram a importância do home care e a ausência do atendimento psicológico/psicanalítico, fundamental para ajudar a mãe a encontrar uma interpretação mais positiva de sua situação. Como a pesquisa foi desenvolvida com apenas duas participantes, não se podem generalizar os resultados.

Abstract This article aims to address maternal suffering in the context of pediatric home care. It tells the story of two mothers of children who were born at term and had normal development until they suffered an accident at home and started to need technological equipment and a home care team to survive. It is a qualitative study in which two clinical vignettes are designed, to psychoanalytically investigate the resilience of these women, and how the (re)framing of maternal pain occurs from the sense of care, in the context of home care. The Caregiver Overload Scale and the exhibition of the documentary "Um dia especial" were used to complement the analysis. The work has as a theoretical reference the studies of Collective Health and Psychoanalysis in which the concepts of trauma, care and resilience stand out. The mothers' narrative links the individual experiences and the social context of their occurrence. The results attested the importance of home care and the absence of psychological / psychoanalytic care, essential to help the mother to find a more positive interpretation of her situation. As the research was developed with only two participants, the results cannot be generalized.

Cuidadores , Assistência Integral à Saúde , Angústia Psicológica , Comportamento Materno/psicologia , Bem-Estar Materno/psicologia , Acidentes Domésticos , Cuidado da Criança , Assistência Domiciliar
Rev. enferm. UFPE on line ; 14: [1-9], 2020. ilus, tab
Artigo em Português | BDENF - Enfermagem | ID: biblio-1116268


Objetivo: avaliar a satisfação e o bem-estar de puérperas na assistência ao parto e nascimento. Método: trata-se de um estudo quantitativo, descritivo e transversal, com 78 puérperas, ao ser utilizado um questionário para a caracterização sociodemográfica e obstétrica, analisado pela estatística descritiva e testes de associações, por meio do teste Qui-quadrado, adotando-se um nível de significância de 95%. Resultados: verificou-se a média de idade de 28,4 anos, destacando-se que 98,7% das pesquisadas realizaram pré-natal, 73,1% receberam alguma orientação profissional no hospital e 93,6% tiveram a presença de um acompanhante. Registra-se, sobre a escala, que 62,8% das mulheres apresentaram ótimo bem-estar. Informa-se que os domínios III e V foram os mais bem avaliados e o domínio IV, o pior. Negou-se a relevância estatística nas correlações entre os níveis de bem-estar e os dados do parto. Conclusão: avaliouse que as mulheres apresentaram ótimo bem-estar na parturição. Elencam-se o contato pele a pele e a presença de acompanhante como fatores importantes. Considera-se necessário incorporar a empatia e a gentileza na assistência para se reduzir os níveis de mal-estar.(AU)

Objective: to evaluate the satisfaction and well-being of puerperal women in childbirth and birth care. Method: this is a quantitative, descriptive and cross-sectional study, with 78 puerperal women, when using a questionnaire for sociodemographic and obstetric characterization, analyzed by descriptive statistics and association tests, using the Chisquare test, adopting significance level of 95%. Results: there was a mean age of 28.4 years, highlighting that 98.7% of those surveyed performed prenatal care, 73.1% received some professional guidance in the hospital and 93.6% had the presence of a companion. It is registered, on the scale, that 62.8% of women showed excellent well-being. It is reported that domains III and V were the best evaluated and domain IV, the worst. Statistical relevance in the correlations between well-being levels and delivery data was denied. Conclusion: it was evaluated that women had excellent well-being in parturition. Skin-to-skin contact and the presence of a companion are important factors. It is considered necessary to incorporate empathy and kindness in care to reduce levels of malaise.(AU)

Objetivo: evaluar la satisfacción y el bienestar de las mujeres puerperales en el cuidado del parto y nacimiento. Método: se trata de un estudio cuantitativo, descriptivo y transversal, con 78 mujeres puerperales, al utilizar un cuestionario para caracterización sociodemográfica y obstétrica, analizado mediante estadística descriptiva y pruebas de asociación, utilizando la prueba de Chi-cuadrado, adoptando nivel de significancia del 95%. Resultados: hubo una edad promedio de 28.4 años, destacando que el 98.7% de los encuestados realizó atención prenatal, el 73.1% recibió alguna orientación profesional en el hospital y el 93.6% tuvo la presencia de un compañero. Se registra, en la escala, que el 62.8% de las mujeres mostraron un excelente bienestar. Se informa que los dominios III y V fueron los mejor evaluados y el dominio IV, el peor. Se denegó la relevancia estadística en las correlaciones entre los niveles de bienestar y los datos del parto. Conclusión: se evaluó que las mujeres tenían un excelente bienestar en el parto. Se notó que el contacto piel con piel y la presencia de un compañero son factores importantes. Se considera necesario incorporar empatía y amabilidad en la atención para reducir los niveles de malestar.(AU)

Humanos , Feminino , Gravidez , Adolescente , Adulto , Trabalho de Parto , Satisfação do Paciente , Parto Humanizado , Período Pós-Parto , Bem-Estar Materno , Tocologia , Parto Normal , Enfermagem Obstétrica , Epidemiologia Descritiva , Estudos Transversais , Empatia
Matronas prof ; 20/21(4/1): 4-12, 2019-2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-192422


OBJETIVO: Describir la experiencia y el bienestar de las mujeres durante el proceso de parto atendido en el Área de Salud 2-Cartagena, del Servicio Murciano de Salud, y relacionarlos con las características ociodemográficas y obstétricas de la muestra y discutir la adecuación de las escalas utilizadas CEQ-E y BMSP2 en el entorno donde se emplean. MÉTODO: Estudio descriptivo de corte transversal realizado sobre 120 mujeres con parto eutócico. Los datos fueron recogidos mediante las encuestas CEQ-E y BMSP2. RESULTADOS: El bienestar y la experiencia durante el parto fueron valorados entre adecuados y óptimos por un 83,8% de las participantes (120 mujeres) con la escala BMSP2, y con una puntuación media de 3,19 sobre 4 puntos con la herramienta CEQ-E. Los resultados de las subescalas indican que el apoyo profesional y el contacto madre-hijo fueron las dimensiones mejor valoradas. El bienestar y la satisfacción no se relacionaron con la edad, la fórmula obstétrica, el tipo de inicio de parto, la duración del parto y el desgarro durante el expulsivo. Únicamente la nacionalidad y el tipo de anestesia se relacionaron de forma estadísticamente significativa con algunas de las subescalas de las herramientas utilizadas. Entre las dos escalas de nuestro estudio existe una correlación positiva moderada (R = 0,557) que contribuye a la validez de criterio de la escala BMSP2. CONCLUSIONES: La correlación positiva entre las dos herramientas nos indica que ambas pueden ser útiles en contextos culturales como el mediterráneo, en el que son valoradas tanto la autoeficacia (dimensión que enfatiza la herramienta CEQ-E elaborada en Suecia) como la participación de la familia (dimensión incluida en la herramienta chilena BMSP2)

OBJECTIVE: Describe the experience and well-being of women in Area II of the Murcian Health Service during the birth process, and relate them to the sociodemographic and obstetric characteristics of the sam-ple, and discuss the adequacy of the scales used CEQ-E and BMSP2 in the environment where they are used. METHOD: Descriptive crosssectional study performed on 120 women with eutocic delivery. The data was collected through the CEQ-E and BMSP2 surveys. RESULTS: The level of well-being was assessed as adequate and optimal in 83.8% of the participants (120 women), with the BMSP2 scale, and with an average score of 3.19 over 4 points with the CEQ-E tool. The results of the subscales indicate that the professional support and the contact mother-newborn were the most valued dimensions. Well-being was not related to age, the obstetric formula, type of onset of labor, the duration of delivery and the tear during the expulsive period. Only the nationality and the type of anesthesia were related in a statistically significant way with some of the subscales of the tools used. Between the two scales of our study, there is moderate positive correlation (R = 0.557) that contributes to the criterion validity of the BMSP2 scale. CONCLUSIONS: The positive correlation between the two surveys indicates that both can be useful in cultural contexts such as the Mediterranean, in which both self-efficacy (dimension that emphasizes the CEQ-E scale developed in Sweden) and family participation are valued (dimension included in the Chilean questionary BMSP2)

Humanos , Feminino , Gravidez , Adulto , Bem-Estar Materno , Trabalho de Parto , Direitos da Mulher , Inquéritos e Questionários , Satisfação do Paciente , Estudos Transversais , Parto Normal/psicologia , Psicometria , Análise de Variância
Rev. Esc. Enferm. USP ; 54: e03606, 2020. tab
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1125595


RESUMO Objetivo Analisar a associação das práticas assistenciais realizadas por profissionais obstétricos com os níveis de bem-estar/mal-estar materno. Método Estudo quantitativo, realizado em uma Unidade de Pré-Parto/Parto/Pós-parto de um Hospital de Ensino com puérperas de parto normal. Foi realizada associação entre as práticas obstétricas e os níveis de bem-estar/mal-estar materno. Resultados Participaram 104 puérperas. As práticas obstétricas que trouxeram mal-estar as parturientes e que obtiveram significância estatística foram: realização de amniotomia (p=0,018), realização de episiotomia (p=0,05), adoção de posições horizontalizadas no período expulsivo (p=0,04), a não utilização de tecnologias não invasivas de cuidado (p=0,029) e o não contato pele a pele mãe-filho (p=0,002). Para a maioria das mulheres, a presença de acompanhante favoreceu o bem-estar, mesmo não tendo uma associação significativamente estatística. Após a realização de regressão logística a não realização de amniotomia foi a única variável que se mostrou significância no bem-estar materno. Conclusão Práticas obstétricas humanizadas têm maior potencial de promover bem-estar materno. Nota-se a importância da enfermeira obstétrica na realização de práticas que proporcionam maior bem-estar às parturientes.

RESUMEN Objetivo Analizar la asociación de las prácticas asistenciales realizadas por profesionales obstétricos con los niveles de bienestar/malestar materno. Método Estudio cuantitativo, realizado en una Unidad de Preparto/Parto/Posparto de un Hospital de Ensino con mujeres puerperales Fue realizada asociación entre las prácticas obstétricas y los niveles de bienestar/malestar materno. Resultados Participaron 104 mujeres puerperales. Las prácticas obstétricas que han traído malestar para las parturientas y que han tenido significancia estadística fueran: realización de amniotomía (p=0,018), realización de episiotomía (p=0,05), adopción de posiciones horizontales en el período expulsivo (p=0,04), la no utilización de las tecnologías no invasivas de cuidado (p=0,029) y el no contacto piel a piel entre madre y hijo (p=0,002). Para la mayoría de las mujeres, la presencia de acompañantes ha favorecido bienestar, mismo sin tener una asociación increíblemente estadística. Después de la realización de la regresión logística no hacer la realización de amniotomía fue la única variable que presentó significancia en el bienestar materno. Conclusión Prácticas obstétricas humanizadas tienen mayor potencial de causar bienestar materno. La enfermera obstétrica en la realización de prácticas que proporcionan mayor bienestar para las mujeres puerperales es de extrema importancia.

ABSTRACT Objective To analyze the association of care practices performed by obstetric professionals with maternal welfare/malaise levels. Method A quantitative study conducted in a Prepartum/Childbirth/Postpartum Unit of a Teaching Hospital with puerperal women who underwent vaginal births. An association was performed between obstetric practices and maternal welfare/malaise levels. Results There were 104 puerperal women who participated. Obstetric practices which caused mothers to feel unwell and which obtained statistical significance were: amniotomy (p = 0.018), episiotomy (p = 0.05), adoption of horizontal positions in the expulsive period (p = 0.04), the non-use of non-invasive care technologies (p = 0.029), and non-skin-to-skin contact between mother and child (p = 0.002). For most women, the presence of a companion favored welfare, even though it did not have a statistically significant association. After performing logistic regression, non-performance of amniotomy was the only variable which showed significance in maternal welfare. Conclusion Humanized obstetric practices have greater potential to promote maternal welfare. The importance of obstetric nurses conducting practices which provide greater welfare to mothers is emphasized.

Humanos , Feminino , Adulto , Bem-Estar Materno , Parto Normal , Enfermagem Obstétrica , Enfermagem Materno-Infantil , Parto Humanizado , Hospitais de Ensino
BMC Pregnancy Childbirth ; 19(1): 261, 2019 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-31337350


BACKGROUND: The increased potential for negative pregnancy outcomes in both extremes of reproductive age is a well-debated argument. The aim of this study was to analyze the prevalence and the outcome of pregnancies conceived at extreme maternal ages. METHODS: This retrospective study considered all single consecutive pregnancies delivered in a tertiary referral center between 2001 and 2014. Patients were categorized into 4 groups according to maternal age at delivery (< 17 years; 18-28 years; 29-39 years; > 40 years). The following outcomes were considered (amongst others): pregnancy-related hypertensive disorders (PRHDs), neonatal resuscitation (NR), neonatal intensive care unit (NICU) admission, periventricular leucomalacia (PVL), and grade 3 and 4 intraventicular hemorrhage (IVH). RESULTS: During the considered period 22,933 single pregnancies gave birth in our unit. We observed 71 women aged < 17 years, and 1552 aged > 40 years. In each year throughout the study period, there was a significant increment in maternal age of 0.041 years (95% CI 0.024-0.058) every new year. Multivariate analysis concluded out that maternal age over 40 years was an independent risk factor for preterm delivery (OR 1.36 95% CI 1.16-1.61, p < 0.05, PRHDs (OR 2.36 95% CI 1.86-3.00, p < 0.05), GDM (OR 1.71 95% CI 1.37-2.12, p < 0.05) cesarean section (OR 1.99 95% CI 1.78-2.23, p < 0.05), abnormal fetal presentation (OR 1.29 95% CI 1.03-1.61, p < 0.05), and fetal PVL (OR 3.32 95% CI 1.17-9.44, p < 0.05). We also observed that maternal age under 17 years or over 40 years was an independent risk factor for grade 3 or 4 neonatal IVH (OR 2.97 95% CI 1.24-7.14, p < 0.05). CONCLUSIONS: These findings confirm a negative impact of extreme maternal ages on pregnancy. These results should be carefully taken into account by maternal care providers in order to inform women adequately, supporting them in understanding potential risks associated with their procreation choices, and to improve clinical surveillance.

Idade Materna , Bem-Estar Materno/estatística & dados numéricos , Resultado da Gravidez/epidemiologia , Adolescente , Adulto , Cesárea/estatística & dados numéricos , Feminino , Idade Gestacional , Humanos , Pré-Eclâmpsia/epidemiologia , Gravidez , Complicações na Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Natimorto/epidemiologia , Adulto Jovem
Women Birth ; 32(5): 449-459, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31345659


PROBLEM: It is not well known how to prepare new multidisciplinary teams aiming to provide culturally safe maternity care for Aboriginal and Torres Strait Islander families in an urban setting. BACKGROUND: National policies recommend increasing the Aboriginal and Torres Strait Islander workforce and cultural competencies of the non-Indigenous workforce as key drivers of culturally safe care. QUESTION: What are the key learnings from staff experiences establishing multidisciplinary teams aiming to provide culturally safe maternity care that aims to privilege Indigenous ways of knowing, being and doing? METHODS: As part of a larger participatory action research project, semi-structured qualitative interviews were conducted December 2014-April 2015 with 21 Aboriginal and Torres Strait Islander and non-Indigenous healthcare staff. Thematic analysis was used to identify learnings for practice. FINDINGS: Four key learnings were identified for forming new teams aiming to provide culturally safe care: (a) having a shared understanding of what characterises cultural safety in the local program context; (b) understanding and valuing different roles and knowledges people bring to the team; (c) acknowledging the influence of race and culture on staff behaviour; and (d) acting on individual and organisational responsibilities for continuous improvement towards cultural safety. DISCUSSION: We present recommendations from our participatory action research approach to respond to these learnings in practice. CONCLUSION: A deliberate workforce investment at the early stages of team development is crucial when aiming to provide culturally safe maternity care that can respond to the unique needs of Aboriginal and Torres Strait Islander women and families.

Continuidade da Assistência ao Paciente , Competência Cultural , Assistência à Saúde Culturalmente Competente , Pesquisa sobre Serviços de Saúde/organização & administração , Serviços de Saúde Materna/organização & administração , Bem-Estar Materno/etnologia , Equipe de Assistência ao Paciente/organização & administração , Adulto , Pesquisa Participativa Baseada na Comunidade , Feminino , Serviços de Saúde do Indígena , Disparidades em Assistência à Saúde , Humanos , Entrevistas como Assunto , Obstetrícia , Grupo com Ancestrais Oceânicos , Pesquisa Qualitativa
Women Birth ; 32(5): 427-436, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31326382


BACKGROUND: The urban-based Malabar Community Midwifery Link Service integrates multidisciplinary wrap-around services along-side continuity of midwifery care for Aboriginal and Torres Strait Islander mothers and babies. AIM: To evaluate the Malabar Service from 1 January 2007 to 31 December 2014. METHODS: A mixed method design. Outcomes for mothers of Aboriginal and/or Torres Strait Islander babies cared for at an urban Australian referral hospital by the Malabar Service were compared to mainstream. Primary outcomes are rates of low birth weight; smoking >20 weeks gestation; preterm birth; and breastfeeding at discharge. Malabar outcomes are also compared to national and state perinatal outcomes. RESULTS: The Malabar Service (n = 505) demonstrated similar rates of preterm birth (aOR 2.2, 95% CI 0.96-4.97); breastfeeding at discharge (aOR 1.1, 95% CI 0.61-1.86); and a higher rate of low birth weight babies (aOR 3.6, 95% CI 1.02-12.9) than the comparison group (n = 201). There was a 25% reduction in smoking rates from 38.9% to 29.1%. Compared to national and state populations, Malabar outcomes were better. Women experienced greater psychosocial complexity but were well supported. Malabar Mothers (n = 9) experienced: accessibility, preparedness for birth and cultural safety. Staff (n = 13) identified going 'above and beyond' and teamwork to provide culturally safe care counterbalanced with concerns around funding and cultural support. CONCLUSIONS: Dedicated integrated continuity of midwifery care with wrap-around services for Aboriginal and/or Torres Strait Islander mothers is highly valued and is culturally safe. The service is as safe as main stream services and promotes better clinical outcomes compared to national and state outcomes.

Continuidade da Assistência ao Paciente , Serviços de Saúde do Indígena , Serviços de Saúde Materna/organização & administração , Bem-Estar Materno/etnologia , Tocologia/organização & administração , Grupo com Ancestrais Oceânicos/psicologia , Parto/etnologia , Adulto , Austrália , Características Culturais , Feminino , Humanos , Obstetrícia , Gravidez , Fumar
Women Birth ; 32(5): 437-448, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31326383


BACKGROUND: Good quality antenatal care is essential to improve the perinatal outcomes of Aboriginal and Torres Strait Islander women in Australia. Group antenatal care (GAC) is an innovative model which places clinical assessment, education and social support into a group setting. Previous studies have found GAC to be associated with improved perinatal outcomes, particularly for vulnerable populations, and high satisfaction levels among group members. No implementations of GAC, or evaluations of its acceptability, for an Indigenous population in Australia have been previously conducted. AIM: To explore the perceptions of a group of Indigenous health workers (n=5) in a health service in Far North Queensland, Australia, towards the prospective acceptability of GAC as an additional choice of model of care for their Indigenous women clients. METHODS: This qualitative acceptability study employed a descriptive/exploratory methodology. Data collection was by semi structured interview. Data analysis was guided by a theoretical framework of acceptability and conducted following a process of iterative categorisation. FINDINGS: No overall precluding factors were identified to render the model unacceptable for Indigenous women in this locality. Some features of the model would not suit all women. Indigenous health workers were interested in increased involvement with antenatal care and participation in a GAC model. CONCLUSION: A foundation of acceptability exists upon which the implementation of a GAC model could offer benefits to Indigenous women in this health service. The positive response of the Indigenous health workers to the concept of GAC endorsed the potential of this model to contribute to the provision of culturally appropriate and effective antenatal care within mainstream services.

Assistência à Saúde/organização & administração , Serviços de Saúde do Indígena/organização & administração , Serviços de Saúde Materna/organização & administração , Bem-Estar Materno/etnologia , Grupo com Ancestrais Oceânicos/etnologia , Cuidado Pré-Natal/métodos , Adulto , Austrália , Feminino , Pessoal de Saúde , Disparidades em Assistência à Saúde , Humanos , Grupo com Ancestrais Oceânicos/psicologia , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Parto , Gravidez , Pesquisa Qualitativa , Qualidade da Assistência à Saúde
Managua; s.n; s.n; jun. 2019. 104 p. ilus, tab, graf.
Tese em Espanhol | LILACS | ID: biblio-1119601


Objetivo: Evaluar la satisfacción de usuarios externos e internos vinculados con el Método Familia Canguro (MFC), Hospital Bertha Calderón Roque, Managua ­ Nicaragua, Junio 2019. Diseño Metodológico: Estudio descriptivo de corte transversal. El universo de estudio lo constituyeron 97 usuarios. Se usaron tres tipos de encuestas de satisfacción que se aplicaron, respectivamente, a 20 madres de bebés a su egreso hospitalario, 40 madres de bebés atendidos en consulta externa y 37 trabajadores de salud vinculados con MFC. La encuesta fue aplicada por la investigadora a usuarios externos; y fue autoadministrada en usuarios internos. Resultados: El 100% de usuarios externos fueron mujeres. De estas el 65% tenían edades 20 - 35 años, 60% escolaridad secundaria, 75% procedencia de Managua. La satisfacción global MFC hospitalario fue de 87%. Los componentes mejor evaluados: cuidados de enfermería 91% y atención médica 89%. La satisfacción global MFC ambulatorio 89%. Los componentes mejor evaluados: entorno físico 98% y atención médica 96%. En relación al personal de salud, 32% edad de 40 ­ 49 años, 70% mujeres, 54% enfermeras, 46% médicos, 54% experiencia en MFC mayor de 5 años, 95% recibieron capacitación para su implementación. El índice global de satisfacción fue del 58%. Los componentes con mejor satisfacción fueron: ambiente e infraestructura y formación con 60%. Conclusiones: La satisfacción global para MFC hospitalario y ambulatorio fue muy buena, siendo mejor a nivel ambulatorio. El nivel de satisfacción del personal de salud fue regular para los componentes comunicación, ambiente e infraestructura y formación

Humanos , Saúde da Mulher , Satisfação do Paciente , Saúde Materna , Hospitais , Bem-Estar Materno , Epidemiologia Descritiva , Estudos Transversais , Administração em Saúde
Int Health ; 11(6): 447-454, 2019 11 13.
Artigo em Inglês | MEDLINE | ID: mdl-31044234


BACKGROUND: The investigation of the potential impact of unintended pregnancy on maternal and child health is important to design effective interventions. This study explored the associations between unintended pregnancy and low birthweight (LBW) and pregnancy complications. METHODS: A cross-sectional survey was conducted among 400 randomly selected women in the postnatal wards of Rajshahi Medical College Hospital, Bangladesh. Multivariate logistic regression analyses were used to identify associations. RESULTS: Results of this study indicate that 30.5% of all pregnancies were unintended and 29.3% of babies were born with LBW. Additionally, 79.3% of women experienced any pregnancy complication (AC), 69.5% experienced medical complications and 44.3% experienced obstetric complications (OCs) during their last pregnancy. Unintended pregnancy was significantly associated with LBW (adjusted odds ratio [AOR]: 3.18, 95% CI: 1.79 to 5.54), maternal experience of OCs (AOR: 1.83, 95% CI: 1.03 to 3.28) and AC (AOR: 2.93, 95%: 1.14 to 7.58). Women with unintended pregnancies were at higher risk of developing high blood pressure and anemia during pregnancy. CONCLUSIONS: Women with unintended pregnancies are at increased risk of producing LBW babies and experiencing complications during pregnancy. Therefore, maternal pregnancy intention should be addressed in interventions aimed to reduce maternal and child morbidity and mortality.

Atitude Frente a Saúde , Recém-Nascido de Baixo Peso , Bem-Estar Materno/estatística & dados numéricos , Complicações na Gravidez/epidemiologia , Gravidez não Planejada/psicologia , Adolescente , Adulto , Bangladesh , Estudos Transversais , Feminino , Humanos , Recém-Nascido , Intenção , Razão de Chances , Gravidez , Adulto Jovem
Physiother Res Int ; 24(4): e1780, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31038256


INTRODUCTION: Women, during the antenatal and post-partum period, report pelvic, low back pain, stress and urge urinary incontinence, colorectal dysfunction, and other co-morbidities that negatively affect health-related quality of life. Exercise and nutrition are important considerations for improving maternal health in this period. PURPOSE: The purpose of this study was to examine the effects of a community-driven nutrition and exercise programme focused on pelvic floor and core stability, healthy nutrition, and breastfeeding counselling over an 8-week period on pelvic floor and urinary distress (UDI), prolapse and colorectal distress for antenatal and post-partum women with limited access to health care, and low socio-economic resources from a Midwestern Region of the United States. MATERIALS AND METHODS: Purposive sample of 35 females, ages 18-44, were recruited for this prospective, preintervention to postintervention study, following ethical approval from Institutional Review Board and voluntary written consent from participants. The Health History Questionnaire, SF-36, Food Frequency Questionnaire, report of pelvic organ prolapse dysfunction (POPDI), colorectal-anal dysfunction (CRADI), and UDI as measured by the Pelvic Floor Distress Inventory (PFDI) were completed before and after intervention. RESULTS: Thirty-five women (n = 35) 18 to 44 years old (mean age of 22.72 ± 3.45 years) completed the study. A significant difference was found from preintervention to postintervention scores means for PFDI total scores, CRADI individual scores, and UDI individual scores (p < .05). POPDI scores decreased preintervention to postintervention but were not significant. A significant improvement in healthy nutrition and breastfeeding postintervention was also found (z = 3.21, p = .001). Further analysis showed significant, but weak, correlation between parity and POPDI (r = .366, p = .033); between parity and UDI (r = .384, p = .03); and between parity and PFDI (r = .419, p = .014). DISCUSSION: Our study found a significant reduction in pelvic floor dysfunction, urinary, and colorectal-anal distress symptoms and improvement in breastfeeding and healthy nutrition following an 8-week community-driven nutrition and exercise programme focused on pelvic floor and core stability, healthy nutrition, and breastfeeding counselling.

Educação em Saúde/métodos , Saúde Materna , Mães/educação , Qualidade de Vida , Adolescente , Adulto , Feminino , Humanos , Bem-Estar Materno/estatística & dados numéricos , Prolapso de Órgão Pélvico/prevenção & controle , Gravidez , Complicações na Gravidez/prevenção & controle , Estudos Prospectivos , Inquéritos e Questionários , Adulto Jovem