Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 6.564
Filtrar
2.
Women Birth ; 32(5): 427-436, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31326382

RESUMO

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.


Assuntos
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
3.
Women Birth ; 32(5): 437-448, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31326383

RESUMO

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.


Assuntos
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
4.
Women Birth ; 32(5): 449-459, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31345659

RESUMO

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.


Assuntos
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
5.
BMC Pregnancy Childbirth ; 19(1): 261, 2019 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-31337350

RESUMO

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.


Assuntos
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
6.
Physiother Res Int ; 24(4): e1780, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31038256

RESUMO

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.


Assuntos
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
7.
Int Health ; 11(6): 447-454, 2019 11 13.
Artigo em Inglês | MEDLINE | ID: mdl-31044234

RESUMO

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.


Assuntos
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
8.
PLoS One ; 14(2): e0211858, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30726275

RESUMO

BACKGROUND: Quality improvement in emergency obstetric care (EmOC) is a critical and cost-effective suite of interventions for the reduction of maternal and newborn mortality and morbidity. This study was undertaken to evaluate the impact of quality improvement interventions following a baseline assessment in Bauchi state, Nigeria. METHODS: This was a prospective before and after study between June 2012, and April 2015 in Bauchi State, Nigeria. The surveys included 21 hospitals designated by Ministry of Health (MoH) as comprehensive EmOC centers and 38 primary healthcare centers (PHCs) designated as basic EmOC centers. Data on EmOC services was collected using structured established EmOC tools developed by the Averting Maternal Death and Disability (AMDD), and analyzed using univariate and bivariate statistical analyses. RESULTS: Facilities providing seven or nine signal EmOC functions increased from 6 (10.2%) in 2012 to 21 (35.6%) in 2015. Basic EmOC facilities increased from 1 (2.6%) to 7 (18.4%) and comprehensive EmOC facilities rose from 3 (14.3%) to 13 (61.9%). Facility birth increased from 3.6% to 8.0%. Cesarean birth rates increased from 3.8% in 2012 to 5.6% in 2015. Met need for EmOC more than doubled from 3.3% in 2012 to 9.9% in 2015. Direct obstetric case fatality rates increased from 3.1% in 2012 to 4.0% in 2015. Major direct obstetric complications as a percent of total maternal deaths was 70.9%, down from 80.1% in 2012. CONCLUSION: The rise in the percent of facility-based births and in met need for EmOC suggest that interventions recommended and implemented after the baseline study resulted in increased availability, access and utilization of EmOC. Higher patient load, late arrival and better record keeping may explain the associated increase in case fatality rates.


Assuntos
Parto Obstétrico/normas , Serviços Médicos de Emergência/normas , Serviços de Saúde Materna/normas , Complicações na Gravidez/terapia , Adulto , Feminino , Instalações de Saúde/normas , Humanos , Mortalidade Materna , Bem-Estar Materno , Nigéria/epidemiologia , Obstetrícia/tendências , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/fisiopatologia
9.
J Immigr Minor Health ; 21(2): 307-314, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29779076

RESUMO

Epidemiological studies report conflicting findings regarding association between maternal immigration status and pregnancy outcomes. In this study we compared risk factors and prevalence of adverse pregnancy outcomes in native Portuguese and migrants. Cross-sectional analysis was conducted using information collected at delivery from the participants of Generation XXI birth cohort. Logistic regression models were fitted to assess the association between migrant status and adverse pregnancy outcomes. Prevalence of risk factors for adverse pregnancy outcomes varied between native Portuguese and migrants: teenage mothers (5.6 and 2.0%), primiparae (57.1 and 63.9%), smoking during pregnancy (23.0 and 19.1%), twins (3.2 and 8.0%), and caesarean section (35.2 and 45.7%). Among singleton births, prevalence of low birthweight, preterm birth and small for gestational age were 7.3 and 3.9%, 7.5 and 6.2%, and 15.1 and 7.6%, respectively for native Portuguese and migrants. The native Portuguese had an adjusted significantly higher risk of low birthweight (OR 2.67, 95% CI 1.30, 5.48) and small for gestational age (OR 2.01, 95% CI 1.26, 3.21), but a similar risk for preterm birth (OR 1.38, 95% CI 0.81, 2, 34). Migrant mothers presented a lower risk of low birthweight and small for gestation and data suggest a healthy immigrant effect.


Assuntos
Emigrantes e Imigrantes/estatística & dados numéricos , Recém-Nascido de Baixo Peso , Bem-Estar Materno/estatística & dados numéricos , Nascimento Prematuro/epidemiologia , Adulto , Feminino , Humanos , Recém-Nascido , Portugal , Gravidez , Resultado da Gravidez/epidemiologia , Prevalência , Fatores de Risco
10.
Trop Med Int Health ; 24(1): 31-42, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30347129

RESUMO

OBJECTIVE: Although distance has been identified as an important barrier to care, evidence for an effect of distance to care on child mortality is inconsistent. We investigated the association of distance to care with self-reported care seeking behaviours, neonatal and post-neonatal under-five child mortality in rural areas of Burkina Faso. METHODS: We performed a cross-sectional survey in 14 rural areas from November 2014 to March 2015. About 100 000 women were interviewed on their pregnancy history and about 5000 mothers were interviewed on their care seeking behaviours. Euclidean distances to the closest facility were calculated. Mixed-effects logistic and Poisson regressions were used respectively to compute odds ratios for care seeking behaviours and rate ratios for child mortality during the 5 years prior to the survey. RESULTS: Thirty per cent of the children lived more than 7 km from a facility. After controlling for confounding factors, there was a strong evidence of a decreasing trend in care seeking with increasing distance to care (P ≤ 0.005). There was evidence for an increasing trend in early neonatal mortality with increasing distance to care (P = 0.028), but not for late neonatal mortality (P = 0.479) and post-neonatal under-five child mortality (P = 0.488). In their first week of life, neonates living 7 km or more from a facility had an 18% higher mortality rate than neonates living within 2 km of a facility (RR = 1.18; 95%CI 1.00, 1.39; P = 0.056). In the late neonatal period, despite the lack of evidence for an association of mortality with distance, it is noteworthy that rate ratios were consistent with a trend and similar to or larger than estimates in early neonatal mortality. In this period, neonates living 7 km or more from a facility had an 18% higher mortality rate than neonates living within 2 km of a facility (RR = 1.18; 95%CI 0.92, 1.52; P = 0.202). Thus, the lack of evidence may reflect lower power due to fewer deaths rather than a weaker association. CONCLUSION: While better geographic access to care is strongly associated with increased care seeking in rural Burkina Faso, the impact on child mortality appears to be marginal. This suggests that, in addition to improving access to services, attention needs to be paid to quality of those services.


Assuntos
Mortalidade da Criança/tendências , Acesso aos Serviços de Saúde/estatística & dados numéricos , Mortalidade Infantil/tendências , Bem-Estar Materno/estatística & dados numéricos , População Rural/estatística & dados numéricos , Viagem/estatística & dados numéricos , Adulto , Burkina Faso , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Serviços de Saúde Materna/organização & administração , Gravidez , Cuidado Pré-Natal/organização & administração , Fatores Socioeconômicos , Transporte de Pacientes/estatística & dados numéricos
11.
Mil Med ; 184(5-6): e440-e446, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30535396

RESUMO

INTRODUCTION: Group prenatal care models have been in use in the USA for over 20 years and have shown benefits in reducing rates of preterm birth and low birth weight infants in high-risk civilian populations. Group prenatal care has been widely implemented at military treatment facilities, despite a lack of high-quality evidence for improved perinatal outcomes in this population. MATERIALS AND METHODS: In this randomized, controlled trial, 129 patients at a military treatment facility received either traditional one-on-one prenatal care or group prenatal care using the CenteringPregnancy model. CenteringPregnancy care was administered by certified nurse midwives and family medicine residents and faculty. The primary outcomes were infant birthweight appropriateness for gestational age, maternal anxiety (as measured by the State-Trait Anxiety Inventory) and depression (as measured by the Center for Epidemiologic Studies-Depression scale), and patient satisfaction (as measured by the Short-Form Patient Satisfaction Questionnaire). Infant birthweights were compared using Chi-square tests for the categorical variables of small for gestational age (SGA), appropriate for gestational age (AGA), or large for gestational age. Maternal mood and satisfaction scores were evaluated before, during, and after the intervention and analyzed using rank sum tests. Additional demographic and outcome data were collected directly from participants and extracted from patient records. RESULTS: Patients receiving group care were more likely to deliver an infant that was appropriate for gestational age, with an incidence ratio of 1.12 [CI = 1.01-1.25, p = 0.04]. Depression and anxiety levels remained similar between groups throughout the study. Satisfaction was similar between groups, though patients receiving group care reported higher satisfaction with the accessibility and convenience of their care at the study's end [p = 0.048]. There were no differences between groups in preterm births, maternal or neonatal morbidity, mode of delivery, maternal weight gain, or breastfeeding rates. CONCLUSIONS: Military parturients receiving group prenatal care in the CenteringPregnancy model were less likely to deliver an small for gestational age or large for gestational age newborn and were more likely to be satisfied with their access to care. Group prenatal care is well received by patients and may positively influence neonatal metabolic status.


Assuntos
Peso ao Nascer , Processos Grupais , Bem-Estar Materno/psicologia , Cuidado Pré-Natal/métodos , Cuidado Pré-Natal/normas , Adulto , Distribuição de Qui-Quadrado , Feminino , Humanos , Recém-Nascido , Bem-Estar Materno/estatística & dados numéricos , Gravidez , Resultado da Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Inquéritos e Questionários
12.
Rev Bras Enferm ; 71(suppl 6): 2620-2627, 2018.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30540036

RESUMO

OBJECTIVE: To analyze the practice of obstetric nurses operating in a prenatal/delivery/postpartum unit of a university hospital in Mato Grosso and the maternal welfare resulted from the care provided in this scenario. METHOD: Study with a quantitative approach, carried out in a prenatal/delivery/postpartum unit of a university hospital in Cuiabá, Mato Grosso. The data were collected through the Scale of Maternal Welfare in Delivery Situation 2, and the study included 104 recent mothers in the period from June to September 2016. The data were analyzed in Epi Info version 7. RESULTS: The results indicate that the practice of obstetric nurses is based on the humanization of labor and childbirth, however, the presence of invasive and unnecessary practices in the service did not influence the level of maternal welfare, which was optimum for 76% of the women. CONCLUSION: The lack of information might make the women less critical and, therefore, influence the evaluation of the care received.


Assuntos
Bem-Estar Materno/psicologia , Mães/psicologia , Enfermagem Obstétrica/métodos , Unidade Hospitalar de Ginecologia e Obstetrícia/normas , Adolescente , Adulto , Brasil , Estudos Transversais , Feminino , Humanos , Serviços de Saúde Materna/normas , Serviços de Saúde Materna/estatística & dados numéricos , Bem-Estar Materno/estatística & dados numéricos , Mães/estatística & dados numéricos , Enfermagem Obstétrica/normas , Unidade Hospitalar de Ginecologia e Obstetrícia/organização & administração , Satisfação do Paciente , Gravidez , Qualidade da Assistência à Saúde/normas , Qualidade da Assistência à Saúde/estatística & dados numéricos
13.
BMC Psychol ; 6(1): 57, 2018 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-30545420

RESUMO

BACKGROUND: Mothers of preterm infants often have symptoms of anxiety and depression, recognized as risk factors for the development of cardiovascular diseases and associated with low rates of heart rate variability (HRV). This study aimed to evaluate the influence of music therapy intervention on the autonomic control of heart rate, anxiety, and depression in mothers. METHODS: Prospective randomized clinical trial including 21 mothers of preterms admitted to the Neonatal Intensive Care Unit of a tertiary hospital, recruited from August 2015 to September 2017, and divided into control group (CG; n = 11) and music therapy group (MTG; n = 10). Participants underwent anxiety and depression evaluation, as well as measurements of the intervals between consecutive heartbeats or RR intervals for the analysis of HRV at the first and the last weeks of hospitalization of their preterms. Music therapy sessions lasting 30-45 min were individually delivered weekly using receptive techniques. The mean and standard deviation of variables were obtained and the normality of data was analyzed using the Kolmogorov-Smirnov test. The paired sample t-test or Wilcoxon test were employed to calculate the differences between variables before and after music therapy intervention. The correlations anxiety versus heart variables and depression versus heart variables were established using Spearman correlation test. Fisher's exact test was used to verify the differences between categorical variables. A significance level of p < 0.05 was established. Statistical analysis were performed using the Statistical Package for the Social Sciences, version 20. RESULTS: Participants in MTG had an average of seven sessions of music therapy, and showed improvement in anxiety and depression scores and autonomic indexes of the time domain (p < 0.05). Significant correlations were found between depression and parasympathetic modulation using linear (r = - 0.687; p = 0.028) and nonlinear analyses (r = - 0.689; p = 0.027) in MTG. CONCLUSION: Music therapy had a significant and positive impact on anxiety and depression, acting on prevention of cardiovascular diseases, major threats to modern society. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (no. RBR-3x7gz8 ). Retrospectively registered on November 17, 2017.


Assuntos
Ansiedade/terapia , Depressão Pós-Parto/psicologia , Depressão Pós-Parto/terapia , Recém-Nascido Prematuro/psicologia , Mães/psicologia , Musicoterapia/métodos , Adulto , Ansiedade/psicologia , Transtornos de Ansiedade , Feminino , Frequência Cardíaca , Humanos , Lactente , Recém-Nascido , Bem-Estar Materno/psicologia , Estudos Prospectivos
14.
R I Med J (2013) ; 101(8): 30-33, 2018 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-30278599

RESUMO

The postpartum period is a time of significant challenge and need as women adapt to hormonal and physical changes, recover from delivery, experience shifting family responsibilities, and endure sleep deprivation, all while caring for and nourishing their newborn. It is also a period of significant maternal health risk. Recent data on U.S. maternal mortality indicate a shift in the timing of maternal deaths over the past 10 years, with the majority of maternal deaths now occurring postpartum, from one day to one year after delivery. Postpartum care also marks a period of transition, as women shift from pregnancy-centered care to interpregnancy and primary care, yet current systems of care are marked by poor coordination of care between providers and patient care settings. Suboptimal postpartum follow-up is particularly worrisome for women with chronic health conditions or pregnancy complications who face both short- and long-term health risks. Given known challenges and medical risks, the single, 6-week postpartum visit women receive is woefully inadequate in addressing maternal health needs. Postpartum visits often fail to address the unique postpartum needs identified by mothers, inadequately connect women with primary care services, and have low attendance. Recognition of these unmet needs of "the Fourth Trimester" have led national organizations, including the American College of Obstetricians and Gynecologists (ACOG), to call for a restructuring of postpartum care to reduce postpartum and long-term morbidity and improve postpartum well-being. Rhode Island has several recent initiatives with the potential to improve outcomes for mother-baby dyads including the Baby Friendly Hospital Initiative (BFHI), the provision of long-acting reversible contraception (LARC) immediately postpartum, and the addition of HPV immunization postpartum. These initiatives remove barriers of access to care and provide vital women's health services prior to discharge. The Fourth Trimester provides a rich opportunity for maternal risk reduction and health promotion at a time when women are motivated and engaged with health care.


Assuntos
Serviços de Saúde Materna/organização & administração , Saúde Materna , Mortalidade Materna/tendências , Bem-Estar Materno , Cuidado Pós-Natal/métodos , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Contracepção Reversível de Longo Prazo/estatística & dados numéricos , Morte Materna/prevenção & controle , Medição de Risco , Estados Unidos
16.
J Womens Health (Larchmt) ; 27(12): 1482-1490, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30311848

RESUMO

BACKGROUND: Intimate partner violence (IPV) is a significant public health problem with many negative consequences, particularly for pregnant women. This randomized trial investigated the effectiveness of an IPV preventive intervention embedded within the Nurse Family Partnership (NFP) program. MATERIALS AND METHODS: Participants enrolled over a 20-month period and were interviewed at baseline and 1- and 2-year follow-up. Eligibility criteria included first pregnancy, eligible for the nutrition program Women, Infants, and Children (WIC), English or Spanish speaking, and at least 15 years of age. All women initially referred and screened were randomized to either intervention (NFP+) or control (NFP only) condition. The final sample consisted of 238 women completing baseline assessments; retention was 81% at 2-year follow-up. RESULTS: Analyses indicated that there were no main effects: the intervention affected participants differently depending on their baseline experience with IPV. For physical violence victimization, an interaction between baseline victimization and treatment was found; the intervention reduced victimization at 1 year (and approached significance at 2 years), but only among women who had not experienced past-year physical victimization at baseline. For sexual violence victimization, another interaction emerged; women in the intervention group were more likely to report sexual violence victimization at 2-year follow-up, but only among participants who had reported sexual victimization at baseline. The only effect on IPV perpetration was psychological perpetration at 2-year follow-up; again, the treatment effect was moderated by baseline perpetration. The intervention reduced psychological perpetration for participants who were nonperpetrators at baseline, but had no effect on those reporting perpetration. CONCLUSIONS: Overall, findings suggest that the intervention was effective in reducing some forms of violence among those not experiencing IPV at baseline, but was ineffective or potentially harmful for those already experiencing IPV.


Assuntos
Vítimas de Crime/psicologia , Violência Doméstica/prevenção & controle , Violência Doméstica/estatística & dados numéricos , Violência por Parceiro Íntimo/prevenção & controle , Violência por Parceiro Íntimo/estatística & dados numéricos , Mães/estatística & dados numéricos , Vítimas de Crime/estatística & dados numéricos , Violência Doméstica/psicologia , Feminino , Serviços de Assistência Domiciliar/organização & administração , Visita Domiciliar , Humanos , Lactente , Bem-Estar do Lactente , Violência por Parceiro Íntimo/psicologia , Bem-Estar Materno , Enfermeiras e Enfermeiros , Gestantes , Estados Unidos , Adulto Jovem
17.
Recurso na Internet em Inglês | LIS - Localizador de Informação em Saúde, LIS-bvsms | ID: lis-LISBR1.1-46275

RESUMO

Site voltado para dar informação e suporte para melhorar o diagnóstico, gerenciamento e prevenção da pré-eclâmpsia através de pesquisa e práticas médicas melhoradas.


Assuntos
Pré-Eclâmpsia , Bem-Estar Materno , Saúde Materna
18.
Rev. enferm. UFPE on line ; 12(8): 2129-2136, ago. 2018.
Artigo em Português | BDENF - Enfermagem | ID: biblio-994456

RESUMO

Objetivo: analisar a satisfação de puérperas acerca das tecnologias não invasivas de cuidados a elas prestados. Método: estudo qualitativo, descritivo, exploratório, com 15 puérperas por meio de entrevista individual utilizando um formulário semiestruturado. Após a saturação dos dados, o resultado foi organizado por categorias e similaridade. Resultados: percebeu-se a satisfação das puérperas em relação aos cuidados prestados aliviando a dor, proporcionando bem-estar e diminuindo o tempo de espera durante o trabalho de parto. Conclusão: em razão dos benefícios consequentes desse novo modelo de assistência obstétrica, que vem sendo preconizado com o uso das TNIC, é imprescindível que essas práticas sejam executadas em todos os serviços de saúde de obstetrícia, principalmente porque, em alguns tipos de serviço, a atuação da Enfermagem Obstétrica é prestada de maneira mais autônoma sendo, assim, preponderante para a oferta desse cuidado pautado nessa assistência humanizada.(AU)


Assuntos
Humanos , Feminino , Gravidez , Percepção , Qualidade da Assistência à Saúde , Trabalho de Parto , Satisfação do Paciente , Tecnologia Biomédica , Parto Humanizado , Parto Normal , Enfermagem Obstétrica , Epidemiologia Descritiva , Pesquisa Qualitativa , Dor do Parto , Maternidades , Bem-Estar Materno
19.
Artigo em Alemão | MEDLINE | ID: mdl-29978234

RESUMO

We evaluated the effect of breastfeeding on maternal health outcomes. We distinguished between long-term effects (breast carcinoma, ovarian carcinoma, endometrial carcinoma, osteoporosis, and type 2 diabetes mellitus) and short-term effects (lactational amenorrhea, postpartum depression, and postpartum weight change).Predominant breastfeeding increases the duration of lactational amenorrhea, which has a short-term effect on the reduction of fertility. There are many studies that show that breastfeeding is protective against breast, ovarian carcinoma, and endometrial carcinoma. The effects depend on the duration of breastfeeding. There is evidence that breastfeeding reduces the risk of type 2 diabetes and metabolic syndrome and cardiac diseases. However, an association between breastfeeding and bone mineral density or maternal depression or postpartum weight change was not clearly evident.


Assuntos
Amenorreia , Aleitamento Materno , Saúde Materna , Bem-Estar Materno , Mães/psicologia , Feminino , Alemanha , Humanos , Período Pós-Parto , Fatores de Tempo
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA