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1.
Medicine (Baltimore) ; 100(4): e23920, 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33530192

RESUMO

BACKGROUND: Lamaze breathing has been widely used as a breathing training method. Nursing intervention including postural nursing, delivery ball, doula nursing, massage and psychological nursing is usually provided by nurses during labor. A number of clinical studies have investigated the effect of Lamaze breathing training combined with nursing intervention on maternal pain relief and outcomes improvement. But there were some scholars who were against it. METHODS: Randomized controlled trials from January 2000 to November 2019 in PubMed, Cochrance Library, Medline, Web of Science, Embase, Chinese Academic Journals, Chinese Biomedical Literature Database, VIP Database, Wanfang Database were searched. Two researchers independently screened the literature according to the criteria. After extracting the data, the researchers used Cochrane system to evaluate the literature quality. Statistical analyses were performed by using Comprehensive Meta Analysis V2 software. RESULTS: Twenty-two randomized controlled trials conducted on 7035 primiparas were eligible. The results revealed that Lamaze breathing training combined with nursing intervention increased the rate of natural delivery (relative risk [RR] = 2.97, 95% confidence interval [CI] [2.48, 3.56]), shortened the length of labor (-2.604, 95% CI [-3.120, -2.087]), alleviated labor pain (RR = 0.194, 95% CI [0.115, 0.325]) and reduced postpartum bleeding (-2.966, 95% CI [-4.056, -1.877]). CONCLUSIONS: Lamaze breathing training combined with nursing intervention was effective for ameliorating the process and outcomes of childbirth in primiparae and deserves to be promoted and applied in clinical practice.


Assuntos
Trabalho de Parto/fisiologia , Parto Normal/métodos , Parto Normal/enfermagem , Parto/fisiologia , Feminino , Humanos , Dor do Parto/terapia , Paridade , Hemorragia Pós-Parto/prevenção & controle , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo
2.
Artigo em Inglês | PAHO-IRIS | ID: phr-53158

RESUMO

[ABSTRACT]. The present report describes the process and results obtained with a knowledge translation project developed in three stages to identify barriers to the Implementation of the National Guidelines for Normal Childbirth in Brazil, as well strategies for effective implementation. The Improving Programme Implementation through Embedded Research (iPIER) model and the Supporting Policy Relevant Reviews and Trials (SUPPORT) tools provided the methodological framework for the project. In the first stage, the quality of the Guidelines was evaluated and the barriers preventing implementation of the recommendations were identified through review of the global evidence and analysis of contributions obtained in a public consultation process. In the second stage, an evidence synthesis was used as the basis for a deliberative dialogue aimed at prioritizing the barriers identified. Finally, a second evidence synthesis was presented in a new deliberative dialogue to discuss six options to address the prioritized barriers: 1) promote the use of multifaceted interventions; 2) promote educational interventions for the adoption of guidelines; 3) perform audits and provide feedback to adjust professional practice; 4) use reminders to mediate the interaction between workers and service users; 5) enable patient-mediated interventions; and 6) engage opinion leaders to promote use of the Guidelines. The processes and results associated with each stage were documented and formulated to inform a review and update of the Guidelines and the development of an implementation plan for the recommendations. Effective implementation of the Guidelines is important for improving the care provided during labor and childbirth in Brazil.


[RESUMEN]. En este informe se presentan los procesos y resultados de un proyecto de traducción de conocimiento desarrollado en tres etapas para identificar los obstáculos y las estrategias para la aplicación efectiva de las Directrices Nacionales para el Parto Normal en el Brasil. El marco metodológico adoptado comprendió la iniciativa iPIER (Improving Program Implementation through Embedded Research) y las herramientas SUPPORT para políticas basadas en evidencia. En la primera etapa se evaluó la calidad de las Directrices y se identificaron los obstáculos a la aplicación de las recomendaciones, teniendo en cuenta la evidencia mundial y el análisis de las contribuciones obtenidas mediante una consulta pública. En la segunda etapa, una síntesis de la evidencia sirvió de base para un diálogo deliberativo para la priorización de los obstáculos. Por último, una nueva síntesis de la evidencia sirvió de base para un segundo diálogo deliberativo y presentó seis opciones para hacer frente a los obstáculos priorizados: 1) fomentar el uso de estrategias de intervención polifacéticas; 2) promover intervenciones educativas para mejorar el uso de directrices sanitarias; 3) realizar auditorías y proporcionar retroalimentación para la adecuación de la práctica profesional; 4) utilizar recordatorios para mediar en la interacción entre profesionales y usuarios; 5) permitir intervenciones mediadas por el paciente; y 6) incluir a líderes de opinión para fomentar el uso de directrices sanitarias. Se documentaron y presentaron los procesos y resultados de cada etapa del proyecto para fundamentar la actualización de las Directrices y la elaboración de un plan de aplicación de las recomendaciones. La aplicación efectiva de las Directrices es importante para mejorar la atención del parto y el nacimiento en el Brasil.


Assuntos
Política Informada por Evidências , Ciência da Implementação , Prática Clínica Baseada em Evidências , Guia de Prática Clínica , Parto Normal , Brasil , Política Informada por Evidências , Ciência da Implementação , Prática Clínica Baseada em Evidências , Guia de Prática Clínica , Parto Normal , Brasil
3.
Artigo em Inglês, Espanhol, Português | LILACS, BDENF - Enfermagem | ID: biblio-1151567

RESUMO

OBJECTIVE: To understand the representations of puerperal women regarding the assistance received during delivery. METHOD: A qualitative research study, carried out in two public maternity hospitals between August and September 2017 with 25 puerperal women. The methodological framework of the Collective Subject Discourse was used. RESULTS: The speeches were grouped in two themes: 1) Humanization and satisfaction with the moment of delivery; 2) Inadequate ambience and suffering generated by assistance during delivery. DISCUSSION: The puerperal women pointed out problems in the physical structure of the maternity hospitals, but represented the care received during delivery as satisfactory, as they reported having been supported by the health team. However, in some speeches unpleasant situations emerged, referring to the use of unnecessary interventions, non-reception and lack of privacy. CONCLUSION: The puerperal women were satisfied with the care received during delivery, although they showed some dissatisfaction. A discussion was held based on current scientific evidence regarding good practices of care during labor and delivery.


OBJETIVO: Compreender as representações das puérperas frente à assistência recebida no parto. MÉTODO: Pesquisa qualitativa, realizada em duas maternidades públicas, com 25 puérperas entre agosto e setembro de 2017. Utilizou-se o referencial metodológico do Discurso do Sujeito Coletivo. RESULTADOS: Os discursos foram agrupados em dois temas: 1) Humanização e satisfação com o momento do parto; 2) Ambiência inadequada e sofrimento gerados pela assistência durante o parto. DISCUSSÃO: As puérperas apontaram problemas na estrutura física das maternidades, mas representaram o cuidado recebido durante o parto como satisfatório, pois referem ter sido apoiadas pela equipe de saúde. Entretanto, em alguns discursos emergiram situações desagradáveis, referentes ao uso de intervenções desnecessárias, não acolhimento e falta de privacidade. CONCLUSÃO: As puérperas mostraram-se satisfeitas com o cuidado recebido no parto, embora tenham demonstrado algumas insatisfações. Ressalta-se que a assistência ao parto deve ser baseada em evidências científicas, pautada nas boas práticas de atenção ao parto.


OBJETIVO: Comprender las percepciones de las puérperas sobre la asistencia recibida durante el parto. MÉTODO: Investigación cualitativa, realizada en dos maternidades públicas, con 25 puérperas entre agosto y septiembre de 2017. Se utilizó el marco metodológico del Discurso del Sujeto Colectivo. RESULTADOS: Los discursos se agruparon en dos temas: 1) Humanización y satisfacción con el momento del parto; 2) Ambiente inadecuado y sufrimiento generado por la asistencia durante el parto. DISCUSIÓN: Las puérperas señalaron problemas en la estructura física de las maternidades, pero manifestaron que la atención recibida durante el parto fue satisfactoria, porque informaron que fueron apoyadas por el equipo de salud. Sin embargo, en algunos discursos surgieron situaciones desagradables, relacionadas con la práctica de intervenciones innecesarias, falta de acogida y de privacidad. CONCLUSIÓN: Las puérperas se mostraron satisfechas con la atención recibida durante el parto, aunque hayan demostrado cierta insatisfacción. Cabe destacar que la atención del parto debe basarse en evidencia científica, basada en buenas prácticas de atención durante el parto.


Assuntos
Humanos , Feminino , Gravidez , Adolescente , Adulto , Saúde da Mulher , Assistência Integral à Saúde , Gestantes , Assistência ao Paciente , Maternidades , Parto Normal , Qualidade da Assistência à Saúde , Avaliação em Saúde , Satisfação do Paciente , Parto Humanizado , Pesquisa Qualitativa , Humanização da Assistência , Entorno do Parto
4.
Artigo em Português | PAHO-IRIS | ID: phr-52973

RESUMO

[RESUMO]. Este relato apresenta os processos e resultados de um projeto de tradução do conhecimento desenvolvido em três etapas para identificar barreiras e estratégias para a efetiva implementação das Diretrizes Nacionais do Parto Normal no Brasil. O referencial metodológico adotado foi o da iniciativa iPIER e das ferramentas SUPPORT para Políticas Informadas por Evidências. Na primeira etapa, a qualidade das Diretrizes foi avaliada e as barreiras à implementação das recomendações foram identificadas, considerando evidências globais e análise de contribuições de uma consulta pública. Na segunda etapa, uma síntese de evidências informou um diálogo deliberativo para priorização de barreiras. Por fim, uma nova síntese de evidências informou um segundo diálogo deliberativo e apresentou seis opções para abordar as barreiras priorizadas: 1) incentivar o uso de estratégias de intervenção multifacetadas; 2) promover intervenções educativas para o uso de diretrizes em saúde; 3) realizar auditoria e feedback para adequação da prática profissional; 4) utilizar lembretes para mediar a interação entre profissionais e usuários; 5) viabilizar intervenções mediadas por pacientes e 6) incluir líderes de opinião para incentivar o uso de diretrizes em saúde. Os processos e resultados de cada etapa do projeto foram documentados e apresentados para informar a atualização das Diretrizes e o desenvolvimento de plano de implementação das recomendações. A efetiva implementação das Diretrizes é relevante para a melhoria da atenção ao parto e nascimento no Brasil.


[ABSTRACT]. The present report describes the process and results obtained with a knowledge translation project developed in three stages to identify barriers to the National Childbirth Guidelines in Brazil as well strategies for effective implementation. The Improving Programme Implementation through Embedded Research (iPIER) model and the Supporting Policy Relevant Reviews and Trials (SUPPORT) tools provided the methodological framework for the project. In the first stage, the quality of the Guidelines was evaluated and the barriers preventing implementation of the recommendations were identified through review of the global evidence and analysis of contributions obtained in a public consultation process. In the second stage, an evidence synthesis was used as basis for a deliberative dialogue aimed at prioritizing the barriers identified. Finally, a second evidence synthesis was presented in a new deliberative dialogue to discuss six options to address the prioritized barriers: 1) promote the use of multifaceted interventions; 2) promote educational interventions for the adoption of guidelines; 3) perform audits and provide feedback to adjust professional practice; 4) use reminders to mediate the interaction between workers and service users; 5) enable patient-mediated interventions; and 6) engage opinion leaders to promote the use of guidelines. The processes and results associated with each stage were documented and formulated to inform a review and update of the Guidelines and the development of an implementation plan for the recommendations. An effective implementation of the Guidelines is relevant to improve the care provided during labor and childbirth in Brazil.


[RESUMEN]. En este informe se presentan los procesos y resultados de un proyecto de traducción de conocimiento desarrollado en tres etapas para identificar los obstáculos y las estrategias para la aplicación efectiva de las Directrices Nacionales para el Parto Normal en el Brasil. El marco metodológico adoptado comprendió la iniciativa iPIER (Improving Program Implementation through Embedded Research) y las herramientas SUPPORT para políticas basadas en evidencia. En la primera etapa se evaluó la calidad de las Directrices y se identificaron los obstáculos a la aplicación de las recomendaciones, teniendo en cuenta la evidencia mundial y el análisis de las contribuciones obtenidas mediante una consulta pública. En la segunda etapa, una síntesis de la evidencia sirvió de base para un diálogo deliberativo para la priorización de los obstáculos. Por último, una nueva síntesis de la evidencia sirvió de base para un segundo diálogo deliberativo y presentó seis opciones para hacer frente a los obstáculos priorizados: 1) fomentar el uso de estrategias de intervención polifacéticas; 2) promover intervenciones educativas para mejorar el uso de directrices sanitarias; 3) realizar auditorías y proporcionar retroalimentación para la adecuación de la práctica profesional; 4) utilizar recordatorios para mediar en la interacción entre profesionales y usuarios; 5) permitir intervenciones mediadas por el paciente; y 6) incluir a líderes de opinión para fomentar el uso de directrices sanitarias. Se documentaron y presentaron los procesos y resultados de cada etapa del proyecto para fundamentar la actualización de las Directrices y la elaboración de un plan de aplicación de las recomendaciones. La aplicación efectiva de las Directrices es importante para mejorar la atención del parto y el nacimiento en el Brasil.


Assuntos
Política Informada por Evidências , Ciência da Implementação , Prática Clínica Baseada em Evidências , Guia de Prática Clínica , Parto Normal , Brasil , Política Informada por Evidências , Ciência da Implementação , Prática Clínica Baseada em Evidências , Guia de Prática Clínica , Parto Normal , Brasil , Política Informada por Evidências , Ciência da Implementação , Prática Clínica Baseada em Evidências , Guia de Prática Clínica
5.
Obstet Gynecol ; 136(4): 707-715, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32925614

RESUMO

OBJECTIVE: To compare neonatal intensive care unit (NICU) or special care nursery admission for deliveries with water immersion compared with deliveries in the matched control group without water immersion. Secondary outcomes included adverse neonatal diagnoses, maternal infections, and perineal lacerations. METHODS: We conducted a retrospective study using electronic health record data (2014-2018) from two health systems (eight hospitals), with similar clinical eligibility, associated with low risks of intrapartum complications, and implementation policies for waterbirth. The water immersion group included women intending waterbirth. Water immersion was recorded prospectively during delivery. The comparison population were women who met the clinical eligibility criteria for waterbirth but did not experience water immersion during labor. Comparison cases were matched (1:1) using propensity scores. Outcomes were compared using Fischer's exact tests and logistic regression with stratification by stage of water immersion. RESULTS: Of the 583 women with water immersion, 34.1% (199) experienced first-stage water immersion only, 65.9% (384) experienced second-stage immersion, of whom 12.0% (70) exited during second stage, and 53.9% (314) completed delivery in the water. Neonatal intensive care unit or special care nursery admissions were lower for second-stage water immersion deliveries than deliveries in the control group (odds ratio [OR] 0.3, 95% CI 0.2-0.7). Lacerations were lower in the second-stage immersion group (OR 0.5, 95% CI 0.4-0.7). Neonatal intensive care unit or special care nursery admissions and lacerations were not different between the first-stage immersion group and their matched comparisons. Cord avulsions occurred for 0.8% of second-stage water immersion deliveries compared with none in the control groups. Five-minute Apgar score (less than 7), maternal infections, and other adverse outcomes were not significantly different between either the first- or second-stage water immersion groups and their control group. CONCLUSION: Hospital-based deliveries with second-stage water immersion had lower risk of NICU or special care nursery admission and perineal lacerations than matched deliveries in the control group without water immersion.


Assuntos
Parto Obstétrico , Registros Eletrônicos de Saúde/estatística & dados numéricos , Doenças do Recém-Nascido , Lacerações , Parto Normal , Complicações do Trabalho de Parto , Adulto , Índice de Apgar , Parto Obstétrico/efeitos adversos , Parto Obstétrico/métodos , Parto Obstétrico/estatística & dados numéricos , Feminino , Humanos , Recém-Nascido , Doenças do Recém-Nascido/diagnóstico , Doenças do Recém-Nascido/prevenção & controle , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Segunda Fase do Trabalho de Parto , Lacerações/diagnóstico , Lacerações/etiologia , Lacerações/prevenção & controle , Masculino , Minnesota/epidemiologia , Parto Normal/efeitos adversos , Parto Normal/métodos , Parto Normal/estatística & dados numéricos , Complicações do Trabalho de Parto/diagnóstico , Complicações do Trabalho de Parto/etiologia , Complicações do Trabalho de Parto/prevenção & controle , Períneo/lesões , Gravidez , Resultado da Gravidez/epidemiologia , Estudos Retrospectivos
6.
Obstet Gynecol ; 136(4): 692-697, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32925628

RESUMO

OBJECTIVE: To evaluate characteristics associated with adverse outcomes in low-risk nulliparous women randomized to elective labor induction at 39 weeks of gestation or expectant management. METHODS: We conducted a secondary analysis of women randomized during the 38th week to induction at 39 weeks of gestation or expectant management. Deliveries before 39 weeks of gestation and those not adherent to study protocol or with fetal anomalies were excluded. A composite of adverse outcomes (perinatal death or severe neonatal complications), third- or fourth-degree lacerations, and postpartum hemorrhage were evaluated. Log binomial regression models estimated relative risks and 95% CIs for associations of outcomes with patient characteristics including randomly assigned treatment group. Interactions between patient characteristics and treatment group were tested. RESULTS: Of 6,096 women with outcome data, 5,007 (82.1%) met criteria for inclusion in this analysis. Frequency of the perinatal composite was 252 (5.0%), 166 (3.3%) for third- or fourth-degree perineal laceration, and 237 (4.7%) for postpartum hemorrhage. In multivariable analysis, intended labor induction at 39 weeks of gestation was associated with a reduced perinatal composite outcome (4.1% vs 6.0%; adjusted relative risk [aRR] 0.71; 95% CI 0.55-0.90), whereas increasing body mass index (BMI) was associated with an increased perinatal composite outcome (aRR 1.04/unit increase; 95% CI 1.02-1.05). Decreased risk of third- or fourth-degree perineal laceration was observed with increasing BMI (aRR 0.96/unit increase; 95% CI 0.93-0.98) and in Black women compared with White women (1.2% vs 3.9%; aRR 0.34; 95% CI 0.19-0.60). Increased risk of postpartum hemorrhage was observed in Hispanic women compared with White women (6.3% vs 4.0%; aRR 1.64; 95% CI 1.18-2.29). Patient characteristics associated with adverse outcomes were similar between treatment groups (P for interaction >.05). CONCLUSION: Compared with expectant management, intended induction at 39 weeks of gestation was associated with reduced risk of adverse perinatal outcome. Patient characteristics associated with adverse outcomes were few and similar between groups. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT01990612.


Assuntos
Doenças do Recém-Nascido/diagnóstico , Trabalho de Parto Induzido , Lacerações , Complicações do Trabalho de Parto , Hemorragia Pós-Parto , Adulto , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Trabalho de Parto Induzido/efeitos adversos , Trabalho de Parto Induzido/métodos , Lacerações/diagnóstico , Lacerações/etnologia , Lacerações/etiologia , Lacerações/prevenção & controle , Masculino , Parto Normal/efeitos adversos , Parto Normal/métodos , Complicações do Trabalho de Parto/etiologia , Complicações do Trabalho de Parto/prevenção & controle , Avaliação de Processos e Resultados em Cuidados de Saúde , Paridade , Morte Perinatal , Hemorragia Pós-Parto/diagnóstico , Hemorragia Pós-Parto/etnologia , Hemorragia Pós-Parto/etiologia , Hemorragia Pós-Parto/prevenção & controle , Gravidez
7.
Obstet Gynecol ; 136(4): 698-705, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32925634

RESUMO

OBJECTIVE: To develop models to predict vaginal delivery in low-risk, nulliparous women contemplating elective induction of labor or expectant management at 39 weeks of gestation. METHODS: We conducted a secondary analysis of a randomized controlled trial of planned elective induction of labor at 39 weeks of gestation compared with expectant management for low-risk nulliparous women. Two groups were included for this analysis: 1) women who were randomized to the induction of labor group and underwent elective induction at 39 0/7-39 4/7 weeks of gestation and 2) women who were randomized to the expectant management group who experienced spontaneous labor or medically indicated delivery (including postterm). Multivariable logistic regression models were developed for each group using patient characteristics that would be available at the time of counseling. Model selection was based on k-fold cross-validation using backward elimination and variables that remained significant at P<.05 were retained. To compare estimated with observed rates, the elective induction of labor model was then applied to each woman in both groups to estimate individualized predicted probabilities of vaginal delivery with elective induction of labor. RESULTS: Of 6,106 women enrolled in the trial, 4,661 met criteria for this analysis. Vaginal delivery occurred in 80.6% of the 2,153 women in the elective induction of labor group and 77.2% of the 2,508 women in the expectant management group (P=.005). The final elective induction of labor model included age, height, weight, and modified Bishop score (area under the receiver operating characteristic curve [AUROC] 0.72, 95% CI 0.70-0.75). The same variables were included in the final expectant management model (AUROC 0.70, 95% CI 0.67-0.72). Across the range of predicted probability deciles derived from the elective induction of labor model, almost all women who underwent elective induction of labor at 39 weeks of gestation had a higher observed chance of vaginal delivery than expectant management. CONCLUSION: Irrespective of the individual predicted chance of vaginal delivery from elective induction of labor at 39 weeks of gestation, vaginal delivery is generally more frequent if elective induction of labor is undertaken rather than expectant management. These data can be used to counsel nulliparous women regarding their "customized" chances of vaginal delivery as they choose between elective induction of labor or expectant management at 39 weeks of gestation. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT01990612.


Assuntos
Trabalho de Parto Induzido , Complicações do Trabalho de Parto , Adulto , Técnicas de Apoio para a Decisão , Feminino , Idade Gestacional , Humanos , Trabalho de Parto Induzido/efeitos adversos , Trabalho de Parto Induzido/métodos , Parto Normal/efeitos adversos , Parto Normal/métodos , Complicações do Trabalho de Parto/etiologia , Complicações do Trabalho de Parto/prevenção & controle , Paridade , Gravidez , Prognóstico
8.
PLoS One ; 15(8): e0237420, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32790709

RESUMO

OBJECTIVE: To prevent the rapid spread of COVID-19, the Chinese government implemented a strict lockdown in Wuhan starting on 23 January, 2020, which inevitably led to the changes in indications for the mode of delivery. In this retrospective study, we present the changes in the indications for cesarean delivery (CD) and the birth weights of newborns after the lockdown in Wuhan. METHODS: A total of 3,432 pregnant women in the third trimester of their pregnancies who gave birth in our hospital from 23 January 2019 to 24 March 2020 were selected as the observation group, while 7,159 pregnant women who gave birth from 1 January 2019 to 22 January 2020 were selected as the control group; control group was matched using propensity score matching (PSM). A comparative analysis of the two groups was performed with the chi-square test, t test and rank sum test. RESULTS: The difference in the overall rate of CD between the two groups was not statistically significant (p<0.05). Among the indications for CD, CD on maternal request (CDMR) and fetal distress were also significantly more common in the observation group (p<0.05) than the control group. Furthermore, we found that the weight of newborns was significantly heavier in the observation group than in the control group when considering full-term or close-to-full-term births (p<0.05). CONCLUSIONS: The results may provide useful information to management practices regarding pregnancy and childbirth after lockdown in other cities or countries, enabling better control of the rate of CD due to CDMR, reducing fetal distress, and controlling newborn weight. We recommend that pregnant women pay more attention to controlling the weight of newborns through diet and exercise.


Assuntos
Betacoronavirus , Peso ao Nascer , Cesárea , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Quarentena/métodos , Adolescente , Adulto , China/epidemiologia , Infecções por Coronavirus/virologia , Feminino , Sofrimento Fetal , Humanos , Recém-Nascido , Pessoa de Meia-Idade , Parto Normal , Pneumonia Viral/virologia , Gravidez , Estudos Retrospectivos , Nascimento a Termo , Adulto Jovem
9.
Sex., salud soc. (Rio J.) ; (35): 260-282, maio-ago. 2020.
Artigo em Espanhol | LILACS | ID: biblio-1139639

RESUMO

Resumen En este artículo se analiza el uso del consentimiento informado en torno a partos y nacimientos, mediante el análisis de las estrategias que efectúan las mujeres gestantes de la Ciudad de Buenos Aires en pos del reconocimiento de sus cuerpos, sus bebés, la fisiología de sus partos y el respeto por sus decisiones informadas. A partir de una investigación etnográfica, se analizan las tensiones que experimentan en sus intentos por hacer respetar sus necesidades, derechos y elecciones. Diferentes estrategias (directivas anticipadas, plan de parto, etc.) son desplegadas por las mujeres para efectivizar su protagonismo en las decisiones médicas respecto de sus partos. Este trabajo sugiere que el consentimiento informado no solo es un procedimiento médico formal que utilizan los/as médicos/as para avalar sus decisiones y dejar por sentado la aceptación del paciente, sino que se trata de una herramienta por la cual las mujeres se apropian y movilizan en sus interacciones con el sistema de salud.


Resumo Este artigo analisa o uso do consentimento informado em torno de partos e nascimentos, analisando as estratégias adotadas por gestantes na cidade de Buenos Aires, a fim de reconhecer seus corpos, seus bebês, a fisiologia de seus nascimentos e respeito por suas decisões informadas. A partir de uma investigação etnográfica, são analisadas as tensões que elas experimentam em suas tentativas de reforçar suas necessidades, direitos e escolhas. Estratégias diferentes (diretrizes antecipadas, plano de parto, etc.) são adotadas pelas mulheres para desempenhar seu papel nas decisões médicas sobre seus partos. Este artigo sugere que o consentimento informado não é apenas um procedimento médico formal que os/as médicos/as usam para apoiar suas decisões e dar como certa a aceitação da paciente, mas que é uma ferramenta pela qual as mulheres se apropriam e mobilizam suas interações com o sistema de saúde.


Abstract This paper inquires about the use of informed consent in childbirths and labours, analysing the strategies employed by pregnant women in Buenos Aires Capital City in pursuit of the recognition of their bodies, their babies, the physiology of their labours and the respect of their informed choices. In the context of an ethnographic study, the tensions that women experience in their attempts to make their needs, rights and decisions respected are analyzed. Different strategies (advance healthcare directive, birth plans, etc.) are devised by women to secure their central position in the decision-making related to their labours. This study suggests that informed consent is not only a formal medical procedure that physicians use to support their decision and have a written document of the patient's agreement, but also a tool used by women to seize control of their interactions in the health-care system.


Assuntos
Humanos , Feminino , Gravidez , Parto Humanizado , Parto Obstétrico , Gestantes , Violência contra a Mulher , Empoderamento para a Saúde/métodos , Consentimento Livre e Esclarecido , Argentina , Tomada de Decisões , Antropologia Cultural , Parto Normal
10.
J. Hum. Growth Dev. (Impr.) ; 30(2): 301-310, May-Aug. 2020. ilus, tab
Artigo em Inglês | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-1114939

RESUMO

INTRODUCTION: Elective cesarean section is associated with several damages to the newborn's health, such as respiratory, gastrointestinal problems and diabetes that last throughout life. However, few studies discuss aspects related to psychological developmentOBJECTIVE: To investigate the development of Brazilian children according to the type of birth and gestational age in the cognitive, language, motor, socio-emotional and adaptive behavior domainsMETHODS: This is an exploratory and descriptive cross-sectional study conducted in the city of São Bernardo do Campo, São Paulo, Brazil, between June 2016 and March 2017. The final sample consisted of 263 children up to 42 months of age. For data collection were applied a socio demographic questionnaire and the Bayley-III Scale. The statistical analysis was based on both a North American reference sample and a local sample using the SPSS version 21, through Pearson's Chi-square statistical test and significance criteria p <0.05RESULTS: A significant difference (p<0.005) was observed, with a higher risk of problems in fine motor development and expressive language in children born at pre-term between 37- 39 weeks compared to those born at term between 39 - 41 weeks. Significant difference (p<0.005) was also observed in sensory processing and adaptive behavior, with greater impairment in children born via elective cesarean section compared to those born vaginallyCONCLUSION: Despite its limitations and discrepancies, this research indicates potential impairments in the psychological development of children born at early term via elective cesarean


INTRODUÇÃO: A cesárea eletiva está associada a diversos prejuízos à saúde do recém-nascido, como problemas respiratórios, gastrointestinais e diabetes, que perduram ao longo da vida. No entanto, poucos estudos discutem os aspectos relacionados ao desenvolvimento psicológicoOBJETIVO: Investigar o desenvolvimento de crianças brasileiras segundo a via de parto e a idade gestacional nos domínios cognitivo, linguagem, motor, socioemocional e comportamento adaptativoMÉTODO: Trata-se de um estudo exploratório-descritivo, transversal, realizado no município de São Bernardo do Campo, entre junho de 2016 e março de 2017. A população foi composta por 400 crianças até 42 meses de idade. Para coleta de dados foram aplicados questionário sociodemográfico e Escala Bayley-III. Foi utilizada para análise estatística tanto a normatização oferecida pela Escala Bayley (norte-americana) quanto a normatização referente à amostra estudada, por meio do SPSS version 21, utilizando o teste estatístico do Qui-Quadrado de Pearson, critérios de significância p<0,05RESULTADOS: Observou-se diferença significativa (p<0,005), com maior risco de problemas no desenvolvimento motor fino e na linguagem expressiva em crianças nascidas a termo precoce (37 a<39 semanas) quando comparadas às nascidas a termo (=39 a <41 semanas). Diferença significativa (p<0,005) também foi observada no processamento sensorial e comportamento adaptativo, com maior prejuízo observado nas crianças nascidas via CE em comparação às nascidas de parto vaginalCONCLUSÃO: Este estudo evidencia o aumento de riscos psicológicos em crianças nascidas via cesárea eletiva quando comparadas com as nascidas por parto vaginal nos aspectos relacionados ao processamento sensorial, motricidade fina, linguagem expressiva e emissão de comportamentos adaptativos


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Recém-Nascido Prematuro , Cesárea , Desenvolvimento Infantil , Serviços de Saúde da Criança , Parto Normal
11.
RECIIS (Online) ; 14(2): 416-430, abr.-jun. 2020. tab, ilus
Artigo em Português | LILACS | ID: biblio-1102804

RESUMO

Este artigo aborda a questão das convocações biopolíticas em torno das vias de nascimento, parto e cesariana, identificadas em dois grandes jornais de circulação nacional: Folha de S.Paulo e O Estado de S. Paulo. Considerados como dispositivos, segundo conceito adotado, esses veículos de mídia propagam o paradoxo: normal e seguro é fazer cesariana; estranho e arriscado é o parto normal. No entanto, mais do que propagarem o discurso em prol da cesariana, essas mídias convocam os leitores, com enunciados ancorados no medo, no controle do corpo e na bioeconomia. A constatação resultou da investigação conceitual realizada nas 390 reportagens sobre o tema publicadas nesses dois jornais entre 2010 a 2015. O período é marcado pelo crescimento constante do número dessas cirurgias no Brasil, o que chegou a ser considerado uma epidemia pela Organização Mundial de Saúde.


This article approaches the issue of biopolitical calls for the processof childbirth, to give birth spontaneouly or surgical procedure known as caesarean section, identified in two major newspapers having national circulation in Brazil: Folha de S.Paulo and O Estado de S. Paulo. Considered as devices, according with the concept taken into account in this study, these media vehicles propagate this paradox: Normal and safe is caesarean section. Strange and risky is normal birth. However, rather than propagating the discourse in favour of caesarean section, these media invite their readers to choose this surgery, with statements anchored in fear, body control and bioeconomy. The findings are resulted from the conceptual investigation conducted in the 390 articles on the theme published in these two newspapers between 2010 and 2015. The period is marked by the steady increasing number of these surgeries in Brazil, which was considered an epidemic by the World Health Organization.


Este artículo aborda el tema de las llamadas biopolíticas acerca de las maneras como nacer, parto y cesárea, identificadas en dos importantes periódicos de difusión nacional en Brasil: Folha de S.Paulo y O Estado de S. Paulo. Considerados como dispositivos, según el concepto adoptado en este estudio, estos vehículos de comunicación propagan la paradoja: lo normal y seguro es la cesárea. Extraño y arriesgado es el parto normal. Sin embargo, más que propagar el discurso a favor de la cesárea, estos medios convocan a sus lectores, con declaraciones ancladas en el miedo, el control corporal y la bioeconomía. La conclusión a que se ha llegado resultó de la investigación conceptual realizada en los 390 artículos sobre el tema publicados en estos dos periódicos entre 2010 y 2015. El período está marcado por el crecimiento constante del número de estas cirugías en Brasil, fenómeno que la Organización Mundial de la Salud consideró una epidemia.


Assuntos
Humanos , Brasil , Cesárea , Comunicação , Parto , Meios de Comunicação de Massa , Gravidez , Jornalismo , Parto Normal , Jornais como Assunto
12.
Rev. chil. obstet. ginecol. (En línea) ; 85(2): 132-138, abr. 2020. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1115508

RESUMO

INTRODUCCIÓN: La gestión actual de camas hospitalarias sigue un modelo de indiferenciación en el que existen camas quirúrgicas, médicas y de pacientes críticos. Las maternidades si bien no siguen este modelo, tienen egresos indiferenciados con pacientes que pueden egresar post parto o aún embarazadas (con patologías perinatales). OBJETIVO: Evaluar diferencias entre egresos con parto normal y aquellos con patologías de alto riesgo obstétrico (ARO) respecto a estancia media (EM) y el consumo de recursos cuantificado con el peso medio de los grupos relacionados con el diagnóstico (PMGRD). MÉTODO: Estudio transversal con egresos maternales periodo 2017-2018. Se usó Categoría Diagnóstica Mayor (CIE - 10) para definir dos grupos de egreso: 1. Con parto normal a término o 2. Con patología ARO. Se compararon 1.658 y 1.669 egresos del grupo 1 y 2 respectivamente. Las variables de resultado son EM y PMGRD. Se compararon variables cuantitativas con t de student y Kruskal Wallis. Se usó Odds Ratio con respectivo intervalo de confianza para evaluar asociación entre variables y regresión logística multivariada para ajustar asociación. RESULTADOS: La edad, proporción de gestantes tardías, EM y PMGRD fue mayor en los egresos ARO (p<0,05). Existe fuerte asociación de EM prolongada (>4 días) y PMGRD elevado (>0.3109) con los egresos ARO (ORa=3.75; IC95%=3.21-4.39 y ORa=1.28; IC95%=1.1-1.49 respectivamente). CONCLUSIONES: Es necesario diferenciar los egresos del servicio de maternidad porque los egresos de ARO muestran mayor complejidad. La evaluación del riesgo usando EM y PMGRD permite analizar con especificidad los egresos maternales para una mejor gestión de camas y del recurso humano.


INTRODUCTION: The current management of hospital beds in Chile follows an undifferentiation model in which there are surgical, medical and critical patient bed. Maternity hospitals although they do not follow this model, have undifferentiated discharges with patients who may leave poatpartum or still pregnant (with perinatal pathologies) OBJECTIVE: To assess differences between discharges with normal delivery and those with high obstetric risk pathologies (HOR) with respect to mean stay (MS) and the resource spending quantified with the average weight of the diagnosis related group (AWDRG). METHOD: Cross-sectional study with maternal discharges between 2017-2018 period. Major Diagnostic Category (ICD - 10) was used to define two discharge groups: 1. With normal term birth or 2. With HOR pathology. 1,658 and 1,669 egress from group 1 and 2 were compared respectively. The outcome variables are EM and AWDRG. Quantitative variables were compared with student t and Kruskal Wallis. Odds Ratio and respective confidence interval were used to evaluate association between variables and multivariate logistic regression to adjust association. RESULTS: Age, proportion of late pregnant women, MS and AWDRG was higher in HOR discharges (p <0.05). There is a strong association of prolonged MS (> 4 days) and elevated AWDRG (> 0.3109) with HOR discharges (ORa = 3.75; 95% CI 3.21-4.39 and ORa = 1.28; 95% CI 1.1-1.49 respectively). CONCLUSIONS: It is necessary to differentiate medical discharge of the maternity service because the HOR egress show greater complexity. The risk assessment using MS and AWDRG allows to analyze with specificity the maternal discharge for a better management of beds and human resources.


Assuntos
Humanos , Feminino , Gravidez , Adulto , Adulto Jovem , Alta do Paciente/estatística & dados numéricos , Grupos Diagnósticos Relacionados , Gravidez de Alto Risco , Salas de Parto/economia , Alta do Paciente/economia , Ocupação de Leitos , Intervalos de Confiança , Modelos Logísticos , Estudos Transversais , Análise Multivariada , Idade Materna , Tempo de Internação , Parto Normal
14.
Midwifery ; 82: 102622, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31951904

RESUMO

OBJECTIVE: To explore the decision making process of women who seek to give birth in water DESIGN: A qualitative design using semi-structured interviews with women who planned a waterbirth was used. Interviews were recorded, transcribed, and coded for emergent themes using a grounded theory approach for analyses SETTING: Twenty-three women (mean age = 33.5 years mean number of children = 2.5) who had planned a waterbirth were recruited from a prenatal care clinic in a mid-sized southeastern city in the United States. Questions explored how they decided to pursue a waterbirth, sources of information, support systems, resistance, and their birth experience FINDINGS: Although all participants used the tub during labor, five did not give birth in the water. Analyses revealed that a belief in their body's ability to give birth along with the desire for limited medical interventions were the primary reasons for choosing waterbirth. Previous positive and negative experiences with birth also shaped their decision. Women actively sought information about waterbirths from the internet and friends. One-third of participants decided to pursue a waterbirth later in pregnancy and changed OB practices in order to have access to a waterbirth. Midwives and doulas were viewed as critical supporters of their waterbirth decision. However, most participants experienced some form of resistance toward their decision from others including family, friends, coworkers, and strangers. The overwhelming majority were positive about their experience and indicated they felt empowered, even if they were unable to give birth in the water, and encouraged other women to consider waterbirth. Most indicated they wanted to have a waterbirth in the future.


Assuntos
Tomada de Decisões , Trabalho de Parto/psicologia , Parto Normal/psicologia , Adulto , Feminino , Humanos , Entrevistas como Assunto/métodos , Parto Normal/normas , North Carolina , Gravidez , Pesquisa Qualitativa , Inquéritos e Questionários
15.
J Perinat Neonatal Nurs ; 34(1): 16-26, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31834005

RESUMO

Consumer demand for water birth has grown within an environment of professional controversy. Access to nonpharmacologic pain relief through water immersion is limited within hospital settings across the United States due to concerns over safety. The study is a secondary analysis of prospective observational Perinatal Data Registry (PDR) used by American Association of Birth Center members (AABC PDR). All births occurring between 2012 and 2017 in the community setting (home and birth center) were included in the analysis. Descriptive, correlational, and relative risk statistics were used to compare maternal and neonatal outcomes. Of 26 684 women, those giving birth in water had more favorable outcomes including fewer prolonged first- or second-stage labors, fetal heart rate abnormalities, shoulder dystocias, genital lacerations, episiotomies, hemorrhage, or postpartum transfers. Cord avulsion occurred rarely, but it was more common among water births. Newborns born in water were less likely to require transfer to a higher level of care, be admitted to a neonatal intensive care unit, or experience respiratory complication. Among childbearing women of low medical risk, personal preference should drive utilization of nonpharmacologic care practices including water birth. Both land and water births have similar good outcomes within the community setting.


Assuntos
Traumatismos do Nascimento/prevenção & controle , Salas de Parto , Parto Normal , Complicações do Trabalho de Parto/prevenção & controle , Características de Residência , Adulto , Feminino , Acesso aos Serviços de Saúde , Humanos , Recém-Nascido , Parto Normal/educação , Parto Normal/métodos , Preferência do Paciente , Gravidez , Resultado da Gravidez/epidemiologia , Utilização de Procedimentos e Técnicas , Sistema de Registros/estatística & dados numéricos , Terapia de Relaxamento/métodos , Estresse Psicológico/etiologia , Estresse Psicológico/prevenção & controle , Estados Unidos
16.
Women Birth ; 33(2): 186-192, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31054879

RESUMO

BACKGROUND: For women with low risk births, waterbirth is an alternative that is requested and provided in approximately a hundred countries. However, in some countries, including Sweden, waterbirth is not generally available. AIM: To explore the experiences, knowledge and attitudes regarding waterbirth among midwives, obstetricians/gynaecologists and neonatologists. METHODS: A cross-sectional study was conducted in Sweden, using a web-based survey distributed via The Swedish Association of Midwives and the Heads of department of all Swedish maternity wards between April and June 2016. The respondents (n = 1609) answered a combination of Likert-scale and open-ended questions. The responses were analysed with descriptive statistics and quantitative content analyses. FINDINGS: Both midwives and physicians stated a lack of experience, knowledge and clinical guidelines related to attending and assisting waterbirths. Overall, midwives had more positive attitudes to waterbirth (38.8% vs 4.5%) as well as towards providing and implementing waterbirth, compared to physicians (71.0% vs 14.9%). Midwives stated significantly more benefits and fewer risks for women and babies, compared to physicians who requested more evidence. CONCLUSIONS: Opinions regarding waterbirth are to some extent based on attitudes rather than actual experience and knowledge. There are diverse interpretations of the strength of evidence and a lack of updating in the research field of waterbirth. As waterbirth is requested by women, health professionals need to update their knowledge in this topic in order to give coherent and evidence-based information and care to prospective parents.


Assuntos
Pessoal de Saúde/estatística & dados numéricos , Tocologia/estatística & dados numéricos , Parto Normal/psicologia , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Inquéritos e Questionários , Suécia
17.
Women Birth ; 33(4): 377-382, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31288963

RESUMO

PROBLEM: Birth can be a contentious issue with maternity care providers and consumers alike advocating fiercely defended and polarising views. These positions are largely shaped by opposing biomedical and natural childbirth constructions of birth. Contemporary debate on homebirth is one such example which illustrates this divide. AIM: To reconceptualise birth by deconstructing current constructions of childbirth contained in homebirth articles published by one online media source in Australia. METHODS: Australia's self-acclaimed largest women's media company was searched for articles pertaining to homebirth. Articles which met inclusion criteria were analysed using poststructural feminist theory and deconstruction techniques informed by Davies and Gannon, Butler and others. FINDINGS: Gender essentialism present in both the biomedical and natural childbirth approaches constructs birth as an act of nature, dictated by biology rather than one with a sociohistorical location. DISCUSSION: Gender essentialism at birth serves to obscure the sociohistorical determinants of birth, making it appear as a static, immutable sort of act, rather than one which is defined by its sociohistorical location and which can be redefined, even reinvented, by its sociohistorical location. CONCLUSION: Gender essentialism is an enduring phenomenon, underpinning seemingly opposing constructions of childbirth. Disengaging childbirth from essentialisms of woman's nature may create possibilities and meanings of childbirth that could be useful for childbearing women.


Assuntos
Formação de Conceito , Parto Domiciliar/psicologia , Meios de Comunicação de Massa , Parto Normal/psicologia , Parto/psicologia , Austrália , Feminino , Identidade de Gênero , Humanos , Relações Interpessoais , Serviços de Saúde Materna , Gravidez , Estereotipagem
18.
J Obstet Gynaecol ; 40(2): 182-187, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31339389

RESUMO

The aim of this study was to investigate whether natural birth has a circadian rhythm. The present study was planned as a retrospective descriptive study of the natural births performed in a Maternity and Children's Diseases Training and Research Hospital in the north of Turkey between January 1 and December 31. The study included 723 (98.9%) cases of natural birth. It was found that the mean age of the women in the study sample was 26.84 ± 5.83 years and the mean gestational age was 38.98 ± 1.95 years. It was determined that the mean labour duration of the women was 12.47 ± 0.78 hours; of all births, 34.6% occurred between 08:00-16:00 hours, 38.2% occurred between 16:01-00:00 hours and 27.2% occurred between 00:01-07:59 hours. Considering the birth time in terms of month, it was observed that the most common birth month was July and the least common birth month was March. In accordance with the study data, it is observed that the labour process occurred at night in the day/night cycle and in the summer months at a higher rate.Impact statementWhat is already known on this subject? Chronological transitions are of critical importance for pregnancy. There are many mechanisms affecting Labour process. One of the most important mechanisms among these is the release and timing of foetal-maternal hormones. The chronological transitions are critical for a normal pregnancy and any temporary alteration may have detrimental effects for foetal development and/or maternal healthWhat the results of this study add? It is observed that births occur at a higher rate at night hours in the day-night cycle and in summer months, and in terms of day, Wednesday is the most common birth day. Considering these results, although it is thought that the levels of hormones released at night lead the birth to occur mostly at night-time hours and non-fully developed thermoregulatory system and sympathetic nervous systems of foetus and sensitivity to temperature may be effective on the number of births in summer months, it is seen that the data are insufficient to reach this conclusion.What the implications are of these findings for clinical practice and/or further research? It is believed that the foetus has a biological clock. This is parallel to fluctuating levels of various hormones affecting labour and delivery, which may be a positive influence on the labour process itself. It seems that more study results are required in addition to these results.


Assuntos
Ritmo Circadiano/fisiologia , Trabalho de Parto/fisiologia , Parto Normal/estatística & dados numéricos , Parto/fisiologia , Fatores de Tempo , Adulto , Feminino , Idade Gestacional , Humanos , Gravidez , Estudos Retrospectivos , Turquia
19.
Matronas prof ; 20/21(4/1): 4-12, 2019-2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-192422

RESUMO

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)


Assuntos
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
20.
Rev. enferm. UFPE on line ; 14: [1-9], 2020. ilus, tab
Artigo em Português | BDENF - Enfermagem | ID: biblio-1116268

RESUMO

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)


Assuntos
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
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