Representation of the black woman on the Brazilian Ministry of Heath advertising posters. / Representatividade da mulher negra em cartazes publicitários do Ministério da Saúde.

OBJECTIVE: To describe and analyze the forms of representation of black women in posters used by the Brazilian Ministry of Health for advertising campaigns on women's sexual and reproductive health. METHOD: Descriptive, exploratory and documentary study with advertising posters addressing the promotion of women's sexual and reproductive health, available at the Virtual Health Library - Brazil. For the analysis of data, the thematic content analysis was used. RESULTS: Out of the 498 identified posters, 161 addressed women's sexual and reproductive health. After applying the exclusion criteria, 41 posters remained, of which 31 (75.6%) represented a white woman, nine (21.9%) a black woman, and one an indigenous woman (2.4%). Data analysis converged to two analytical categories: the pseudo representation of black women; and women's sexual and reproductive health limited to pregnancy and postpartum. CONCLUSION: The representation of the black woman in the advertising posters of the Brazilian Ministry of Health is low, and the themes addressed in the posters do not contemplate all the phenomena that make up the sexual and reproductive health of women during their life cycle.

Common mental disorders and associated factors: a study of women from a rural area.

OBJECTIVE: Identifying the prevalence of Common Mental Disorders and analyzing the influence of sociodemographic, economic, behavioral and reproductive health variables on Common Mental Disorders in women of childbearing age living in the rural area of Uberaba-MG, Brazil. METHOD: An observational and cross-sectional study. Socio-demographic, economic, behavioral and reproductive health instruments were used, along with the Self-Reporting Questionnaire (SRQ-20) to identify common mental disorders. Multiple logistic regression was used for multivariate data analysis. RESULTS: 280 women participated in the study. The prevalence of Common Mental Disorders was 35.7%. In the logistic regression analysis, the variables of living with a partner and education level were associated with Common Mental Disorders, even after adjusting for the other variables. CONCLUSION: Our findings evidenced an association of social and behavioral factors with Common Mental Disorders among rural women. Identification and individualized care in primary health care are essential for the quality of life of these women. OBJETIVO: Identificar a prevalência do transtorno mental comum e analisar a influência de variáveis sociodemográficas, econômicas, comportamentais e de saúde reprodutiva sobre o transtorno mental comum em mulheres em idade fértil, residentes na zona rural do município de Uberaba-MG, Brasil. MÉTODO: Estudo observacional e transversal. Foram utilizados instrumentos de caracterização sociodemográfica, econômica, comportamental e de saúde reprodutiva, e o Self-Reporting Questionnaire (SRQ-20) para identificar os transtornos mentais comuns. Na análise multivariada dos dados, foi utilizada a regressão logística múltipla. RESULTADOS: Participaram do estudo 280 mulheres. A prevalência do transtorno mental comum foi de 35,7%. Na análise de regressão logística, as variáveis convivência com o companheiro e escolaridade, associaram-se ao transtorno mental comum, mesmo após o ajuste para as demais variáveis. CONCLUSÃO: Os achados evidenciaram a associação de fatores sociais e comportamentais com o transtorno mental comum, entre mulheres rurais. A identificação e a assistência individualizada na atenção primária de saúde são essenciais para a qualidade de vida destas mulheres. OBJETIVO: Identificar la prevalencia de trastornos mentales comunes y analizar la influencia de las variables socio-demográficas, económicas, de comportamiento y de salud reproductiva en el trastorno mental común en las mujeres en edad fértil, que viven en el municipio rural de Uberaba, Minas Gerais, Brasil. MÉTODO: Estudio observacional y transversal. Se usaron instrumentos sociodemográficos, económicos, de comportamiento y salud reproductiva, y el Self-Reporting Questionnaire (SRQ-20) para identificar los trastornos mentales comunes. En el análisis multifactorial de los datos, se utilizó la regresión logística múltiple. RESULTADOS: El estudio incluyó a 280 mujeres. La prevalencia de los trastornos mentales comunes fue de 35,7%. En el análisis de regresión logística, las variables convivencia con su pareja y la escolarización se asociaron con trastorno mental común, incluso después de ajustar por otras variables. CONCLUSIÓN: Los resultados muestran la relación entre los factores sociales y de comportamiento con el trastorno mental común entre las mujeres rurales. La identificación y la atención individual en la atención primaria de salud son esenciales para la calidad de vida de las mujeres.

[Under the shadow of maternity: pregnancy, suicidal ideation, and intimate partner violence]. / Sob a sombra da maternidade: gravidez, ideação suicida e violência por parceiro íntimo.

OBJECTIVE: To investigate the association between intimate partner violence and indicators of suicidal ideation during the current pregnancy. METHODS: This is a cross-sectional observational study developed with 358 pregnant women selected by systematic random sampling in Ribeirão Preto, southeastern Brazil. The Back Suicidal Ideation Scale and an adapted version of the instrument used in the World Health Organization Multi-country Study on Women's Health and Domestic Violence were used to identify indicators of suicidal ideation and psychological, physical, and sexual acts of intimate partner violence during the current pregnancy. Multiple logistic regression was used to obtain adjusted prevalence odds ratios with a 95% confidence interval. RESULTS: The prevalence of indicators of suicidal ideation was 7.8%. Of the participants, 17.6% reported some type of intimate partner violence during the current pregnancy. Among these, 95.2% reported having suffered psychological violence, 36.5% physical violence, and 1.6% sexual violence. Multiple logistic regression analysis showed that women exposed to violence were 6.29 times more likely to have indicators of suicidal ideation. CONCLUSIONS: Policy makers and health care providers must be made aware of the impact of intimate partner violence, including in terms of suicidal ideation, especially during pregnancy. The adoption of simple measures, such as the scales used in the present study, may provide information regarding the extent of intimate partner violence and suicidal ideation in health care services.

Depressive disorder in pregnant Latin women: does intimate partner violence matter?

AIMS AND OBJECTIVES: To identify the association of antenatal depressive symptoms with intimate partner violence during the current pregnancy in Brazilian women. BACKGROUND: Intimate partner violence is an important risk factor for antenatal depression. To the authors' knowledge, there has been no study to date that assessed the association between intimate partner violence during pregnancy and antenatal depressive symptoms among Brazilian women. DESIGN: Cross-sectional study. METHODS: Three hundred and fifty-eight pregnant women were enrolled in the study. The Edinburgh Postnatal Depression Scale and an adapted version of the instrument used in the World Health Organization Multi-country Study on Women's Health and Domestic Violence were used to measure antenatal depressive symptoms and psychological, physical and sexual acts of intimate partner violence during the current pregnancy respectively. Multiple logistic regression and multiple linear regression were used for data analysis. RESULTS: The prevalence of antenatal depressive symptoms, as determined by the cut-off score of 12 in the Edinburgh Postnatal Depression Scale, was 28·2% (101). Of the participants, 63 (17·6%) reported some type of intimate partner violence during pregnancy. Among them, 60 (95·2%) reported suffering psychological violence, 23 (36·5%) physical violence and one (1·6%) sexual violence. Multiple logistic regression and multiple linear regression indicated that antenatal depressive symptoms are extremely associated with intimate partner violence during pregnancy. CONCLUSION: Among Brazilian women, exposure to intimate partner violence during pregnancy increases the chances of experiencing antenatal depressive symptoms. RELEVANCE TO CLINICAL PRACTICE: Clinical nurses and nurses midwifes should pay attention to the particularities of Brazilian women, especially with regard to the occurrence of intimate partner violence, whose impacts on the mental health of this population are extremely significant, both during the gestational period and postpartum.

[Intimate partner violence against pregnant women: study about the repercussions on the obstetric and neonatal results]. / Violência do parceiro íntimo contra a gestante: estudo sobre as repercussões nos resultados obstétricos e neonatais.

This observational, descriptive and analytic study aimed to identify the prevalence of IPV cases among pregnant women and classify them according to the type and frequency; identify the obstetric and neonatal results and their associations with the intimate partner violence (IPV) occurrence in the current pregnancy. It was developed with 232 pregnant women who had prenatal care at a public maternity hospital. Data were collected via structured interview and in the patients' charts and analyzed through the statistic software SAS® 9.0. Among the participants, 15.5% suffered IPV during pregnancy, among that 14.7% suffered psychological violence, 5.2% physical violence and 0.4% sexual violence. Women who did not desire the pregnancy had more chances of suffering IPV (p<0.00; OR=4.32 and 95% CI [1.77 - 10.54]). With regards to the obstetric and neonatal repercussions, there was no statistical association between the variables investigated. Thus, for the study participants there were no negative obstetric and neonatal repercussions related to IPV during pregnancy.

Partners with a Highly Favorable Attitude Toward Breastfeeding Contribute to Promoting Initiation and Length of Breastfeeding for More than 5 Months in a Population-Based Canadian Study.

Introduction: Promoting maternal breastfeeding for at least 6 months is important to improve children physical health during infancy and neurodevelopmental outcomes in childhood. For this guideline to be followed, it is paramount to identify what factors best support the initiation and length of breastfeeding. This study estimates the contribution of various child- and parent-level factors, as well as the sociodemographic context in predicting maternal breastfeeding initiation and duration. Methods: This study draws on data from the Quebec Longitudinal Study of Child Development. Mothers who never breastfed when the infant was 5 months old (n = 630, 28.3%) were compared to mothers who breastfed for less than 5 months (n = 844, 38.0%) and mothers breastfeeding for more than 5 months (n = 749, 33.7%), using multivariable multinomial regression models. Results: Mothers with a partner showing a positive attitude toward breastfeeding were up to 13 times more likely to breastfeed their infant for more than 5 months. The positive attitude of partners toward breastfeeding was the strongest predictor of breastfeeding duration, followed by the maternal educational attainment and timing she returns to work. Most prenatal and perinatal child-level factors and the sociodemographic context predicted breastfeeding duration, but to a lesser extent. Discussion: This finding underscores the role of the partner's attitude in promoting initiation and length of breastfeeding. As such, educational campaigns and health practitioners could target both the mother and their partner in promoting breastfeeding.

Puerperal women's social interactions related to their sexual health after childbirth.

OBJECTIVE: To analyze puerperal women's experiences of sexual health after childbirth from the perspective of symbolic interactionism. METHOD: Descriptive, qualitative study. Twenty semi-structured interviews were conducted by videoconference with women in the remote puerperium, captured by snowball technique and searched for "seeds" on Instagram®. Bardin's content analysis and Symbolic Interactionism were used as references. RESULTS: The puerperal women signify sexual health from a perspective of comprehensive healthcare. However, due to the duality between "being a woman" and "being a mother", they recognize fear, bodily transformations and changes in focus from the love relationship to caring for the baby as factors that interfere with sexual health. And they choose to put themselves aside, prioritizing caring for others. They re-signify sexual health by recognizing the importance of taking care of themselves in biopsychosocial aspects and try to recover self-care for a healthy sexual experience. CONCLUSION: Despite the meanings attributed, women's social interactions with the puerperium interfere negatively with sexual health. Professionals should be sensitized to the inclusion of actions that promote changes in the social action of these women towards self-care.

Assisting Homeless Women in a City in Brazil during the COVID-19 Pandemic in the Context of a Street Outreach Office: The Perceptions of Health Professionals.

This study aimed to understand the perception of Street Outreach Office professionals regarding the health care offered to homeless women during the COVID-19 pandemic. This is a qualitative and descriptive study developed with nine health professionals of a Street Outreach Office team from a large city in the countryside of São Paulo State (Brazil) from December 2020 to April 2021. Data were obtained through interviews using a semi-structured script with questions about care practices directed to homeless women. The data were analyzed according to content analysis in the thematic modality. Two thematic categories were identified: (i) the reorganization of the Street Outreach Office to meet the demands of the population and (ii) the challenges in caring for homeless women during the pandemic. The activities were intensified with the team's expansion and distribution of supplies such as masks and alcohol-based hand sanitizers. Our findings showed that the primary problem faced was pregnancy during the pandemic. The lack of material and structural resources and social apparatus to care for homeless women was also evidenced. It was possible to conclude that even with all the adversities, the professionals employed creative strategies, contributing, within their limitations, to the care of homeless women.

Stealthing among university students: associated factors.

OBJECTIVE: To identify the practice of stealthing among university students and the associations between the profile of these young people and this practice. METHOD: Cross-sectional study carried out at a university campus in a city in the countryside of Sao Paulo. Data collection was carried out online by RedCap between May and September 2018, through questionnaires with identification data, sociodemographic characteristics and sexual and reproductive health. Data were analyzed by IBM-SPSS, version 17.0. RESULTS: A total of 380 students participated in the study, aged between 18 and 24 years old, most of them unpaid students, coming from private education, not having a religion and being single. Most of them were biologically female and identified as cisgender and heterosexual women. As for stealthing, 1.33% of the participants had performed it and 11.44% had already undergone this practice. There was a significant association between having been stealthed and the variables female biological sex (p = 0.000) and identifying as a woman (p = 0.000). CONCLUSION: The occurrence of stealthing is higher among those who have been stealthed than among those who have done it and having been stealthed is associated with being female and identifying as a woman.

Emotional consequences of the COVID-19 pandemic in adolescents: challenges to public health.

OBJECTIVE: To describe adolescents' everyday activities and emotional consequences related to the COVID-19 pandemic. METHOD: Qualitative study grounded in Alfred Schütz's social phenomenology, involving 22 students at two public schools in a municipality in the state of São Paulo, Brazil. Interviews were conducted, had their audio recorded, and were analyzed according to a thematic categorization. RESULTS: Five categories emerged from the accounts: i) adolescents' reaction before the COVID-19 pandemic; ii) emotional consequences; iii) concern about the family; iv) adolescents' adaptation; and v) fragmentation of social support networks. Feelings such as uncertainty, fear, anguish, anxiety, and lack of motivation, depressive symptoms, and extreme suicidal ideation were reported. CONCLUSION: Paying attention to adolescents' psychosocial needs is essential, especially in face of the possibility of post-traumatic stress as a result of the COVID-19 pandemic. Health professionals' technical competence combined with sensibility, strengthening of social support networks, and engagement of different community sectors are fundamental for promoting adolescent mental health in the current transition and resignification period following the COVID-19 pandemic.

Characterization of adolescent sexual practices. / Caracterização das práticas sexuais de adolescentes.

OBJECTIVE: to characterize adolescents' sexual practices and their association with sociodemographic variables, sources of information and behavioral habits. METHOD: a descriptive, observational, cross-sectional study conducted with 85 adolescents from public elementary and high schools in a city in the state of São Paulo. Data were collected through a structured, self-administered and anonymous questionnaire. Statistical analysis was performed using the χ2 test and Fisher's test. RESULTS: 21.2% had started their sexual life through oral sex, with a predominance of females (94.4%), self-reported brown color (55.0%). The practice of vaginal sex was reported in 31.8%, with a mean age of initiation at 14.5 years. The female sex was predominant (77.0%), with a self-reported brown color (40.0%). The practice of anal sex was detected in 7.1%, with a mean age of 14.4 years, prevalent in females (83.3%), with a self-reported black color (50.0%). There was an association of alcohol, drugs and tobacco use with sexual practices (p<0.05). CONCLUSION: a diversity of sexual practices associated with substance use was detected, emphasizing the importance of the nurse's role in planning and carrying out health education interventions with adolescents and families.(1) Analysis of the sequence and time of initiation of sexual practices, demonstrating the diversity of sexual activities performed by adolescents. (2) Family context and low openness to dialogue and its correlation with the initiation of adolescent sexual practices. (3) Behavioral habits: association of alcohol, tobacco and drug consumption by adolescents with sexual activities.

Women who live in mining on the French-Brazilian border: daily challenges.

OBJECTIVES: to describe the daily life of Brazilian women who work in mining. METHODS: a descriptive, qualitative study, with analysis based on the theory of Symbolic Interactionism. Non-participant observations, field diary writing, sociodemographic form, non-directive interviews, recorded and transcribed in full, were carried out with 19 women who work in mining areas on the French-Brazilian Amazon border. RESULTS: two categories emerged: Life trajectories: women's work in mining; Woman, mother and prospector: the multiple facets of gender inequality on the Amazon border. FINAL CONSIDERATIONS: assessing the daily experiences of women in the Amazonian mines allowed identifying their health needs, evidencing the need to direct and implement public and social policies and health practices for comprehensive care of these women's health.

Attention to Women's Sexual and Reproductive Health at the Street Outreach Office.

The aim of study was to understand care strategies for homeless women, focusing on aspects of sexual and reproductive health from the perspective of Street Outreach Office strategy professionals. This is a qualitative study carried out in a large city in the countryside of São Paulo, Brazil. Data were collected from December 2020 to April 2021 through semi-structured interviews, and the results were obtained through content analysis and thematic modality. Nine health professionals participated in this study, and the analysis of the interviews allowed identifying three thematic categories: (i) being female and sex on the streets (violence and oppression); (ii) gynecology as a gateway to comprehensive care for homeless women; and (iii) pregnancy, puerperium and motherhood in the context of the streets. This study contributes to the reflection of professional practices within the Street Outreach Office, allowing the understanding of challenges in assisting homeless women, aiming to raise awareness of professionals and services that make up the health care network.

Development and validation of a prototype application on breastfeeding for health professionals.

OBJECTIVE: To develop and validate a prototype mobile application on breastfeeding for health professionals. METHOD: Methodological study. To build this prototype, information obtained from interviews with six health professionals who were certified as international breastfeeding consultants was employed. For validating the prototype, screenshots were sent to each professional participating in the first phase, as well as an adapted instrument to assess appearance, content, and language. RESULTS: Most assessments were "great" or "good". The participating professionals have also made important considerations for content enhancement, mainly for the clinical content. CONCLUSION: The prototype was positively assessed by the professionals, fulfilling the proposed objective. This study is highly important for breastfeeding care professional practice, since it presents a tool which improves quality of care by contributing to the best evidence-based practice.

Anxiety and its influence on maternal breastfeeding self-efficacy.

OBJECTIVE: to identify the levels of anxiety and breastfeeding self-efficacy in puerperal women at the intervals of 60, 120, and 180 days postpartum; and to verify the influence of anxiety on breastfeeding self-efficacy among these puerperal women. METHOD: an analytical, longitudinal and prospective study, conducted with 186 puerperal women, and which used a sociodemographic and obstetric characterization questionnaire, the State-Trait Anxiety Inventory, and the Breastfeeding Self-Efficacy Scale - Short Form. The analyses were performed by means of descriptive statistics, and Fisher's Exact Test was used. RESULTS: most of the puerperal women presented low levels of trait anxiety (55.4%) and of state anxiety (66.2% at 60 days, 72.8% at 120 days, and 75.5% at 180 days), and a high level of self-efficacy (77.3% at 60 days, 75.3% at 120 days, and 72.1% at 180 days of puerperium). Low levels of trait anxiety and state anxiety were associated with high self-efficacy at 60 days (p=0.0142 and p=0.0159, respectively). CONCLUSION: it is necessary to pay greater attention to the mental health of puerperal women, considering that those who presented low levels of anxiety had higher levels of self-efficacy, a situation that can result in longer exclusive breastfeeding.

Relationship of the type of breastfeeding in the sexual function of women.

OBJECTIVE: to relate the type of breastfeeding in the women's sexual function. METHOD: a cross-sectional study conducted with 150 women in the postpartum period registered in the Family Health Strategy of a large Brazilian municipality. Two instruments were used: one for characterizing sociodemographic, obstetric and breastfeeding variables, and the Female Sexual Function Index for the sexual function. Descriptive data analysis was performed, comparing the variables of interest using the Analysis of Variance, Brown-Forsythe and Tukey tests. RESULTS: there was statistical significance between the groups that practiced different types of breastfeeding in the vaginal lubrication domain (p = 0.015), with the mothers in mixed or partial breastfeeding presenting a higher score for this domain (3.8). CONCLUSION: there is a difference in the female sexual function between different types of breastfeeding. Women who presented better vaginal lubrication belonged to the mixed breastfeeding group.

Self-esteem assessment of young female university students according to race/skin color criteria.

OBJECTIVE: to evaluate and compare the self-esteem of young female university students aged between 18 and 24 years old according to race/skin color criteria. METHOD: a cross-sectional and quantitative study, developed with 240 undergraduate female students from a public Brazilian university. Data collection took place online through a structured questionnaire that included the participants' sociodemographic and lifestyle habits, and the Rosenberg Self-Esteem Scale. For data analysis, descriptive statistics, association test, and comparison of means were used. RESULTS: most of the young women had a mean level of self-esteem. No statistically significant association was found among the "self-esteem level" and "self-reported skin color or race" variables. CONCLUSION: although no significant association was identified between self-reported skin color or race and level of self-esteem, young black women have lower mean self-esteem scores than young non-black women. Strategies that strengthen the self-esteem of young female university students are necessary to prevent harms to their physical and mental health, and, consequently, to their academic performance.

Women's sexual health six months after a severe maternal morbidity event.

OBJECTIVE: to investigate female sexual function in women six months postpartum and to compare sexual function among women who had and who did not have severe maternal morbidity (SMM). METHOD: a cross-sectional study conducted with 110 women in the postpartum period, with and without SMM. Two instruments were used, one for the characterization of sociodemographic and obstetric variables and the Female Sexual Function Index (FSFI) for sexual function. Univariate, bivariate and regression model analyses were performed. RESULTS: FSFI scores showed 44.5% of female sexual dysfunction, of which 48.7% were among women who had SMM and 42.0% among those who had not. There were significant differences between age (P=0.013) and duration of pregnancy (P<0.001) between women with or without SMM. Among the cases of SMM, hypertensive disorders were the most frequent (83%). An association was obtained between some domains of the FSFI and the following variables: orgasm and self-reported skin color, satisfaction and length of relationship, and pain and SMM. CONCLUSION: white women have greater difficulty in reaching orgasm when compared to non-white women and women with more than 120 months of relationship feel more dissatisfied with sexual health than women with less time in a relationship. Women who have had some type of SMM have more dyspareunia when compared to women who have not had SMM.

Breastfeeding self-efficacy in adult women and its relationship with exclusive maternal breastfeeding.

OBJECTIVE: to analyze the relationship between maternal self-efficacy to breastfeed and sociodemographic, obstetric, and neonatal variables; between the duration of exclusive breastfeeding and sociodemographic variables; and between the breastfeeding self-efficacy and the duration of exclusive breastfeeding at the intervals of 30, 60, and 180 days postpartum. METHOD: a longitudinal and prospective study conducted with 224 women. A sociodemographic questionnaire, the Breastfeeding Self-Efficacy Scale - Short Form, and a questionnaire on breastfeeding and child feeding were used for collecting the data. Fisher's exact test and Pearson's correlation coefficient test were used for analysis. RESULTS: there was no association between breastfeeding self-efficacy and the duration of exclusive breastfeeding identified at 30, 60, and 180 days. Self-efficacy was associated with the type of delivery and complications in the postpartum period. There was also an association between religion and exclusive breastfeeding 30 and 60 days postpartum, and assistance with baby care and exclusive breastfeeding at 60 days. CONCLUSION: It was identified that the type of delivery, complications in the postpartum period, religion, and assistance with baby care corroborate to increase maternal confidence in the ability to breastfeed.

Interdisciplinary simulation scenario in nursing education: Humanized childbirth and birth.

OBJECTIVE: to develop and validate with a panel of experts a scenario of maternal-child clinical simulation, related to humanized childbirth and birth. METHOD: methodological study based on the Jeffries framework and standardized guides of the International Nursing Association for Clinical Simulation in Learning, which used analysis with descriptive statistics for general aspects of adherence to the aforementioned guide and inferential statistics for validating the checklist of actions through the Intraclass Correlation Coefficient (ICC). RESULTS: the scenario contains learning objectives, necessary resources, prebriefing and debriefing of guidelines, description of the simulated situation, participants and roles, and checklist of expected actions. The validation obtained an agreement level above 80% in all aspects evaluated by 31 experts, highlighting realism of the environment and setting, vital sign parameters, alignment with scientific literature and encouragement of critical thinking and problem solving. In addition, the checklist of actions was validated with 0.899 agreement among experts, statistically analyzed by the ICC and Cronbach's alpha 0.908 (95% confidence interval). CONCLUSION: the simulated scenario on humanized childbirth and birth can strengthen the articulation between women's and children's health disciplines, and was validated by experts.