The Remote Approach in a Qualitative Study During the COVID-19 Pandemic: A Perspective Considering the Researcher's Life Experiences and the Trustworthiness.

The COVID-19 pandemic has raised a wide range of challenges for qualitative researchers, especially when most of the world was facing isolation during the first wave in 2020. The scientific literature rapidly raised discussion regarding data collection adaptation for remote inquiry and ethical dilemmas. However, it is still necessary to discuss the implications of running qualitative studies as a researcher immersed in a global emergency, precisely when the researchers themselves are involved in this context. To what extent, or in what way, can being fully immersed in this context influence all phases of the research? What is the role of reflexivity in this context? We proposed a new discussion based on the study we performed remotely in 2020, among infected pregnant women, using concepts of the Freudian feeling of uncanny to explore the life experience of the researcher. We also considered the concept of the discourse of the master from Jacques Lacan to debate the researchers' position during the pandemic and to bring practical implications.

The experience of women infected by the COVID-19 during pregnancy in Brazil: a qualitative study protocol.

BACKGROUND: The Coronavirus disease (COVID-19) is highly infectious, with the recent World Health Organization decree confirming a global public health emergency. The outcomes related to maternal and fetal health among pregnant women infected with the virus are still poorly understood. The world population has been waiting for answers and remains constantly alert about the pandemic's progress. It is not yet known what impact this pandemic experience will have on the population's mental health, especially pregnant women. METHOD: We aim to understand and discuss the experiences of women who were infected by COVID-19 during pregnancy, in relation to the illness process, community relations, and social media influences. This is a qualitative study in which we will interview women who were infected by COVID-19 during pregnancy and received medical care from a tertiary university hospital specializing in women's health in Brazil. We will use the techniques of Semi-Directed Interviews of Open and In-depth Questions, socio-demographic and health data sheets, and Field Diaries. We will use purposive sampling and the criterion of theoretical saturation for its construction. The interviews will be conducted by phone or video call, with audio recorded for later transcription. The treatment of the data will be completed through Thematic Analysis and discussed in light of the Health Psychology framework, with the production of categories that answer the proposed research questions. DISCUSSION: It is expected that the results contribute to the understanding about the demands that come to the health professional of women infected by COVID-19 during pregnancy in a pandemic situation. INTRODUçãO: A doença causada pelo coronavírus (COVID-19) é altamente infecciosa, com a recente declaração da Organização Mundial de Saúde confirmando emergência global de saúde pública. Os desfechos relacionados a saúde materno-fetal entre gestantes infectadas pelo vírus ainda são pouco conhecidos. A população mundial tem aguardado respostas e se mantém constantemente em alerta sobre o progresso da pandemia. Ainda não se sabe qual será o impacto da experiência da pandemia sobre a saúde mental da população, especialmente entre mulheres grávidas. MéTODO: O objetivo deste estudo é compreender e discutir as experiências de mulheres infectadas pelo COVID-19 durante a gravidez, em relação ao processo de adoecimento, às relações comunitárias e a influência de mídias sociais. Este é um estudo qualitativo em que serão entrevistadas mulheres infectadas pelo COVID-19 durante a gestação, atendidas em um hospital universitário terciário especializado em saúde da mulher no Brasil. Serão usadas as técnicas de Entrevistas Semi-Dirigidas de Perguntas Abertas em Profundidade, ficha de dados sociodemográficos e de saúde e diários de campo. A amostra será selecionada intencionalmente, usando o critério de saturação teórica para a sua construção. As entrevistas serão conduzidas por telefone ou videoconferência, com áudio gravado para posterior transcrição. O tratamento dos dados seguirá a Análise Temática e os resultados serão discutidos sob conceitos de Psicologia da Saúde, com a produção de categorias que respondam as questões de pesquisa propostas. DISCUSSãO: Espera-se que os resultados contribuam para a compreensão de demandas emergentes entre profissionais de saúde para mulheres infectadas pelo COVID-19 durante a gestação em situação de pandemia.

The experience of pregnant women and their families who were infected with covid-19 before vaccination: A qualitative approach within a multicenter study in Brazil.

BACKGROUND: Pregnant and postpartum women infected by COVID-19 are at increased risk of adverse outcomes, including negative effects on their mental health. Brazilian maternal mortality rate due to COVID-19 is 2.5 times higher than overall mortality rates. This study aimed to understand how pregnant/postpartum women experienced the COVID-19 suspicion/investigation or confirmed infection in different Brazilian cities, the pandemic's consequences to women and their families, and their needs to improve maternal health services during public health emergencies. METHODS: We conducted a qualitative study with 27 women with COVID-19 and 6 of their family members, as part of a multicenter study among 15 maternity hospitals in Brazil. We applied in-depth interviews through telephone calls when women received the diagnostic or had a suspect infection and after 60 days. Another semi-structured interview was applied to their close family members. The interviews were considered through thematic analysis. RESULTS: From the thematic content analysis three major themes emerged from the first and second interviews: (Cucinotta and Vanelli, 2020) assistance received by the woman and newborn in the medical services; (World Health Organization (WHO) 2021) stigma/fear of contamination from health workers and from family and friends reported by the women; (Allotey et al., 2020) the COVID-19 pandemic impact. CONCLUSION: Before the availability of the COVID-19 vaccine, pregnant women experienced fear of death, hospitalization, quarantine, loss of family members, and financial repercussions, resulting in physical, psychological, and socioeconomic impacts on these women's lives.

Stigma, guilt and motherhood: Experiences of pregnant women with COVID-19 in Brazil.

BACKGROUND: The COVID-19 pandemic raises health issues worldwide. Infected pregnant women may have negative mental health outcomes, but little is known about their emotional experiences. AIM: We aimed to understand the experience of women infected with COVID-19 during pregnancy, regarding their feelings, their relationships, and the influence of social media. METHODS: We conducted a qualitative study among 22 women infected with COVID-19 during pregnancy, from a tertiary hospital during the first wave of the pandemic in Brazil (May-August 2020). We applied semi-directed interviews, sociodemographic and health data sheets, and field diaries. We built the sample purposefully. Interviews were audio-recorded and transcribed verbatim. We used thematic analysis and discussed data considering the health psychology framework. RESULTS: We created five categories following a timeline perspective, from before infection to the experience after recovering. Pregnant women were resistant to believing the diagnosis. They described a fear of serious symptoms or death, concerns about the fetus, sorrow from being isolated, and worries about stigma. Family relationships were ambiguous, generating either support or tension. The attachment to the health team through telemedicine or support during hospitalization produced a feeling of security. CONCLUSIONS: Participants psychologically denied the COVID-19 diagnosis and did not accomplish isolation properly, even upon medical recommendations. The illness may produce a traumatic experience, regardless of mild or severe symptoms, but family/friend support and contact with the health team helped them to cope. We offer important insights for the clinical approach and future research, emphasizing that infected pregnant women require emotional support.

The Role of Health-related Behaviors in Gestational Weight Gain among Women with Overweight and Obesity: A Cross-sectional Analysis.

OBJECTIVE: To evaluate the influence of health-related behaviors including food intake, physical activity, sleep time, smoking habits, stress, depression, and optimism on excessive gestational weight gain (GWG) among women with overweight and obesity. METHODS: A cross-sectional study was conducted at the Women's Hospital of the Universidade de Campinas, Campinas, state of São Paulo, Brazil, with 386 mediate postpartum women that fit the inclusion criteria of ≥ 19 years old, first prenatal care visit at or before 14 weeks, and single live baby. Dietary habits, physical exercise practice, sleep duration, smoking and alcohol habits were self-reported. Psychosocial history was evaluated using the Edinburgh Postpartum Depression Scale (EPDS), Perceived Stress Scale (PSS), and Life Orientation Test-Revised (LOT-R). Sociodemographic, obstetric, anthropometric, and neonatal data were retrieved from medical records. Descriptive statistics and stepwise logistic regression were performed. RESULTS: The prevalence of overweight and obesity was 29.27% and 24.61%, respectively, according to the body mass index (BMI). Excessive GWG was observed in 47.79% of women with overweight and in 45.26% of women with obesity. Excessive GWG among overweight and obese women was associated with inadequate vegetable and bean consumption (odds ratio [OR] = 2.95, 95% confidence interval [CI]: 1.35-6.46 and OR = 1.91; 95%CI: 1.01-3.63, respectively) and stress (OR = 1.63; 95%CI 1.01-2.64). After adjustment by maternal age, multiparity, sleep duration, smoking, and alcohol intake, we found that stress (PSS ≥ 20) was associated with excessive GWG in women with overweight or obesity (OR: 1.75; 95%CI: 1.03-2.96). CONCLUSION: Among women with overweight and obesity, stress is the main variable associated with excessive GWG. Inadequate vegetables and beans consumption also showed association with excessive GWG.

OBJETIVO: Avaliar a influência de comportamentos relacionados à saúde: ingestão alimentar, atividade física, tempo de sono, tabagismo, estresse, depressão e otimismo no ganho de peso gestacional (GPG) excessivo em mulheres com sobrepeso e obesidade. MéTODOS: Estudo transversal no Hospital da Mulher, Universidade de Campinas, Campinas, SP, Brasil, com 386 mulheres no puerpério mediato, ≥ 19 anos, primeira consulta pré-natal até 14 semanas e cuja gestação resultou em neonato vivo. Os comportamentos relacionados à saúde foram autorreferidos. História psicossocial foi avaliada usando: Escala de Depressão Pós-Parto de Edimburgo (EPDS, na sigla em inglês), Escala de Estresse Percebido (PSS, na sigla em inglês) e Teste de Orientação à Vida-Revisado (LOT-R, na sigla em inglês). Dados sociodemográficos, obstétricos, antropométricos e neonatais foram obtidos dos prontuários médicos. Realizou-se análises descritivas e regressão logística. RESULTADOS: A prevalência de sobrepeso e obesidade foi de 29,27% e de 24,61%, respectivamente. Ganho de peso gestacional excessivo foi observado em 47,79% das mulheres com sobrepeso e em 45,26% das mulheres com obesidade. O consumo inadequado de verduras e feijão (razão de probabilidade [OR] = 2,95; índice de confiança [IC] 95%: 1,35­6,46 e OR = 1,91; IC95%: 1,01­3,63, respectivamente) e estresse (OR = 1,63; IC95%: 1,01­2,64) foram associados ao GPG excessivo em mulheres com sobrepeso e obesidade. Análises ajustadas para idade materna, multiparidade, duração do sono, tabagismo e ingestão de álcool mostraram que o estresse (PSS ≥ 20) associou-se ao GPG excessivo em mulheres com sobrepeso e obesidade (OR = 1.75; 95%CI: 1.03­2.96). CONCLUSãO: Entre mulheres com sobrepeso e obesidade, o estresse foi a principal variável associada ao GPG excessivo. O consumo inadequado de verduras e feijão também se associou com o GPG excessivo.

The role of health-related behaviors in gestational weight gain among women with overweight and obesity: A cross-sectional analysis / Papel dos comportamentos relacionados à saúde no ganho de peso gestacional em mulheres com sobrepeso e obesidade: Um estudo transversal

Abstract Objective To evaluate the influence of health-related behaviors including food intake, physical activity, sleep time, smoking habits, stress, depression, and optimism on excessive gestational weight gain (GWG) among women with overweight and obesity. Methods A cross-sectional study was conducted at the Women's Hospital of the Universidade de Campinas, Campinas, state of São Paulo, Brazil, with 386 mediate postpartum women that fit the inclusion criteria of ≥ 19 years old, first prenatal care visit at or before 14 weeks, and single live baby. Dietary habits, physical exercise practice, sleep duration, smoking and alcohol habits were self-reported. Psychosocial history was evaluated using the Edinburgh Postpartum Depression Scale (EPDS), Perceived Stress Scale (PSS), and Life Orientation Test-Revised (LOT-R). Sociodemographic, obstetric, anthropometric, and neonatal data were retrieved from medical records. Descriptive statistics and stepwise logistic regression were performed. Results The prevalence of overweight and obesity was 29.27% and 24.61%, respectively, according to the body mass index (BMI). Excessive GWG was observed in 47.79% of women with overweight and in 45.26% of women with obesity. Excessive GWG among overweight and obese women was associated with inadequate vegetable and bean consumption (odds ratio [OR] = 2.95, 95% confidence interval [CI]: 1.35-6.46 and OR = 1.91; 95%CI: 1.01-3.63, respectively) and stress (OR = 1.63; 95%CI 1.01-2.64). After adjustment by maternal age, multiparity, sleep duration, smoking, and alcohol intake, we found that stress (PSS ≥ 20) was associated with excessive GWG in women with overweight or obesity (OR: 1.75; 95%CI: 1.03-2.96). Conclusion Among women with overweight and obesity, stress is the main variable associated with excessive GWG. Inadequate vegetables and beans consumption also showed association with excessive GWG.

Resumo Objetivo Avaliar a influência de comportamentos relacionados à saúde: ingestão alimentar, atividade física, tempo de sono, tabagismo, estresse, depressão e otimismo no ganho de peso gestacional (GPG) excessivo em mulheres com sobrepeso e obesidade. Métodos Estudo transversal no Hospital da Mulher, Universidade de Campinas, Campinas, SP, Brasil, com 386 mulheres no puerpério mediato, ≥ 19 anos, primeira consulta pré-natal até 14 semanas e cuja gestação resultou em neonato vivo. Os comportamentos relacionados à saúde foram autorreferidos. História psicossocial foi avaliada usando: Escala de Depressão Pós-Parto de Edimburgo (EPDS, na sigla em inglês), Escala de Estresse Percebido (PSS, na sigla em inglês) e Teste de Orientação à Vida-Revisado (LOT-R, na sigla em inglês). Dados sociodemográficos, obstétricos, antropométricos e neonatais foram obtidos dos prontuários médicos. Realizou-se análises descritivas e regressão logística. Resultados A prevalência de sobrepeso e obesidade foi de 29,27% e de 24,61%, respectivamente. Ganho de peso gestacional excessivo foi observado em 47,79% das mulheres com sobrepeso e em 45,26% das mulheres com obesidade. O consumo inadequado de verduras e feijão (razão de probabilidade [OR] = 2,95; índice de confiança [IC] 95%: 1,35-6,46 e OR = 1,91; IC95%: 1,01-3,63, respectivamente) e estresse (OR = 1,63; IC95%: 1,01-2,64) foram associados ao GPG excessivo em mulheres com sobrepeso e obesidade. Análises ajustadas para idade materna, multiparidade, duração do sono, tabagismo e ingestão de álcool mostraram que o estresse (PSS ≥ 20) associou-se ao GPG excessivo em mulheres com sobrepeso e obesidade (OR = 1.75; 95%CI: 1.03-2.96). Conclusão Entre mulheres com sobrepeso e obesidade, o estresse foi a principal variável associada ao GPG excessivo. O consumo inadequado de verduras e feijão também se associou com o GPG excessivo.