Inadequate adherence to highly active anti-retroviral therapy (HAART) provokes important secondary effects in people living with aids. The objective was to identify the factors that make HAART adherence easy or difficult, according to aids patients attended at a university hospital in the state of São Paulo, Brazil. We interviewed 200 diagnosed aids patients using HAART for at least 6 months. Patients were interviewed individually, using a semi-structured design. Qualitative and quantitative analysis was used. 59% of the participants were men; average age was 38.2 years; 51% did not finish basic education; 50.5% did not perform any remunerated work. Patients had been using anti-retroviral agents for an average time of 5 years. The number of anti-retroviral pills ranged from 3 to 24. The main difficulties mentioned for adherence were: taste, size, number, smell of pills (40.0%); intense collateral effects (14.4%); psychological factors (13.7%); different times to take the pills (10.8%). Patients mentioned the following facilitators: coincidence of times to take the drugs (26.2%), no facility (16.4%), and administration associated to some habit (16.0%). The nursing group needs to reinforce supervised surveillance, educational and intervention actions.
Objectives: to evaluate prenatal care provided to low-risk pregnant women users of the Sistema Único de Saúde (SUS) (Public Health System) in the city of Joinville, SC. Methods: this is a cross-sectional observational study carried out from March 2018 to February 2019, through interview and analysis of the Pregnant Card of puerperal over 18 years old, from Joinville, who underwent prenatal care at SUS, excluding recent given up puerperal. Prenatal care was evaluated according to the recommended criteria by the Prenatal and Birth Humanization Program. Results: 683 mothers were interviewed. The criteria with the highest levels of adequacy were accessibility (99.6%), early initiation on prenatal care (92.7%) and 6 or more consultations (87.1%) and the criteria with the lowest rates of adequacy were the set of guidelines (17.7%) and the third and first trimester exams (42.5% and 63.5% respectively). Conclusion: it is concluded that the prenatal care provided by SUS in the city of Joinville, despite the almost universal accessibility, the early onset and the prevalence of puerperal women with more than 6 consultations, showed a sharp decline in the analysis of the recommended indicators.
BackgroundThis study aimed to identify the perinatal mortality coefficient, the epidemiological profile, causes and avoidable factors at a reference public maternity hospital in southern Brazil.MethodsIn this cross-sectional study, 334 medical records of postpartum women and newborns were evaluated between January 1st, 2011 and December 31st, 2015. The Expanded Wigglesworth Classification was used to assess the causes of perinatal mortality and the International Statistical Classification of Diseases and Related Health Problems (ICD-10/SEADE Foundation) was used for the preventable perinatal mortality analysis. Absolute numbers and percentages were used for data analysis. The perinatal mortality formula was used to calculate the perinatal mortality rate.ResultsThe perinatal mortality rate was 13.2/1000 total births, with a predominance of white race/color; mothers were 21–30 years of age, had experienced their first pregnancy and had completed their high school education.ConclusionThe main factors associated with perinatal death were antepartum fetal death in 182 (54.49%) cases, and avoidable death through appropriate prenatal care in 234 (70.05%) cases.
RESUMOOBJETIVO: Analisar os fatores envolvidos com a prematuridade em primigestas que realizaram o pré-natal na atenção primária de Joinville-SC. MÉTODOS: Trata-se de um estudo caso controle, realizado na Maternidade Darcy Vargas em Joinville-SC, período de março de 2018 a fevereiro de 2019 através de amostra randomizada composta de 257 puérperas primigestas maiores de 18 anos, que realizaram o acompanhamento pré-natal exclusivamente em Atenção Primária à Saúde. A população foi dividida em dois grupos, primigestas com parto prematuro e primigestas com parto a termo. Para o cálculo de razão de chance, os valores foram considerados significativos quando P<0,05. CEP nº2.487.567. RESULTADOS: As pacientes foram separadas em primigestas com parto prematuro (n=15/5,83%) e primigestas com parto a termo (n=242/94,16%). As características maternas destoaram quanto ao número de consultas de pré-natal (6 vs 9 P<0,001), nas puérperas com parto e prematuro e a termo respectivamente.
O parto prematuro caracteriza-se pela ocorrência do nascimento entre 20 e 37 semanas de gestação, havendo uma repercussão clínica alarmante para o recém nascido e para a gestante. O objetivo do estudo foi avaliar o impacto da prematuridade relacionados ao recém nascido e às características maternas observadas em pacientes de baixo risco atendidos em uma maternidade pública da cidade de Joinville, Santa Catarina. Sendo um estudo caso-controle cuja população foi randomizada entre puérperas primigestas atendidas na Maternidade Darcy Vargas, no período de março de 2018 a fevereiro de 2019 contabilizando uma amostra total de 722 puérperas. Dessa forma, os fatores relacionados com o desfecho de prematuridade foram uso de drogas pela gestante e a diminuição de frequência de consultas pré-natais. Em relação aos fatores neonatais analisados que foram relacionados com a prematuridade: menor capurro, menores índices de apgar, baixo peso ao nascer, internação neonatal foram características que diferenciam os prematuros dos recém-nascidos a termo.
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