Objective To know the nurses' perception about early skin-to-skin contact. Methods A qualitative and exploratory-descriptive study carried out at the Obstetric Center of a university hospital in southern Brazil. The participants were eight nurses who answered a qualitative interview in April 2019. The interviews followed a guiding script and were analyzed according to thematic content analysis: data sorting and classification and final analysis. Results Nurses know the skin-to-skin contact practice and the importance of doing it properly. In their work routine, they perceive that this contact does not happen as it should and they understand the importance of recording it. Conclusion Nurses aim for skin-to-skin contact to be carried out in an early and uninterrupted manner; however, the limitations related to the health team's work processes are highlighted. The study reinforces the importance of reducing unnecessary interventions at birth.
Objectives To examine maternal characteristics associated with adverse pregnancy outcomes (APOs) among HIV-infected women. Design Prospective cohort study Setting Multiple sites in Latin America and the Caribbean Population First on-study pregnancy among HIV-1-infected women enrolled in NISDI (Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) International Site Development Initiative) Perinatal (2002–2007) and LILAC (2008–2012) studies. Methods Frequencies of APOs assessed among pregnancies. Risk factors investigated by logistic regression analysis. Main Outcome measures APOs including preterm delivery (PT), low birth weight (LBW), small for gestational age (SGA), stillbirth (SB) and neonatal death. Results Among 1512 women, 1.9% (95% confidence interval [CI] 1.3–2.7%) of singleton pregnancies resulted in a stillbirth and 32.9% (30.6–35.4%) had at least one APO. Of 1483 singleton live births, 19.8% (17.8–21.9%) were PT, 14.2% (12.5–16.1%) were LBW, 12.6% (10.9–14.4%) were SGA, and 0.4% (0.2–0.9%) of infants died within 28 days after birth. Multivariable logistic regression modeling indicated that the following risk factors increased the probability of having one or more APOs: lower maternal body mass index (odds ratio [OR]=2.2; 95% CI: 1.4–3.5) at delivery, hospitalization during pregnancy (OR=3.3; 95% CI: 2.0–5.3), hypertension during pregnancy (OR=2.7; 95% CI: 1.5–4.8), antiretroviral use at conception (OR=1.4; 95% CI: 1.0–1.9) and tobacco use during pregnancy (OR=1.7; 95% CI: 1.3–2.2). Results of fitting multivariable logistic regression models for PT, LBW, SGA and SB are also reported. Conclusions HIV-infected women had relatively high occurrence of APOs and some maternal risk factors were associated with these APOs. Interventions targeting modifiable risk factors should be evaluated further.
RESUMOEste estudo caracteriza-se por ser uma pesquisa qualitativa que objetivou desvelar a percepção e a vivência em relação ao tratamento antirretroviral do adolescente com síndrome da imunodefi ciência adquirida. A pesquisa foi realizada em serviços de referência em dois municípios na região sul do Brasil. A produção dos dados foi desenvolvida com a dinâmica de criatividade e sensibilidade mapa falante, por cinco participantes. Foi aplicada a técnica de análise temática do conteúdo. Das produções artísticas e depoimentos emergiram o cotidiano do uso dos medicamentos e o silêncio do diagnóstico da doença e do tratamento que implicam o cuidado à saúde. Conclui-se que é necessário o envolvimento dos profi ssionais de saúde, possibilitando espaços para a família e promovendo diálogos desta com o adolescente, visando à adesão ao tratamento. Descritores: Saúde do Adolescente; HIV; Síndrome de Imunodefi ciência Adquirida; Adesão à Medicação; Antirretroviral de Alta Atividade. ABSTRACTThis study is characterized as a qualitative research with the objective of unveiling the perception and experience regarding the antiretroviral treatment of the adolescent with acquired immunodefi ciency syndrome. The research was carried out within reference health care centers in two municipalities from the southern region of Brazil. The data production was developed through the creativity and sensitiveness dynamics of talking map type by a group of fi ve participants. One applied the technique of content thematic analysis. The artistic productions and testimonies evidenced their daily experience with use of medications and the silence on the diagnosis of the disease and its treatment that implies the health care. The conclusion drawn is that the involvement of health professionals is needed since it opens spaces for the family besides promoting the dialogue of its members with the adolescent aiming at the adhesion to the treatment.
Understand the meaning of the experiences of parents of children with congenital heart disease regarding feelings, obstacles and expectations. Methods: exploratory qualitative study conducted at a pediatric intensive care unit of a reference hospital. Participants corresponded to seven mothers and four fathers of children with congenital heart defect, surgically corrected and with more than 8 hours of admission, totalling 11 participants. Data collection was performed through semi-structured individual recorded interviews. Data were described according to thematic content analysis. Results: five thematic categories emerged: (1) unpreparedness to face the problem; (2) feelings involved (3) factors that make difficult to face the problem; (4) factors that facilitate facing the problem; (5) spirituality. Conclusion: each family is unique and needs support to better face the disease and its process. It is essential to develop interdisciplinary network support, providing comprehensive care.
The aim of this study was to know the nurses' conception about the emphasis of the activities that they develop in the work process, in the clinic model assistance. This study is a qualitative research, with dialetic approach. To form the sample one nurse was chosen in each of the 17 units of a university hospital in Porto Alegre/RS. The data were collected through semi-structured interview. To analyze the data the material was classified in relevant structures, from which nine categories were established. The results showed that, although there is a prevalence of management activities of the care concerning the assistance activities, the nurses considered that these dimensions are indissociable in their work. It was concluded that the relation between assisting and managing are not excluding and that the management is one of the dimensions of nursing care.
Intended and unintended pregnancies occur frequently among HIV-infected women. We evaluated the occurrence of repeat pregnancy and characteristics associated with this outcome among HIV-infected women in Latin America and the Caribbean who were participating in the National Institute of Child Health and Human Development (NICHD) International Site Development Initiative (NISDI). Of the 1342 HIV-infected pregnant women enrolled in NISDI, 124 (9.2%) had one or more repeat pregnancies on study. Median time between the index delivery and date of conception of the subsequent pregnancy was 1.4 years (range 0.1–5.7). Younger age [odds ratio (OR)=1.07, 95% confidence interval (CI): 1.04–1.11 per one-year decrease in age], hospitalization during the index pregnancy or up to 6 months postpartum [OR=2.0, 95% CI: 1.2–3.4], and poor index pregnancy outcome (stillbirth or spontaneous/therapeutic abortion) [OR=3.4, 95% CI: 1.4–8.4] were associated with increased occurrence of repeat pregnancy in multivariable analysis. Among women with repeat pregnancies, the proportion receiving antiretroviral treatment (versus prophylaxis) increased from 39.4% at the time of the index pregnancy to 81.8% at the time of the repeat pregnancy (p<0.001). These results can help identify women most likely to benefit from reproductive counseling in order to assist with healthy pregnancy planning and prevention of unintended pregnancies.
RESUMO. O estudo aborda as práticas de cuidado à saúde no grupo materno-infantil de risco, tendo como foco a família da mãe adolescente e seu filho, na fase de recém-nascido até a lactente. Com a finalidade de promoção e educação em saúde voltada a esse grupo, o objetivo foi conhecer as vivências da mãe adolescente e sua família. Trata-se de um estudo qualitativo do tipo descritivo. Foram investigadas 12 mães adolescentes de comunidades carentes das cidades de Porto Alegre e de São Leopoldo, Rio Grande do Sul. Os dados foram coletados por meio de entrevistas semi-estruturadas. Foi utilizada a técnica de Análise de Conteúdo proposta por Minayo (1993). Os resultados revelaram três categorias: enfrentamento da família com a chegada da criança; alterações na vida familiar e a participação da família no cuidado da criança. Ao final do estudo, foi possível conhecer que as mães adolescentes procuram apoio de sua família em situações de auxílio nos cuidados iniciais do bebê, pois manifestaram medo de realizá-los, delegando-os a outros familiares ou a pessoas próximas. Além disso, a chegada de um bebê altera não só a dinâmica da família, mas também os modos de enfrentamento da situação, interferindo nos projetos de vida dos jovens pais .
Objetivo: analisar a ocorrência e a associação da sífilis congênita com a realização do pré-natal e tratamento da gestante e do parceiro.Método: estudo retrospectivo do período de 2006 a 2015, observando dados do Brasil, Rio Grande do Sul e Porto Alegre, com base em indicadores do Ministério da Saúde.Resultados: a taxa de sífilis congênita em menores de um ano de idade aumentou de 2 para 6,5 no Brasil, de 1,5 para 11,5 no Rio Grande do Sul e de 4,4 para 30,2 em Porto Alegre. Em torno de 74% de mulheres realizaram o pré-natal nas três esferas. Das gestantes 80% não realizaram o tratamento ou o fizeram de maneira inadequada. O percentual de tratamento do parceiro não ultrapassou 20,5%. Conclusão: esse estudo observou o aumento da ocorrência da sífilis congênita. Ainda, a realização do pré-natal não assegurou tratamento adequado das gestantes e de seus parceiros.
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