Produção do cuidado de gestantes dependentes de drogas: um <i>scoping review</i>

Abstract

Introduction: this study was motivated from the reflection and identification in the assistance practice, the difficulty of access and adherence of pregnant and dependent on drugs women to ambulatory care services. We intended to answer the following question: how are pregnant and dependent on alcohol, tobacco and illicit drugs women being cared in outpatient health services? Goals: to characterize the selected studies with the focus on the intervention modality and the strategies of care adopted to the pregnant women; to conceptualize the production of care for pregnant and dependent on drugs women, based on the emerging concepts of the selected work. Methodology: this is a review study of the type Scoping Review. The results were obtained from the LILACS, MEDLINE, BEDENF, PUBMED, WEB OF SCIENCE and CINAHL databases, in Portuguese, English and Spanish, from the following controlled descriptors: pregnant, street drugs, standard of care, substance abuse treatment centers, susbtance-related disorders, mental health, women's health services, ambulatory care. Results: 939 related studies were identified. After the application of inclusion criteria, exclusion and evaluation of articles by judges, nine studies of the PUBMED database, published in the United States of America, were selected. All of the studies involved a randomized clinical trial type design. The period of publication was from 2007 to 2015. The pregnant women were mostly single, low income and aged between 18 and 50 years old. The production of knowledge was led by Medicine (66.6%), participation of Nursing (22.2%) and Nutrition (11.1%). The main intervention modalities were made in groups, randomized clinical trial and individual monitoring. The main tools used to follow up these groups were: improved motivational interview, brief intervention, therapeutic work place and contingency incentives.The following elements emerged from the selected works that allowed the formulation of the concept of care production: relational care, bonding, listening sensitivity to socio-historical-cultural approach, gender and time. Conclusion: from the present study it was possible to analyze the emergent elements and formulate a concept of care production for pregnant women.

Consumo de drogas durante pré-natal de baixo risco: estudo transversal

“…O reconhecimento do uso de drogas na gestação deve ser incrementado na rotina da assistência ao pré-natal de baixo risco, pois o rastreio precoce permite a possibilidade do acesso a serviços especializados de tratamento e alternativas de enfrentamento ao uso de drogas na gestação, evitando e/ou amenizando complicações maternas com práticas de redução dos danos (10)(11) . Estudos que estabeleçam a prevalência do uso de drogas nesse nível de atenção podem influenciar a discussão sobre aspectos organizacionais dos serviços de saúde da mulher e da rede de cuidado na perspectiva da assistência à saúde no ciclo gravídico puerperal.…”