Flávia Azevedo Gomes-Sponholz

Intimate partner violence against pregnant women: study about the repercussions on the obstetric and neonatal results

Este estudio tuvo como objetivos describir el proceso de traduccion y adaptacion cultural del instrumento Perceived Stigmatization Questionnaire (PSQ) y analizar la consistencia interna de los items en la etapa del pre-test. El PSQ fue desarrollado para la evaluacion de la percepcion de los comportamientos estigmatizantes de victimas de quemaduras. El proceso de adaptacion fue realizado de agosto del 2012 a febrero del 2013, incluyendo las etapas preconizadas en la literatura. Como parte de ese proceso, fue realizado el pre-test con 30 adultos victimas de quemaduras. Todos los participantes de esa etapa informaron comprender los items del instrumento y la escala de respuesta. No hubo sugerencias o cambios en la version probada. El valor del alfa de Cronbach en el pre-test fue de 0,87. La contribucion del estudio esta en la descripcion de la operacionalizacion de cada una de las etapas de ese proceso metodologico y demuestra la consistencia interna de los items en el pre-test.

Mental health of women who suffer intimate partner violence during pregnancy

Objective . To identify the relationship between intimate partner violence (IPV) during pregnancy and mental disorders in women in the pregnancy-puerperal cycle. Method . A review was conducted of papers published in Portuguese, English and Spanish regarding the study theme. The databases explored were PubMed, CINAHL, LILACS and PsycINFO. Results . The 17 included papers studied the relationship between IPV and: pre- and postpartum depression (41%); pregnancy anxiety (23%) and pregnancy posttraumatic stress disorder (12%). None of the studies investigated the association between IPV and suicidal ideation. Conclusion. IPV against women during the pregnancy-puerperal cycle causes negative impacts on mental health. Concrete actions shall be proposed regarding the prevention, identification and treatment of women exposed to IPV during their pregnancy period. Key words: spouse abuse; pregnancy; postpartum period; mental health; nursing. How to cite this article: Fonseca-Machado MO, Alves LC, Freitas PS, Monteiro JCS, Gomes-Sponholz F. Mental health of women who suffer intimate partner violence during pregnancy . Invest Educ Enferm. 2014;32(2):

Breast feeding among Brazilian adolescents: practice and needs.

OBJECTIVES to characterise breast feeding practices among Brazilian adolescents and identify their breast feeding needs. METHODS the study was undertaken in Ribeirão Preto, Brazil in two stages. The first stage analysed data from the Second National Survey of Breast-feeding Prevalence, held in August 2008, which included 229 adolescent mothers. The second stage was a qualitative approach, and involved interviews with 10 adolescent mothers in a primary care unit. The data from the first stage were analysed in June 2010 based on descriptive statistics. The data obtained from the interviews were transcribed and organised using thematic content analysis. FINDINGS breast feeding was reported by 75% of the adolescent mothers. Of the 144 mothers with infants aged <180 days, 84% reported that they were breast feeding: 19% were breast feeding exclusively, 17% were breast feeding predominantly, 49% were providing complementary feeding, and 16% had weaned their infants. Analysis of the interviews led to the identification of three thematic units: concern for the childs health; breast feeding difficulties; and health team and family support. CONCLUSIONS the majority of the adolescent mothers presented conditions that were favourable to breast feeding (e.g. did not work outside the home, only had one child, breast fed in the first hour post partum). However, the practice of breast feeding still failed to meet the recommendations of the World Health Organization. The interviews led to identification of the breast feeding needs and demands of adolescent mothers, many of which were related to the needs of their infants. It is important to know what adolescent mothers think about breast feeding, in order to encourage the establishment of practices to keep breastfeeding as longer as possible in a satisfactory way for both mothers and infants.

Transcutaneous electrical nerve stimulation for the relief of post-partum uterine contraction pain during breast-feeding: a randomized clinical trial.

To evaluate transcutaneous electrical nerve stimulation (TENS) used to relieve uterine contraction pain during breast‐feeding in multiparous women.

Intimate partner violence and anxiety disorders in pregnancy: the importance of vocational training of the nursing staff in facing them

Objetivos: identificar la relacion entre el trastorno de estres postraumatico, ansiedad estado-rasgo y la convivencia con pareja intima violenta durante el embarazo. Metodo: estudio observacional y transversal, desarrollado con 358 mujeres embarazadas. Fueran utilizados el Post-Traumatic Stress Disorder Checklist – Civilian Version, el Inventario de Ansiedad Estado-Rasgo y una version adaptada del instrumento utilizado por World Health Organization Multi-country Study on Women’s Health and Domestic Violence. Resultados: despues de ajustar el modelo de regresion logistica multiple, el comportamiento violento de las parejas, que se produjo durante el embarazo, se asocio con la indicacion de trastorno de estres postraumatico. Los modelos de regresion lineal multiple ajustados evidenciaron que las victimas de violencia, en el embarazo actual, tenian una puntuacion mas alta de sintomas de ansiedad estado-rasgo que las que no son o no fueran victimas de violencia. Conclusion: reconocer que la pareja intima violenta es factor de riesgo clinicamente relevante e identificable para la aparicion de los trastornos de ansiedad durante el embarazo y que puede ser un primer paso en la prevencion de esos problemas.Descriptores: Maltrato Conyugal; Ansiedad; Trastornos por Estres Postraumatico; Embarazo; Enfermeria; Salud Publica.855Objetivo: identificar a relacao entre transtorno de estresse pos-traumatico, ansiedade-traco e estado e violencia por parceiro intimo, durante a gestacao. Metodo: estudo observacional e transversal, desenvolvido com 358 gestantes. Foram utilizados o Post-Traumatic Stress Disorder Checklist – Civilian Version, o Inventario de Ansiedade Traco-Estado e uma versao adaptada do instrumento usado no World Health Organization Multi-country Study on Women’s Health and Domestic Violence. Resultados: apos se ajustar ao modelo de regressao logistica multipla, a violencia por parceiro intimo, ocorrida durante a gestacao, associou-se com o indicativo de transtorno de estresse pos-traumatico. Os modelos de regressao linear multipla ajustados evidenciaram que as vitimas de violencia, na atual gestacao, apresentaram maiores escores dos sintomas de ansiedadetraco e estado do que as nao vitimas. Conclusao: reconhecer a violencia por parceiro intimo como um fator de risco clinicamente relevante e identificavel, para a ocorrencia de transtornos ansiosos, durante a gestacao, pode ser um primeiro passo na prevencao desses problemas.Objective: to identify the relationship between posttraumatic stress disorder, trait and state anxiety, and intimate partner violence during pregnancy. Method: observational, cross-sectional study developed with 358 pregnant women. The Posttraumatic Stress Disorder Checklist - Civilian Version was used, as well as the State-Trait Anxiety Inventory and an adapted version of the instrument used in the World Health Organization Multi-country Study on Womens Health and Domestic Violence. Results: after adjusting to the multiple logistic regression model, intimate partner violence, occurred during pregnancy, was associated with the indication of posttraumatic stress disorder. The adjusted multiple linear regression models showed that the victims of violence, in the current pregnancy, had higher symptom scores of trait and state anxiety than non-victims. Conclusion: recognizing the intimate partner violence as a clinically relevant and identifiable risk factor for the occurrence of anxiety disorders during pregnancy can be a first step in the prevention thereof.

Severe lactational mastitis: particularities from admission

OBJECTIVE to identify characteristics of women who have suffered severe lactational mastitis. METHOD a descriptive, retrospective, documentary, quantitative study was performed. Data were collected from patient records of 114 hospitalized women from January of 2009 to December of 2013. Data were analyzed by using descriptive statistics. RESULTS a higher percentage of severe lactational mastitis was found in young, primiparous women who had completed high school, who had no partner, and did not have a job; 96.5% of women had breast complications before admission and remained hospitalized an average of 4.4 days; at discharge, 23.7% of women had weaned their infants. CONCLUSION this study showed that severe lactational mastitis can cause great harm to the woman and the baby.

Preconception health behaviors associated with pregnancy planning status among Brazilian women

OBJECTIVE The objective of this study is to assess preconception health behaviors among Brazilian women, and analyze the effect of pregnancy planning status in carrying out preconception measures. METHOD This is a cross-sectional quantitative study conducted with 807 women, of whom 649 had a planned or ambivalent pregnancy. Preconception health behaviors were assessed by the Brazilian version of the London Measure of Unplanned Pregnancy. RESULTS Preconception health behaviors were performed by only 15.9% of women. Among those who planned their pregnancy, less than half completed a health measure (47.0%); the most common was seeking medical assistance and improving the diet. Multiple logistic regression analysis showed a strong association between the preconception health behaviors and a planned pregnancy (adjusted OR = 16.77; 95% CI: 9.47-29.81). Age over 30 years, paid work, and the time interval between menarche and first sexual intercourse were also associated with completing preconception measures. CONCLUSION The low frequency of preconception health measures, even among women who planned their pregnancy, indicates the urgency of including preconception care on the agenda of public health policies in Brazil. OBJETIVO Mensurar a realização do preparo pré-concepcional, descrever as medidas adotadas como preparo pré-concepcional e analisar o efeito do planejamento da gravidez na realização do preparo pré-concepcional. MÉTODO Estudo quantitativo, do tipo transversal, conduzido com 807 mulheres, das quais 649 tinham gravidez planejada ou ambivalente. O preparo pré-concepcional foi mensurado a partir do London Measure of Unplanned Pregnancy , versão Brasil. RESULTADOS O preparo pré-concepcional foi realizado por apenas 15,9% das mulheres. Dentre as que planejaram a gravidez, menos da metade realizou algum preparo (47,0%), sendo os mais frequentes ter procurado assistência médica e mudanças na alimentação. Análise de regressão logística múltipla mostrou forte associação entre a realização do preparo pré-concepcional e o planejamento da gravidez (ORajustado=16,77; IC95% 9,47-29,81). A idade acima de 30 anos, o trabalho remunerado e o intervalo de tempo entre a menarca e a primeira relação sexual também estiveram associados à realização do preparo pré-concepcional. CONCLUSÃO A baixa frequência de realização de preparo pré-concepcional, mesmo entre mulheres com gravidez planejada, indica a urgência de se incluir o cuidado pré-concepcional na agenda de políticas públicas de saúde.Medir la realizacion de la preparacion pre concepcional, describir las medidas adoptadas como preparacion pre concepcional y analizar el efecto de la planificacion del embarazo en la preparacion pre concepcional. METODO Estudio cuantitativo, del tipo transversal, conducido con 807 mujeres, de las cuales 649 tenian embarazo planificado o ambivalente. La preparacion pre concepcional fue medida mediante el London Measure of Unplanned Pregnancy , version Brasil. RESULTADOS La preparacion pre concepcional fue realizada por solo el 15,9% de las mujeres. Entre las que planificaron el embarazo, menos de la mitad realizo alguna preparacion (47,0%), siendo las mas frecuentes haber buscado asistencia medica y cambios en la alimentacion. El analisis de regresion logistica multiple mostro fuerte asociacion entre la realizacion de la preparacion pre concepcional y la planificacion del embarazo (ORajustado=16,77; IC95% 9,47-29,81). La edad superior a 30 anos, el trabajo remunerado y el intervalo de tiempo entre la menarca y la primera relacion sexual tambien estuvieron asociados con la realizacion de la preparacion pre concepcional. CONCLUSION La baja frecuencia de realizacion de preparacion pre concepcional, aun entre mujeres con embarazo planificado, senala la urgencia de incluirse el cuidado pre concepcional en la agenda de politicas publicas de salud.

Violência do parceiro íntimo contra a gestante: estudo sobre as repercussões nos resultados obstétricos e neonatais

Este estudio tuvo como objetivos describir el proceso de traduccion y adaptacion cultural del instrumento Perceived Stigmatization Questionnaire (PSQ) y analizar la consistencia interna de los items en la etapa del pre-test. El PSQ fue desarrollado para la evaluacion de la percepcion de los comportamientos estigmatizantes de victimas de quemaduras. El proceso de adaptacion fue realizado de agosto del 2012 a febrero del 2013, incluyendo las etapas preconizadas en la literatura. Como parte de ese proceso, fue realizado el pre-test con 30 adultos victimas de quemaduras. Todos los participantes de esa etapa informaron comprender los items del instrumento y la escala de respuesta. No hubo sugerencias o cambios en la version probada. El valor del alfa de Cronbach en el pre-test fue de 0,87. La contribucion del estudio esta en la descripcion de la operacionalizacion de cada una de las etapas de ese proceso metodologico y demuestra la consistencia interna de los items en el pre-test.

Continuing education in nursing as a factor associated with knowledge on breastfeeding

Objetivo. Identificar el conocimiento de los profesionales de enfermeria de la Estrategia de Salud de la Familia sobre la lactancia materna y las posibles asociaciones entre el conocimiento y los aspectos personales, profesionales y de autoevaluacion. Metodologia. Estudio observacional de tipo transversal, desarrollado en unidades de salud de la familia de un municipio de Minas Gerais, Brasil, con 85 profesionales de enfermeria. Los datos fueron recolectados mediante un cuestionario. Resultados. La media de aciertos de los profesionales en este test de conocimiento fue de 6.6 y fue mayor en el grupo que participo en cursos sobre lactancia materna. Conclusion. Se precisa una educacion permanente, proporcionando movilizacion reflexiva y critica, una problematizacion de la realidad y la identificacion de las necesidades de los usuarios.

Maternal Mortality in Brazil: Proposals and Strategies for its Reduction

1Universidade Estadual de Campinas, Campinas, SP, Brazil 2 Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Rio de Janeiro, RJ, Brazil 3School of Nursing, Universidade de São Paulo, Ribeirão Preto, SP, Brazil 4Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil 5 Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, Brazil 6Universidade de São Paulo, São Paulo, SP, Brazil 7 Faculdade de Medicina São Leopoldo Mandic, Campinas, SP, Brazil 8Universidade de Pernambuco, Recife, PE, Brazil