Ianê Nogueira do Vale

Exclusive breastfeeding practices reported by mothers and the introduction of additional liquids

OBJETIVO: avaliar o conceito de aleitamento materno exclusivo para nutrizes, comparando o periodo em que consideraram realiza-lo e a idade de introducao de outros liquidos. METODO: estudo descritivo transversal, com 309 mulheres que tiveram filhos em um hospital universitario do interior de Sao Paulo, Brasil. Foi realizada analise descritiva dos dados, com cruzamento das variaveis de interesse por meio de teste nao parametrico de Kruskal-Wallis, teste quiquadrado e teste exato de Fisher. RESULTADOS: aproximadamente 30% das mulheres informaram introducao de outros liquidos antes dos seis meses de vida, enquanto afirmavam estar em aleitamento materno exclusivo. Verificou-se associacao das seguintes variaveis com a introducao precoce de liquidos: mulheres sem vinculo empregaticio (p=0,0386), mais jovens (p=0,0159) e primiparas (p= 0,003). CONCLUSAO: e possivel que o conceito de aleitamento exclusivo nao seja claro para as mulheres, pois entendem que pratica-lo significa nao dar outro tipo de leite, podendo oferecer outros liquidos. Isto mostra que a promocao do aleitamento materno deve contemplar a abordagem de crencas e valores, assegurando dialogo efetivo e compreensao junto as maes.Objetivo: evaluar el concepto de la lactancia materna exclusiva mantenido por mujeres lactantes en comparacion con el periodo de duracion de la lactancia considerado por ellas y la edad de los bebes al momento de introduccion de liquidos adicionales. Metodo: Estudio descriptivo transversal realizado con 309 mujeres que dieron a luz bebes en un hospital universitario en Sao Paulo, Brasil. Los datos fueron sometidos a analisis descriptivo; las variables de interes fueron cruzados mediante la prueba no parametrica de Kruskal-Wallis, el chi-cuadrado y la prueba exacta de Fisher. Resultados: el 30% de las mujeres reportaron haber introducido liquidos adicionales antes de que los bebes llegaran a los seis meses de edad, al mismo tiempo afirmaron haber dado lactancia materna exclusiva. Las siguientes variables se asociaron con la introduccion temprana de liquidos: la falta de empleo (p=0,0386), edad materna juvenil (p=0,0159) y el primer embarazo (p=0,003). Conclusion: el concepto de la lactancia materna exclusiva puede no ser totalmente claro para las mujeres, ya que parecen creer que significa no alimentar a los ninos con otros tipos de leche, pero que la administracion de otros liquidos se permite. Esto demuestra que la promocion de la lactancia materna deberia tomar en consideracion creencias y valores para lograr el dialogo y la comprension efectiva con las madres.Descriptores: Lactancia Materna; Ingestion de Liquidos; Conocimiento; Madres; Nutricion del Lactante; Destete.

Avaliação da autoestima de gestantes com uso da Escala de Autoestima de Rosenberg

The objective of this descriptive, cross-sectional study was to evaluate the self-esteem of 127 pregnant women seen in a prenatal care program conducted in a public school hospital. Data collection was performed using the Rosenbergs Self-esteem Scale; unsatisfactory self-esteem was related to socio-demographic and health variables of the pregnant woman, and to the presence or absence of support systems. Descriptive and univariate statistical analysis were used to assess possible associations. Pregnant women who had low scores for self-esteem were 60% of all subjects. As for the sociodemographic data, women with fewer years of education presented higher frequency of lower self-esteem scores, which disagrees with other studies. Pregnant women who report having an unplanned pregnancy presented higher prevalence of low self-esteem than those who reported having planned their pregnancy. The lack of support from the partner to look after the baby was also associated to the pregnant womens low self-esteem. Other associations between variables were not statistically significant.The objective of this descriptive, cross-sectional study was to evaluate the self-esteem of 127 pregnant women seen in a prenatal care program conducted in a public school hospital. Data collection was performed using the Rosenbergs Self-esteem Scale; unsatisfactory self-esteem was related to socio-demographic and health variables of the pregnant woman, and to the presence or absence of support systems. Descriptive and univariate statistical analysis were used to assess possible associations. Pregnant women who had low scores for self-esteem were 60% of all subjects. As for the socio-demographic data, women with fewer years of education presented higher frequency of lower self-esteem scores, which disagrees with other studies. Pregnant women who report having an unplanned pregnancy presented higher prevalence of low self-esteem than those who reported having planned their pregnancy. The lack of support from the partner to look after the baby was also associated to the pregnant womens low self-esteem. Other associations between variables were not statistically significant.

Prática de aleitamento materno exclusivo informado pela mãe e oferta de líquidos aos seus filhos

OBJETIVO: avaliar o conceito de aleitamento materno exclusivo para nutrizes, comparando o periodo em que consideraram realiza-lo e a idade de introducao de outros liquidos. METODO: estudo descritivo transversal, com 309 mulheres que tiveram filhos em um hospital universitario do interior de Sao Paulo, Brasil. Foi realizada analise descritiva dos dados, com cruzamento das variaveis de interesse por meio de teste nao parametrico de Kruskal-Wallis, teste quiquadrado e teste exato de Fisher. RESULTADOS: aproximadamente 30% das mulheres informaram introducao de outros liquidos antes dos seis meses de vida, enquanto afirmavam estar em aleitamento materno exclusivo. Verificou-se associacao das seguintes variaveis com a introducao precoce de liquidos: mulheres sem vinculo empregaticio (p=0,0386), mais jovens (p=0,0159) e primiparas (p= 0,003). CONCLUSAO: e possivel que o conceito de aleitamento exclusivo nao seja claro para as mulheres, pois entendem que pratica-lo significa nao dar outro tipo de leite, podendo oferecer outros liquidos. Isto mostra que a promocao do aleitamento materno deve contemplar a abordagem de crencas e valores, assegurando dialogo efetivo e compreensao junto as maes.Objetivo: evaluar el concepto de la lactancia materna exclusiva mantenido por mujeres lactantes en comparacion con el periodo de duracion de la lactancia considerado por ellas y la edad de los bebes al momento de introduccion de liquidos adicionales. Metodo: Estudio descriptivo transversal realizado con 309 mujeres que dieron a luz bebes en un hospital universitario en Sao Paulo, Brasil. Los datos fueron sometidos a analisis descriptivo; las variables de interes fueron cruzados mediante la prueba no parametrica de Kruskal-Wallis, el chi-cuadrado y la prueba exacta de Fisher. Resultados: el 30% de las mujeres reportaron haber introducido liquidos adicionales antes de que los bebes llegaran a los seis meses de edad, al mismo tiempo afirmaron haber dado lactancia materna exclusiva. Las siguientes variables se asociaron con la introduccion temprana de liquidos: la falta de empleo (p=0,0386), edad materna juvenil (p=0,0159) y el primer embarazo (p=0,003). Conclusion: el concepto de la lactancia materna exclusiva puede no ser totalmente claro para las mujeres, ya que parecen creer que significa no alimentar a los ninos con otros tipos de leche, pero que la administracion de otros liquidos se permite. Esto demuestra que la promocion de la lactancia materna deberia tomar en consideracion creencias y valores para lograr el dialogo y la comprension efectiva con las madres.Descriptores: Lactancia Materna; Ingestion de Liquidos; Conocimiento; Madres; Nutricion del Lactante; Destete.

Assessment of self-esteem in pregnant women using Rosenberg's self-esteem scale

The objective of this descriptive, cross-sectional study was to evaluate the self-esteem of 127 pregnant women seen in a prenatal care program conducted in a public school hospital. Data collection was performed using the Rosenbergs Self-esteem Scale; unsatisfactory self-esteem was related to socio-demographic and health variables of the pregnant woman, and to the presence or absence of support systems. Descriptive and univariate statistical analysis were used to assess possible associations. Pregnant women who had low scores for self-esteem were 60% of all subjects. As for the sociodemographic data, women with fewer years of education presented higher frequency of lower self-esteem scores, which disagrees with other studies. Pregnant women who report having an unplanned pregnancy presented higher prevalence of low self-esteem than those who reported having planned their pregnancy. The lack of support from the partner to look after the baby was also associated to the pregnant womens low self-esteem. Other associations between variables were not statistically significant.The objective of this descriptive, cross-sectional study was to evaluate the self-esteem of 127 pregnant women seen in a prenatal care program conducted in a public school hospital. Data collection was performed using the Rosenbergs Self-esteem Scale; unsatisfactory self-esteem was related to socio-demographic and health variables of the pregnant woman, and to the presence or absence of support systems. Descriptive and univariate statistical analysis were used to assess possible associations. Pregnant women who had low scores for self-esteem were 60% of all subjects. As for the socio-demographic data, women with fewer years of education presented higher frequency of lower self-esteem scores, which disagrees with other studies. Pregnant women who report having an unplanned pregnancy presented higher prevalence of low self-esteem than those who reported having planned their pregnancy. The lack of support from the partner to look after the baby was also associated to the pregnant womens low self-esteem. Other associations between variables were not statistically significant.

Opinião dos alunos quanto ao ensino dos diagnósticos de enfermagem segundo a taxonomia da NANDA

In accordance to North American Nursing Diagnosis Association (NANDA) , nursing diagnosis is a clinical judgement of the individual, family or community answers to the vital process or to the actual or potential health problems.These gives the basis for the itervention selection, by which the nurse is responsible. Believing in the importance of nursing diagnosis, its teaching was introduced 4 years ago In the subjects of Womans Health Assistence and Perinatal Nursing, In the 6o. period of the undergraduate course In nursing at UNICAMP. Aiming At evaluating these experience, we proposed to get the students opinion and obtain subsides to perfect teaching. Teoric teaching of 4 hours was given and it was indicated the basical bibliography. The supervised pratical application was developed during 21 hours in a neonatal unit and 45 hours in health, centers. At the end of the subjects, 16 students aswered a form with closed and open questions. All the students considered valid the study of the nursing diagnoses. Most of the students considered more proper to introduce the teaching in the 3°. semester, when the nursing basic procedues is begun. As to the difficult of learning in the use of diagnoses, 68,7% of the students reported a diffucult level higher to 25% and lower to 75%. The students group consideres that the study of nursing diagnoses brought modifications in, its concept of nursing assistance.In accordance to North American Nursing Diagnosis Association (NANDA), nursing diagnosis is a clinical judgement of the individual, family or community answers to the vital process or to the actual or potential health problems. These gives the basis for the intervention selection by which the nurse is responsible. Believing in the importance of nursing diagnosis, its teaching was introduced 4 years ago in the subjects of Woman s Health Assistance and Perinatal Nursing, in the 6o. period of the undergraduate course in nursing at UNICAMP. Aiming at evaluating these experience, we proposed to get the students opinion and obtain subsides to perfect teaching. Teoric teaching of 4 hours was given and it was indicated the basic bibliography. The supervised practical application was developed during 21 hours in a neonatal unit and 45 hours in health centers. At the end of the subjects, 16 students answered a form with closed and open questions. All the students considered valid the study of the nursing diagnoses. Most of the students considered more proper to introduce the teaching in the 3o. semester, when the nursing basic procedures is begun. As to the difficult of learning in the use of diagnoses, 68.7% of the students reported a difficult level higher to 25% and lower to 75%. The students group considers that the study of nursing diagnoses brought modifications in its concept of nursing assistance.

Diagnóstico de enfermagem "conflito no desempenho do papel de mãe" em mães de recém-nascidos hospitalizados

Objetivo: Verificar si las madres de los recien nacidos hospitalizados reconocen las caracteristicas definitorias de “conflicto de rol parental” como representativas de esa experiencia. Metodos: Estudio transversal y descriptivo realizado en una unidad neonatal de un hospital de ensenanza publica en el estado de Sao Paulo. La muestra consistio en 100 mujeres que le asignaron puntuaciones de 1 a 5 para las caracteristicas que definen el diagnostico, en la que 1 significa “nada caracteristico” y 5 significa “completamente caracteristico de lo que estoy viviendo”. Resultados: De la muestra total, 96 mujeres se auto-identificaron con el diagnostico. Las caracteristicas mas comunes que definen fueron: “ansiedad”, “ expresa preocupacion por los cambios en el rol parental”, “ expresa sentimientos de frustracion”, “ expresa preocupacion sobre la familia (p. ej., funcionamiento, comunicacion, salud), “ y “temor”. Las mujeres que estaban con sus hijos con menor frecuencia durante la hospitalizacion tenian un mayor numero de caracteristicas definitorias. Conclusion: Se observo una alta prevalencia de las caracteristicas definitorias del diagnostico estudiado, lo que sugiere la relevancia del tema y la necesidad de nuevos estudios que se desarrollaran en la unidad neonatal.

Factors related to unsuccessful lactogenesis – a literature review

The objective of this literature review was to investigate the factors that may interfere in the production of breast milk (lactogenesis), making difficult the establishment of lactation and having hypogalactia as a result. Since breast milk is widely known as the most natural and important food for newborns, it is necessary for nurses to understand and acknowledge the physiological mechanisms involved in lactation in order to help mothers to achieve a successful breastfeeding. Methodology: Two computerized databases were assessed in search for articles: Literature Latin American and Caribbean Health Sciences and Medical Literature and Retrieval System On Line, both covering a 10 years (1997-2007) period. Considering the objective of the study, 21 articles were selected; other academic text-books were also consulted for supporting the development of contents and concepts on lactation physiology. Results: Factors related to failure and/or delay in lactogenesis were: placental retention; deficiency and /or resistance to prolactine; presence of ovarian cysts; breast’s structural alterations; obesity; primiparity; prolonged labor and delivery; cesarean and hypotension. Conclusion: Lactogenesis is a subject that has not been properly acknowledged by nurses, although being essential for the proper establishment of breastfeeding, which is an important issue in nursing care and research. Relevance to clinical practice: When nurses take care of women who experience difficulties on breastfeeding, it is important to consider factors that may interfere in their lactogenesis; this issue seems to be rarely discussed in nursing literature. Therefore, in order to make women’s breastfeeding experience meaningful, enjoyable and effective, nurses should improve their knowledge to investigate factors related to those difficulties and plan interventions. This review is hoped to contribute in raising some aspects that should be addressed in client’s assessment and taken into consideration on planning nursing care.

Percepção materna quanto aos filhos recém-nascidos hospitalizados

Estudo transversal e descritivo, desenvolvido em unidade neonatal de um hospital publico de ensino do estado de Sao Paulo, Brasil, em que se objetivou verificar a percepcao das maes quanto aos filhos recem-nascidos hospitalizados. A amostra foi constituida por 100 mulheres, questionadas, por meio do Inventario de Percepcao Neonatal de Broussard, sobre quanta dificuldade esperavam que os bebes da unidade, em geral, apresentassem para comportamentos como: chorar; alimentar; regurgitar ou vomitar; evacuar; dormir e estabelecer uma rotina. Em seguida, as mesmas perguntas foram repetidas sobre o proprio filho. Noventa maes consideraram os filhos com menos dificuldades que os outros bebes da unidade. As mulheres mais jovens e as maes de bebes com maiores pesos tenderam a considerar seus filhos com mais dificuldade. O Inventario e de facil aplicacao e pode ser util no processo de avaliacao da interacao mae-filho, embora seu resultado nao possa ser considerado de forma isolada.Cross-sectional descriptive study conducted in the neonatal unit of a public teaching hospital in the state of São Paulo, Brazil, which aimed to determine the perceptions of mothers about their newborns hospitalized children. The sample consisted of 100 women questioned, through the Neonatal Perception Inventory Broussard, about how much trouble was expected to be presented by babies of the general unit, on behaviors such as crying; feeding; regurgitate or vomit; evacuate; sleep and have a routine. Then, the same questions were repeated about their own babies. Ninety mothers considered their children with fewer difficulties than other babies at the unit. Younger women and mothers of infants with higher weights tended to consider their children with more difficulty. The Inventory is easy to apply and may be useful in the evaluation of mother-child interaction, although its result cannot be considered in isolation.

Prácticas de lactancia materna exclusiva reportadas por las madres y la introducción de líquidos adicionales

OBJETIVO: avaliar o conceito de aleitamento materno exclusivo para nutrizes, comparando o periodo em que consideraram realiza-lo e a idade de introducao de outros liquidos. METODO: estudo descritivo transversal, com 309 mulheres que tiveram filhos em um hospital universitario do interior de Sao Paulo, Brasil. Foi realizada analise descritiva dos dados, com cruzamento das variaveis de interesse por meio de teste nao parametrico de Kruskal-Wallis, teste quiquadrado e teste exato de Fisher. RESULTADOS: aproximadamente 30% das mulheres informaram introducao de outros liquidos antes dos seis meses de vida, enquanto afirmavam estar em aleitamento materno exclusivo. Verificou-se associacao das seguintes variaveis com a introducao precoce de liquidos: mulheres sem vinculo empregaticio (p=0,0386), mais jovens (p=0,0159) e primiparas (p= 0,003). CONCLUSAO: e possivel que o conceito de aleitamento exclusivo nao seja claro para as mulheres, pois entendem que pratica-lo significa nao dar outro tipo de leite, podendo oferecer outros liquidos. Isto mostra que a promocao do aleitamento materno deve contemplar a abordagem de crencas e valores, assegurando dialogo efetivo e compreensao junto as maes.Objetivo: evaluar el concepto de la lactancia materna exclusiva mantenido por mujeres lactantes en comparacion con el periodo de duracion de la lactancia considerado por ellas y la edad de los bebes al momento de introduccion de liquidos adicionales. Metodo: Estudio descriptivo transversal realizado con 309 mujeres que dieron a luz bebes en un hospital universitario en Sao Paulo, Brasil. Los datos fueron sometidos a analisis descriptivo; las variables de interes fueron cruzados mediante la prueba no parametrica de Kruskal-Wallis, el chi-cuadrado y la prueba exacta de Fisher. Resultados: el 30% de las mujeres reportaron haber introducido liquidos adicionales antes de que los bebes llegaran a los seis meses de edad, al mismo tiempo afirmaron haber dado lactancia materna exclusiva. Las siguientes variables se asociaron con la introduccion temprana de liquidos: la falta de empleo (p=0,0386), edad materna juvenil (p=0,0159) y el primer embarazo (p=0,003). Conclusion: el concepto de la lactancia materna exclusiva puede no ser totalmente claro para las mujeres, ya que parecen creer que significa no alimentar a los ninos con otros tipos de leche, pero que la administracion de otros liquidos se permite. Esto demuestra que la promocion de la lactancia materna deberia tomar en consideracion creencias y valores para lograr el dialogo y la comprension efectiva con las madres.Descriptores: Lactancia Materna; Ingestion de Liquidos; Conocimiento; Madres; Nutricion del Lactante; Destete.

Maternal perception regarding hospitalized newborns

Estudo transversal e descritivo, desenvolvido em unidade neonatal de um hospital publico de ensino do estado de Sao Paulo, Brasil, em que se objetivou verificar a percepcao das maes quanto aos filhos recem-nascidos hospitalizados. A amostra foi constituida por 100 mulheres, questionadas, por meio do Inventario de Percepcao Neonatal de Broussard, sobre quanta dificuldade esperavam que os bebes da unidade, em geral, apresentassem para comportamentos como: chorar; alimentar; regurgitar ou vomitar; evacuar; dormir e estabelecer uma rotina. Em seguida, as mesmas perguntas foram repetidas sobre o proprio filho. Noventa maes consideraram os filhos com menos dificuldades que os outros bebes da unidade. As mulheres mais jovens e as maes de bebes com maiores pesos tenderam a considerar seus filhos com mais dificuldade. O Inventario e de facil aplicacao e pode ser util no processo de avaliacao da interacao mae-filho, embora seu resultado nao possa ser considerado de forma isolada.Cross-sectional descriptive study conducted in the neonatal unit of a public teaching hospital in the state of São Paulo, Brazil, which aimed to determine the perceptions of mothers about their newborns hospitalized children. The sample consisted of 100 women questioned, through the Neonatal Perception Inventory Broussard, about how much trouble was expected to be presented by babies of the general unit, on behaviors such as crying; feeding; regurgitate or vomit; evacuate; sleep and have a routine. Then, the same questions were repeated about their own babies. Ninety mothers considered their children with fewer difficulties than other babies at the unit. Younger women and mothers of infants with higher weights tended to consider their children with more difficulty. The Inventory is easy to apply and may be useful in the evaluation of mother-child interaction, although its result cannot be considered in isolation.