Liana Mara Rocha Teles

Exame físico no pré-natal: construção e validação de hipermídia educativa para a Enfermagem

Objective: To describe the development and validation of an educational hypermedia for undergraduates and nurses about the technique of physical examination in the prenatal period. Methods: A development study, conducted between June and October 2010, following these steps: developing content, production of media, organization of student-tutor space, design, delivery and validation of hypermedia. Results: We developed hypertext, hyperlinks, audiovisual materials, communication spaces, assessments and support materials. The seven experts in nursing considered the consistency of the hypermedia for nursing practice and to facilitate the teaching-learning process to be fully adequate. Of the three informatics specialists, two considered the hypermedia to have fully adequate functionality. Conclusion: We constructed an educational hypermedia, validated by experts, using a variety of media resources that made it possible to optimize the teaching and learning process.OBJETIVO: Describir el proceso de desarrollo y validacion de los mass media educativos para graduandos y profesionales de enfermeria respecto a la tecnica de realizacion del examen fisico en el prenatal. METODOS: Estudio de desarrollo, realizado entre junio y octubre del 2010, siguiendo las etapas: levantamiento del contenido, produccion de los massmedia, organizacion del espacio alumno-tutor, elaboracion, disponibilizacion y validacion del hiper mass media. RESULTADOS: Fueron desarrollados hipertextos, hiperlinks, recursos audiovisuales, espacios de comunicacion, evaluaciones y material de apoyo. Los siete especialistas en enfermeria consideraron totalmente adecuada la coherencia de los mass media para la practica de enfermeria y facilitacion del proceso ensenanza-aprendizaje. De los tres especialistas en Informatica, dos consideraron totalmente adecuada la funcionalidad de la hiper mass media. CONCLUSION: Se construyo una hiper mass media, utilizando diversos recursos mediaticos que la tornan apta para optimizar el proceso ensenanza y aprendizaje y que fue validada por especialistas.

Development and validating an educational booklet for childbirth companions

Objective The article describes the steps in producing and validating an educational booklet for childbirth companions. Method Methodological study conducted in 2011 consisting of the following steps: situational assessment; establishing brochure content; content selection and referencing; drafting the text; design of illustrations; layout; consultation of specialists; consultation of target audience; amendments; proofreading; evaluation using the Flesch Reading Ease Formula. The topics portrayed the sequence of events involving support from gestation to the postpartum period. Results The concordance rate among companions was greater than or equal to 81.8% for the topics organisation, writing style, presentation and motives. The overall Content Validity Index of the booklet was 0.94. The booklet was classified as easy reading or very easy reading according to the results of the Flesch Reading Ease Formula. Conclusion The presentation and content of the manual were validated for use with the target audience by the specialists and representatives of the target audience.OBJECTIVE The article describes the steps in producing and validating an educational booklet for childbirth companions. METHOD Methodological study conducted in 2011 consisting of the following steps: situational assessment; establishing brochure content; content selection and referencing; drafting the text; design of illustrations; layout; consultation of specialists; consultation of target audience; amendments; proofreading; evaluation using the Flesch Reading Ease Formula. The topics portrayed the sequence of events involving support from gestation to the postpartum period. RESULTS The concordance rate among companions was greater than or equal to 81.8% for the topics organisation, writing style, presentation and motives. The overall Content Validity Index of the booklet was 0.94. The booklet was classified as easy reading or very easy reading according to the results of the Flesch Reading Ease Formula. CONCLUSION The presentation and content of the manual were validated for use with the target audience by the specialists and representatives of the target audience.

Tecnologias utilizadas por acompanhantes no trabalho de parto e parto: estudo descritivo

Aim: to evaluate the knowledge of companions about the use of support techniques during childbirth. Method: a descriptive, cross-sectional quantitative study undertaken at the Assis Chateaubriand Maternity Hospital with a sample of 62 companions. Data collection was undertaken from May to November 2011, through individual interviews and a survey. The Pearsons chi-square tests and Fishers exact test for statistical associations were used. Results: 59 (95.2%) of the companions who witnessed the birth did not undergo any training; 32 (51.6%) were selected at the time of entry of the pregnant women in the emergency room; emotional support activities were predominant. The experience of witnessing the birth was considered to be positive on the part of 58 (96%) of the companions. Discussion: the most common relationship between companion and the pregnant woman were mother and daughter respectively. Feelings of insecurity and fear were experienced by some of the companions. Conclusion: the companion’s presence during labor constitutes a major form of care.

Maternal deaths at a public maternity Hospital in Fortaleza: an epidemiological study

The objectives of this study were to analyze the maternal deaths, which occurred in a public maternity hospital in Fortaleza, Ceara State, Brazil and identify associations between time of death and the cases. An analysis was performed on the medical records, death certificates and notification forms regarding 96 maternal deaths that occurred between 2000 and 2008. The most prevalent delivery type was cesarean section (45, 46.8%) and the most prevalent causes of death were: hypertensive syndrome (27, 28.1%), infection (17, 17.7%) and hemorrhage (16, 16.7%). There was a statistically significant association between: cesarean section, hypertension syndrome and infection (x²=14.40, p=0.00; x²=4.02, p=0.04); deaths in the postpartum period and hypertensive syndrome (x²=6.13, p=0.01) and infection (x²=7.65, p=0.00). The characterization of these deaths helps in the recognition of groups at risk, and in developing preventive measures.O objetivo do estudo foi analisar os obitos maternos ocorridos em uma Maternidade Publica de Fortaleza-CE e identificar a existencia de associacoes entre o momento do obito e as causas do obito. Foram revisados prontuarios, declaracoes de obito e fichas de notificacao referentes aos 96 obitos maternos ocorridos entre 2000 e 2008. O tipo de parto mais prevalente foi o cesareo (45;46,8%) e as causas de obitos mais evidenciadas foram: sindrome hipertensiva (27;28,1%); infeccao (17;17,7%); e hemorragia (16;16,7%). Houve associacao estatistica significante entre: cesariana e as causas de obito sindrome hipertensiva e infeccao (x²:14,40, p:0,00; x²:4,02, p:0,04); mortes ocorridas no puerperio e sindrome hipertensiva (x²:6,13, p:0,01) e infeccao (x²:7,65, p:0,00). A caracterizacao desses obitos auxilia no reconhecimento dos grupos de risco e na elaboracao de medidas preventivas.

Óbitos maternos em uma maternidade pública de Fortaleza: um estudo epidemiológico

The objectives of this study were to analyze the maternal deaths, which occurred in a public maternity hospital in Fortaleza, Ceara State, Brazil and identify associations between time of death and the cases. An analysis was performed on the medical records, death certificates and notification forms regarding 96 maternal deaths that occurred between 2000 and 2008. The most prevalent delivery type was cesarean section (45, 46.8%) and the most prevalent causes of death were: hypertensive syndrome (27, 28.1%), infection (17, 17.7%) and hemorrhage (16, 16.7%). There was a statistically significant association between: cesarean section, hypertension syndrome and infection (x²=14.40, p=0.00; x²=4.02, p=0.04); deaths in the postpartum period and hypertensive syndrome (x²=6.13, p=0.01) and infection (x²=7.65, p=0.00). The characterization of these deaths helps in the recognition of groups at risk, and in developing preventive measures.O objetivo do estudo foi analisar os obitos maternos ocorridos em uma Maternidade Publica de Fortaleza-CE e identificar a existencia de associacoes entre o momento do obito e as causas do obito. Foram revisados prontuarios, declaracoes de obito e fichas de notificacao referentes aos 96 obitos maternos ocorridos entre 2000 e 2008. O tipo de parto mais prevalente foi o cesareo (45;46,8%) e as causas de obitos mais evidenciadas foram: sindrome hipertensiva (27;28,1%); infeccao (17;17,7%); e hemorragia (16;16,7%). Houve associacao estatistica significante entre: cesariana e as causas de obito sindrome hipertensiva e infeccao (x²:14,40, p:0,00; x²:4,02, p:0,04); mortes ocorridas no puerperio e sindrome hipertensiva (x²:6,13, p:0,01) e infeccao (x²:7,65, p:0,00). A caracterizacao desses obitos auxilia no reconhecimento dos grupos de risco e na elaboracao de medidas preventivas.

Physical examination during prenatal care: construction and validation of educational hypermedia for nursing*

Objective: To describe the development and validation of an educational hypermedia for undergraduates and nurses about the technique of physical examination in the prenatal period. Methods: A development study, conducted between June and October 2010, following these steps: developing content, production of media, organization of student-tutor space, design, delivery and validation of hypermedia. Results: We developed hypertext, hyperlinks, audiovisual materials, communication spaces, assessments and support materials. The seven experts in nursing considered the consistency of the hypermedia for nursing practice and to facilitate the teaching-learning process to be fully adequate. Of the three informatics specialists, two considered the hypermedia to have fully adequate functionality. Conclusion: We constructed an educational hypermedia, validated by experts, using a variety of media resources that made it possible to optimize the teaching and learning process.OBJETIVO: Describir el proceso de desarrollo y validacion de los mass media educativos para graduandos y profesionales de enfermeria respecto a la tecnica de realizacion del examen fisico en el prenatal. METODOS: Estudio de desarrollo, realizado entre junio y octubre del 2010, siguiendo las etapas: levantamiento del contenido, produccion de los massmedia, organizacion del espacio alumno-tutor, elaboracion, disponibilizacion y validacion del hiper mass media. RESULTADOS: Fueron desarrollados hipertextos, hiperlinks, recursos audiovisuales, espacios de comunicacion, evaluaciones y material de apoyo. Los siete especialistas en enfermeria consideraron totalmente adecuada la coherencia de los mass media para la practica de enfermeria y facilitacion del proceso ensenanza-aprendizaje. De los tres especialistas en Informatica, dos consideraron totalmente adecuada la funcionalidad de la hiper mass media. CONCLUSION: Se construyo una hiper mass media, utilizando diversos recursos mediaticos que la tornan apta para optimizar el proceso ensenanza y aprendizaje y que fue validada por especialistas.

Corrimentos vaginais em gestantes: comparacao da abordagem sindromica com exames da pratica clinica da enfermagem

This is a study for assessment of a quantitative approach in pregnant women (N=104), in which findings of vaginal infection were compared. The findings were obtained by two means, flowchart of vaginal discharge, and typical examinations in the clinical nursing practice. Data were collected from January to July 2011 through interviews and gynecological examinations. The flowchart showed no efficacy to identify candidiasis and trichomoniasis. Furthermore, it showed low sensitivity (0.0%; 50%) and positive predictive value (0.0%; 3.6%) for both infections, and low specificity for trichomoniasis (46%). The flowchart was shown to be satisfactory for bacterial vaginosis, with high sensitivity (100%), negative predictive value (100%), and accuracy (74%). We conclude that use of the flowchart should be reassessed, as it was not able to identify important infections in pregnant women. A continuous effort must be directed for development of effective tests in order to prevent the spread of infection and reduce the number of unnecessary treatments.This is a study for assessment of a quantitative approach in pregnant women (N=104), in which findings of vaginal infection were compared. The findings were obtained by two means, flowchart of vaginal discharge, and typical examinations in the clinical nursing practice. Data were collected from January to July 2011 through interviews and gynecological examinations. The flowchart showed no efficacy to identify candidiasis and trichomoniasis. Furthermore, it showed low sensitivity (0.0%; 50%) and positive predictive value (0.0%; 3.6%) for both infections, and low specificity for trichomoniasis (46%). The flowchart was shown to be satisfactory for bacterial vaginosis, with high sensitivity (100%), negative predictive value (100%), and accuracy (74%). We conclude that use of the flowchart should be reassessed, as it was not able to identify important infections in pregnant women. A continuous effort must be directed for development of effective tests in order to prevent the spread of infection and reduce the number of unnecessary treatments.

Avaliação epidemiológica da prevenção da transmissão vertical do HIV

Objective: To assess actions directed toward prevention of vertical transmission of HIV. Methods: Epidemiological and documental study with 1,364 seropositive pregnant women notified in the Notifiable Diseases Information System over ten years. Data were expressed as frequencies, and linear regression analysis was applied. The analysis was conducted by using the statistical software R, version 2.12.1. Results: The number of notified cases of seropositive pregnant women increased during the 10-year period; 41.72% of women used antiretroviral therapy in the prenatal period and 84.53% of women did prenatal care The prevalence of cesarean delivery was 63.12%; 67.01% of parturients used antiretroviral during labor and 71.48% of children started therapy within the first 24 hours of life. Conclusion: Actions directed toward prevention of vertical transmission of HIV are partly effective because less than the half of infected pregnant women used antiretroviral therapy in the prenatal period.

Eficácia de manual educativo para acompanhantes de parto: estudo piloto de ensaio clínico randomizado

ABSTRACT Objective: to evaluate the effectiveness of an educational manual in the instrumentalization of companions to provide support to the parturients and check its influence on the satisfaction of companions and women during vaginal delivery. Method: pilot study of a randomized controlled clinical trial with 65 companions and puerperal women (intervention = 21 and control = 44). The previous knowledge of the companions was evaluated at baseline. The Evaluation Form for Companions in the Delivery Room was used to measure the actions provided and the satisfaction with the experience, and the Questionnaire for Evaluation of the Experience and Satisfaction of Puerperal Women with Labor and Delivery was used to evaluate the satisfaction of women with childbirth. The Student’s t-test or Wilcoxon, chi-square or Fisher’s exact test, risk ratios and 95% confidence intervals were used. Results: the companions in the intervention group performed a greater number of support actions (7.2 vs 4.6, p: 0.001) and had higher satisfaction scores (72.4 vs 64.2; p = 0.00). Puerperal women in the intervention group had higher satisfaction with childbirth (119.6 vs 107.9; p: 0.000). Conclusion: the manual was effective for the instrumentalization of companions, contributed to support actions to the parturients and had repercussions on the satisfaction of companions and women with the birthing process. RBR-776d9sObjetivo: avaliar a eficacia de um manual educativo na instrumentalizacao do acompanhante para prestar apoio a parturiente e verificar a sua influencia na satisfacao do acompanhante e da mulher com o processo de parto vaginal. Metodo: piloto de ensaio clinico controlado randomizado com 65 acompanhantes e puerperas (intervencao=21 e controle=44). O conhecimento previo dos acompanhantes foi avaliado em linha de base. Utilizou-se o Formulario de Avaliacao do Acompanhante em Sala de Parto para mensurar as acoes prestadas e a satisfacao com a experiencia e o Questionario de Experiencia e Satisfacao com o Parto para avaliar a satisfacao da puerpera com este. Foram utilizados os testes t de Student ou Wilcoxon, Qui-quadrado ou exato de Fisher, razoes de risco e intervalos de confianca a 95%. Resultados: acompanhantes do grupo intervencao realizaram maior numero de acoes de apoio (7,2 vs 4,6; p:0,001) e tiveram escores mais altos de satisfacao com o parto (72,4 vs 64,2; p:0,00). Puerperas do grupo intervencao tiveram maior satisfacao com o parto (119,6 vs 107,9; p:0,000). Conclusao: o manual foi eficaz na instrumentalizacao do acompanhante, contribuiu para acoes de apoio a parturiente e repercutiu na satisfacao do acompanhante e da mulher com o processo de parto. RBR-776d9s

Exclusive Breastfeeding: Guidance In The Process Of Communication Between Nursing Staff And Recent Mothers

Objective: To identify the guidelines offered and the respective communication techniques used by Nursing staff for the practice of exclusive breastfeeding, during the establishment of the communication with recent mothers. Method: Descriptive study with a qualitative approach, between March and December 2012, in a reference Hospital of Fortaleza, with eleven Nursing professionals. Results: Most Nursing professionals of the study focused their guidelines on the importance of maintaining the practice of exclusive breastfeeding up to the first six months of the childs life, highlighting the benefits for the baby, mom and the family, and in the clinical management of breastfeeding. Conclusions: By using the techniques of communication, Nursing professionals have demonstrated to be in tune with recent mothers when promoting their participation in the breastfeeding process, instructing them and offering encouragement. However, the social and emotional aspects that permeate the practice of breastfeeding were not mentioned by the Nursing staff.