Luciana Olga Bercini

Mortalidade neonatal de residentes em localidade urbana da região sul do Brasil

Caracterizou-se a mortalidade neonatal de residentes em Maringa -Parana, no ano de 1990, segundo algumas variaveis. O material de estudo constituiu-se de 87 obitos. Foram utilizadas informacoes retiradas das declaracoes de obito, dos prontuarios hospitalares, das entrevistas domiciliares, dos prontuarios dos nucleos integrados de saude e dos laudos de necropsia. O coeficiente de mortalidade neonatal foi de 19,4 por 1.000 nascidos vivos. A maioria dos obitos ocorreu na primeira semana de vida (92,0%), em recem-nascidos com menos de 37 semanas de gestacao (79,8%), em criancas com baixo peso ao nascer (74,1%), em recem-nascidos do sexo masculino (56,3%) e em criancas nascidas atraves de cesariana (54,2%). As causas basicas de obito foram codificadas de acordo com a Classificacao Internacional das Doencas - 9a revisao. As Causas perinatais juntamente com as Anomalias congenitas responderam por 94,0% dos obitos neonatais. As Causas perinatais foram responsaveis por 83,2% dos obitos neonatais, onde a prematuridade ocupou o primeiro lugar, causando 15,8% das mortes. Constatou-se, tambem, que a prematuridade foi a causa associada mais frequente dos obitos de recem-nascidos (59,0%).

Presença da família nas unidades de terapia intensiva pediátrica e neonatal: visão da equipe multidisciplinar

Resumen O presente estudo tem por objetivo compreender a visao da equipe multidisciplinar quanto a presenca da familia nas Unidades de Terapia Intensiva (UTI) pediatrica e neonatal. A pesquisa teve como eixo norteador a abordagem qualitativa. Para a analise e interpretacao dos dados, optou-se pela analise de conteudo. Os dados foram coletados em junho de 2006, por meio de entrevista semi-estruturada junto a 25 profissionais atuantes nas UTI pediatrica e neonatal de dois hospitais na regiao noroeste do Estado do Parana. Do discurso destes profissionais, desvelou-se o conflito intimo vivenciado por cada um com relacao a presenca da familia nas unidades. Conclui-se que o primeiro passo para a mudanca e melhor aceitacao dos familiares dentro da UTI e sensibilizar os profissionais quanto a impor tância da presenca da familia para a crianca em momentos de crise, como na hospitalizacao. The present study has the aim to understand the view of a multidisciplinary team as for the presence of family in the Units of Pediatric and Neonatal Intensive Care (ICU). The research has had as a guide axis the qualitative approach. For the analysis and data interpretation, it has been opted for the content analysis. Data were collected in June of 2006, through a semi-structured interview with 25 professionals in action at the pediatric and neonatal Intensive Care Unit of two hospitals in the northwest area of Parana State. From the statements of these professionals, the intimate conflict was revealed, lived by each one, regarding the presence of the family in the units. The first step for behavioral changing and better acceptance of parents in the ICU is sensitizing the professionals for the importance of the family into the childs life in moments of crisis, as well as in the hospitalization.

Early contact and breastfeeding: meanings and experiences

The aim of this study was to analyze the meanings and experiences of early contact and breastfeeding of the postpartum women admitted at a Baby-Friendly Hospital. It is a descriptive, exploratory study, with qualitative approach, that was developed in a teaching hospital in the Northwest of Parana state between November 2011 and January 2012, involving the participation of 16 postpartum women. Data were collected by means of non-participant systematic observation of the childbirths and semi-structured interview. The data collected were analyzed using the thematic content analysis. The results revealed that, soon after childbirth, the child-mother binomial provided the woman with a unique experience, triggering various sensations into the bio-psycho-social-cultural context of each one of the mothers, with feelings and meanings that favored the mother-child bond and the outset of breastfeeding. DESCRIPTORS: Mother-child relations. Breast feeding. Humanization of assistance. Nursing.Resumen pt: O estudo tem como objetivo analisar os significados e as vivencias do contato e da amamentacao precoces de puerperas internadas em um Hospital Amigo da C...

Bebê de risco: acompanhando o crescimento infantil no primeiro ano de vida

Objective: To monitor the growth of high-risk babies in the first year of life. Methods: Analytical, cohort study, conducted with 237 babies born in Maringa - PR, between May 1 to October 31, 2008, under the Program for the Surveillance of At-Risk Infants. Results: Growth changes were present in 188 (79.3%) infants and occurred mainly after the first trimester of life. A slower than expected growth rate showed statistical association with maternal age of less than 18 years, education of less than 8 years, presence of congenital anomalies, and birth weight greater than or equal to 2,500g born at term. Conclusion: The evaluation of growth in at-risk infants should include a multidimensional analysis, considering the biological and maturational aspects of each specific risk condition, and adaptation of the baby and his/her family on this evolutionary path.

Uso de chupeta e aleitamento materno exclusivo

Estudo quantitativo cujos objetivos foram comparar o tempo de Aleitamento Materno Exclusivo (AME) entre os grupos de idade de inicio do uso da chupeta e verificar a presenca de associacao entre o uso da chupeta e a interrupcao precoce do AME. A amostra foi de 362 criancas cujas maes realizaram o pre-natal na atencao basica de saude de Maringa, 2009. Utilizaram-se a analise ANOVA nao parametrica de Kruskal-Wallis, qui-quadrado e razao de chances. Mais da metade das criancas nao fazia uso de chupeta; entre as que usavam, em 26,51% dos casos, ela foi introduzida no primeiro mes. Nao foi encontrada diferenca significativa entre o tempo de AME e as faixas de idade de inicio do uso da chupeta; no entanto, encontrou-se significância entre o grupo de criancas que nao usaram chupeta com os demais grupos (p<0,05). Houve associacao significativa entre o uso da chupeta e o desmame precoce (p<0,05; OR=3,2).

The practice of the fourth step of the baby friendly hospital initiative

Objective: Analyze the factors involved in the practice of the fourth step of the Baby Friendly Hospital Initiative, from the experience of postpartum women admitted to a Baby Friendly Hospital. Methods: This is a descriptive, exploratory study, in which a qualitative approach was used. Data was collected from November 2011 to January 2012, through systematic observation of non-participating deliveries and semi-structured interviews with 16 subjects. For the data treatment, the thematic modality content analysis was applied. Results: The main obstacles to the realization of the fourth step were the priority given to routine care after birth, cesarean delivery and the different work process promoted by the determinations of the Baby Friendly Hospital Initiative. Conclusion: We conclude that reflection upon, and (re)construction of, knowledge and practices concerning this step are necessary.Objective: Analyze the factors involved in the practice of the fourth step of the Baby Friendly Hospital Initiative, from the experience of postpartum women admitted to a Baby Friendly Hospital. Methods: This is a descriptive, exploratory study, in which a qualitative approach was used. Data was collected from November 2011 to January 2012, through systematic observation of non-participating deliveries and semi-structured interviews with 16 subjects. For the data treatment, the thematic modality content analysis was applied. Results: The main obstacles to the realization of the fourth step were the priority given to routine care after birth, cesarean delivery and the different work process promoted by the determinations of the Baby Friendly Hospital Initiative. Conclusion: We conclude that reflection upon, and (re)construction of, knowledge and practices concerning this step are necessary.Objetivo: Analizar los factores implicados en la practica de la cuarta etapa de la Iniciativa Hospital Amigo del Nino a partir de la experiencia de las puerperas internadas. Metodos: Se trata de un estudio descriptivo, exploratorio, con abordaje cualitativo. La recoleccion de datos fue realizada de noviembre de 2011 a enero de 2012, por medio de la observacion sistematica no participante de los partos, apuntes de diario de campo y entrevista semiestructurada con 16 sujetos. Para el tratamiento de los datos, fue aplicado el analisis de contenido modalidad tematica. Resultados: Los principales obstaculos para la realizacion del cuarto paso fueron la prioridad dada a los cuidados de rutina tras el nacimiento, el parto por cesarea y el proceso de trabajo dispar de las determinaciones de la Iniciativa Hospital Amigo del Nino. Conclusion: Se concluye que es necesaria la (re)construccion y reflexion de saberes y practicas acerca de esa etapa.

Early contact and breastfeeding in a baby friendly hospital

Aim: To analyze the experiences and meanings of early contact and breastfeeding of women, housed in a Baby Friendly Hospital, and the factors involved in these practices. Method: This was a descriptive, exploratory study in which we used a qualitative approach, conducted between November 2011 and January 2012, with 16 subjects. The data was submitted to content analysis and thematic modality. Results: The approximation, between mother and child shortly after birth, provided a unique experience for women; with feelings and meanings favorable to mother-child bonding and the initiation of breastfeeding. The main obstacles, to the realization of the early contact and breastfeeding, were: the priority given to routine care after birth and the caesarean delivery. Conclusion: In order to consolidate the fourth step, of the Baby Friendly Hospital Initiative, it was necessary to go beyond a purely technical approach; the approach ought to take into account the socio-cultural characteristics of patients; professionals; institutions; and society

Use of pacifier and exclusive breastfeeding

Estudo quantitativo cujos objetivos foram comparar o tempo de Aleitamento Materno Exclusivo (AME) entre os grupos de idade de inicio do uso da chupeta e verificar a presenca de associacao entre o uso da chupeta e a interrupcao precoce do AME. A amostra foi de 362 criancas cujas maes realizaram o pre-natal na atencao basica de saude de Maringa, 2009. Utilizaram-se a analise ANOVA nao parametrica de Kruskal-Wallis, qui-quadrado e razao de chances. Mais da metade das criancas nao fazia uso de chupeta; entre as que usavam, em 26,51% dos casos, ela foi introduzida no primeiro mes. Nao foi encontrada diferenca significativa entre o tempo de AME e as faixas de idade de inicio do uso da chupeta; no entanto, encontrou-se significância entre o grupo de criancas que nao usaram chupeta com os demais grupos (p<0,05). Houve associacao significativa entre o uso da chupeta e o desmame precoce (p<0,05; OR=3,2).

Child, family and multidisciplinary team: intersections care - an exploratory study

Objetivos: caracterizar as necessidades dos educadores e dos profissionais de saude de Centro de Educacao Infantil sobre conhecimentos acerca da saude infantil; desvelar suas percepcoes acerca do trabalho multidisciplinar desenvolvido e relacionar estrategias para otimizar esse trabalho. Metodo: estudo qualitativo exploratorio, realizado com nove educadores e tres profissionais da saude. Os dados foram coletados nos meses de abril e maio de 2011 atraves de entrevistas semi-estruturadas e analisados por meio da analise de conteudo. Resultados: tres categorias: A importância do conhecimento em relacao ao cuidado infantil na creche – visao dos educadores infantis; A necessidade de uma rotina de comunicacao e atendimento integrado; Percebendo a necessidade de conhecimento e renovacao. Discussao: os resultados indicam que todos os profissionais percebem a importância do trabalho interdisciplinar e de uma comunicacao efetiva, bem como, apresentam a necessidade de um maior conhecimento acerca da saude da crianca, advindo de atualizacoes e de educacao continuada.

At-risk infants: monitoring children's growth in the first year of life

Objective: To monitor the growth of high-risk babies in the first year of life. Methods: Analytical, cohort study, conducted with 237 babies born in Maringa - PR, between May 1 to October 31, 2008, under the Program for the Surveillance of At-Risk Infants. Results: Growth changes were present in 188 (79.3%) infants and occurred mainly after the first trimester of life. A slower than expected growth rate showed statistical association with maternal age of less than 18 years, education of less than 8 years, presence of congenital anomalies, and birth weight greater than or equal to 2,500g born at term. Conclusion: The evaluation of growth in at-risk infants should include a multidimensional analysis, considering the biological and maturational aspects of each specific risk condition, and adaptation of the baby and his/her family on this evolutionary path.