Luiza Akiko Komura Hoga

A dimensão subjetiva do profissional na humanização da assistência à saúde: uma reflexão

This article reflects upon the humanization of health care, the demand for which is growing. It involves several complex and interdependent dimensions. The professionals subjective perspective and the interpersonal relationship are discussed and shown to be important factors in the humanization of health care. The necessity of professionals self-awareness and the awareness of their defenses are emphasized since they are considered to be important for the creation of an real encounter between professionals and patients. These topics are essential for the humanization and promotion of health care.This article reflects upon the humanization of health care, the demand for which is growing. It involves several complex and interdependent dimensions. The professionals subjective perspective and the interpersonal relationship are discussed and shown to be important factors in the humanization of health care. The necessity of professionals self-awareness and the awareness of their defenses are emphasized since they are considered to be important for the creation of an real encounter between professionals and patients. These topics are essential for the humanization and promotion of health care.This article reflects upon the humanization of health care, the demand for which is growing. It involves several complex and interdependent dimensions. The professionals subjective perspective and the interpersonal relationship are discussed and shown to be important factors in the humanization of health care. The necessity of professionals self-awareness and the awareness of their defenses are emphasized since they are considered to be important for the creation of an real encounter between professionals and patients. These topics are essential for the humanization and promotion of health care.

Sexuality and quality of life of breast cancer patients post mastectomy

AIM To evaluate the sexual functioning of breast cancer patients post mastectomy and its association with their quality of life, the personal characteristics of women and their partners, breast reconstruction, cancer staging and adjuvant therapies. METHODS A cross-sectional study was carried out in a University hospital located in the SouthEast of Brazil. A total of 100 women were included in the study. The parameters evaluated were sexual functioning, which was assessed based on the Sexual Quotient - Female Version (SQ-F), quality of life (QoL), evaluated by the Medical Outcomes Study 36-item Short Form (SF-36), cancer staging, breast reconstruction, adjuvant therapies and the personal characteristics of patients (age, years of study and years of marriage) and their partners (age, years of study). RESULTS The majority (40.48%) of women had an unfavorable to regular SQ-F score. A significant positive correlation (p<0.05) was found between the SQ-F score and years of education (p=0.03), and the following SF-36 domains: functional capacity (p=0.03), vitality (p=0.06), emotional limitations (p=0.00) and mental health (p=0.03). A significant negative correlation was found between SQ-F score and the age of the partners (p=0.03). SQ-F mean value was significantly higher (p=0.04) among women who underwent breast reconstruction. CONCLUSIONS Women with low educational level, who have older partners, and who did not have a breast reconstruction should receive special attention with respect to their sexuality, and the effects of mastectomy on the sexuality of patients should be assessed. Oncology nurses are best qualified to recognize issues related to sexuality and quality of life, and can offer specific and meaningful support for breast cancer patients.

Integrative Review: Concepts And Methods Used In Nursing

Resumen 
La Revision Integradora (RI) tiene una reputacion internacional en la investigacion en enfermeria y en la practica basada en la evidencia. Esta RI tuvo como objetivo identificar y analizar los conceptos y los metodos indicados para la realizacion de una RI en enfermeria. Fueron consultados nueve recursos de informacion y fuentes de literatura gris. Se incluyeron diecisiete estudios de RI. Los resultados indican que: la mayoria de los estudios primarios fueron realizados en EE.UU.; es posible tener varias preguntas de investigacion o hipotesis e incluir estudios primarios de diferentes perspectivas teoricas y metodologias; es un tipo de analisis que puede ir mas alla de la sintesis de las conclusiones de los estudios primarios, permitiendo abarcar otras dimensiones de la investigacion y finalmente presenta potencial para el desarrollo de nuevas teorias y problemas de investigacion. En conclusion, la RI es comprendida como un tipo de revision de naturaleza compleja que demanda metodos normalizados y sistematicos para garantizar el rigor requerido en la investigacion cientifica y por lo tanto la legitimidad de las evidencias establecidas.UNLABELLED Integrative review (IR) has an international reputation in nursing research and evidence-based practice. This IR aimed at identifying and analyzing the concepts and methods recommended to undertaking IR in nursing. Nine information resources,including electronic databases and grey literature were searched. Seventeen studies were included. The results indicate that: primary studies were mostly from USA; it is possible to have several research questions or hypotheses and include primary studies in the review from different theoretical and methodological approaches; it is a type of review that can go beyond the analysis and synthesis of findings from primary studies allowing exploiting other research dimensions, and that presents potentialities for the development of new theories and new problems for research. CONCLUSION IR is understood as a very complex type of review and it is expected to be developed using standardized and systematic methods to ensure the required rigor of scientific research and therefore the legitimacy of the established evidence.

Adolescent maternity in a low income community: experiences revealed by oral history

Adolescent maternity involves relevant factors associated with each family, culture and society. This research aimed to describe the experiences in the trajectory of adolescent maternity. The oral history method was used, obtaining the narratives of 21 adolescent mothers living in a low income community located in São Paulo City, Brazil. The following descriptive categories emerged from the narratives: Pregnancy: an event in the initial phase of the relationship; Insufficient knowledge and access to contraceptives, gender inferiority and Gods will: the ways to look at pregnancy; To escape from family problems and define the life course: the personal meanings attributed to pregnancy; More gain than pain: the balance of adolescent maternity. Adolescent maternity in low income contexts involves very complex factors and requires an integral, integrated, personal and family centered care.La maternidad en la adolescencia esta relacionada a factores asociados con la familia, cultura y sociedad.El objetivo de esta investigacion fue describir experiencias durante la maternidad en la adolescencia. El metodode historia oral fue realizado, recolectando las narrativas de 21 madres adolescentes que viven en una comunidadde bajos ingresos, ubicada en la Ciudad de Sao Paulo, Brasil. Las categorias descriptivas fueron: Embarazo:consecuencia de una fase temprana en la relacion; Conocimiento y acceso insuficientes sobre anticonceptivos,inferioridad relacionada al genero y el sentir necesidad de Dios: significados personales sobre el embarazo;Escapar de los problemas familiares y definir su vida: los significados personales atribuidos al embarazo;Mayores beneficios que perdidas: evaluando la maternidad en la adolescencia. La maternidad en la adolescenciaen un contexto de pobreza involucra varios factores complejos; necesitando de cuidado integral e integrado,centrada en la persona y familia.DESCRIPTORES: embarazo en adolescencia; condiciones sociales; asistencia a la salud; cultura

Adult male involvement in reproductive health: an ethnographic study in a community of São Paulo City, Brazil.

The purpose of this research was to explore the involvement in reproductive health of adult men in a low-income community in São Paulo City, Brazil. The ethnonursing research method was used and data were collected through interviews with seven key and eight general informants. Lack of common sex education was found and informants’ knowledge depended on their own families’ involvement and individual life experience with machismo. Informants’ behaviors and attitudes toward women were constructed by their own male-centered values. Leininger’s culture care modes were used to explain culturally meaningful nursing care actions and decisions.

Pesquisa etnográfica em enfermagem

: This article makes an deals with ethnographic research in nursing. It discusses the goal and the relevance of this kind of research the professional context. It includes also issues related to rigor and ethics. It points out basic aspects of participant-observation and ethnographic interview methods, and makes an overview of data collection, analysis and utilization of this data for culture description.Este artigo faz uma abordagem da pesquisa etnografica em enfermagem. Discute sobre a finalidade e a relevância deste tipo de pesquisa no contexto da profissao. Abrange tambem questoes relativas ao rigor metodologico e a etica. Faz um delineamento sobre o metodo da observacao participante e a entrevista, tecendo consideracoes sobre a coleta, analise e utilizacao dos dados para a descricao da cultura.

Razões e reflexos da gravidez na adolescência: narrativas dos membros da família

Resumen El embarazo de la adolescencia constituye un problema de salud pública emergente en numerosos países. Este ar tículo describe las causas que propician el embarazo en la adolescencia y el reflejo que tiene en la familia bejo la perspectiva de sus miembros. El método de investigación utilizado fue el análisis narrativo. Fueron entrevistadas 19 personas que vivenciaron la experiencia del embarazo durante la adolescencia dentro del contexto familiar. A partir de los relatos surgieron las categorías descriptivas: a) Las causas del embarazo en la adolescencia, b) Los reflejos del embarazo sobre la familia y la vida de las adolescentes. El embarazo en la adolescencia provocó impacto en la dinámica familiar y y las características dependieron de las creencias y de los valores que prevalecían en cada familia. . Los profesionales deben obtener datos sistematizados relacionados con cada familia para ofrecer asistencia adecuada de acuerdo con las demandas que son particulares a cada uno de ellos. Palavras Clave: Embarazo en Adolescencia. Familia. Prestación de Atención de Salud. 1Livre-docente em Enfermagem. Professora Associada do Depar tamento de Enfermagem Materno-Infantil da Escola de Enfermagem da Universidade de São Paulo (EEUSP). Brasil. E-mail: kikatuca@usp.br, 2Doutora em Saúde Pública. Professora do Departamento de Enfermagem em Saúde Coletiva da Escola de Enfermagem da Universidade de São Paulo (EEUSP). Brasil. E-mail: alvilela@usp.br , 3Mestre em Enfermagem. Aluna de Doutorado da Escola de Enfermagem da USP. Bolsista CAPES. Brasil. E-mail: lureber te@usp.br PESQUISA RESEARCH INVESTIGACIÓN Adolescent pregnancy is a growing public health problem that affects several countries. This ar ticle describes the factors that contribute to teenage pregnancy and the impact it has on the family from the point of view of the family members. The present research applied the qualitative approach and was developed using the method of narrative analysis to interview 19 individuals who experienced pregnancy during adolescence in a family context. Two descriptive categories emerged from these testimonies. a) The factors that contribute to adolescent pregnancy b) Consequences of pregnancy on the family and impact on the life of the adolescent. Pregnancy during adolescence has an impact on the family dynamics, and its characteristics can vary depending on the beliefs and values that exist in each family. Systematized data associated to this problem should be obtained in order to provide adequate attention to the demands of adolescents and their family membersAdolescent pregnancy is a growing public health problem that affects several countries. This article describes the factors that contribute to teenage pregnancy and the impact it has on the family - from the point of view of the family members. The present research applied the qualitative approach and was developed using the method of narrative analysis to interview 19 individuals who experienced pregnancy during adolescence in a family context. Two descriptive categories emerged from these testimonies. a) The factors that contribute to adolescent pregnancy b) Consequences of pregnancy on the family and impact on the life of the adolescent. Pregnancy during adolescence has an impact on the family dynamics, and its characteristics can vary depending on the beliefs and values that exist in each family. Systematized data associated to this problem should be obtained in order to provide adequate attention to the demands of adolescents and their family membersAbstract Resumen El embarazo de la adolescencia constituye un problema desalud publica emergente en numerosos paises. Este articulodescribe las causas que propician el embarazo en laadolescencia y el reflejo que tiene en la familia bejo la perspectivade sus miembros. El metodo de investigacion utilizado fue elanalisis narrativo. Fueron entrevistadas 19 personas quevivenciaron la experiencia del embarazo durante laadolescencia dentro del contexto familiar. A partir de losrelatos surgieron las categorias descriptivas: a) Las causasdel embarazo en la adolescencia, b) Los reflejos del embarazosobre la familia y la vida de las adolescentes. El embarazo enla adolescencia provoco impacto en la dinamica familiar y y lascaracteristicas dependieron de las creencias y de los valoresque prevalecian en cada familia. . Los profesionales debenobtener datos sistematizados relacionados con cada familiapara ofrecer asistencia adecuada de acuerdo con las demandasque son particulares a cada uno de ellos.Palavras ClavePalavras Clave: Embarazo en Adolescencia. Familia.Prestacion de Atencion de Salud.

Práticas contraceptivas entre jovens universitários: o uso da anticoncepção de emergência

This study investigated contraceptive practices and especially the use of emergency contraception by 487 young students at a public university in São Paulo State. A structured questionnaire was sent by e-mail and completed online in December 2007. Contraceptive methods and use of emergency contraception were investigated. Female and male students reported a high proportion of contraceptive use, mainly condoms and the pill. Half of the students had already used emergency contraception, often when already using some other highly effective method. Among female students, multiple regression analysis showed that current age, age at sexual initiation, not having used condoms in sexual relations, condom failure, and knowing someone that has used emergency contraception were associated with use of the latter. The option for emergency contraception proved to be more closely related to inconsistencies in the use of regular methods than to lack of their use, and can thus be considered a marker for discontinuity in regular contraception.

Maternidade na adolescência em uma comunidade de baixa renda: experiências reveladas pela história oral

Adolescent maternity involves relevant factors associated with each family, culture and society. This research aimed to describe the experiences in the trajectory of adolescent maternity. The oral history method was used, obtaining the narratives of 21 adolescent mothers living in a low income community located in São Paulo City, Brazil. The following descriptive categories emerged from the narratives: Pregnancy: an event in the initial phase of the relationship; Insufficient knowledge and access to contraceptives, gender inferiority and Gods will: the ways to look at pregnancy; To escape from family problems and define the life course: the personal meanings attributed to pregnancy; More gain than pain: the balance of adolescent maternity. Adolescent maternity in low income contexts involves very complex factors and requires an integral, integrated, personal and family centered care.La maternidad en la adolescencia esta relacionada a factores asociados con la familia, cultura y sociedad.El objetivo de esta investigacion fue describir experiencias durante la maternidad en la adolescencia. El metodode historia oral fue realizado, recolectando las narrativas de 21 madres adolescentes que viven en una comunidadde bajos ingresos, ubicada en la Ciudad de Sao Paulo, Brasil. Las categorias descriptivas fueron: Embarazo:consecuencia de una fase temprana en la relacion; Conocimiento y acceso insuficientes sobre anticonceptivos,inferioridad relacionada al genero y el sentir necesidad de Dios: significados personales sobre el embarazo;Escapar de los problemas familiares y definir su vida: los significados personales atribuidos al embarazo;Mayores beneficios que perdidas: evaluando la maternidad en la adolescencia. La maternidad en la adolescenciaen un contexto de pobreza involucra varios factores complejos; necesitando de cuidado integral e integrado,centrada en la persona y familia.DESCRIPTORES: embarazo en adolescencia; condiciones sociales; asistencia a la salud; cultura

Gravidez na adolescência: valores e reações dos membros da família

Objective: To describe the experience of 19 family members regarding teen pregnancy. Methods: This was a qualitative study using narrative analysis approach. Results: Three categories emerged: a) family values and sexual orientations given; b) receiving the pregnancy news and arrangements made; and, c) providing support tot eh pregnant teen. Conclusions: Teen pregnancy happened in a solid family organization context and the trajectory of teenager mothers after childbirth was characterized by family bonding and social network support. The new mother received material and psychoemotional support from her family members.