Maria de Lourdes Costa da Silva

Domestic maternal experience with preterm newborn children

OBJECTIVE Exploring maternal experience with premature newborn children in a domestic environment. METHODS The study was qualitative and used focus group interviews with 24 women who had had preterm deliveries in a public maternity hospital located in Northeast Brazil during June and October 2005. The mothers returned to the hospital facility at least 30 days after the newborn were discharged to share their experiences in caring for a premature infant at home. RESULTS Interview data was analysed for content, four thematic nuclei being identified: hospital discharge, preparing the family for discharge, caring for a premature baby at home and life changes arising from the premature birth. The greatest difficulties reported by the mothers in caring for their premature children at home were related to feeding and feelings of insecurity and fear were expressed which showed the need for a support network for the families following discharge. CONCLUSIONS The mothers care of premature infants at home represented changes for parents in everyday family life, work and social life, thus showing the need for a support network for them during the transition from hospital to home when considering premature children.Objective Exploring maternal experience with premature newborn children in a domestic environment.

Representações de mães sobre hospitalização do filho prematuro

Qualitative study aimed at knowing the representations of mothers about the hospitalization of their premature son in a Neonatal Intensive Care Unit (NICU). The sample was composed of eighteen mothers of premature newborns hospitalized in a school hospital in Natal, Brazil. A semi-structured interview was used and data analysis showed that hospitalization of a child is represented by the mothers as meanings, feelings, difficulties and uncertainties. It is considered that prematurity represents a maternal challenge from the moment of the premature birth, proceeding with disturbances inherent to hospitalization. These require awareness, listening and dialogue on the part of health professionals in an effective manner in order to strengthen maternal adaptation to prematurity.Estudo qualitativo que objetivou conhecer as representacoes de maes sobre a hospitalizacao do filho prematuro na Unidade de Terapia Intensiva Neonatal (UTIN). Inclui dezoito maes de prematuros internados na UTIN de um hospital escola em Natal (RN). Utilizou-se a entrevista semi-estruturada e na analise dos dados evidenciou-se que a hospitalizacao do filho e representada pelas maes por significados, sentimentos, dificuldades e incertezas. Considera-se que a prematuridade representa um desafio materno desde o momento da constatacao do parto pre-termo, prosseguindo com os percalcos inerentes a hospitalizacao e requer conhecimento, escuta e dialogo dos profissionais de saude de forma efetiva para fortalecimento da adequacao materna a prematuridade.

Nursing diagnoses of newborns with sepsis in a Neonatal Intensive Care Unit

OBJETIVOS: elaborar los Diagnosticos de Enfermeria de recien nacidos con sepsis en una unidad neonatal y caracterizar el perfil de los neonatos y de las madres. METODO: se trata de un estudio transversal y cuantitativo; la muestra fue constituida por 41 neonatos. Se realizaron examenes fisicos y se consultaron las ficha medicas utilizando un instrumento apropiado. La elaboracion de los Diagnosticos de Enfermeria siguio un proceso de inferencia diagnostica y se baso en la North American Nursing Diagnosis Association 2012-2014. RESULTADOS: las madres tenian cerca de 25 anos, un promedio bajo de consultas prenatal y varias complicaciones en el embarazo; los recien nacidos fueron predominantemente prematuros y de muy bajo peso al nacer. Cinco Diagnosticos de Enfermeria fueron preponderantes y todos los neonatos presentaron Riesgo de choque septico y Riesgo de desequilibrio del volumen de liquidos. CONCLUSION: los Diagnosticos de Enfermeria de neonatos con sepsis pueden orientar la formulacion de planes asistenciales especificos. El estudio contribuye con la generacion de nuevos conocimientos y encontro varias relaciones entre los Diagnosticos de Enfermeria y las variables seleccionadas en la caracterizacion de los neonatos que merecen ser elucidadas con mas detalles a partir de nuevas investigaciones sobre el temaObjectives to elaborate the Nursing Diagnoses of newborns with sepsis in a neonatal intensive care unit and characterize the profile of the neonates and their mothers. Method a cross-sectional and quantitative study, with a sample of 41 neonates. A physical examination and consultation of the hospital records were undertaken, using an instrument. The elaboration of the Nursing Diagnoses followed a process of diagnostic inference and was based on the North American Nursing Diagnosis Association 2012-2014. Results the mothers were around 25 years old, had a low average number of pre-natal consultations, and various complications during the pregnancy; and the newborns were predominantly premature and with very low birth weights. Five Nursing Diagnoses predominated, and all the neonates presented Risk of Shock and Risk of fluid volume imbalance. Conclusion the Nursing Diagnoses of the neonates with sepsis can guide the formulating of specific assistential plans. The study contributes to the generation of new knowledge and found various relationships between the Nursing Diagnoses and the variables selected in the characterization of the neonates, which deserve to be elucidated in greater detail based on further research on the issue.

Women with cardiovascular risk after preeclampsia: is there follow-up within the Unified Health System in Brazil?

OBJETIVOS: identificar mulheres com risco cardiovascular, cinco anos apos a pre-eclâmpsia, e averiguar o seguimento dessas mulheres no Sistema Unico de Saude, em Natal, Rio Grande do Norte. METODOS: estudo exploratorio, quantitativo, realizado na Maternidade Escola Januario Cicco, em Natal. A amostra foi de 130 mulheres, 65 com pre-eclâmpsia e 65 normotensas. RESULTADOS: constatou-se diferenca estatistica significativa no que se refere ao indice de massa corporea, peso, historico familiar de doencas cardiovasculares e complicacao cardiovascular entre as mulheres com pre-eclâmpsia previa e as normotensas. Os grupos desconheciam os fatores de risco cardiovasculares e, alem disso, referiam dificuldades de acesso aos servicos de atencao primaria. CONCLUSOES: as mulheres com historico de pre-eclâmpsia possuiam risco aumentado de desenvolver doencas cardiovasculares, desconheciam as complicacoes tardias dessa doenca e nao recebiam seguimento ambulatorial diferenciado em relacao as normotensas.Objectives to identify women with cardiovascular risk, five years after a preeclampsic episode (PE), and identify the follow-up of these women within the Unified Health System (Sistema Único de Saúde - SUS), in the city of Natal/RN. Methods a quantitative and exploratory study conducted at the Januário Cicco University Maternity Ward/RN. The sample consisted of 130 women, 65 with a PE episode and 65 who were normotensive. Results we found statistical significance with regard to body mass index, weight, family history of cardiovascular disease (CVD) and cardiovascular complications when comparing women with previous PE to normotensive women. The groups were unaware of their cardiovascular risk factors and, in addition, they reported difficulties in accessing primary health care (PHC) services. Conclusions women with a PE history are at increased risk of developing CVD, unaware of late PE complications, and lacked customized care when compared to normotensive patients.

Diagnósticos de enfermagem de recém-nascidos com sepse em uma Unidade de Terapia Intensiva Neonatal

OBJETIVOS: elaborar los Diagnosticos de Enfermeria de recien nacidos con sepsis en una unidad neonatal y caracterizar el perfil de los neonatos y de las madres. METODO: se trata de un estudio transversal y cuantitativo; la muestra fue constituida por 41 neonatos. Se realizaron examenes fisicos y se consultaron las ficha medicas utilizando un instrumento apropiado. La elaboracion de los Diagnosticos de Enfermeria siguio un proceso de inferencia diagnostica y se baso en la North American Nursing Diagnosis Association 2012-2014. RESULTADOS: las madres tenian cerca de 25 anos, un promedio bajo de consultas prenatal y varias complicaciones en el embarazo; los recien nacidos fueron predominantemente prematuros y de muy bajo peso al nacer. Cinco Diagnosticos de Enfermeria fueron preponderantes y todos los neonatos presentaron Riesgo de choque septico y Riesgo de desequilibrio del volumen de liquidos. CONCLUSION: los Diagnosticos de Enfermeria de neonatos con sepsis pueden orientar la formulacion de planes asistenciales especificos. El estudio contribuye con la generacion de nuevos conocimientos y encontro varias relaciones entre los Diagnosticos de Enfermeria y las variables seleccionadas en la caracterizacion de los neonatos que merecen ser elucidadas con mas detalles a partir de nuevas investigaciones sobre el temaObjectives to elaborate the Nursing Diagnoses of newborns with sepsis in a neonatal intensive care unit and characterize the profile of the neonates and their mothers. Method a cross-sectional and quantitative study, with a sample of 41 neonates. A physical examination and consultation of the hospital records were undertaken, using an instrument. The elaboration of the Nursing Diagnoses followed a process of diagnostic inference and was based on the North American Nursing Diagnosis Association 2012-2014. Results the mothers were around 25 years old, had a low average number of pre-natal consultations, and various complications during the pregnancy; and the newborns were predominantly premature and with very low birth weights. Five Nursing Diagnoses predominated, and all the neonates presented Risk of Shock and Risk of fluid volume imbalance. Conclusion the Nursing Diagnoses of the neonates with sepsis can guide the formulating of specific assistential plans. The study contributes to the generation of new knowledge and found various relationships between the Nursing Diagnoses and the variables selected in the characterization of the neonates, which deserve to be elucidated in greater detail based on further research on the issue.

Mulheres com risco cardiovascular após pré-eclâmpsia: há seguimento no Sistema Único de Saúde?

OBJETIVOS: identificar mulheres com risco cardiovascular, cinco anos apos a pre-eclâmpsia, e averiguar o seguimento dessas mulheres no Sistema Unico de Saude, em Natal, Rio Grande do Norte. METODOS: estudo exploratorio, quantitativo, realizado na Maternidade Escola Januario Cicco, em Natal. A amostra foi de 130 mulheres, 65 com pre-eclâmpsia e 65 normotensas. RESULTADOS: constatou-se diferenca estatistica significativa no que se refere ao indice de massa corporea, peso, historico familiar de doencas cardiovasculares e complicacao cardiovascular entre as mulheres com pre-eclâmpsia previa e as normotensas. Os grupos desconheciam os fatores de risco cardiovasculares e, alem disso, referiam dificuldades de acesso aos servicos de atencao primaria. CONCLUSOES: as mulheres com historico de pre-eclâmpsia possuiam risco aumentado de desenvolver doencas cardiovasculares, desconheciam as complicacoes tardias dessa doenca e nao recebiam seguimento ambulatorial diferenciado em relacao as normotensas.Objectives to identify women with cardiovascular risk, five years after a preeclampsic episode (PE), and identify the follow-up of these women within the Unified Health System (Sistema Único de Saúde - SUS), in the city of Natal/RN. Methods a quantitative and exploratory study conducted at the Januário Cicco University Maternity Ward/RN. The sample consisted of 130 women, 65 with a PE episode and 65 who were normotensive. Results we found statistical significance with regard to body mass index, weight, family history of cardiovascular disease (CVD) and cardiovascular complications when comparing women with previous PE to normotensive women. The groups were unaware of their cardiovascular risk factors and, in addition, they reported difficulties in accessing primary health care (PHC) services. Conclusions women with a PE history are at increased risk of developing CVD, unaware of late PE complications, and lacked customized care when compared to normotensive patients.

Vivência materna domiciliar com recém-nascido prematuro

OBJECTIVE Exploring maternal experience with premature newborn children in a domestic environment. METHODS The study was qualitative and used focus group interviews with 24 women who had had preterm deliveries in a public maternity hospital located in Northeast Brazil during June and October 2005. The mothers returned to the hospital facility at least 30 days after the newborn were discharged to share their experiences in caring for a premature infant at home. RESULTS Interview data was analysed for content, four thematic nuclei being identified: hospital discharge, preparing the family for discharge, caring for a premature baby at home and life changes arising from the premature birth. The greatest difficulties reported by the mothers in caring for their premature children at home were related to feeding and feelings of insecurity and fear were expressed which showed the need for a support network for the families following discharge. CONCLUSIONS The mothers care of premature infants at home represented changes for parents in everyday family life, work and social life, thus showing the need for a support network for them during the transition from hospital to home when considering premature children.Objective Exploring maternal experience with premature newborn children in a domestic environment.

Representations of mothers about the hospitalization of their premature child

Qualitative study aimed at knowing the representations of mothers about the hospitalization of their premature son in a Neonatal Intensive Care Unit (NICU). The sample was composed of eighteen mothers of premature newborns hospitalized in a school hospital in Natal, Brazil. A semi-structured interview was used and data analysis showed that hospitalization of a child is represented by the mothers as meanings, feelings, difficulties and uncertainties. It is considered that prematurity represents a maternal challenge from the moment of the premature birth, proceeding with disturbances inherent to hospitalization. These require awareness, listening and dialogue on the part of health professionals in an effective manner in order to strengthen maternal adaptation to prematurity.Estudo qualitativo que objetivou conhecer as representacoes de maes sobre a hospitalizacao do filho prematuro na Unidade de Terapia Intensiva Neonatal (UTIN). Inclui dezoito maes de prematuros internados na UTIN de um hospital escola em Natal (RN). Utilizou-se a entrevista semi-estruturada e na analise dos dados evidenciou-se que a hospitalizacao do filho e representada pelas maes por significados, sentimentos, dificuldades e incertezas. Considera-se que a prematuridade representa um desafio materno desde o momento da constatacao do parto pre-termo, prosseguindo com os percalcos inerentes a hospitalizacao e requer conhecimento, escuta e dialogo dos profissionais de saude de forma efetiva para fortalecimento da adequacao materna a prematuridade.

Clinical information systems for the management of tuberculosis in primary health care

ABSTRACT Objective: to analyze the clinical information systems used in the management of tuberculosis in Primary Health Care. Method: descriptive, quantitative cross-sectional study with 100 health professionals with data collected through a questionnaire to assess local institutional capacity for the model of attention to chronic conditions, as adapted for tuberculosis care. The analysis was performed through descriptive and inferential statistics. Results: Nurses and the Community Health Agents were classified as having fair capacity with a mean of 6.4 and 6.3, respectively. The city was classified as having fair capacity, with a mean of 6.0 and standard deviation of 1.5. Family Health Units had higher capacity than Basic Health Units and Mixed Units, although not statistically relevant. Clinical records and data on tuberculosis patients, items of the clinical information systems, had a higher classification than the other items, classified as having fair capacity, with a mean of 7.3 and standard deviation of 1.6, and the registry of TB patients had a mean of 6.6 and standard deviation of 2.0. Conclusion: clinical information systems are present in the city, mainly in clinical records and patient data, and they have the contribution of professionals linked with tuberculosis patients.Objetivo: analizar los sistemas de información clínica utilizados en el manejo de la tuberculosis em la Atención Primaria de Salud. Método: estudio transversal, descriptivo y cuantitativo, realizado con 100 profesionales de salud con datos recogidos a partir de un cuestionario para evaluar la capacidad institucional local para el modelo de atención a las condiciones crónicas, adaptado para la atención a la tuberculosis. El análisis fue realizado a través de la estadística descriptiva e inferencial. Resultados: los Enfermeros y los Agentes Comunitarios de Salud tuvieron una clasificación razonable con un promedio de 6,4 y 6,3, respectivamente. El municipio fue clasificado con capacidad razonable, con promedio 6,0 y desviación estándar de 1,5. Las Unidades de Salud de la Familia obtuvieron una capacidad superior a las Unidades Básicas de Salud y Unidades Mixtas, a pesar de no haber presentado relevancia estadística. Las historias clínicas y los datos sobre portadores de tuberculosis, ítems de los sistemas de información clínica, obtuvieron mayor clasificación, razonable, con un promedio de 7,3 y desviación estándar de 1,6 y registro de portadores de TB, con promedio de 6,6 y desviación estándar de 2,0. Conclusión: los sistemas de información clínica están presentes en el municipio, principalmente en las historias clínicas y los registros de los pacientes, y cuentan con la contribución de profesionales con vínculo con los portadores de tuberculosis.

Risk Assessment of Morbidity and Mortality in the Neonatal Transport

Neonatal transport is related to risk, which destabilizes the clinical condition of the newborn. This study aimed to present the assessment of risk of morbidity and mortality of the NB during the inter- and intra-hospital transport in accordance with the TRIPS and ERTIH-Neo scores. Cross-sectional study, descriptive and retrospective, held in the year 2014 in a maternity School, located in Rio Grande do Norte. The data were from the record of 57 transports performed with newborns in the Neonatal Intensive Care Unit. The collected data were submitted to descriptive statistical analysis through absolute and relative frequencies. The results of the TRIPS was possible in only 26% of the population, the majority of the scores were higher than 10. As for intra-hospital transport, there was a predominance of newborns who had obtained a score between 16 and 20. It was concluded that the realization of transport involved risks of neonatal morbidity and mortality.