Maria Gorete Lucena de Vasconcelos

Significados atribuídos à vivência materna como acompanhante do recém-nascido pré-termo e de baixo peso

OBJETIVOS: identificar o significado de ser mae acompanhante do recem-nascido pre-termo e de baixo peso, em participantes de um grupo de apoio multidisciplinar. METODOS: pesquisa qualitativa, realizada por meio de estudo descritivo e exploratorio. O contexto da investigacao foi o Hospital das Clinicas da Universidade Federal de Pernambuco, sendo os dados coletados por meio da observacao e entrevista gravada com 16 maes acompanhantes, no periodo de marco a dezembro de 2003, seguindo criterios de inclusao ate a saturacao teorica, em resposta a duas questoes norteadoras. Utilizou-se a analise de conteudo, na modalidade analise tematica transversal. RESULTADOS: a idade das maes variou entre 15 e 28 anos e 11 delas ja tinham um filho. A partir da percepcao materna acerca da experiencia vivida, foram identificados quatro temas: o sofrimento pela separacao da familia e o apoio recebido; o alojamento materno como prisao; a nao admissao da possibilidade de alta sem o filho e o alojamento materno enquanto espaco de novas amizades, aconselhamento e conflitos. CONCLUSOES: o estudo aponta para a necessidade da acao humana de cuidar. O aprendizado coletivo se da de forma concreta e positiva num contexto formal, podendo servir como subsidio para outras realidades.

As representações sociais do aleitamento materno para mães de prematuros em unidade de cuidado canguru

Os objetivos do estudo foram identificar as representacoes sociais sobre aleitamento materno de pre-termo, em unidade de Cuidado Canguru, sob a optica das maes que estao amamentando, e descrever os conflitos e contradicoes que eles vivenciam nesse contexto institucional. A pesquisa utiliza-se de uma abordagem qualitativa em que foi empregado o primeiro estagio da analise de enunciacao a luz da Teoria das Representacoes Sociais. As representacoes encontradas sao: os bebes saudaveis sao alimentados no peito, o leite materno confere a protecao e a preservacao da vida de uma crianca prematura, o aleitamento materno e o complemento da maternidade e amamentar um bebe prematuro e uma experiencia dificil e desgastante. Os conflitos sao decorrentes da assimilacao de conteudos e discurso tecnico, succao tardia e representacoes sobre leite materno.

Duração e fatores associados ao aleitamento materno em crianças menores de 24 meses de idade no estado de Pernambuco

OBJETIVOS: avaliar a duracao do aleitamento materno em criancas menores de 24 meses de idade no estado de Pernambuco e verificar a associacao de fatores com o aleitamento materno total. METODOS: corte transversal com 852 criancas ate 24 meses de idade que fizeram parte da amostra de 2078 menores de cinco anos selecionada para a II Pesquisa Estadual de Saude e Nutricao. Os dados foram coletados no periodo de fevereiro a maio de 1997. Utilizou-se a analise de sobrevivencia para calculo da mediana do aleitamento materno e das associacoes com a situacao do domicilio, renda per capita, escolaridade materna, consultas no pre-natal, orientacao sobre aleitamento materno, tipo de parto e peso ao nascer. RESULTADOS: atraves de analise de sobrevivencia verificou-se que a duracao mediana do aleitamento materno exclusivo, predominante e total foi de 24, 77 e 112 dias, respectivamente. A duracao mediana do aleitamento materno total foi significantemente mais prolongada entre as criancas que residiam na Regiao Metropolitana do Recife (148 dias), cujas maes percebiam um rendimento familiar per capita acima de dois salarios minimos (201 dias), que haviam frequentado seis ou mais consultas no pre-natal (129 dias) e recebido orientacao sobre aleitamento materno durante o pre-natal (126 dias). O peso ao nascer, a alfabetizacao materna e o tipo de parto nao influenciaram significativamente o aleitamento total. CONCLUSOES: verificou-se um crescimento na duracao do aleitamento materno em Pernambuco, particularmente na Regiao Metropolitana do Recife, demonstrando ser o pre-natal um dos fatores de oportunidade para orientar e incentivar as maes a amamentarem seus filhos.

Práticas alimentares no primeiro ano de vida

The study aimed to examine the relevant published literature to food practices in the fi rst year of life of teenage mothers’ children, through an integrative review within Lilacs, Medline and Cochrane, databases from 2000 to 2010. We used the keywords: adolescent, breastfeeding, mixed feedingand infant nutrition, from which we selected eleven articles that composed the study sample. The results indicated the paucity of published research on the proposed topic, especially for those focusing on complementary feeding, revealing a gap in global production on the subject. New researches, therefore, need to be developed with a focus on teenage mothers, exploring infant feeding in all its dimensions.

Enfrentamento e percepção da mulher em relação à infecção pelo HIV

OBJECTIVE To analyze women’s perceptions and coping regarding the discovery of an HIV infection. METHODS A qualitative study in an HIV/AIDS Specialist Helpdesk in Recife, PE, Northeastern Brazil, from January to September 2010, involving eight women living with asymptomatic HIV aged between 27 and 37 years, without criteria for diagnosis of AIDS infected through intercourse and monitored by the service for at least one year. Forms were used to characterize the clinical situation and semi-structured interviews to understand perceptions and feelings related to personal trajectory after diagnosis and different ways of facing the diagnosis in family and social life. Content analysis was performed as suggested by Bardin. RESULTS The thematic category that emerged was stigma and discrimination. The women had life trajectories marked by stigma, which was perceived as discrimination after the diagnosis and in the experiences of everyday life. The revelation of the infection was perceived as limiting to a normal life, leading to the need to conceal the diagnosis. The discriminatory attitudes of some health care professionals, non-specialist in HIV/AIDS, had a negative impact on future experiences in other health services. Besides the effects of institutional stigma, the perception of women was that the service did not include dedicated space for the expression of other needs beyond the disease, which could help in fighting the infection. CONCLUSIONS Living with HIV was strongly linked to stigma. The results show the importance of strengthening educational approaches and emotional support at the time of diagnosis in order to facilitate coping with the condition of seropositivity.OBJECTIVE To analyze women’s perceptions and coping regarding the discovery of an HIV infection. METHODS A qualitative study in an HIV/AIDS Specialist Helpdesk in Recife, PE, Northeastern Brazil, from January to September 2010, involving eight women living with asymptomatic HIV aged between 27 and 37 years, without criteria for diagnosis of AIDS infected through intercourse and monitored by the service for at least one year. Forms were used to characterize the clinical situation and semi-structured interviews to understand perceptions and feelings related to personal trajectory after diagnosis and different ways of facing the diagnosis in family and social life. Content analysis was performed as suggested by Bardin. RESULTS The thematic category that emerged was stigma and discrimination. The women had life trajectories marked by stigma, which was perceived as discrimination after the diagnosis and in the experiences of everyday life. The revelation of the infection was perceived as limiting to a normal life, leading to the need to conceal the diagnosis. The discriminatory attitudes of some health care professionals, non-specialist in HIV/AIDS, had a negative impact on future experiences in other health services. Besides the effects of institutional stigma, the perception of women was that the service did not include dedicated space for the expression of other needs beyond the disease, which could help in fighting the infection. CONCLUSIONS Living with HIV was strongly linked to stigma. The results show the importance of strengthening educational approaches and emotional support at the time of diagnosis in order to facilitate coping with the condition of seropositivity.

Psicodinâmica interativa mãe-criança e desmame

Breastfeeding is one of the main interventions in reducing child morbimortality, a privileged process to subjectivation, to child development and to prevention of disturbances in child-mother bond, when it is well experienced by the dyad. The study analyzed the psychodynamics involved in early weaning and late weaning, based on the interaction of two mother-child dyads with severe malnutrition, involving babies aged six and 15 months, hospitalized in a teaching institution. Qualitative methods based on psychoanalysis were used, with semi-structured interviews and observations. Early weaning seemed related to difficulties constructing motherhood and bonding; late weaning appeared to reflect an excess of maternal affection or difficulty in accepting the father figure.

Sentimentos de pais diante do nascimento de um recém-nascido prematuro

Study carried through in a Neonatal Unit of a Federal Public Hospital at Recife, with the objectives to analyze the feelings of the parents facing to the premature newborn birth; to investigate the parents feelings facing to this newborn one birth, during hospitalization in the Neonatal Unit; to understand the relation newborn premature birth with the formation of the affective bond between the parents and the premature newborn and to describe the premature birth repercussions in the family. The information’s collection was carried through by means of recorded interviews, with signature of the free assent and clarified, into dependences of the related hospital, with 12 parents of premature newborn, who had answered the question: how do you feel being father/mother of a premature baby? The interviews were recorded, transcribing and had been submitted to the content analysis, modality thematic analysis that resulted in three categories with its respective subjects: 1) ambiguous feelings of the parents facing to the premature birth; 2) the separation imposed to the family for hospitalization; 3) the prematurity justified for the divine determination. As conclusion, it was evidenced that the experience of parents of becoming premature unchain ambivalent feelings, that the RN hospitalization leads to mother separation he of the familiar context, beyond the removal of the too much family members of this RN, and that, however, these parents seem to search in the religion the support to accept the son real and to continue believing its recovery. Descriptors: Neonatal nursing; Family; Newborn; Premature. SENTIMIENTOS DE LOS PADRES FRENTE AL NACIMIENTO DE UN RECIÉN NACIDO PREMATURO

Maternal factors regulating preterm infants' responses to pain and stress while in maternal kangaroo care.

Investigou-se associacao entre fatores maternos e resposta de prematuros submetidos a puncao de calcâneo em posicao canguru. Trata-se de estudo descritivo envolvendo 42 maes e prematuros de uma unidade neonatal. A coleta ocorreu nos periodos basal, procedimento e recuperacao. Mensuraram-se a mimica facial, sono e vigilia, choro, cortisol salivar e frequencia cardiaca neonatais, alem de se mensurar o comportamento, cortisol salivar e estado mental maternos. Analisou-se a influencia das variaveis explanatorias maternas nas variaveis de resposta neonatais por analise bivariada, analise de variância e regressao multipla. A depressao e/ou ansiedade e comportamento materno nao influenciaram a resposta do prematuro a dor e estresse. O cortisol salivar pre-puncao materno explicou a variância do cortisol salivar pos-puncao neonatal (p=0,036); e o cortisol salivar noturno materno, juntamente com a idade pos-natal neonatal, explicaram a variância da frequencia cardiaca neonatal (p=0,001). A capacidade das maes em regular seu proprio estresse contribuiu para resposta de dor e estresse do prematuro.canguru”, presentada a la Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Centro Colaborador de la OMS para el Desarrollo de la Investigación en Enfermería, Brasil. Apoyo financiero de la FAPESP (2007/05051-1) y del CNPq (200113/2008-9). 2 PhD, Profesor Adjunto, Faculdade de Enfermagem, Universidade Federal de Goiás, Brasil. 3 PhD, Profesor Asistente, University of British Columbia, School of Nursing, Canada. 4 Estudiante de Doctorado, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Centro Colaborador de la OMS para el Desarrollo de la Investigación en Enfermería, Brasil. 5 PhD, Profesor Adjunto, Departamento de Enfermagem, Universidade Federal de Pernambuco, Brasil. 6 PhD, Profesor Asociado, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Centro Colaborador de la OMS para el Desarrollo de la Investigación en Enfermería, Brasil. 7 PhD, Profesor Titular, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Centro Colaborador de la OMS para el Desarrollo de la Investigación en Enfermería, Brasil.

Prevalencia de lesao do septo nasal em prematuros no uso de prongas nasais

The aim of this study was to investigate the prevalence and factors associated with nasal septum injury in preterm infants in the use of noninvasive ventilation. A cross-sectional study with data collection between March and July 2012 and with search for records, interviews with mothers and nasal evaluation of 47 premature in the neonatal unit of a teaching hospital in Recife, Pernambuco, northeastern Brazil. A descriptive bivariate statistical analysis was performed through the chi-square test or Fisher exact test using the SPSS software. The prevalence of nasal lesions was 68.1%, associated with low birth weight and duration of treatment. The prevalence of nasal injury in this population is high and associated with low birth weight and length of stay in noninvasive ventilation. Due to these facts the necessity for preventive actions was noticed, such as continuous care in nursing, suitability of devices and permanent education in service.Investigar la prevalencia y factores asociados con la lesion del tabique nasal en bebes prematuros en uso de la ventilacion no invasiva. Estudio de corte transversal, los datos se obtuvieron de los registros medicos, entrevistas con las madres y 47 de evaluacion prematura de nasal entre marzo y julio de 2012, en la unidad neonatal de un hospital universitario de Recife, Pernambuco, Noreste de Brasil. El analisis se realizo mediante estadistica descriptiva y bivariado mediante la prueba de chi-cuadrado o la prueba exacta de Fisher, utilizando el software SPSS. La prevalencia de lesiones nasales fue 68,1%, bajo peso al nacer y la duracion del tratamiento se asocio con una lesion nasal. La prevalencia de lesion nasal en esta poblacion es alta y se asocia con bajo peso al nacer y la duracion de la estancia en la ventilacion no invasiva. Esto infiere la necesidad de medidas preventivas, como la atencion de enfermeria, un ajuste continuo de los dispositivos de servicio y educacion continua.The aim of this study was to investigate the prevalence and factors associated with nasal septum injury in preterm infants in the use of noninvasive ventilation. A cross-sectional study with data collection between March and July 2012 and with search for records, interviews with mothers and nasal evaluation of 47 premature in the neonatal unit of a teaching hospital in Recife, Pernambuco, northeastern Brazil. A descriptive bivariate statistical analysis was performed through the chi-square test or Fisher exact test using the SPSS software. The prevalence of nasal lesions was 68.1%, associated with low birth weight and duration of treatment. The prevalence of nasal injury in this population is high and associated with low birth weight and length of stay in noninvasive ventilation. Due to these facts the necessity for preventive actions was noticed, such as continuous care in nursing, suitability of devices and permanent education in service.

Fragilidade da rede social de famílias de crianças com doença crônica

Chronic disease in childhood affects the family social relations. The social network can contribute for a better coping by giving support. This work aims to analyze the fragilities of the social network of families in this condition. It is a qualitative study conducted in a public hospital of Paraíba, from April to June 2011, using genogram, ecomap and semi-structured interview with seven family members of children with chronic disease. The thematic analysis of the results helped to characterize the network and understand the social interactions in the course of the disease and the types of support received. The empirical category (dis)articulation of the social network and the modifications in family routine was built in this process and pointed the diversity of the social network composition, emphasizing that the social support provided by the network is significant, however, not always continuous and suitable with the needs of the families.La enfermedad cronica en la ninez afecta las relaciones sociales familiares. La red social podra contribuir para un mejor enfrentamiento cuando ofrece apoyo. Se objetivo analizar las fragilidades de la red social de familias de ninos con enfermedad cronica. Se trata de una investigacion cualitativa, realizada en un hospital publico de Paraiba, en el periodo de abril a junio de 2011, utilizando genograma, ecomapa y entrevista semiestructurada con siete familiares de ninos con enfermedades cronicas. El analisis tematico de los resultados posibilito caracterizar la red y aprehender las interacciones sociales en la trayectoria de la enfermedad y los tipos de apoyo que recibieron. La categoria empirica (des)articulacion de dicha red y las modificaciones en la rutina de la familia, fue construida en ese proceso y apunto la diversidad de la composicion de dicha red, evidenciando que el apoyo social fornecido por la red supradicha es significativo, sin embargo, no siempre es continuo y condicente con las necesidades de las familias.