Mirian Santos Paiva

Avaliação da cobertura e indicadores do Programa de Humanização do Pré-natal e Nascimento no município de Salvador, Bahia, Brasil

OBJECTIVES: calculate selected indicators for the prenatal care provided to pregnant women by public healthcare services in Salvador, Bahia, Brazil. METHODS: this quantitative study, carried out in the city of Salvador used records of prenatal care from those health units integrating the Brazilian Prenatal and Birth Humanization Program (BPBHP), kept records from their pregnant subjects and contributed regularly with information to the SISPRENATAL database in 2002. Data from the Municipal Health Departments Regulation and Assessment Coordination (reference year = 2002) were analyzed by means of a statistical software and presented in simple frequencies. RESULTS: the indicators under investigation determined prenatal care coverage of 14.2% in the health clinics, totaling 6044 women. Of these 37.8% were registered in the BPBHP. Anti- tetanus vaccine or additional doses were given to 33.5% of the subjects in the BPBHP and HIV testing was performed in 17.6%. CONCLUSIONS: during 2002, it was determined that the BPBHP in Salvador provided low coverage for prenatal care, anti-tetanus vaccination and anti-HIV testing. Although BPBHP has the objective of maternal and neonatal mortality reduction, it failed to cover the major cause of maternal death in Salvador: abortion.

VULNERABILIDADE DE MULHERES USUÁRIAS DE DROGAS AO HIV/AIDS EM UMA PERSPECTIVA DE GÊNERO

Este artigo discute a vulnerabilidade de mulheres usuarias de drogas a infeccao pelo HIV/AIDS. Trata de estudo qualitativo cujos dados foram apreendidos pela observacao de campo e entrevista com dezoito mulheres, durante atividades de extensao direcionadas a pessoas usuarias de drogas. A analise apontou condutas relacionadas as praticas sexuais e ao uso de drogas, interligadas e norteadas por construcoes socio-culturais que ampliam a vulnerabilidade das usuarias a infeccao pelo HIV. Independente do tipo de droga, modalidade e rede de uso, o consumo de drogas por mulheres e sua convivencia com pessoas usuarias de drogas, em relacionamentos sexuais e afetivos, constituem situacoes de vulnerabilidade a infeccao pelo HIV, com grau diferenciado nos niveis individual e social. Essas situacoes estao permeadas por relacoes desiguais de genero e poder e apontam para necessidade de estudos e de intervencao numa abordagem de genero contemplando pessoas usuarias de drogas, em particular as do sexo feminino.

Vulnerabilidade de mulheres em união heterossexual estável à infecção pelo HIV/Aids: estudo de representações sociais

Se discuten representaciones sociales de mujeres en union heterosexual estable, respecto de vulnerabilidad a infeccion por VIH/SIDA. Datos generados a partir de asociacion libre de palabras, constituyendose en muestra de investigacion fundamentada en Teoria de las Representaciones Sociales, desarrollada con mujeres seronegativas para VIH, de capital e interior de Bahia. El analisis factorial de correspondencia revelo significatividad para: procedencia, escolaridad y tiempo de union. La aceptacion de la traicion surgio como factor de vulnerabilidad para participantes con 1-5 anos de union estable del interior. Las mujeres de capital con 6-10 anos de union representan a la monogamia como forma de prevencion. Mujeres con mayor tiempo de union y escolaridad basica se auto-representan como invulnerables, al contrario de aquellas con 1-5 anos de union y escolarizacion media. Los resultados sugieren aumentar acciones para desnaturalizar coerciones socioculturales que engendran representaciones y favorecen la exposicion de la mujer en union estable al SIDA.This article discusses the social representations of women living in common-law marriage in terms of their vulnerability to becoming infected with HIV/AIDS. Data were obtained through the free association of words, and consisted of an excerpt of a study founded on the Social Representations Theory developed with HIV-negative women living in the state capital and cities in the interior of Bahia. The correspondence factor analysis showed significance for the variables: origin, education level and time spent in common-law marriage. Their acceptance of marital affairs emerged as a vulnerability factor for respondents with one to five years spent in common-law marriage, living in cities in the interior. Women from the capital, with 6-10 years spent in common-law marriage, reported monogamy as a form of prevention. Women with a longer common-law marriage who had completed only a primary education reported feeling invulnerable, which was the opposite of those with one to five years in common-law marriage with a secondary education. Results show there is a need for more interventions aiming to denaturalize the socio-cultural coercions that generate representations and make women in common-law marriages more vulnerable to AIDS.

Representações sociais de profissionais de saúde sobre o consumo de drogas: um olhar numa perspectiva de gênero

Estudo de carater qualitativo, desenvolvido com objetivo de apreender as representacoes sociais de profissionais de saude sobre o consumo de drogas, numa perspectiva de genero. Os dados foram coletados de marco a julho de 2004, atraves da observacao participante, em uma unidade de saude especializada na assistencia a pessoas usuarias de drogas em Salvador-Bahia; e de entrevista semi-estruturada com 19 profissionais que atuam na referida unidade. Os dados foram submetidos a tecnica de analise de conteudo tematica, sendo identificadas duas categorias: o consumo de drogas como uma forma de enfrentar a vida; o ocultamento das mulheres usuarias. O contexto de atuacao dos profissionais revelou diferentes realidades em relacao as mulheres que consomem drogas, que vao de encontro as representacoes dos profissionais sobre este grupo populacional. Ressaltamos a influencia do contexto na elaboracao das representacoes sociais. Visando uma assistencia humanizada e equânime, sugerimos ampliacao da abordagem de genero para os entrevistados e a inclusao de outros profissionais em estudos como este.

Sobrecarga e qualidade de vida de mães de crianças e adolescentes com doença crônica: revisão integrativa

Abstract Objective: to identify and analyze the evidence available regarding evaluation of burden and quality of life of mothers who are caregivers for children and adolescents with chronic illnesses. Method: an integrative review, undertaken in the electronic sources MEDLINE; Academic Search Premier; CINAHL; LILACS; SciELO and PubMed, between 2010 and 2014. Results: among the 22 documents selected, there was a predominance of convenience samples and non-experimental transversal designs, at the levels IV and III2. The caregiver burden scales used were the Zarit Burden Interview and Montgomery-Borgatta Caregiver Burden Scale-Revised along with the following instruments for evaluating quality of life: The World Health Organization Quality of Life-BREF Scale; Self-report questionnaires; The Ulm Quality of Life Inventory for Parents of chronically ill children; Asthma Caregiver Quality of Life Questionnaire; and the Nottingham Health Profile. Quality-of-life appears to be influenced in a complex and interrelated way by the physical and mental health of the mothers who are caregivers, in accordance with their level of independence, social relationships, environment, and the extent to which they see themselves as burdened. Conclusion: the revealing of the results for the evaluation of burden and quality of life of mothers who are caregivers has implications for the planning and implementation of effective interventions, by the multidisciplinary team, if they are to relieve the burden.Objetivo: identificar e analisar as evidencias disponiveis sobre avaliacao de sobrecarga e qualidade de vida de maes cuidadoras de criancas e adolescentes com doenca cronica. Metodo: revisao integrativa, realizada nas fontes eletronicas MEDLINE; Academic Search Premier; CINAHL; LILACS; SciELO e PubMed, entre 2010 e 2014. Resultados: dos 22 documentos selecionados prevaleceram as amostras de conveniencia, desenhos transversais, nao experimentais, nos niveis IV e III2. As escalas de sobrecarga do cuidador utilizadas foram Zarit Burden Interview e Montgomery-Borgatta Caregiver Burden Scale-Revised e os instrumentos de avaliacao da qualidade de vida: The World Health Organization Quality of Life-BREF Scale; Self-report questionnaires; The Ulm Quality of Life Inventory for Parents of chronically ill children; Asthma Caregiver Quality of Life Questionnaire; Perfil de Saude de Nottingham Health Profile. A qualidade de vida comparece influenciada de forma complexa e inter-relacionada pela saude fisica e mental das maes cuidadoras, de acordo com seu nivel de independencia, relacoes sociais, ambiente e o quanto se percebem sobrecarregadas. Conclusao: a revelacao dos resultados de avaliacao de sobrecarga e qualidade de vida das maes cuidadoras implica no planejamento e implementacao de intervencoes efetivas, pela equipe multidisciplinar, que aliviem a sobrecarga.

Burden and quality of life of mothers of children and adolescents with chronic illnesses: an integrative review

Abstract Objective: to identify and analyze the evidence available regarding evaluation of burden and quality of life of mothers who are caregivers for children and adolescents with chronic illnesses. Method: an integrative review, undertaken in the electronic sources MEDLINE; Academic Search Premier; CINAHL; LILACS; SciELO and PubMed, between 2010 and 2014. Results: among the 22 documents selected, there was a predominance of convenience samples and non-experimental transversal designs, at the levels IV and III2. The caregiver burden scales used were the Zarit Burden Interview and Montgomery-Borgatta Caregiver Burden Scale-Revised along with the following instruments for evaluating quality of life: The World Health Organization Quality of Life-BREF Scale; Self-report questionnaires; The Ulm Quality of Life Inventory for Parents of chronically ill children; Asthma Caregiver Quality of Life Questionnaire; and the Nottingham Health Profile. Quality-of-life appears to be influenced in a complex and interrelated way by the physical and mental health of the mothers who are caregivers, in accordance with their level of independence, social relationships, environment, and the extent to which they see themselves as burdened. Conclusion: the revealing of the results for the evaluation of burden and quality of life of mothers who are caregivers has implications for the planning and implementation of effective interventions, by the multidisciplinary team, if they are to relieve the burden.Objetivo: identificar e analisar as evidencias disponiveis sobre avaliacao de sobrecarga e qualidade de vida de maes cuidadoras de criancas e adolescentes com doenca cronica. Metodo: revisao integrativa, realizada nas fontes eletronicas MEDLINE; Academic Search Premier; CINAHL; LILACS; SciELO e PubMed, entre 2010 e 2014. Resultados: dos 22 documentos selecionados prevaleceram as amostras de conveniencia, desenhos transversais, nao experimentais, nos niveis IV e III2. As escalas de sobrecarga do cuidador utilizadas foram Zarit Burden Interview e Montgomery-Borgatta Caregiver Burden Scale-Revised e os instrumentos de avaliacao da qualidade de vida: The World Health Organization Quality of Life-BREF Scale; Self-report questionnaires; The Ulm Quality of Life Inventory for Parents of chronically ill children; Asthma Caregiver Quality of Life Questionnaire; Perfil de Saude de Nottingham Health Profile. A qualidade de vida comparece influenciada de forma complexa e inter-relacionada pela saude fisica e mental das maes cuidadoras, de acordo com seu nivel de independencia, relacoes sociais, ambiente e o quanto se percebem sobrecarregadas. Conclusao: a revelacao dos resultados de avaliacao de sobrecarga e qualidade de vida das maes cuidadoras implica no planejamento e implementacao de intervencoes efetivas, pela equipe multidisciplinar, que aliviem a sobrecarga.

The practice of family health strategy workers when caring for women in gender violence situations

The aim of the present study was to describe the practice of Family Health Strategy workers when dealing with women in gender violence situations. It is a qualitative study, conducted with 25 healthcare workers from three Family Health Strategy units in a municipality of the state of Bahia, Brazil. Data were collected through a semi-structured interview and analyzed based on the discourse analysis method. The results yielded two empirical categories: expression of violence against women due to gender issues, with display of physical and psychological violence by a spouse, and strategies to face up gender violence. The second category displayed that the units actions that do not contemplate gender issues and that referrals to assistance services do not receive counter-referrals. We emphasize the need for Family Health Strategy staff to receive qualification for acting in gender violence situations, and for public management to promote a network structure for assistance services. DESCRIPTORS: Violence against women. Family health. Gender and health. Nursing.The aim of the present study was to describe the practice of Family Health Strategy workers when dealing with women in gender violence situations. It is a qu...

A interferência do contexto assistencial na visibilidade do consumo de drogas por mulheres

Considerando a crescente demanda por assistencia a drogadicao feminina e sua internacionalmente reconhecida especificidade, este estudo qualitativo, realizado em Salvador-Ba, no periodo de outubro/2003 a setembro/2004, com profissionais de saude, propoe investigar se o contexto assistencial em que eles se encontram interfere na visibilidade do consumo feminino de drogas. Atraves da observacao participante e da analise de conteudo de entrevistas com dezenove profissionais, revelaram-se situacoes especificas quanto a visibilidade de mulheres usuarias de acordo com o local de atendimento (“instituicao” versus “rua”). Diferencas na percepcao da demanda, tipo de droga utilizado, idade, papeis sociais desempenhados e influencia do parceiro para inicio e manutencao do consumo de drogas demonstraram que o contexto assistencial influencia na representacao daqueles profissionais sobre as usuarias de drogas, o que pode interferir nas estrategias assistenciais implementadas. Recomenda-se a articulacao entre os dois contextos assistenciais na unidade estudada e desta com outros servicos de saude.

Especificidades de usuários(as) de drogas visando uma assistência baseada na heterogeneidade

O artigo enfoca a heterogeneidade de grupos e de pessoas usuarias de drogas, com enfase nas especificidades de mulheres. Trata-se de revisao da literatura sobre o fenomeno das drogas e saude, a partir de textos selecionados que utilizam a variavel empirica sexo. Foram identificadas diferencas no consumo de drogas entre homens e mulheres e especificidades entre mulheres tanto em relacao a aspectos epidemiologicos quanto aos determinantes socio-culturais do fenomeno. Identificou-se que a taxa de consumo, tipo da droga, idade, mortalidade e comorbidade foram aspectos responsaveis pelas principais diferencas de genero. Especificamente em grupos de mulheres, foram identificadas diferencas relacionadas ao tipo de droga versus idade e procura por tratamento versus tipo de atividade desenvolvida pela unidade de saude. Os dados demonstram que a assistencia as pessoas usuarias de drogas deve contemplar especificidades individuais e de grupos.

Social representations concerning the breastfeeding practices of women from three generations

Breastfeeding is a practice that involves teaching and learning across generations. Women experiencing breastfeeding need models that come from their mothers and maternal grandmothers. Therefore, this studys objectives were to capture social representations concerning breastfeeding held by women from three different generations of the same family and identify continuities and discontinuities in the practice and representation related to the phenomenon and the work of nurses in this process. This qualitative study based on the Social Representations Theory was developed in a hospital in Itabuna, BA, Brazil. The sample consisted of 21 women. Data were collected between October 2009 and July 2010. We show that the representations move between positive and negative perceptions, and that the teaching-learning process is conducted across generations, especially by nurses, through observation and the media, and that childcare is defined by feeding, body, health and affection. We conclude that it is necessary to understand the representations from both individual and generational perspectives. DESCRIPTORS: Breastfeeding. Family. Generation. Woman. Nursing.Breastfeeding is a practice that involves teaching and learning across generations. Women experiencing breastfeeding need models that come from their mothers and maternal grandmothers. Therefore, this studys objectives were to capture social representations concerning breastfeeding held by women from three different generations of the same family and identify continuities and discontinuities in the practice and representation related to the phenomenon and the work of nurses in this process. This qualitative study based on the Social Representations Theory was developed in a hospital in Itabuna BA, Brazil. The sample consisted of 21 women. Data were collected between October 2009 and July 2010. We show that the representations move between positive and negative perceptions, and that the teaching-learning process is conducted across generations, especially by nurses, through observation and the media, and that childcare is defined by feeding, body, health and affection. We conclude that it is necessary to understand the representations from both individual and generational perspectives. DESCRIPTORS: Breastfeeding. Family. Generation. Woman. Nursing