Raimunda Magalhães da Silva

Prevalence and factors associated with syphilis in parturient women in Northeast, Brazil

BackgroundCongenital syphilis is a major public health concern, even after the implementation of intervention protocols in several countries. This study aimed to analyze the prevalence and socio-demographic, behavioral and institutional factors associated with syphilis in parturient women attending public maternity hospitals in Northeast, Brazil.MethodsA cross-sectional study was conducted from June to September 2010 with a proportionate stratified sampling of 222 parturient women using a structured questionnaire. The study analyzed socio-demographic, behavioral and institutional variables. The structured questionnaire was conducted with parturient women and complementary information was obtained through hospitals records, admission forms and prenatal cards. Data were stored using the Statistical Package SPSS version 18. A descriptive statistical analysis was performed using frequency distribution, central tendency and measures of spread for the variables. A bivariate analysis was done using chi square test and Fisher’s exact test, with a significance level of 5% and a 95% confidence interval, in order to analyze the relation between the variables and risk factors for syphilis. The multivariate logistic regression analysis was done in the statistical package STATA, version 11.0.ResultsThe prevalence of syphilis in parturient women was 7.7%. The bivariate analyses showed that the rate was higher among women who: were from Fortaleza (p = 0.019), studied for less than nine years (p = 0.044), had more than one sexual partner in life (p = 0.021), did not live with partner (p = 0.022), used illegal drugs (p < 0.0001), whose partner used illegal drugs and had diagnosis of syphilis (p = 0.001 and p < 0.0001 respectively). The non-adjusted analysis found significant positive association between syphilis and the following variable: being from Fortaleza (OR = 7.26; CI 95% = 1.49-100.20), having studied for less than nine years (OR = 7.97; CI 95% = 0.87-12.89), having more than one sexual partner in life (OR = 3.75; CI 95% = 1.59-107.11), not living with partner (OR = 3.75; CI95% = 1.03-12.15), and parturient women and partner used illegal drugs (OR = 7.34; CI95% = 1.69-27.57; OR = 4.93; CI95% = 1.58-16.05), respectively. The adjusted multiple logistic regression analysis showed that none of the variables remained significant.ConclusionThis study enabled to identify a high prevalence of syphilis in parturient women and that this situation is associated with socio-demographic, behavioral and institutional variables.

Evidências qualitativas sobre o acompanhamento por doulas no trabalho de parto e no parto

The objective of this study was to conduct a metasynthesis of evidence of the work of doulas assisting women in labor and during childbirth. Articles between 2000 and 2009 were located in the Medline, PubMed, SciELO, and Lilacs databases using the key search words: doulas, gestation, labor, and alternative therapy. Seven articles were selected for the study and four categories were created: the support provided by doulas; the birth mothers experiences; professional relationship: and opinions and experiences of professionals. The doulas offered physical, emotional, spiritual and social support. Experiments showed that the professionals stimulated the mother/child relationship, oriented towards successful breastfeeding, and contributed to the prevention of post-partum depression. Controversy was observed among professionals regarding acceptance of the role of the doula as a member of the obstetrics team. The doulas care was considered innovative, calming, encouraging, and attended all the needs of the pregnant woman. The conclusion is that qualitative studies on the work of doulas are recent, incipient, but revealing as to the important possibility of humanizing labor and childbirth.

Sexually transmitted infections associated syndromes assisted in the primary health care in Northeast, Brazil

BackgroundThe lack of information on the care for sexually transmitted infections (STI) associated syndromes may contribute for its non-inclusion as prevention and control strategy for STI in Brazil. This study aims to analyze the cases of STI – Associated Syndromes assisted in primary health care center in a city in Northeast Brazil associating them with socio-demographic and behavioral variables.MethodsThis is a retrospective study that analyzed 5148 consultation forms and medical records of patients assisted in a primary health care center who presented at least one genital syndrome from 1999 to 2008. Was considered as dependent variables the genital syndromes and serologies for syphilis and HIV and as independent variables the socio-demographic and behavioral aspects. It was used Pearson’s chi-square test to analyze the differences between the categorical variables, with a significance level of 5%. It was performed a multivariate analysis through the multivariate logistic regression model with the variables with p <0.05. We used odds ratio with a confidence interval of 95%.ResultsThe most frequent syndromes were vaginal discharge and/or cervicitis (44%) and genital wart (42.2%). Most people were between 20 and 39 years old (70%) and women (74.2%). Genital ulcer was most prevalent among men (OR = 2.67; CI 95% 1.99-3.58) and people who studied more than eight years (OR = 1.33; CI 95% 1.00-1.75) and wart prevailed among men (OR = 3.92; IC 95% 3.36-4.57), people under 29 years old (OR = 1.81; CI 95% 1.59-2.07) and who studied more than eight years (OR = 1.75; CI 95% 1.54-1.99). The Venereal Disease Research Laboratory (VDRL) was positive in 7.3% of men and in 7.1% of women and the Anti-HIV in 3.1% of men and 0.7% of women.ConclusionVaginal discharge was the most frequent syndrome assisted in primary health care, followed by genital wart. The high prevalence of genital wart justifies the greater effort for the proper follow-up of these cases. Men presented more genital wart and ulcer and reported having more sexual partners, showing their need for a greater access and inclusion in health activities developed in primary health care in Brazil.

Produção científica sobre promoção da saúde nos cursos de pós-graduação brasileiros

Discutir a promocao de saude no contexto da qualidade de vida dos individuos/coletividade e no meio academico e uma articulacao politica, teorica e metodologica, portanto esta pesquisa teve por objetivo analisar a producao cientifica sobre promocao da saude registrada na Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (Capes). Foi realizada uma revisao sistematica no banco de teses da Capes e analisados 678 trabalhos registrados entre 2000 e 2004 e identificadas as categorias curso, ano, regiao brasileira, area de conhecimento e resumo (tipo de estudo e coleta de dados). Constatou-se a predominância do curso de mestrado academico com 531 (78,2%) pesquisas; entre os anos em que foram desenvolvidas as pesquisas sobre promocao da saude, prevaleceu o ano de 2003, com 189 (27,8%) estudos, e entre as regioes brasileiras destacou-se a regiao Sudeste com 411 (60,5%) trabalhos. Na categoria area de conhecimento, preponderou a Saude Coletiva com 138 (16%) pesquisas. No resumo do qual foi extraido o tipo de estudo, destacou-se a pesquisa qualitativa com 200 (29,4%) trabalhos. Conclui-se, portanto, que a producao cientifica na tematica de promocao de saude encontra-se progredindo, pois, no Brasil, a Politica Nacional de Promocao de Saude regularizou-se em 2004, sendo assim uma area em evidencia para atuacao interdisciplinar e descoberta de novas praticas e acoes em saude.

Knowledge of healthcare professionals regarding the vertical transmission of syphilis in Fortaleza -CE, Brazil

The aim of this study was to investigate the knowledge of family health strategy professionals regarding the prevention and control of the vertical transmission of syphilis. This cross-sectional study was carried out in Fortaleza, Ceara, Brazil, from August to October 2009. A questionnaire was used, with its correct answers being in line with the recommendations of the Ministry of Health. Univariate analysis was carried out, with frequency distribution, mean and standard deviation. A total of 269 professionals participated, 44.7% had 6 to 10 years of experience in the FHS, and 60% of the questions regarding their knowledge were answered correctly: 75.8% were aware of the request period of the Venereal Disease Research Laboratory (VDRL) test; 78.1% of the alternative drug for the treatment for pregnant women allergic to penicillin, 55.1% of the request period for VDRL for cure and control, and 50.2% of the conduct with a sexual partner. It was concluded that healthcare professionals are unaware of the appropriate actions for the prevention and control of congenital syphilis.The aim of this study was to investigate the knowledge of family health strategy professionals regarding the prevention and control of the vertical transmission of syphilis. This cross-sectional study was carried out in Fortaleza, Ceara, Brazil, from August to October 2009. A questionnaire was used, with its correct answers being in line with the recommendations of the Ministry of Health. Univariate analysis was carried out, with frequency distribution, mean and standard deviation. A total of 269 professionals participated, 44.7% had 6 to 10 years of experience in the FHS, and 60% of the questions regarding their knowledge were answered correctly: 75.8% were aware of the request period of the Venereal Disease Research Laboratory (VDRL) test; 78.1% of the alternative drug for the treatment for pregnant women allergic to penicillin, 55.1% of the request period for VDRL for cure and control, and 50.2% of the conduct with a sexual partner. It was concluded that healthcare professionals are unaware of the appropriate actions for the prevention and control of congenital syphilis.

Percepção sobre qualidade de vida de mulheres participantes de oficinas educativas para dor na coluna

The aim of this study was to analyze how women with back pain perceived their quality of life after having attended educational workshops on back pain directed to self-care and prevention. This qualitative study was conducted in a Higher Education Institution in Fortaleza, Ceara, Brazil, during the months April and May 2005, using a sample of nine women who had concluded eight workshops. The focal group method was selected for data collection, and the sessions were filmed and recorded. Data were grouped into categories and sequentially analyzed. All women thought they had a good quality of life, independently of having a poor health, no money and no a job. All this was overcome by their faith in God. All women reported that, before the workshops, the pain had interfered in their daily and social lives and that, after the intervention, the pain had calmed down or disappeared. The awareness of self-care provided physical, intellectual and emotional well being, improved mobility and decision-making and allowed them to return to their activities. Besides, it helped to eliminate or reduce pain medication. The study made us realize the importance of evaluating the quality of life in order to guide us in the choice of the most effective therapeutic measures.

Prática do autocuidado vivenciada pela mulher hipertensa: um análise no âmbito da educação em saúde

La investigacion abordo la practica del autocuidado vivenciada por la mujer hipertensa. Estudio exploratorio-descriptivo, fundamentado en la teoria del autocuidado de Orem y desarrollado con 200 mujeres hipertensas en una institucion publica de salud de Fortaleza-CE. Los datos fueron recogidos durante las consultas de enfermeria, organizados en categorias y analizados de acuerdo a los fundamentos de la teoria escogida. En la muestra pesquisada, cerca de 172 (86%) mujeres descubrieron su hipertension mediante senales e sintomas relacionados al climaterio. Se evidencio ademas en las mujeres un deficit de conocimiento, adhesion parcial al tratamiento y una practica ineficaz de autocuidado en virtud de ese deficit. De esa forma, concluyese que la practica del autocuidado era influenciada por la edad, por el estadio de desarrollo y por problemas sociales, financieros y de salud.

Uso de práticas integrativas e complementares por doulas em maternidades de Fortaleza (CE) e Campinas (SP)

Abstract This study aimed to analyze the Integrative and Complementary Practices (ICP) applied by doulas in the cities of Fortaleza and Campinas-SP. This is a qualitative study encompassing fifteen doulas: nine from Fortaleza (Brazil, CE) and six from Campinas (Brazil, SP). The data were collected in the second half of 2010 by conducting semi-structured and pre-organized interviews following the procedures of thematic content analysis. The interpretations of the results were based on the idea that institu-tionalization of knowledge and practices happen through the conformation of nuclei and fields. The nucleus demarcates the identity of an area of knowl-edge and the professionals’ practices, and the field demarcates the blurred limits among disciplines that can be submitted to conflicts. We observed that the support offered by doulas permeates a variety of practices framed in traditional medicine as well as in complementary and alternative medicine. ICP was associated with decreases in length of labor, superior pain management, ability of making deci-sion and empowering of women. It is understood that the range of activities offered by doulas and the use of ICP converge to the uniqueness, respect and autonomy of women. Furthermore, it proposes a new model of awareness and practices centered on the importance of the natural process of childbirth.

Significado do cuidado familiar à mulher mastectomizada

It was aimed to understand the meaning of family care offered to mastectomized women. This is a qualitative study that used as theoretical reference the symbolic and methodological Interactionism and the Grounded Theory. 11 relatives were interviewed between July and August 2008. The results showed the following phenomena: facing family difficulty to take care, facing the diagnosis of breast cancer in the family and noticing the family care after surgery. It was concluded that, in spite of participants valuing family care, some felt unprepared to effectively perform it. A consistent family relationship is considered a fundamental strategy for the rehabilitation of mastectomized women.

The ways in which blind mothers cope with taking care of their children under 12 years old

Resumen pt: Objetivou-se analisar o enfrentamento de maes cegas no cuidado dos filhos menores de 12 anos, com enfase na promocao da saude, prevencao de riscos e educ...This study was aimed at analyzing the ways in which blind mothers cope with taking care of their children under 12 years old and is focused on health promotion, risk prevention and education. This is a qualitative study held in Fortaleza, in the state of Ceara, at the homes of nine blind mothers. A semi-structured interview was performed, from which the core meanings emerged: suitability of the home environment in order to prevent domestic accidents; prevention and treatment of diseases and monitoring of education. Data analysis was based on the concepts of coping and symbolic interactionism. The fact that the mothers are aware of the suitability of the home environment was evident. The pursuit for health promotion was done through the demand for healthcare system. Concerning education, the mothers are aware of the importance of the study and of monitoring its development. Despite the limitations and difficulties, it was observed that they care for and educate their children with the intention of raising good natured and responsible people for the society.