Rosa Aurea Quintella Fernandes

Quality of life in the mediate postpartum: a quantitative study

Introduction: Postpartum is a period of deep physical and emotional changes for women which may interfere in their quality of life. The objectives of this exploratory descriptive study of quantitative approach were to identify the Quality of Life Index (QLI) of women in the mediate puerperium, using an adaptation of the Ferrans & Powers instrument, and to assess the influence of the following variables on these women’s quality of life: type of delivery, breastfeeding, breast conditions and baby’s health. Method: The data were collected from April to June 2007. The sample consisted of 144 women, and the majority (70%) had Caesarean delivery. Results: The mean score of quality of life was relatively high (25.82), the maximum being 30.0. In this research, two of the variables studied indicated a statistically significant difference, and thus influenced negatively the Quality of Life of women in the mediate puerperium: nipple fissure and breast engorgement issues, or the association of both conditions, as well as problems with the baby´s health. The results allowed us to affirm that there was no statistically significant difference (in general or by domain) in the women’s quality of life concerning the different types of delivery. Moreover, there was no statistical difference in the QoL of the women who presented an unfavorable attitude toward breastfeeding. Conclusions: The study demonstrated that issues that were considered simple, such as nipple fissure and breast engorgement, may interfere in the QoL of puerperal women. Relevance to clinical practice: Nurses must become aware of their role as educators in their clinical practice. The appropriate guidance and support to the mother in the beginning of the breastfeeding process consist of uncomplicated light technologies that are easy to be followed, and that can reflect in a positive way on the QoL of the women.

Pregnancy and quality of life: assessment during the gestational trimesters

An exploratory and descriptive study whose objectives were: to identify the Quality of Life Index (QLI) for pregnant women, in the first, second and third trimesters using an adaptation of the Ferrans & Powers instrument. The sample consisted of 198 pregnant women. who had undergone prenatal exams in basic health units of inland cities of the State of Sao Paulo. The mean of the General QLI was 23.84 ( maximum 30). Analyzing the General QLI, there was a statistical difference between the pregnant women of the first trimester with relation to the ones of the second. Pregnant women of the first trimester presented higher indexes of quality of life. There was no significant difference in the comparison between the pregnant women of the second trimester and the ones of the third semester, similarly to those between the first and third trimesters.

Quality of life: considerations about concept and instruments of measure.

The concept of quality of life has been having more and more attention in scientific literature in different areas, specially nursing. It is a concept with many meanings, different possibilities of focusing and uncountable and controversial theories and methods. The text reflects about the importance of the construction and analysis of the concept of quality of life for the nursing area. Deals with the main instruments used for measuring and also establishes a relationship between quality of life and health. These efforts have helped to clear up the concept and achieve some maturity. When we get to know the quality of life of people is easier to change paradigms in what concerns the assistance in the health/sickness process, for the reason that in some traditional assistance, social/economical, psychological and cultural aspects are not considered, which are so important in the actions of promotion, prevention, treatment and rehabilitation of health.

Breastfeeding: helping mothers at home, after discharge from hospital. A descriptive study

The problems mother face during breastfeeding may lend to early weaning. The period after discharging from hospital is critical, since woman not always find support and orientation to successfully overcome this phase. The purpose of this descriptive, exploratory study was to identify the difficulties mothers have to face during breastfeeding, after discharging from hospital and to guide them, by means of telephone calls. 64 women who gave birth at a private hospital were interviewed in September and October 2003. The results showed that mothers had a good level of education, 65% had finished the secondary school and 30% higher education. A the moment of the telephone call, which occurred in the 8th and 9th day after birth, 95% were exclusively breastfeeding and 92% did not mention any difficulties. However, 61% of theses women presented fissure between the 3rd and 4th day and 23%continnued having this problem. Breast engorgement mentioned by 19% of the breast-feeding women, occurred between the 4th and 5th day. It was concluded that the telephone approach helped some mothers to immediately overcome problems while others were referred to nursing consultation as the hospital. These difficulties could be overcome more efficiently if contacts occurred earlier.

Records of anti-tetanic immunization in documents of mothers. A descriptive study

Before the confirmation that, there is as much lack of knowledge among women about the importance of anti-tetanic vaccination during the gestation period, as deficiency in data about this immunization, it was decided to elaborate a research in order to verify and analyze the records of anti-tetanic immunization in documents of groups of 50 Mothers in a poor community of the City of Sao Paulo. This study, descriptive and quantitative, was made in the period from April 2005 to April 2006. There were collected data in records of vaccination and prenatal periods, and also other kinds of records such as social, demographic and obstetric distinctions. The results showed that in 24% of the cases there were flaws in the vaccination scheme. The conclusion is that improving the quality of the records is a must, besides orientating women about the importance of vaccination, what involves the necessity of a closer follow up and assistance during the prenatal period.

Nursing diagnoses identified in homeless women.

An exploratory descriptive study with a quantitative approach whose objective were: to identify the nurses’ diagnoses in homeless women, using the domains and classes of the NANDA Taxonomy II as its basic structure. The sample was composed of forty homeless women, who attend philanthropic institutions in the downtown area of the city of Sao Paulo. The data were collected between January thirty first and July thirty first of 2006. As for the diagnoses, forty-two classified by the NANDA Taxonomy II were identified. The ten most frequent diagnoses were: inefficient health maintenance (80%); damaged dentition (78%); constipation (35%).We identified thirty other diagnoses, which we decided to call probable, since the defining characteristics and related factors did not match the NANDA Taxonomy. Moreover, other very particular situations were identified in this population; most of them were of a social character, which had neither been included in the identified diagnoses nor in the probable ones, due to the lack of elements to classify them.

Evaluation of prenatal care in low risk pregnancies in the city of Francisco Morato-SP

A descriptive exploratory study whose aim was to verify the quality of low-risk prenatal assistance in the city of Francisco Morato, based on indicators. The analysis observed the triad proposed by Donabedian9, (structure, process and outcome). Seventy-seven (77) puerperae were interviewed, the registries of the Pregnant Woman’s Card and the prenatal care records of those women were analyzed, and the physical structure of the Health Units was observed. Regarding the process indicators, none of the 9 analyzed Units achieved the desirable score (= or > 80%). The structure indicators showed that all the Units possess the minimum necessary material and equipment; nevertheless, none presented a documentation system nor carried out an active search of the pregnant women who failed to attend. The result indicators point out that the majority (79%) considered the service between good and excellent in regard to the assistance and 62.3% reported they were satisfied. It was concluded that for the quality improvement of prenatal assistance, it is essential that all professionals in the city’s Health Units take up continuing education courses.

Oral health of low-income pregnant women in a community of a São Paulo municipality: problems perceived and access to treatment

An exploratory descriptive study whose purpose was to verify oral health problems perceived by low-income pregnant women in a community of a Sao Paulo municipality, as well as their access to treatment during pregnancy. The sample consisted of 169 women who participated in the pregnant women´s group in the Sao Lucas Nucleus for Women’s Health Care, from August 2004 to April 2007. Results showed that the pregnant women’s mean age was 23.7 years, with an age variation of 14 to 42 years, 21.8% of which were adolescent. The educational level was low, as only 16% had concluded the eighth grade, 15.3% had finished high school and 49.7% had not completed the basic education program. Only 10.6% were employed and the family income was 1.4 times the minimum wage. Regarding the perception of oral health problems, 44.9% of the sample identified some problems, such as pain (35.5%), dental cavities (27.6%) or gum bleeding (19.7%). Of the pregnant women who reported problems, only 39.4% sought professional help. Among these, 63.3% did not obtain access to treatment because they were unable to get dental appointments (70%) or due to the fact that they were pregnant (13.3%). It was therefore concluded that, at least in this community, full procedures to assist pregnant women are not being adequately provided. Some women and even some health practitioners erroneously believe that pregnancy represents an obstacle to dental treatments. Therefore, it is necessary to provide better attention from professionals in prenatal assistance regarding the importance of oral health care and its effects on both the women’s and the babies’ health.