Roselena Bazilli Bergamasco

Percepção da causalidade e dos sinais de near miss atribuídos por mulheres sobreviventes

The objective of this paper is to report the perception of signs and the causes identified by surviving women of the near miss process in the pregnant-delivery cycle. The theoretical framework was based on medical anthropology concepts. Data collection was carried out through interviews arranged as narratives by 13 women who were in an intensive care unit and analyzed according to oral history procedures. During the period of near miss occurrences, the women realized that “something was wrong” and reported their difficulties in obtaining care. They complained about the care received. They pointed out a lack of clarification and orientation concerning their treatment and how to deal with adverse situations during pregnancy. This study concludes that the majority of these women were victims of a lack of knowledge about their own health situation, which led them to search for care only when their clinical status demanded emergency procedures. RESUMEN: El objetivo de este artículo es reportar la percepción de señales y las causas de complicaciones en mujeres supervivientes del proceso de near miss, en el período de embarazo y puerperio. Como marco teórico, se utilizaron conceptos de la antropología médica. Los datos han sido recolectados por medio de entrevistas organizadas en narrativas, con 13 mujeres salidas de una unidad de terapia intensiva, y han sido analizados según los pasos de la historia oral. Las mujeres reportaron que durante la ocurrencia del near miss se dieron cuenta de que algo “iba mal”, que había problemas en la atención médica, y se quejaron de la asistencia recibida. Apuntaron fallos en el esclarecimiento y la orientación sobre el tratamiento, sobre las formas de tratar con situaciones adversas en el embarazo y sobre las posibilidades de agravamiento de enfermedades preexistentes. La mayoría de las mujeres no tenía información sobre su salud, lo que las llevó a buscar asistencia apenas cuando el cuadro exigía atención de emergencia. PALAVRAS-CHAVE: Complicações na gravidez. Saúde da mulher. Medicina reprodutiva. KEywORDS: Pregnancy complications, Women’s health. Reproductive medicine. PALABRAS CLAVE: Complicaciones del embarazo. Salud de la mujer. Medicina reproductiva. Godoy SR, Gualda DMR, Bergamasco RB, Tsunechiro MA Roselena Bazilli Bergamasco Endereço: Avenida Dr. Enéas de Carvalho Aguiar, 419 05403-000 São Paulo, SP, Brasil E-mail: roselena@usp.br Artigo original: Pesquisa Recebido em: 14 de janeiro de 2008 Aprovação final: 15 de agosto de 2008The objective of this paper is to report the perception of signs and the causes identified by surviving women of the near miss process in the pregnant-delivery cycle. The theoretical framework was based on medical anthropology concepts. Data collection was carried out through interviews arranged as narratives by 13 women who were in an intensive care unit and analyzed according to oral history procedures. During the period of near miss occurrences, the women realized that “something was wrong” and reported their difficulties in obtaining care. They complained about the care received. They pointed out a lack of clarification and orientation concerning their treatment and how to deal with adverse situations during pregnancy. This study concludes that the majority of these women were victims of a lack of knowledge about their own health situation, which led them to search for care only when their clinical status demanded emergency procedures. RESUMEN: El objetivo de este artículo es reportar la percepción de señales y las causas de complicaciones en mujeres supervivientes del proceso de near miss, en el período de embarazo y puerperio. Como marco teórico, se utilizaron conceptos de la antropología médica. Los datos han sido recolectados por medio de entrevistas organizadas en narrativas, con 13 mujeres salidas de una unidad de terapia intensiva, y han sido analizados según los pasos de la historia oral. Las mujeres reportaron que durante la ocurrencia del near miss se dieron cuenta de que algo “iba mal”, que había problemas en la atención médica, y se quejaron de la asistencia recibida. Apuntaron fallos en el esclarecimiento y la orientación sobre el tratamiento, sobre las formas de tratar con situaciones adversas en el embarazo y sobre las posibilidades de agravamiento de enfermedades preexistentes. La mayoría de las mujeres no tenía información sobre su salud, lo que las llevó a buscar asistencia apenas cuando el cuadro exigía atención de emergencia. PALAVRAS-CHAVE: Complicações na gravidez. Saúde da mulher. Medicina reprodutiva. KEywORDS: Pregnancy complications, Women’s health. Reproductive medicine. PALABRAS CLAVE: Complicaciones del embarazo. Salud de la mujer. Medicina reproductiva. Godoy SR, Gualda DMR, Bergamasco RB, Tsunechiro MA Roselena Bazilli Bergamasco Endereço: Avenida Dr. Enéas de Carvalho Aguiar, 419 05403-000 São Paulo, SP, Brasil E-mail: roselena@usp.br Artigo original: Pesquisa Recebido em: 14 de janeiro de 2008 Aprovação final: 15 de agosto de 2008

Severe obstetric morbidity - near miss. Meaning for surviving women: oral history.

The aim of this study was to understand the meaning of the near miss experience during pregnancy, labor, birth and puerperium in the life of the women who survived. The conceptions of Medical Anthropology were used as the theoretical framework for the analysis and the Oral History as the methodological reference. The research was developed including women who live in a micro-region of the northwest of Sao Paulo state and Fernandopolis district. Thirteen women who returned from the intensive care unit of a municipal general hospital, from 2003 to 2005, participated in this study. The interviews were presented as narratives. The data showed that the experience of a severe complication with risk of death was remarkable, unpleasant, evidencing feelings of suffer, fear and worry. The women noticed that “something is wrong”, then they looked for a health service unit and evaluated the assistance given. The main women’s worry was related to the child, the husband and the family. The findings of this study permitted to have a comprehensive vision of the experience of the women who faced the risk of maternal death and survived, as well as the changes in their lives and the ways of coping and overcoming the difficulties found.

Repercussions of near miss and women's perception of care received in the critical care unit

Objective: To report the repercussions of near miss on the life of women who survived that event and the women’ perception of the care received during the near miss event in the critical care unit. Methods: This was a qualitative study using oral history interviewing. Medical anthropology served as the conceptual framework for the study. Data were collected from 2003 to 2005 through narrative interviews with 13 women who were discharged from a critical care unit and who were residents in Fernandopolis, SP. Results: Some of the women reported that the experience of near miss brought suffering and sequelae such as infertility, depressive symptoms, and lack of perspectives in life. Other women were able to adjust and redirect their life. Many women complained of the care received, and the negligence and/or incompetence of health care professionals during the near miss event. Conclusion: The study’s findings allowed us to understand the experience of this sample of women and suggested they receive a dehumanized care. There is a need for further studies regarding health care professional ethical behaviors.

Near miss: repercussões e percepção da assistência recebida por mulheres sobreviventes egressas de uma unidade de terapia intensiva

Objective: To report the repercussions of near miss on the life of women who survived that event and the women’ perception of the care received during the near miss event in the critical care unit. Methods: This was a qualitative study using oral history interviewing. Medical anthropology served as the conceptual framework for the study. Data were collected from 2003 to 2005 through narrative interviews with 13 women who were discharged from a critical care unit and who were residents in Fernandopolis, SP. Results: Some of the women reported that the experience of near miss brought suffering and sequelae such as infertility, depressive symptoms, and lack of perspectives in life. Other women were able to adjust and redirect their life. Many women complained of the care received, and the negligence and/or incompetence of health care professionals during the near miss event. Conclusion: The study’s findings allowed us to understand the experience of this sample of women and suggested they receive a dehumanized care. There is a need for further studies regarding health care professional ethical behaviors.

Near miss: repercusiones y percepción de la asistencia recibida por mujeres sobrevivientes egresadas de una unidad de cuidados intensivos

Objective: To report the repercussions of near miss on the life of women who survived that event and the women’ perception of the care received during the near miss event in the critical care unit. Methods: This was a qualitative study using oral history interviewing. Medical anthropology served as the conceptual framework for the study. Data were collected from 2003 to 2005 through narrative interviews with 13 women who were discharged from a critical care unit and who were residents in Fernandopolis, SP. Results: Some of the women reported that the experience of near miss brought suffering and sequelae such as infertility, depressive symptoms, and lack of perspectives in life. Other women were able to adjust and redirect their life. Many women complained of the care received, and the negligence and/or incompetence of health care professionals during the near miss event. Conclusion: The study’s findings allowed us to understand the experience of this sample of women and suggested they receive a dehumanized care. There is a need for further studies regarding health care professional ethical behaviors.

Perception of causality and signs of near miss referred by surviving women

The objective of this paper is to report the perception of signs and the causes identified by surviving women of the near miss process in the pregnant-delivery cycle. The theoretical framework was based on medical anthropology concepts. Data collection was carried out through interviews arranged as narratives by 13 women who were in an intensive care unit and analyzed according to oral history procedures. During the period of near miss occurrences, the women realized that “something was wrong” and reported their difficulties in obtaining care. They complained about the care received. They pointed out a lack of clarification and orientation concerning their treatment and how to deal with adverse situations during pregnancy. This study concludes that the majority of these women were victims of a lack of knowledge about their own health situation, which led them to search for care only when their clinical status demanded emergency procedures. RESUMEN: El objetivo de este artículo es reportar la percepción de señales y las causas de complicaciones en mujeres supervivientes del proceso de near miss, en el período de embarazo y puerperio. Como marco teórico, se utilizaron conceptos de la antropología médica. Los datos han sido recolectados por medio de entrevistas organizadas en narrativas, con 13 mujeres salidas de una unidad de terapia intensiva, y han sido analizados según los pasos de la historia oral. Las mujeres reportaron que durante la ocurrencia del near miss se dieron cuenta de que algo “iba mal”, que había problemas en la atención médica, y se quejaron de la asistencia recibida. Apuntaron fallos en el esclarecimiento y la orientación sobre el tratamiento, sobre las formas de tratar con situaciones adversas en el embarazo y sobre las posibilidades de agravamiento de enfermedades preexistentes. La mayoría de las mujeres no tenía información sobre su salud, lo que las llevó a buscar asistencia apenas cuando el cuadro exigía atención de emergencia. PALAVRAS-CHAVE: Complicações na gravidez. Saúde da mulher. Medicina reprodutiva. KEywORDS: Pregnancy complications, Women’s health. Reproductive medicine. PALABRAS CLAVE: Complicaciones del embarazo. Salud de la mujer. Medicina reproductiva. Godoy SR, Gualda DMR, Bergamasco RB, Tsunechiro MA Roselena Bazilli Bergamasco Endereço: Avenida Dr. Enéas de Carvalho Aguiar, 419 05403-000 São Paulo, SP, Brasil E-mail: roselena@usp.br Artigo original: Pesquisa Recebido em: 14 de janeiro de 2008 Aprovação final: 15 de agosto de 2008The objective of this paper is to report the perception of signs and the causes identified by surviving women of the near miss process in the pregnant-delivery cycle. The theoretical framework was based on medical anthropology concepts. Data collection was carried out through interviews arranged as narratives by 13 women who were in an intensive care unit and analyzed according to oral history procedures. During the period of near miss occurrences, the women realized that “something was wrong” and reported their difficulties in obtaining care. They complained about the care received. They pointed out a lack of clarification and orientation concerning their treatment and how to deal with adverse situations during pregnancy. This study concludes that the majority of these women were victims of a lack of knowledge about their own health situation, which led them to search for care only when their clinical status demanded emergency procedures. RESUMEN: El objetivo de este artículo es reportar la percepción de señales y las causas de complicaciones en mujeres supervivientes del proceso de near miss, en el período de embarazo y puerperio. Como marco teórico, se utilizaron conceptos de la antropología médica. Los datos han sido recolectados por medio de entrevistas organizadas en narrativas, con 13 mujeres salidas de una unidad de terapia intensiva, y han sido analizados según los pasos de la historia oral. Las mujeres reportaron que durante la ocurrencia del near miss se dieron cuenta de que algo “iba mal”, que había problemas en la atención médica, y se quejaron de la asistencia recibida. Apuntaron fallos en el esclarecimiento y la orientación sobre el tratamiento, sobre las formas de tratar con situaciones adversas en el embarazo y sobre las posibilidades de agravamiento de enfermedades preexistentes. La mayoría de las mujeres no tenía información sobre su salud, lo que las llevó a buscar asistencia apenas cuando el cuadro exigía atención de emergencia. PALAVRAS-CHAVE: Complicações na gravidez. Saúde da mulher. Medicina reprodutiva. KEywORDS: Pregnancy complications, Women’s health. Reproductive medicine. PALABRAS CLAVE: Complicaciones del embarazo. Salud de la mujer. Medicina reproductiva. Godoy SR, Gualda DMR, Bergamasco RB, Tsunechiro MA Roselena Bazilli Bergamasco Endereço: Avenida Dr. Enéas de Carvalho Aguiar, 419 05403-000 São Paulo, SP, Brasil E-mail: roselena@usp.br Artigo original: Pesquisa Recebido em: 14 de janeiro de 2008 Aprovação final: 15 de agosto de 2008

Percepción de la causalidad y de las señales del near miss identificados por mujeres supervivientes

The objective of this paper is to report the perception of signs and the causes identified by surviving women of the near miss process in the pregnant-delivery cycle. The theoretical framework was based on medical anthropology concepts. Data collection was carried out through interviews arranged as narratives by 13 women who were in an intensive care unit and analyzed according to oral history procedures. During the period of near miss occurrences, the women realized that “something was wrong” and reported their difficulties in obtaining care. They complained about the care received. They pointed out a lack of clarification and orientation concerning their treatment and how to deal with adverse situations during pregnancy. This study concludes that the majority of these women were victims of a lack of knowledge about their own health situation, which led them to search for care only when their clinical status demanded emergency procedures. RESUMEN: El objetivo de este artículo es reportar la percepción de señales y las causas de complicaciones en mujeres supervivientes del proceso de near miss, en el período de embarazo y puerperio. Como marco teórico, se utilizaron conceptos de la antropología médica. Los datos han sido recolectados por medio de entrevistas organizadas en narrativas, con 13 mujeres salidas de una unidad de terapia intensiva, y han sido analizados según los pasos de la historia oral. Las mujeres reportaron que durante la ocurrencia del near miss se dieron cuenta de que algo “iba mal”, que había problemas en la atención médica, y se quejaron de la asistencia recibida. Apuntaron fallos en el esclarecimiento y la orientación sobre el tratamiento, sobre las formas de tratar con situaciones adversas en el embarazo y sobre las posibilidades de agravamiento de enfermedades preexistentes. La mayoría de las mujeres no tenía información sobre su salud, lo que las llevó a buscar asistencia apenas cuando el cuadro exigía atención de emergencia. PALAVRAS-CHAVE: Complicações na gravidez. Saúde da mulher. Medicina reprodutiva. KEywORDS: Pregnancy complications, Women’s health. Reproductive medicine. PALABRAS CLAVE: Complicaciones del embarazo. Salud de la mujer. Medicina reproductiva. Godoy SR, Gualda DMR, Bergamasco RB, Tsunechiro MA Roselena Bazilli Bergamasco Endereço: Avenida Dr. Enéas de Carvalho Aguiar, 419 05403-000 São Paulo, SP, Brasil E-mail: roselena@usp.br Artigo original: Pesquisa Recebido em: 14 de janeiro de 2008 Aprovação final: 15 de agosto de 2008The objective of this paper is to report the perception of signs and the causes identified by surviving women of the near miss process in the pregnant-delivery cycle. The theoretical framework was based on medical anthropology concepts. Data collection was carried out through interviews arranged as narratives by 13 women who were in an intensive care unit and analyzed according to oral history procedures. During the period of near miss occurrences, the women realized that “something was wrong” and reported their difficulties in obtaining care. They complained about the care received. They pointed out a lack of clarification and orientation concerning their treatment and how to deal with adverse situations during pregnancy. This study concludes that the majority of these women were victims of a lack of knowledge about their own health situation, which led them to search for care only when their clinical status demanded emergency procedures. RESUMEN: El objetivo de este artículo es reportar la percepción de señales y las causas de complicaciones en mujeres supervivientes del proceso de near miss, en el período de embarazo y puerperio. Como marco teórico, se utilizaron conceptos de la antropología médica. Los datos han sido recolectados por medio de entrevistas organizadas en narrativas, con 13 mujeres salidas de una unidad de terapia intensiva, y han sido analizados según los pasos de la historia oral. Las mujeres reportaron que durante la ocurrencia del near miss se dieron cuenta de que algo “iba mal”, que había problemas en la atención médica, y se quejaron de la asistencia recibida. Apuntaron fallos en el esclarecimiento y la orientación sobre el tratamiento, sobre las formas de tratar con situaciones adversas en el embarazo y sobre las posibilidades de agravamiento de enfermedades preexistentes. La mayoría de las mujeres no tenía información sobre su salud, lo que las llevó a buscar asistencia apenas cuando el cuadro exigía atención de emergencia. PALAVRAS-CHAVE: Complicações na gravidez. Saúde da mulher. Medicina reprodutiva. KEywORDS: Pregnancy complications, Women’s health. Reproductive medicine. PALABRAS CLAVE: Complicaciones del embarazo. Salud de la mujer. Medicina reproductiva. Godoy SR, Gualda DMR, Bergamasco RB, Tsunechiro MA Roselena Bazilli Bergamasco Endereço: Avenida Dr. Enéas de Carvalho Aguiar, 419 05403-000 São Paulo, SP, Brasil E-mail: roselena@usp.br Artigo original: Pesquisa Recebido em: 14 de janeiro de 2008 Aprovação final: 15 de agosto de 2008