Sandra Lúcia Arantes

A participação das mulheres com câncer de mama na escolha do tratamento: um direito a ser conquistado

The purpose of this study was to identify how women with breast cancer perceive themselves as subjects in the process of making decisions on their own treatment. Two objectives were pursued: (a) to identify social and political determinants that by affecting the socialization process of these women might have influenced them in adopting a style of participation and (b) to understand the meaning of such participation as it was perceived by these women at the time they decided on their treatment options. The theoretical-methodological support adopted was that of Symbolic Interactionism. The population sample included nine women with breast cancer. Semi-structured interviews allowed data to be gathered and led to collecting further field notes and data from medical records. The hermeneutic dialectic method was employed as a compass for data interpretation which made it possible to identify two broad theme units: construction of the female identity and style of participation when choosing ones own treatment. By means of these units it was possible to grasp what it meant for these women to deal with the issue of limits and therefore of ethics. In their view they did not participate in the decision-making process being regarded as unqualified to decide on the fate of their own bodies and lives. They were thus seen as obedient subjects in relation to medical decisions that are based on the principle of beneficence where health care delivery is dependent on hierarchical social relationships and power structures are present between classes genders and levels of knowledge. (authors)

Structure in Brazilian maternity hospitals: key characteristics for quality of obstetric and neonatal care

This study aimed to evaluate key characteristics of structure in a sample of maternity hospitals in Brazil. Structure was evaluated according to Ministry of Health criteria and included: geographic location, obstetric volume, presence of ICU, teaching activities, staff qualifications, and availability of equipment and medicines. The results showed differences in staff qualifications and availability of equipment in obstetric and neonatal care according to type of financing, region of the country, and degree of complexity. The North/Northeast and Central-West regions presented the most serious problems with structure. The public and mixed hospitals were better structured in the South/Southeast, reaching satisfactory levels on various items, similar or superior to the private hospitals. The current study contributes to the debate on quality of structure in Brazils hospital services and emphasizes the need to develop analytical studies considering process and results of obstetric and neonatal care.This study aimed to evaluate key characteristics of structure in a sample of maternity hospitals in Brazil. Structure was evaluated according to Ministry of Health criteria and included: geographic location, obstetric volume, presence of ICU, teaching activities, staff qualifications, and availability of equipment and medicines. The results showed differences in staff qualifications and availability of equipment in obstetric and neonatal care according to type of financing, region of the country, and degree of complexity. The North/Northeast and Central-West regions presented the most serious problems with structure. The public and mixed hospitals were better structured in the South/Southeast, reaching satisfactory levels on various items, similar or superior to the private hospitals. The current study contributes to the debate on quality of structure in Brazil’s hospital services and emphasizes the need to develop analytical studies considering process and results of obstetric and neonatal care.

Estrutura das maternidades: aspectos relevantes para a qualidade da atenção ao parto e nascimento

This study aimed to evaluate key characteristics of structure in a sample of maternity hospitals in Brazil. Structure was evaluated according to Ministry of Health criteria and included: geographic location, obstetric volume, presence of ICU, teaching activities, staff qualifications, and availability of equipment and medicines. The results showed differences in staff qualifications and availability of equipment in obstetric and neonatal care according to type of financing, region of the country, and degree of complexity. The North/Northeast and Central-West regions presented the most serious problems with structure. The public and mixed hospitals were better structured in the South/Southeast, reaching satisfactory levels on various items, similar or superior to the private hospitals. The current study contributes to the debate on quality of structure in Brazils hospital services and emphasizes the need to develop analytical studies considering process and results of obstetric and neonatal care.This study aimed to evaluate key characteristics of structure in a sample of maternity hospitals in Brazil. Structure was evaluated according to Ministry of Health criteria and included: geographic location, obstetric volume, presence of ICU, teaching activities, staff qualifications, and availability of equipment and medicines. The results showed differences in staff qualifications and availability of equipment in obstetric and neonatal care according to type of financing, region of the country, and degree of complexity. The North/Northeast and Central-West regions presented the most serious problems with structure. The public and mixed hospitals were better structured in the South/Southeast, reaching satisfactory levels on various items, similar or superior to the private hospitals. The current study contributes to the debate on quality of structure in Brazil’s hospital services and emphasizes the need to develop analytical studies considering process and results of obstetric and neonatal care.

Avaliação da implantação do currículo integrado no programa de graduação em enfermagem

Objective: Evaluating the implementation dynamics of the integrated curriculum in the nursing undergraduate program. Methods: A cross-sectional study on the change of the integrated curriculum of the nursing undergraduate course, with the use of an instrument for assessing the curricular dynamics that allowed reaching students and teachers. Results: Among the 89 participants, 22 were teachers and 67 students. In the group distribution, according to the adequacy levels of curriculum dynamics, 61% considered it as Very Adequate, 18% identified it as Fully Adequate; 9% said it was Adequate, and only 1% reported it to be Partially Adequate. Conclusion: The implementation dynamics of the integrated nursing curriculum was assessed as positive in the different components that constitute the movement of changes.

Atuação da enfermeira obstetra na Comunidade Anhanguera, Campo Grande (MS), na prevenção do câncer cérvico-uterino

Este e um estudo transversal, realizado entre as mulheres da Comunidade Anhanguera, com os objetivos de: conhecer o perfil demografico, socio-cultural, ginecologico e obstetrico, avaliar o comportamento preventivo em saude, e elaborar um plano de assistencia de enfermagem obstetrica. O instrumento de pesquisa foi um formulario aplicado durante visitas domiciliarias a 104 mulheres. Nossos resultados mostraram que 23,08 % desconhecia o exame preventivo de câncer, 50,00 % nunca o realizou, 77,88 % apresentava queixas ginecologicas mas, 62,96% nao procuraram os servicos de saude. Com base nos diagnosticos de enfermagem encontrados foi elaborado um plano de assistencia de enfermagem e educacao em saude as mulheres da comunidade.In the community of Anhanguera a poor neighborhood of the state of Mato Grosso do Sul Brazil a cross-sectional study was carried out in May 1995 dealing with the prevention of cervical cancer. 104 out of 142 women living in the community were enrolled and semistructured questionnaires containing questions concerning demographic sociocultural obstetrical gynecological information and diagnosis were administered. Second-year nursing school students made the home visits and collected the data. A 1995 analysis showed that in the previous 10 years there had been a steady increase of deaths due to cervical cancer in this state especially among women aged 50 years and older owing to difficulty of access to prevention programs or the lack thereof in basic health units and nonutilization of such services by women at risk. Most women studied were in reproductive age with little or no education and a steady partner. There was a high percentage of multiparas (38.46%) 79.25% of deliveries were normal and 20.75% were by cesarean section. 94.66% of newborn infants were breast-fed and 73.39% were breast-fed for 6 months or more. 23.08% of the women did not know about cervical cancer prevention programs and only 50% reported that they had made a visit for preventive examination at least once. 77.88% of the women had gynecological complaints (amount of menstrual flow vaginal discharge dysmenorrhea lower abdominal pain menstrual irregularity and vulvar itching) but only 37.04% obtained medical help.

Estructura de los hospitales de maternidad: aspectos relevantes para la calidad de la atención durante el parto y el nacimiento

This study aimed to evaluate key characteristics of structure in a sample of maternity hospitals in Brazil. Structure was evaluated according to Ministry of Health criteria and included: geographic location, obstetric volume, presence of ICU, teaching activities, staff qualifications, and availability of equipment and medicines. The results showed differences in staff qualifications and availability of equipment in obstetric and neonatal care according to type of financing, region of the country, and degree of complexity. The North/Northeast and Central-West regions presented the most serious problems with structure. The public and mixed hospitals were better structured in the South/Southeast, reaching satisfactory levels on various items, similar or superior to the private hospitals. The current study contributes to the debate on quality of structure in Brazils hospital services and emphasizes the need to develop analytical studies considering process and results of obstetric and neonatal care.This study aimed to evaluate key characteristics of structure in a sample of maternity hospitals in Brazil. Structure was evaluated according to Ministry of Health criteria and included: geographic location, obstetric volume, presence of ICU, teaching activities, staff qualifications, and availability of equipment and medicines. The results showed differences in staff qualifications and availability of equipment in obstetric and neonatal care according to type of financing, region of the country, and degree of complexity. The North/Northeast and Central-West regions presented the most serious problems with structure. The public and mixed hospitals were better structured in the South/Southeast, reaching satisfactory levels on various items, similar or superior to the private hospitals. The current study contributes to the debate on quality of structure in Brazil’s hospital services and emphasizes the need to develop analytical studies considering process and results of obstetric and neonatal care.

The participation of women with breast cancer in choosing their own treatment: a still unachieved right

The purpose of this study was to identify how women with breast cancer perceive themselves as subjects in the process of making decisions on their own treatment. Two objectives were pursued: (a) to identify social and political determinants that by affecting the socialization process of these women might have influenced them in adopting a style of participation and (b) to understand the meaning of such participation as it was perceived by these women at the time they decided on their treatment options. The theoretical-methodological support adopted was that of Symbolic Interactionism. The population sample included nine women with breast cancer. Semi-structured interviews allowed data to be gathered and led to collecting further field notes and data from medical records. The hermeneutic dialectic method was employed as a compass for data interpretation which made it possible to identify two broad theme units: construction of the female identity and style of participation when choosing ones own treatment. By means of these units it was possible to grasp what it meant for these women to deal with the issue of limits and therefore of ethics. In their view they did not participate in the decision-making process being regarded as unqualified to decide on the fate of their own bodies and lives. They were thus seen as obedient subjects in relation to medical decisions that are based on the principle of beneficence where health care delivery is dependent on hierarchical social relationships and power structures are present between classes genders and levels of knowledge. (authors)

La participación de las mujeres con cáncer de mama en el momento de escoger el tratamiento: un derecho a ser conquistado

The purpose of this study was to identify how women with breast cancer perceive themselves as subjects in the process of making decisions on their own treatment. Two objectives were pursued: (a) to identify social and political determinants that by affecting the socialization process of these women might have influenced them in adopting a style of participation and (b) to understand the meaning of such participation as it was perceived by these women at the time they decided on their treatment options. The theoretical-methodological support adopted was that of Symbolic Interactionism. The population sample included nine women with breast cancer. Semi-structured interviews allowed data to be gathered and led to collecting further field notes and data from medical records. The hermeneutic dialectic method was employed as a compass for data interpretation which made it possible to identify two broad theme units: construction of the female identity and style of participation when choosing ones own treatment. By means of these units it was possible to grasp what it meant for these women to deal with the issue of limits and therefore of ethics. In their view they did not participate in the decision-making process being regarded as unqualified to decide on the fate of their own bodies and lives. They were thus seen as obedient subjects in relation to medical decisions that are based on the principle of beneficence where health care delivery is dependent on hierarchical social relationships and power structures are present between classes genders and levels of knowledge. (authors)

Actuación de la enfermera obstétra en la comunidad Anhanguera, Campo Grande (MS), en la prevención del cáncer de cuello uterino

Este e um estudo transversal, realizado entre as mulheres da Comunidade Anhanguera, com os objetivos de: conhecer o perfil demografico, socio-cultural, ginecologico e obstetrico, avaliar o comportamento preventivo em saude, e elaborar um plano de assistencia de enfermagem obstetrica. O instrumento de pesquisa foi um formulario aplicado durante visitas domiciliarias a 104 mulheres. Nossos resultados mostraram que 23,08 % desconhecia o exame preventivo de câncer, 50,00 % nunca o realizou, 77,88 % apresentava queixas ginecologicas mas, 62,96% nao procuraram os servicos de saude. Com base nos diagnosticos de enfermagem encontrados foi elaborado um plano de assistencia de enfermagem e educacao em saude as mulheres da comunidade.In the community of Anhanguera a poor neighborhood of the state of Mato Grosso do Sul Brazil a cross-sectional study was carried out in May 1995 dealing with the prevention of cervical cancer. 104 out of 142 women living in the community were enrolled and semistructured questionnaires containing questions concerning demographic sociocultural obstetrical gynecological information and diagnosis were administered. Second-year nursing school students made the home visits and collected the data. A 1995 analysis showed that in the previous 10 years there had been a steady increase of deaths due to cervical cancer in this state especially among women aged 50 years and older owing to difficulty of access to prevention programs or the lack thereof in basic health units and nonutilization of such services by women at risk. Most women studied were in reproductive age with little or no education and a steady partner. There was a high percentage of multiparas (38.46%) 79.25% of deliveries were normal and 20.75% were by cesarean section. 94.66% of newborn infants were breast-fed and 73.39% were breast-fed for 6 months or more. 23.08% of the women did not know about cervical cancer prevention programs and only 50% reported that they had made a visit for preventive examination at least once. 77.88% of the women had gynecological complaints (amount of menstrual flow vaginal discharge dysmenorrhea lower abdominal pain menstrual irregularity and vulvar itching) but only 37.04% obtained medical help.

Role of the obstetric nurse in the Anhanguera community, Campo Grande (MS), for the prevention of cervical uterine cancer

Este e um estudo transversal, realizado entre as mulheres da Comunidade Anhanguera, com os objetivos de: conhecer o perfil demografico, socio-cultural, ginecologico e obstetrico, avaliar o comportamento preventivo em saude, e elaborar um plano de assistencia de enfermagem obstetrica. O instrumento de pesquisa foi um formulario aplicado durante visitas domiciliarias a 104 mulheres. Nossos resultados mostraram que 23,08 % desconhecia o exame preventivo de câncer, 50,00 % nunca o realizou, 77,88 % apresentava queixas ginecologicas mas, 62,96% nao procuraram os servicos de saude. Com base nos diagnosticos de enfermagem encontrados foi elaborado um plano de assistencia de enfermagem e educacao em saude as mulheres da comunidade.In the community of Anhanguera a poor neighborhood of the state of Mato Grosso do Sul Brazil a cross-sectional study was carried out in May 1995 dealing with the prevention of cervical cancer. 104 out of 142 women living in the community were enrolled and semistructured questionnaires containing questions concerning demographic sociocultural obstetrical gynecological information and diagnosis were administered. Second-year nursing school students made the home visits and collected the data. A 1995 analysis showed that in the previous 10 years there had been a steady increase of deaths due to cervical cancer in this state especially among women aged 50 years and older owing to difficulty of access to prevention programs or the lack thereof in basic health units and nonutilization of such services by women at risk. Most women studied were in reproductive age with little or no education and a steady partner. There was a high percentage of multiparas (38.46%) 79.25% of deliveries were normal and 20.75% were by cesarean section. 94.66% of newborn infants were breast-fed and 73.39% were breast-fed for 6 months or more. 23.08% of the women did not know about cervical cancer prevention programs and only 50% reported that they had made a visit for preventive examination at least once. 77.88% of the women had gynecological complaints (amount of menstrual flow vaginal discharge dysmenorrhea lower abdominal pain menstrual irregularity and vulvar itching) but only 37.04% obtained medical help.