Suzete Maria Fustinoni

Sexualidade feminina: compreendendo seu significado

Para compreender o significado da sexualidade entre mulheres participantes do grupo de orientacao sobre este tema em um servico de planejamento familiar, foi realizado este estudo de natureza qualitativa com enfoque fenomenologico. Atraves das falas das participantes e de reducao fenomenologica encontramos o tema central: vivendo a sexualidade. Os resultados permitiram-nos conhecer um pouco mais sobre o assunto uma vez que as mulheres que procuram o grupo o fazem com o objetivo de curar o seu problema, acreditando terem disfuncoes sexuais, fato que e desmistificado ao perceberem que apresentam dificuldades em vivenciar sua sexualidade.The present qualitative study with a phenomenological focus aimed at understanding the meaning of female sexuality to women who participate in the activities of an orientation group about this subject, organized by a family planning service. Through the analysis of the participants speeches and phenomenological reduction, authors found the central subject: Living sexuality. Results allowed authors to learn a little more on this subject, especially considering that women who took part in this group aimed at solving their problem as they believed they had sexual disorders. However, this fact was demystified, enabling them to understand that they have problems in living their sexuality.

O significado dado pelo profissional de saúde para trabalho de parto e parto humanizado

Objective: To understand the meaning the healthcare professional in charge of the woman in childbirth gives to labor and humanizing delivery. Methods: This is a qualitative research with a phenomenological perspective. Seven physicians and four nurses working at the obstetric center of a public hospital in the city of Sao Paulo were interviewed. Results: After data analysis, two subthemes emerged: Understanding labor and humanizing delivery as a group of differentiated healthcare and behavioral measures, and Identifying failures in the search for healthcare humanization. Conclusion: The study showed that there are still disagreements regarding what is understood as humanizing delivery and what is done in practice. Humanization remains a government policy that is far from efficient, not only because of infrastructural deficits or financial shortages, but because of a lack of contact with the theme, resulting in healthcare that is not individualized or human.ABSTRACT Objective: To understand the meaning the healthcare professional in charge of the woman in childbirth gives to labor and humanizingdelivery. Methods: This is a qualitative research with a phenomenological perspective. Seven physicians and four nurses working at theobstetric center of a public hospital in the city of Sao Paulo were interviewed. Results: After data analysis, two subthemes emerged:Understanding labor and humanizing delivery as a group of differentiated healthcare and behavioral measures, and Identifying fa ilures in thesearch for healthcare humanization. Conclusion: The study showed that there are still disagreements regarding what is understood ashumanizing delivery and what is done in practice. Humanization remains a government policy that is far from efficient, not only because ofinfrastructural deficits or financial shortages, but because of a lack of contact with the theme, resulting in healthcare that is not individualizedor human. Keywords: Humanizing delivery; Humanization of assistance; Professional practice; Obstetrical nursing

The meaning given by the healthcare professional to labor and humanizing delivery

Objective: To understand the meaning the healthcare professional in charge of the woman in childbirth gives to labor and humanizing delivery. Methods: This is a qualitative research with a phenomenological perspective. Seven physicians and four nurses working at the obstetric center of a public hospital in the city of Sao Paulo were interviewed. Results: After data analysis, two subthemes emerged: Understanding labor and humanizing delivery as a group of differentiated healthcare and behavioral measures, and Identifying failures in the search for healthcare humanization. Conclusion: The study showed that there are still disagreements regarding what is understood as humanizing delivery and what is done in practice. Humanization remains a government policy that is far from efficient, not only because of infrastructural deficits or financial shortages, but because of a lack of contact with the theme, resulting in healthcare that is not individualized or human.ABSTRACT Objective: To understand the meaning the healthcare professional in charge of the woman in childbirth gives to labor and humanizingdelivery. Methods: This is a qualitative research with a phenomenological perspective. Seven physicians and four nurses working at theobstetric center of a public hospital in the city of Sao Paulo were interviewed. Results: After data analysis, two subthemes emerged:Understanding labor and humanizing delivery as a group of differentiated healthcare and behavioral measures, and Identifying fa ilures in thesearch for healthcare humanization. Conclusion: The study showed that there are still disagreements regarding what is understood ashumanizing delivery and what is done in practice. Humanization remains a government policy that is far from efficient, not only because ofinfrastructural deficits or financial shortages, but because of a lack of contact with the theme, resulting in healthcare that is not individualizedor human. Keywords: Humanizing delivery; Humanization of assistance; Professional practice; Obstetrical nursing

Perineal outcomes on the left lateral versus vertical semi-sitting birth positions: a randomized study

OBJETIVO: Avaliar se existe associacao entre o resultado perineal em posicoes de parto nao convencionais. METODOS: Estudo clinico randomizado realizado no Centro de Parto Normal da cidade de Itapecerica da Serra, Sao Paulo, Brasil. A amostra foi constituida por 158 nuliparas divididas aleatoriamente na posicao de parto lateral esquerda (81 no grupo experimental) e vertical semi-sentada (77 no grupo controle). RESULTADOS: As mulheres do grupo experimental apresentaram menor edema vulvar - 13,6% vs 29,9%, OR 2.71 (95% IC 1,22 -6,02), episiotomia 16,0% vs 35,1 (OR 2.46 (95% IC 1,27 4,74) e laceracao de labios 37,0% vs 19,5% OR 2,43 (95% IC 1,18 5,01). Na posicao vertical tiveram menor risco de laceracao de 1o grau - 37,7% vs 56,8%. Entretanto, tiveram mais risco de laceracao de 2o grau e episiotomia OR 2,11 (95% 1,02 4,35). O edema vulvar aumentou o risco de trauma espontâneo e episiotomia OR 3,99 (95% IC 1,80 8,85. CONCLUSAO: Esses dados confirmam a hipotese de que a posicao lateral esquerda oferece menos risco de traumas perineais graves.

Female sexuality: understanding its meaning

Para compreender o significado da sexualidade entre mulheres participantes do grupo de orientacao sobre este tema em um servico de planejamento familiar, foi realizado este estudo de natureza qualitativa com enfoque fenomenologico. Atraves das falas das participantes e de reducao fenomenologica encontramos o tema central: vivendo a sexualidade. Os resultados permitiram-nos conhecer um pouco mais sobre o assunto uma vez que as mulheres que procuram o grupo o fazem com o objetivo de curar o seu problema, acreditando terem disfuncoes sexuais, fato que e desmistificado ao perceberem que apresentam dificuldades em vivenciar sua sexualidade.The present qualitative study with a phenomenological focus aimed at understanding the meaning of female sexuality to women who participate in the activities of an orientation group about this subject, organized by a family planning service. Through the analysis of the participants speeches and phenomenological reduction, authors found the central subject: Living sexuality. Results allowed authors to learn a little more on this subject, especially considering that women who took part in this group aimed at solving their problem as they believed they had sexual disorders. However, this fact was demystified, enabling them to understand that they have problems in living their sexuality.

Perfil clínico, sociodemográfico e epidemiológico da mulher com câncer de mama

Objective: To describe the main clinical, therapeutic and epidemiological characteristics of women diagnosed with breast cancer in the Pérola Byington Hospital, between the years 2000 and 2006. Methods: This was a cross sectional study and quantitative nature. Data collection was performed using a structured form. Results: Most of the women were married, white, with low education, catholic and housewives. About 75% had at least one pregnancy, and 33.1% breastfed. Just over 30% had hormone replacement. Smokers were 14.7% and 2.7% were ex-smokers. The initial clinical staging of highest incidence are the II and III, representing together 66.5% of cases. Before the first consultation, 91.3% of women had no diagnosis of breast cancer and no prior treatment. Conclusion: Knowing the profile of women affected by breast cancer is essential for targeting of resources and decision-making. Descriptors: Breast neoplasms; Epidemiology; Women’s health. 1 Undergraduate Student of Nursing from the Federal University of São Paulo (UNIFESP). 2 Master and PhD student in Health Sciences from the Federal University of São Paulo (UNIFESP). 3 PhD in Nursing from the University of São Paulo (USP). Adjunct Professor of the Federal University of São Paulo (UNIFESP). 4 PhD in Health Sciences from the Federal University of São Paulo (UNIFESP). 5 PhD in Nursing from the Federal University of São Paulo. Professor and Director of the São Paulo School of Nursing, of the Federal University of São Paulo (UNIFESP). ISSN 2175-5361. DOI: 10.9789/2175-5361.2017.v9i2.473-479 Magalhães G; Brandão-Souza C; Fustinoni SM; et al. Clinical, sociodemographic and... J. res.: fundam. care. online 2017. abr./jun. 9(2): 473-479 474 RESUMO Objetivo: Descrever as principais características clínico-terapêuticas e epidemiológicas de mulheres diagnosticadas com câncer de mama no Hospital Pérola Byington, entre os anos de 2000 e 2006. Métodos: Tratase de um estudo de corte transversal e natureza quantitativa. A coleta de dados foi realizada por meio de um formulário estruturado. Resultados: A maior parte das mulheres era casada, branca, com baixa escolaridade, católica e do lar. Cerca de 75% tiveram pelo menos uma gravidez, e 33,1% amamentaram. Pouco mais de 30% fizeram reposição hormonal. Eram fumantes 14,7%, e 2,7% ex-fumantes. Os estadiamentos clínicos iniciais de maior incidência são os II e III, juntos representam 66,5% dos casos. Cerca de 91,3% das mulheres não apresentavam diagnóstico do tumor de mama e nem tratamento anterior à primeira consulta. Conclusão: Conhecer o perfil das mulheres acometidas pelo câncer de mama é imprescindível para o direcionamento de recursos e tomadas de decisão. Descritores: Neoplasias da mama; Epidemiologia; Saúde da mulher. RESUMEN Objetivo: Describir las principales características clínicas, terapéuticas y epidemiológicas de las mujeres diagnosticadas con cáncer de mama en el Hospital Pérola Byington, entre los años 2000 y 2006. Métodos: Se realizó un estudio de corte transversal y de naturaleza cuantitativa. La recolección de datos se realizó mediante un formulario estructurado. Resultados: La mayoría de las mujeres estaban casadas, blancas, con bajo nivel de educación, católica y dueña de casa. Aproximadamente el 75% tenía al menos un embarazo, y el 33,1% con leche materna. Algo más del 30% tenían de reemplazo hormonal. Las fumadoras eran el 14,7% y el 2,7% ex fumadoras. La estadificación clínica inicial de mayor incidencia son la II y III, en conjunto representan 66,5% de los casos. Sobre el 91,3% de las mujeres no tenían un diagnóstico de tumor de mama y no se sometieron a tratamiento previo a la primera consulta. Conclusión: Conocer el perfil de las mujeres afectadas por cáncer de mama es esencial para la orientación de los recursos y la toma de decisiones. Descriptores: Neoplasias de la mama; Epidemiología; Salud de la mujer. INTRODUCTION The breast cancer is the most common cause of death among women and, except for nonmelanoma skin cancer, is the most prevalent in 140 countries. For the years 2014-2015 it is estimated that in Brazil there will be 57,000 new cases.1 The Southeast and South regions are characterized by the predominance of breast cancer, with São Paulo being the Brazilian state with the highest number of cases foreseen for the period from 2014 to 2015: 16,160 new cases.3 Against the impact of the disease, it has been created a set of systematic information about the behavior, characteristics and trends of the disease that aim to collect, analyze and classify information of all new cases of cancer, in order to build reliable statistical data of the event of cancer in the population in question. Such tools, called Population-Based Cancer Registry (PBCR) and Cancer Hospital Registry (CHR), assist in the monitoring and evaluation of control activities and cancer research, and help in taking forward the decision to the effects of the treatments.4,5 Registering this data is not always an easy task, considering the lack of material and human resources. The risk of distortion is real,4 and completeness is, often, bad.5 However, there is availability of training and updating of professionals aiming at improved quality. The information contained in RHCS give grants to several studies, including the survival6 and analysis of temporal trends of the phenomena associated with the disease,5 also being possible all characterization of the population according to clinical and epidemiological variables. Given the above and disease-related social impact, this study is envisioned that can assist in knowledge about the profile of women affected by breast cancer and also offer grants to develop strategies for prevention, early detection and treatment of this cancer. OBJECTIVE To describe the clinical-therapeutic, socio-demographic and epidemiological profile of women diagnosed with breast cancer treated at Pérola Byington Hospital. METHOD This is a cross-sectional study, of a quantitative nature, held at the Pérola Byington Hospital, Health Reference Center for Women, in São Paulo. Data were extracted from the RHC and the medical records of women treated in this hospital. The study sample was random among women who received the first diagnosis of breast cancer between the years 2000 and 2006, totaling 299 records. The variables were defined from the Cancer Hospital Records Manual, routines and procedures of INCA,4 which is the database feeding the Hospital Cancer Registry Information System (SisRHC). Out of the total of the variables, were chosen 16 sociodemographics, 9 referring to the tumor and 2 referring to the treatment, since they were considered to be the most interesting for the profile design. In women who have more than one primary tumor, it was considered only the first diagnosis. As inclusion criteria, the woman should have done the first diagnosis of breast cancer, confirmed by biopsy, in service study from 2000 to 2006. Data collection was performed using a form with the sociodemographic and clinical variables. The data collection period was from August 2013 to April 2014. Data were stored in a spreadsheet using Excel program and performed the simple frequency of tests for the variables using the Statistical Package for the Social Sciences version 19. The study was approved by the Unifesp Ethics Committee’s second opinion No. 572,865. ISSN 2175-5361. DOI: 10.9789/2175-5361.2017.v9i2.473-479 Magalhães G; Brandão-Souza C; Fustinoni SM; et al. Clinical, sociodemographic and... J. res.: fundam. care. online 2017. abr./jun. 9(2): 473-479 475 RESULTS Table 1 shows the sociodemographic profile. The predominant age group is between 50 and 69 years (44.15%). The average age was 53.95 with a median of 52 and standard deviation of 13.5 years. With regard to skin color, 31.5% were white and more than 50% of the sample had incompleteness of this variable. Married women predominate with 26.4%. As for education, 4.7% of the study population reported having incomplete primary education, 2% are illiterate and only 0.3% have higher level. Among occupations, the predominance of women was housewifes with 10%. In variable religion, 30.4% were Catholic. The incompleteness of the data was an important limiting factor in the study, ranging from 52.5% in the variable race/ color and 88.3% in variable education. Table 1 – Sociodemographic profile of women diagnosed with breast cancer and treated at Pérola Byington Hospital from January 1, 2000 through December 31, 2006

Association of gestational age with the option of pregnancy termination for fetal abnormalities incompatible with neonatal survival

ABSTRACT Objective: To identify the profile of women seen in a Fetal Medicine unit, diagnosed with fetal abnormality incompatible with neonatal survival in their current pregnancy, and to check the association of gestational age upon diagnosis with the option of pregnancy termination. Methods: This is a retrospective cohort study carried out in the Fetal Medicine Outpatients Clinic of a university hospital, in the city of São Paulo (SP), Brazil, using medical records of pregnant women with fetus presenting abnormalities incompatible with neonatal survival. The sample comprised 94 medical records. The Statistical Package for the Social Sciences (SPSS), version 19, was used for the data statistical analysis. Results: The population of the study included young adult women, who had complete or incomplete high school education, employed, with family income of one to three minimum wages, single, nonsmokers, who did not drink alcoholic beverages or used illicit drugs. Women with more advanced gestational age upon fetal diagnosis (p=0.0066) and/or upon admission to the specialized unit (p=0.0018) presented a lower percentage of termination of pregnancy. Conclusion: Due to characteristics different from those classically considered as of high gestational risk, these women might not be easily identified during the classification of gestational risk, what may contribute to a late diagnosis of fetal diseases. Early diagnosis enables access to specialized multiprofessional care in the proper time for couples counseling on the possibility of requesting legal authorization for pregnancy termination.

Resultado perineal nas posições de parto lateral esquerda versus vertical semi-sentada: estudo randomizado

OBJETIVO: Avaliar se existe associacao entre o resultado perineal em posicoes de parto nao convencionais. METODOS: Estudo clinico randomizado realizado no Centro de Parto Normal da cidade de Itapecerica da Serra, Sao Paulo, Brasil. A amostra foi constituida por 158 nuliparas divididas aleatoriamente na posicao de parto lateral esquerda (81 no grupo experimental) e vertical semi-sentada (77 no grupo controle). RESULTADOS: As mulheres do grupo experimental apresentaram menor edema vulvar - 13,6% vs 29,9%, OR 2.71 (95% IC 1,22 -6,02), episiotomia 16,0% vs 35,1 (OR 2.46 (95% IC 1,27 4,74) e laceracao de labios 37,0% vs 19,5% OR 2,43 (95% IC 1,18 5,01). Na posicao vertical tiveram menor risco de laceracao de 1o grau - 37,7% vs 56,8%. Entretanto, tiveram mais risco de laceracao de 2o grau e episiotomia OR 2,11 (95% 1,02 4,35). O edema vulvar aumentou o risco de trauma espontâneo e episiotomia OR 3,99 (95% IC 1,80 8,85. CONCLUSAO: Esses dados confirmam a hipotese de que a posicao lateral esquerda oferece menos risco de traumas perineais graves.

Resultado perineal en las posiciones de parto lateral izquierdo versus vertical semi-sentada: estudio randomizado

OBJETIVO: Avaliar se existe associacao entre o resultado perineal em posicoes de parto nao convencionais. METODOS: Estudo clinico randomizado realizado no Centro de Parto Normal da cidade de Itapecerica da Serra, Sao Paulo, Brasil. A amostra foi constituida por 158 nuliparas divididas aleatoriamente na posicao de parto lateral esquerda (81 no grupo experimental) e vertical semi-sentada (77 no grupo controle). RESULTADOS: As mulheres do grupo experimental apresentaram menor edema vulvar - 13,6% vs 29,9%, OR 2.71 (95% IC 1,22 -6,02), episiotomia 16,0% vs 35,1 (OR 2.46 (95% IC 1,27 4,74) e laceracao de labios 37,0% vs 19,5% OR 2,43 (95% IC 1,18 5,01). Na posicao vertical tiveram menor risco de laceracao de 1o grau - 37,7% vs 56,8%. Entretanto, tiveram mais risco de laceracao de 2o grau e episiotomia OR 2,11 (95% 1,02 4,35). O edema vulvar aumentou o risco de trauma espontâneo e episiotomia OR 3,99 (95% IC 1,80 8,85. CONCLUSAO: Esses dados confirmam a hipotese de que a posicao lateral esquerda oferece menos risco de traumas perineais graves.

El significado dado por el profesional de salud al trabajo de parto y parto humanizado

Objective: To understand the meaning the healthcare professional in charge of the woman in childbirth gives to labor and humanizing delivery. Methods: This is a qualitative research with a phenomenological perspective. Seven physicians and four nurses working at the obstetric center of a public hospital in the city of Sao Paulo were interviewed. Results: After data analysis, two subthemes emerged: Understanding labor and humanizing delivery as a group of differentiated healthcare and behavioral measures, and Identifying failures in the search for healthcare humanization. Conclusion: The study showed that there are still disagreements regarding what is understood as humanizing delivery and what is done in practice. Humanization remains a government policy that is far from efficient, not only because of infrastructural deficits or financial shortages, but because of a lack of contact with the theme, resulting in healthcare that is not individualized or human.ABSTRACT Objective: To understand the meaning the healthcare professional in charge of the woman in childbirth gives to labor and humanizingdelivery. Methods: This is a qualitative research with a phenomenological perspective. Seven physicians and four nurses working at theobstetric center of a public hospital in the city of Sao Paulo were interviewed. Results: After data analysis, two subthemes emerged:Understanding labor and humanizing delivery as a group of differentiated healthcare and behavioral measures, and Identifying fa ilures in thesearch for healthcare humanization. Conclusion: The study showed that there are still disagreements regarding what is understood ashumanizing delivery and what is done in practice. Humanization remains a government policy that is far from efficient, not only because ofinfrastructural deficits or financial shortages, but because of a lack of contact with the theme, resulting in healthcare that is not individualizedor human. Keywords: Humanizing delivery; Humanization of assistance; Professional practice; Obstetrical nursing