Valdecyr Herdy Alves

Parto e nascimento: saberes e práticas humanizadas

Este estudo teve como objetivos descrever os conceitos instituidos pelos profissionais de saude que atuam na atencao ao parto e nascimento sobre a humanizacao do parto, identificar saberes e praticas da humanizacao do parto e nascimento, e avaliar a implementacao dos saberes e praticas na assistencia ao parto e nascimento e sua relacao com a humanizacao. Trata-se de uma pesquisa qualitativa do tipo descritivo-exploratoria realizada na Maternidade do Hospital Universitario Antonio Pedro, cujos sujeitos foram dezesseis profissionais de saude, entre medicos obstetras e enfermeiros obstetras. Os dados foram obtidos atraves de entrevista semiestruturada e analisados pelo metodo da analise de conteudo. Concluiu-se que os profissionais detem conhecimentos acerca das politicas de saude que dispoem sobre a humanizacao do parto e nascimento, seguem estes preceitos, e sua pratica profissional vai ao encontro do que e preconizado pelas politicas. Estes resultados, no entanto, divergem de resultados observados em estudos anteriores.

Mães de recém-nascidos hospitalizados: em/entre círculos no processo de amamentação

Objective: To describe the process of breastfeeding of mothers with newborns (NB) hospitalized in a neonatal unit. Methods: This is a qualitative approach study, conducted in a maternity hospital located in the central region of Curitiba/PR, from April to May 2007. Were interviewed ten mothers of infants hospitalized. Data were collected through interviews and subjected to content analysis. Results: Was identified the following thematic unit: the process of breastfeeding of mothers with infants hospitalized and the paths of vicious and virtuous circles. The elements of the “vicious circle” were related to attendance/health actions; the elements of the “virtuous circle” were related to strengthening the role of women, importance and appreciation of context and, social network. Conclusion: Considering the various dimensions that constitute the process of breastfeeding, it is very urgent the incorporation of practices that reinforce the principle and the meaning of integral healthcare.

Associação entre as orientações pré-natais em aleitamento materno e a satisfação com o apoio para amamentar

OBJECTIVES: to analyze the association between prenatal guidance on breastfeeding and satisfaction of pregnant women with the breastfeeding support provided. METHODS: a cross-sectional study was carried out in the city of Rio de Janeiro, Brazil, with a representative sample of 461 pregnant women accompanied at 15 hospitals with more than 1000 deliveries/year as part of the Brazilian National Health System. Seven of these hospitals were accredited by the Baby-Friendly Hospital Initiative and eight not. The prevalence rates for satisfaction were obtained using a Poisson regression model with robust variance and a hierarchized model. RESULTS: 62.0% of pregnant women were satisfied with the support received for breastfeeding. The variables associated with the outcome on multiple analysis were having received guidance on breastfeeding (PR=1.77; CI95%: 1.38-2.28), having received guidance on free demand (PR=1.52; CI95%: 1.22-1.88), having received guidance on not using a feeding bottle and other kinds of milk (PR=1.35; CI95%: 1.15-1.58) and quality of prenatal care in the view of the pregnant woman (RP=1.22; CI95%: 1.08-1.38). CONCLUSIONS: the satisfaction of the pregnant woman with the breastfeeding support received did not vary according to the socio-demographic characteristics of the woman, although it was associated with prenatal guidance on breastfeeding, underlining the importance of the quality of care.

REFLEXÕES SOBRE O VALOR DA AMAMENTAÇÃ O COMO PRÁTICA DE SAÚDE: UMA CONTRIBUIÇÃ O DA ENFERMAGEM

The study aims at the identification and analysis, under the view of the nurses, of the axiological value process of the promotion, protection and support related to the maternal breastfeeding. It presents a qualitative and descriptive approach. 11 acting nurses had participated on the Program of Maternal Breastfeeding - Amiga da Amamentacao (Breatsfeeding Friend) Basic Unit Initiative in Rio de Janeiro city. In the analysis, the formulation of thematic categories and the articulation with Max Scheler Value Theory were chosen. The data demonstrated the operational form linked to the guidelines of Health Ministry, as nutritional approach, instead of recovering the breastfeeding woman as a familiar and social value of the care net, which threatens the value of breastfeeding and prevents the entire potential of feeling/knowing/doing. We conclude that the comprehension of the value of care related to biological, cultural and social aspects, grants the breastfeeding caring quality and that it has to be more and more valued and stimulated, as breastfeeding deepens the affection link between mother and child. DESCRIPTORS: Nursery. Breast feeding. Social values.Resumen pt: O estudo objetiva identificar e analisar, sob a otica de enfermeiros, o processo de valoracao axiologica da promocao, protecao e apoio ao aleitamento mat...

O manejo clínico da amamentação: saberes dos enfermeiros

Objetivo:Discutir el conocimiento de las enfermeras en el manejo clinico de la lactancia materna, visando los beneficios del amamantamiento en la salud de las mujeres y de los ninos.Metodo:Estudio descriptivo, exploratorio, cualitativo, realizado en maternidades publicas de Niteroi con 59 enfermeras que trabajan en el centro obstetrico, en el alojamiento conjunto y en la enfermeria de gestantes. Los datos fueron recolectados a traves de entrevistas semiestructuradas y analizados de acuerdo con la construccion de categorias tematicas.Resultados:El conocimiento de las enfermeras sobre el manejo clinico de la lactancia materna resulta de una experiencia tecnica de asistencia basada en actitudes de apoyo a la lactancia, envolviendo la madre, el recien-nacido y la familia.Conclusion:El conocimiento tecnico-cientifico es muy importante debido al favorecimiento de las estrategias para promover la lactancia materna en el manejo clinico del amamantamiento.Objective: Discuss the knowledge of nurses in the clinical management of breastfeeding, so the benefits of breastfeeding on the health of women and children. Method: A descriptive, exploratory qualitative study conducted in public hospitals of Niteroi with fifty-nine nurses working in obstetrics center, rooming and ward pregnant. Data were collected through semi-structured interviews and analyzed according to the construction of thematic categories. Results: Knowledge of nurses about the clinical management of breastfeeding, the result of an assistance expertise based on attitudes to support lactation involving women-nursing mother, the newborn and family. Conclusion: The technical and scientific knowledge it becomes very important because the strategies to promote breastfeeding in the clinical management of breastfeeding.

Information for the option of planned home birth: women's right to choose

This article is part of an investigation which used the institutional ethnography of Dorothy Smith, aiming to describe womens process of choice in planned home birth. It used interviews held with 17 women who gave birth at home between 2008 and 2010 in Rio de Janeiro. We selected one category: information - a step for the option for planned home birth. The category was constructed based on six subcategories: knowing persons who had a home birth; knowing persons with negative experiences; the Internet as a source of information; books as a source of information, information from health professionals; and, the exchanging of information between women. The information acts as a network of knowledge, reports and experiences in their symbolic dimensions, favoring the raising of consciousness and the social organization of support. These knowledges and practices are a foundation for a social understanding and the womens discourse in the option for planned home birth. DESCRIPTORS: Health policy. Normal birth. Information. Obstetric nursing.This article is part of an investigation which used the institutional ethnography of Dorothy Smith, aiming to describe womens process of choice in planned home birth. It used interviews held with 17 women who gave birth at home between 2008 and 2010 in Rio de Janeiro. We selected one category: information - a step for the option for planned home birth. The category was constructed based on six subcategories: knowing persons who had a home birth; knowing persons with negative experiences; the Internet as a source of information; books as a source of information, information from health professionals; and, the exchanging of information between women. The information acts as a network of knowledge, reports and experiences in their symbolic dimensions, favoring the raising of consciousness and the social organization of support. These knowledges and practices are a foundation for a social understanding and the womens discourse in the option for planned home birth. DESCRIPTORS: Health politicy. Natural childbirth. Information. Nursing obstetrics.

Manejo clínico da amamentação: Valoração axiológica sob a ótica da mulher-nutriz

Objective: To analyze the axiological value of nurturing women regarding the clinical management of breastfeeding. Methods: This is a phenomenological qualitative study based on the theory of Max Schelers values, conducted between May and June 2014 in the joint quarters of two university hospitals in Niteroi/RJ and Santa Maria/RS. Twenty nursing mothers participated in the study and The data was organized, subjected to the comprehensive analysis technique and was interpreted according to the value theory and the specific policies of breastfeeding. Results: Two thematic units emerged in the study: breastfeeding clinical management and its vital value and the health network to support breastfeeding care: a utility value. Conclusion: The management of breastfeeding enables a health care that goes beyond the interests, intentions and views of health professionals and institutions; human and existential questions must be seized by rational experiences, linked to those relating to the perception of the nurturer. This perception provides a reframing that is centered in the care provided to women, children and the family.Objective: To analyze the axiological value of nurturing women regarding the clinical management of breastfeeding. Methods: This is a phenomenological qualitative study based on the theory of Max Schelers values, conducted between May and June 2014 in the joint quarters of two university hospitals in Niterói/RJ and Santa Maria/RS. Twenty nursing mothers participated in the study and The data was organized, subjected to the comprehensive analysis technique and was interpreted according to the value theory and the specific policies of breastfeeding. Results: Two thematic units emerged in the study: breastfeeding clinical management and its vital value and the health network to support breastfeeding care: a utility value. Conclusion: The management of breastfeeding enables a health care that goes beyond the interests, intentions and views of health professionals and institutions; human and existential questions must be seized by rational experiences, linked to those relating to the perception of the nurturer. This perception provides a reframing that is centered in the care provided to women, children and the family.

Manejo clínico da amamentação: atuação do enfermeiro na Unidade de Terapia Intensiva Neonatal

Aim: to understand the clinical management of breastfeeding performed by nurses in the Neonatal Intensive Care Unit (NICU) of the University Hospital Antonio Pedro, Universidade Federal Fluminense. Method: a descriptive, exploratory study with qualitative approach, through semi-structured interviews with 11 nurses working in this Unit, whose statements were submitted to content analysis in the thematic mode. Results: two categories emerged: the guidance strategies of nurses in the clinical management of breastfeeding in the NICU; and Network of promotion and support for nursing mothers at hospital discharge: a path to successful breastfeeding. Both categories focus on the guidelines as a strategy for encouraging and supporting breastfeeding. Final considerations: nurses trained and sensitized to the practice of clinical management of breastfeeding contribute to the support of breastfeeding and coping with early weaning

A peregrinação no período reprodutivo: uma violência no campo obstétrico

Objective: To describe and analyze the perceptions of women about obstetric care in reference to the attendance of their right of access to health care during the process of labor and birth. Method: Descriptive and exploratory study. Were interviewed 56 women in sets of four public hospitals in Metropolitan Region II of Rio de Janeiro State, developed in 2014. Data analysis were the thematic content mode. Results: Showed a recurring problem for women, the pilgrimage, which has three connotations about the law, lack of care and feelings experienced by women who searches service care. These points are interconnected by the logic of failure with action to ensure sexual rights, reproductive and human, in addition to unpreparedness of the institutions in providing quality care. Conclusion: It was found the need for changes in obstetric care paradigms, valuing respect, care to women in behalf of your health.Objetivo: Describir y analizar las percepciones de las mujeres acerca de la atencion obstetrica en relacion con el cuidado de su derecho de acceso a la asistencia sanitaria durante el proceso de parto y el nacimiento. Metodos: Descriptivo, exploratorio celebro 56 mujeres en grupos de cuatro hospitales publicos especiales Metropolitana Region II del Estado de Rio de Janeiro, desarrollado en 2014. El analisis de datos fue el modo de contenido tematico. Resultados: Mostro un problema recurrente para las mujeres, la peregrinacion, que tiene tres connotaciones acerca de la ley, la falta de atencion y sentimientos experimentados por el servicio de busqueda. Estos puntos estan interconectados por la logica del incumplimiento de las medidas para garantizar los derechos sexuales, reproductivos y humanos, ademas de la falta de preparacion de las instituciones en la prestacion de una atencion de calidad. Conclusion: Se encontro la necesidad de cambios en los paradigmas de atencion obstetrica, valorando el respeto, la atencion a las mujeres por el bien de su salud.

Informação para a opção pelo parto domiciliar planejado: um direito de escolha das mulheres

This article is part of an investigation which used the institutional ethnography of Dorothy Smith, aiming to describe womens process of choice in planned home birth. It used interviews held with 17 women who gave birth at home between 2008 and 2010 in Rio de Janeiro. We selected one category: information - a step for the option for planned home birth. The category was constructed based on six subcategories: knowing persons who had a home birth; knowing persons with negative experiences; the Internet as a source of information; books as a source of information, information from health professionals; and, the exchanging of information between women. The information acts as a network of knowledge, reports and experiences in their symbolic dimensions, favoring the raising of consciousness and the social organization of support. These knowledges and practices are a foundation for a social understanding and the womens discourse in the option for planned home birth. DESCRIPTORS: Health policy. Normal birth. Information. Obstetric nursing.This article is part of an investigation which used the institutional ethnography of Dorothy Smith, aiming to describe womens process of choice in planned home birth. It used interviews held with 17 women who gave birth at home between 2008 and 2010 in Rio de Janeiro. We selected one category: information - a step for the option for planned home birth. The category was constructed based on six subcategories: knowing persons who had a home birth; knowing persons with negative experiences; the Internet as a source of information; books as a source of information, information from health professionals; and, the exchanging of information between women. The information acts as a network of knowledge, reports and experiences in their symbolic dimensions, favoring the raising of consciousness and the social organization of support. These knowledges and practices are a foundation for a social understanding and the womens discourse in the option for planned home birth. DESCRIPTORS: Health politicy. Natural childbirth. Information. Nursing obstetrics.