Fatores associados à maior satisfação das mulheres com o atendimento ao parto em maternidades no Sul do Brasil

A satisfação da mulher com o atendimento ao parto é considerada uma importante medida de desfecho, além de ser uma forma indireta de avaliar a qualidade dos serviços, centrada na percepção da usuária. O objetivo deste estudo foi identificar os fatores associados à maior satisfação das mulheres com o atendimento ao seu parto em maternidades das redes pública e privada. Trata-se de estudo transversal com mulheres que tiveram parto em uma maternidade pública e outra privada em Porto Alegre, RS. Foram selecionadas aleatoriamente puérperas que tiveram recém-nascidos a termo e sem intercorrências neonatais. As entrevistas ocorreram 30 dias após o parto, em seus domicílios, onde foi aplicado presencialmente questionário estruturado. A satisfação com o parto foi medida por meio de uma escala com cinco níveis, de muito satisfeita a muito insatisfeita. Foram estimadas razões de prevalência (RP) por regressão de Poisson com variância robusta, utilizando modelo hierarquizado. Após análise multivariável, os fatores que se mantiveram associados à maior satisfação com o parto foram: estar satisfeita com o pré-natal (RP 1,3; IC 95% 1,06-1,59), compreender as informações dadas (RP 1,40; IC 95% 1,01-1,95), não sofrer violência obstétrica (RP 1,53 IC 1,01-2,31), e ter o bebê colocado para mamar na primeira hora de vida (RP 1,63; IC 95% 1,26-2,11). Além disso, privacidade no local de parto, sentir-se à vontade para fazer perguntas e pedir analgesia e ser atendida também se relacionaram com a satisfação nas análises de sensibilidade. Podemos concluir que a melhor avaliação das mulheres sobre a experiência de parto está relacionada com princípios básicos da relação profissional-parturiente, como ética, empatia e habilidades de comunicação; além de outras ações como qualificada atenção prénatal e amamentação do bebê na primeira hora de vida.Women's satisfaction with childbirth is considered an important outcome measure, besides being an indirect way of evaluating the quality of services, centered on the user’s perception. The objective of this study was to evaluate the associated factors with greater women's satisfaction with childbirth in public and private maternity hospitals. This is a crosssectional study with women who had delivered in a public or in a private maternity in Porto Alegre, RS. Postpartum women who had full-term newborns without neonatal complications were randomly selected. A structured questionnaire was applied, in person, at their home 30 days after the delivery. Satisfaction with childbirth was measured by a five-level scale, from very satisfied to very unsatisfied. Prevalence ratios (PR) were estimated by Poisson regression with robust variance using a hierarchical model. After multivariate analysis, the factors that remained associated with greater satisfaction with childbirth were: be satisfied with prenatal care (PR 1,3, 95% CI 1,06-1,59) understand the given information (PR 1.40, 95% CI 1.01- 1.95), do not suffer obstetric violence (PR 1.53, 95% CI 1,01-2,31), and breastfeed the baby in the first hour of life (PR 1.63, 95% CI, 1.26-2.11). In addition, privacy at the place of delivery, being comfortable to ask questions and asking for analgesia and being attended were also related to satisfaction in the sensitivity analyses. In conclusion, the best evaluation of women about childbirth experience is related to basic principles of the professional-parturient relationship such as ethics, empathy and communication skills; as well as other actions such as qualified prenatal care and breastfeeding the baby in the first hour of life

Factors associated with women’s satisfaction with prenatal care in Porto Alegre, Rio Grande do Sul, Brazil

O objetivo deste artigo é identificar fatores associados à plena satisfação com a atenção pré-natal em serviços de saúde de Porto Alegre, Rio Grande do Sul. Estudo transversal, com 287 mulheres que realizaram pré-natal na capital gaúcha. As mulheres foram selecionadas aleatoriamente em duas maternidades de grande porte (pública e privada) e entrevistadas nos seus domicílios, cerca de 30 dias após o parto, entre janeiro e agosto de 2016. A satisfação foi aferida por meio de escala Likert (muito satisfeita a muito insatisfeita). Foram estimadas razões de prevalência (RP) por regressão de Poisson com estimação robusta da variância, utilizando modelo hierarquizado. Os fatores associados à plena satisfação foram: ingresso no ensino superior (RP=1,49; IC95%:1,08- 2,06); atendimento multiprofissional (RP=1,29; IC95%:1,00-1,66); recebimento de orientações sobre amamentação (RP=1,33; IC95%:1,05-1,68) e sobre local do parto (RP=1,56; IC95%:1,12- 2,17); e sentimento da mulher de estar à vontade para fazer perguntas e participar das decisões (RP=5,17; IC95%:1,79-14,96). Os achados sugerem que serviços de pré-natal que oferecem cuidado multiprofissional, que dão orientações, e que oportunizam às gestantes o sentimento de estar à vontade para questionar e decidir sobre seu cuidado, proporcionam maior satisfação.This article aims to identify factors associated with full satisfaction with prenatal care in health services in Porto Alegre (RS), Brazil. This is a cross-sectional study with 287 women that attended prenatal care in the state capital. Women were randomly selected at two large maternity hospitals (public and private) and interviewed at their homes around 30 days after delivery, from January to August 2016. Satisfaction was measured by a Likert scale (very satisfied to very unsatisfied). Prevalence ratios (PR) were estimated by Poisson regression with robust variance, using a hierarchical model. Factors associated with greater satisfaction were higher education (PR=1.49; 95% CI: 1.08-2.06); multiprofessional care (PR=1.29; 95% CI: 1.00-1.66); receiving information about breastfeeding (PR=1.33; 95% CI: 1.05-1.68) and place of delivery (PR=1.56; 95% CI: 1.12-2.17); and women feeling comfortable asking questions and participating in decisions (PR=5.17; 95% CI: 1.79-14.96). The findings suggest that prenatal care services that offer multiprofessional care, provide guidance, and make pregnant women feel comfortable asking and deciding about their care may generate greater satisfaction

Association between maternal satisfaction with breastfeeding and postpartum depression symptoms

Background Due to the multiple health benefits of breastfeeding, it is essential to identify factors that may negatively interfere with this healthy practice. Among such factors are postpartum depression (PPD) and maternal satisfaction with breastfeeding. The objective of this study was to evaluate the association between maternal satisfaction with breastfeeding and symptoms of PPD in the first month after childbirth. Methods This cross-sectional study nested in a cohort study was conducted in Porto Alegre, Brazil, with 287 puerperal women selected at two maternity hospitals, one public and one private. Women were interviewed at their homes the week after the infant completed 30 days of life. A structured questionnaire was applied, as well as instruments to evaluate maternal satisfaction with breastfeeding (Maternal Breastfeeding Evaluation Scale) and to screen for PPD (Edinburgh Postnatal Depression Scale). The association between higher satisfaction with breastfeeding (outcome) and negative PPD screening test was assessed using Poisson regression with robust variance, adjusting for specific covariables. Adjusted prevalence ratios (aPR) and respective 95% confidence intervals (95%CI) were estimated. Results The prevalence of increased satisfaction with breastfeeding (defined as women with scores above the median) was 47% higher among women who screened negative for PPD when compared to those with a positive result (aPR 1.47; 95%CI 1.01–2.16). This result was adjusted for maternal age and skin color, cohabitation with the infant’s father, planned pregnancy, type of delivery, exclusive breastfeeding, and occurrence of breastfeeding problems. Conclusions The findings of this study showed an association between higher maternal satisfaction with breastfeeding and absence of PPD symptoms, reinforcing the importance of caring for the mental health of pregnant and puerperal women and paying attention to their satisfaction with breastfeeding.Telemedicin

Maternal satisfaction with breastfeeding in the first month postpartum and associated factors

Background:Breastfeeding success has been measured based on its duration, disregarding satisfaction with thematernal experience. Studies to investigate maternal satisfaction with breastfeeding are rare, especially in Brazil, andlittle is known about their determinants. The aim of this study was to measure the level of satisfaction withbreastfeeding in a group of women in the first month of their child’s life, and to identify factors associated withhigher maternal satisfaction.Methods:A cross-sectional study nested within a cohort was conducted with 287 women recruited at two (onepublic, one private) maternity services in the city of Porto Alegre, southern Brazil, from January to July 2016. Womenresiding in the municipality who had given birth to a healthy singleton born at term, were rooming in, and hadinitiated breastfeeding were randomly included. During the week after the child was 30 days old, women wereinterviewed at their homes to measure the level of maternal satisfaction with breastfeeding, using the MaternalBreastfeeding Evaluation Scale (MBFES), validated for use in the Brazilian population. Associations between maternalsatisfaction and explanatory variables were estimated using multivariate Poisson regression with robust variance ina four-level hierarchical approach. Satisfaction level was categorized using as cutoff point the median scoreobtained with the MBFES. Women with scores equal to or above the median were considered to have higher levelsof satisfaction, whereas those scoring below the median were considered to be less satisfied.Results:Maternal satisfaction with breastfeeding in the first month postpartum was high, with a median score of124 on MBFES, close to the maximum score (145 points). The prevalence of more elevated levels of satisfactionwith breastfeeding was higher among women with brown (pardo) and black skin color (prevalence ratio [PR] 1.33,95%CI 1.05;1.69), those who lived with the partner (PR 1.75, 95%CI 1.05;2.94), who planned to breastfeed for 12months or more (PR 1.48, 95%CI 1.02;2.17), and who did not report low milk supply (PR 1.47, 95%CI 1.03;2.10) orcracked nipples (PR 1.29, 95%CI 1.01;1.65).Conclusions:The factors associated with maternal satisfaction with breastfeeding in the first month postpartuminclude individual factors and maternal expectations, family constitution, as well as breastfeeding-related problems

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Clínica Psicodinâmica do Trabalho: a prática em diversos contextos de trabalho

This study aims to present clinical practice under various work contexts, recently held from North to South of Brazil. The psychodynamic clinic of labour is characterized by the analysis of mental processes mobilized by the meeting between the subject and the impositions generated by the work organization five clinical practices are presented that are developed in laboratories of labor psychodynamics at the University of Brasilia (DF), Federal University of Amazonas and Federal University of Rio Grande do Sul, Brazil. These practices provide a systematic methodology in labour clinic resulting in unique practices depending on the sociocultural and institutional reality of each studied category. The reported experiences show the demand diversity and the importance of the clinic listening of work suffering. The reports show that the distance between the prescribed and the true rules which triggers the suffering is also the researchers' tasks, requiring mobilization and creation of suitable alternatives in each reality. It also indicates the need for future studies to articulate other fields that contribute to deepen the use of listening devices. It seems a powerful reference for psychoanalysis. This articulation contributes to suffering's analytical listening and supports a construction proposal of an Analytical Clinic of Labour

Telecondutas : mpox

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