Midwives-led intervention program to reduce fear of childbirth in pregnant women: a Portuguese project in development

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Urinary incontinence: the impact on the quality of life

Quality of life (QoL) assessment represents an emerging focus in the health area since it use can complement clinical practice and optimize resources. Urinary incontinence is a common consequence in the oncologic pathology of the prostate that severely affects QoL.A descriptive, analytical and longitudinal study was conducted with the participation of oncological patients from the ambulatory urology department of an oncology hospital unit of the North of Portugal. The sample, obtained through convenience non-probabilistic sampling between October 2015 and July 2016, included 60 patients. The ICIQ-SF was used. The impact on QOL was classified as: zero (0), no impact; from 1 to 3, slight impact; 4 to 6, moderate; from 7 to 9, severe; and, of 10 or more, very serious. Urinary incontinence had a moderate impact on the perception of QoL of patients in M0 and M1. It was observed that as the symptoms decreased, the patients’ perception of QoL increased and M3 and M6 had a slight impact.info:eu-repo/semantics/publishedVersio

Sexual dysfunction and quality of life in prostate cancer.

Prostate cancer causes changes, such as erectile dysfunction, with a significant impact on the perception of quality of life (QoL). The aim of this study is to identify changes in perception of QoL related to erectile dysfunction over time. A descriptive, analytical and longitudinal study was conducted with the participation of oncological patients from the ambulatory urology department of an oncology hospital unit of the North of Portugal. The sample, obtained through convenience non-probabilistic sampling between October 2015 and July 2016, included 60 patients. The instrument used for data collection was IIEF-5 (International Index of Erectile Function-5) that evaluates the severity degree of erectile dysfunction (ED). Sexual function did not present clinical or statistical differences along the studied period. Cultural issues related to privacy preservation may justify our sexual function scores. Early identification of QoL changes may guide nurses to patient-centered care.info:eu-repo/semantics/publishedVersio

Doctor Versus Midwifery-led Care: A Commentary on a Task-shift, not Only Complex but Difficult to Accept

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Maternal self-efficacy in newborn care: influence of maternal variables

Aim: To analyze the influence of sociodemographic, obstetric, childbirth, and breastfeeding variables on maternal self-efficacy in newborn care. Design: Descriptive cross-sectional study. Methods: The study was conducted in three hospital units in the Northern region of Portugal, with a non-probabilistic sample composed of 340 women recruited at postnatal wards on the day of hospital discharge. A questionnaire including the mother’s sociodemographic, obstetric, childbirth, and breastfeeding data was used. For the analysis of maternal self-efficacy in newborn care, the Scale of Perceived Parental Self-Efficacy in Child Care was used. The scale is a 20-item self-report instrument developed to identify women with low levels of self-efficacy in newborn care. Descriptive and inferential statistics were used for data analysis. Results: Significant differences concerning maternal self-efficacy in newborn care were found with regard to level of education and parity, with multiparous women and women with lower levels of education presenting higher levels of self-efficacy in newborn care. Conclusion: The analysis of these variables could be valuable in building new knowledge to support the development of an action model that would allow at-risk women to be highly confident in their parenting role.info:eu-repo/semantics/publishedVersio

Construir a confiança para o parto : desenvolvimento e avaliação de um programa de intervenção em enfermagem

A autoeficácia da mulher durante o trabalho de parto influencia a forma como este é percebido e afeta a sua satisfação com a experiência de parto. No trabalho de parto, a utilização de estratégias de coping vai resultar da intencionalidade da mulher, que por sua vez depende dos julgamentos de autoeficácia, pois é em função desses juízos que o indivíduo tem incentivo para agir e imprimir uma determinada direção às suas ações. Vários estudos demonstraram ser, por isso, necessário que a preparação para o parto incorpore e reforce este conceito. A presente investigação teve como finalidade desenvolver e avaliar um programa de intervenção em enfermagem que, tendo por base o reforço da autoeficácia, permita à mulher uma maior satisfação com a experiência de parto e, dessa forma, a promoção de uma melhor ligação mãe-filho. Incluiu quatro estudos, desenvolvidos em duas etapas. A primeira teve como finalidade elaborar um programa de intervenção em enfermagem promotor da autoeficácia para lidar com o trabalho de parto. Para a sua concretização realizou-se uma revisão da literatura e efetuaram-se dois estudos: um exploratório, de cariz qualitativo, com o objetivo geral de identificar um conjunto de intervenções de enfermagem adequadas à promoção da autoeficácia no trabalho de parto. Incluiu entrevistas a 25 mulheres no período pós-parto. O segundo, um estudo de consensos, de cariz quantitativo, com o objetivo de validar a relevância das intervenções identificadas. Compreendeu uma amostra de 42 peritos na área em estudo. A segunda etapa teve como finalidade implementar e avaliar a eficácia e o impacte, do programa de intervenção em enfermagem previamente elaborado, na perceção de autoeficácia das grávidas para lidar com o trabalho de parto e na satisfação com a experiência de parto. Englobou dois estudos: um exploratório, descritivo, de cariz misto, cuja amostra compreendeu 246 grávidas e que teve como objetivo conhecer as suas expetativas e preferências relativas ao trabalho de parto, à preparação para o parto e à sua confiança para lidarem com o trabalho de parto. Para a sua concretização foi utilizado um guião de entrevista semiestruturada, duas escalas e o questionário de autoeficácia no trabalho de parto (QAETP). E, ainda, um estudo quasi-experimental, com um desenho pré e pós-teste, incluindo uma amostra de 121 mulheres, 66 alocadas ao grupo experimental e 55 ao grupo controlo. Para a sua elaboração, usou-se o QAETP e o questionário de experiência e satisfação com o parto (QESP). As intervenções de enfermagem passíveis de promover a autoeficácia para lidar com o trabalho de parto identificadas, a teoria da autoeficácia de Bandura, o modelo de promoção de saúde de Nola Pender e a filosofia Lamaze, constituíram a base para a elaboração do programa “Construir a Confiança para o Parto”. Os resultados obtidos permitiram concluir que o programa foi eficaz na promoção da autoeficácia da mulher para lidar com o trabalho de parto, promovendo um aumento significativo das expetativas de resultado e de autoeficácia; de sentimentos positivos durante o trabalho de parto; no uso das técnicas de relaxamento e respiratórias no trabalho de parto. Foi, igualmente eficaz, na concretização das expetativas das mulheres para o parto, na perceção de controlo e na redução do medo durante o trabalho de parto, e na experiência e satisfação com o parto.The woman’s self-efficacy during labour influences the way it is understood and affects the satisfaction with the experience of childbirth. During labour, the use of coping strategies will result in woman’s intentionality, which in turn depend on the self-efficacy judgments, as it is according to this these judgements that the individual has the motivation to act and direct her actions. Several studies have therefore shown the need to include and reinforce this concept in childbirth education. The aim of this research was to develop and evaluate a nursing intervention programme. On the foundation of this program there was the self-efficacy strengthening, which allowed pregnant woman a greater satisfaction with the childbirth experience, resulting in the development of a better mother-child bonding. The research included four studies developed in two stages. During the first stage, a nursing intervention programme was created to promote self-efficacy to cope with labour. To develop this programme, a literature review was conducted as well as two studies: an exploratory study and a consensus study. The first one, of qualitative nature, aims to identify a set of suitable nursing interventions for promoting self-efficacy during labour. This study included interviews to 25 women on the post-natal period. The second one, of quantitative nature, aims to validate the relevance of the identified interventions. This study involved 42 specialists in this area. During the second stage, the goal was to implement and evaluate efficacy and impact of the nursing intervention programme previously defined. The efficacy of the evaluation was measured according to the pregnant women’s perception of self-efficacy to cope with labour and the overall satisfaction of the process. This stage included two studies as well: an exploratory descriptive study and a quasi-experimental study. The first one, of mixed nature, aims to know the expectations and preferences of 246 pregnant women regarding labour, childbirth education, and their own confidence to cope with labour. To accomplish this study, a semi-structured interview guide was used, as well as two scales and a childbirth self-efficacy questionnaire (CBSEI). The second study, had a pre and post-test design, and included a sample of 121 women, 66 of which were allocated to the experimental group and the remaining 55 to the control group. For this study, the CBSEI and the experience and satisfaction with childbirth questionnaire (QESP) were used. The identified nursing interventions to promote self-efficacy to cope with labour, the Bandura self-efficacy theory, the Nola Pender health promotion model and the Lamaze philosophy were the foundation for the elaboration of the programme “Building Trust to Childbirth”. The results achieved allowed to determine that the programme was effective in promoting woman’s self-efficacy to cope with labour, promoting a significant increase in: a) expectations of results and self-efficacy, b) positive feelings during labour and c) the use of relaxation and breathing technics during labour. Moreover, the programme was equally effective on the fulfilment of women’s childbirth expectations, on the perception of control and reduction of fear of childbirth, and on the satisfaction with the childbirth experience

Preparing for childbirth: women's look

INTRODUCTION. Childbirth preparation is a form of health intervention education performed by specialist nurses in maternal health and obstetrics aimed at promoting self-e'cacy during labour. In planning an e'cient childbirth education intervention, it is essential that nurses know the pregnant women’s/couple’s expectations on this speci+c issue. OBJECTIVES. To understand the pregnant women’s expectations related to preparation for childbirth. MATERIAL AND METHODS. This was an exploratory, transversal study of qualitative nature where data was collected through interviews, after an informed consent was signed. The Bardin technique was applied to data analysis. A non-probability sample of 224 pregnant women was made, all over 20 years of age, with 28 weeks or more of gestation. The majority of participants possessed an advanced degree, were married or living in a marital situation, and were experiencing their +rst pregnancy. RESULTS. From an analysis of the interviews, three categories emerged: knowledge, ability, and self-e'cacy to deal with labour, and seven subcategories. These results corroborate +ndings of other researchers who have concluded that couples wish to be informed regarding how to prepare for labour, and that this preparation is relevant when the acquired knowledge helps the pregnant woman or couple make decisions and exercise control over their labour experience. CONCLUSION. The results enabled nurse-midwives to increase their knowledge and understanding of pregnant women’s labour preparation expectations and preferences. Knowledge of this variety can assist these professionals in planning e9ective, quality interventions, which in turn can clearly contribute to gains in healthinfo:eu-repo/semantics/publishedVersio

El temor al parto en tiempos de pandemia del nuevo coronavirus

OBJECTIVE: Reflect on how the new coronavirus pandemic triggered or accentuated the fear of childbirth in pregnant women and affected childbirth care practices. METHODS: Reflective analysis of women's pregnancy and childbirth experiences during the current pandemic, supported by the latest scientific evidence and recommendations on the topic. RESULTS: Pregnancy and childbirth are life-changing events for women, but during the new coronavirus pandemic, fear and uncertainty have taken on an unprecedented dimension in the negative way that many pregnant women have anticipated and experienced childbirth. FINAL CONSIDERATIONS: The current period has accentuated a chronic problem: a paternalistic system of health institutions in the approach to childbirth, dense with additional levels of fear in pregnant women. In this context, addressing the fear of childbirth means not giving up the promotion of safe and positive birth experiences for women.Objetivo: Refletir acerca da forma como a pandemia do novo coronavírus desencadeou ou acentuou o medo do parto nas gestantes e afetou as práticas de assistência ao parto. Métodos: Análise reflexiva sobre as experiências de gravidez e parto de mulheres, durante a atual pandemia, sob o suporte das mais recentes evidências científicas e recomendações sobre o tema. Resultados: A gravidez e o parto são acontecimentos transformadores na vida das mulheres, mas, no decorrer da pandemia do novo coronavírus, o medo e a incerteza ganharam uma dimensão sem precedentes na forma negativa como muitas gestantes têm antecipado e experienciado o parto. Considerações finais: O período atual acentuou um problema crónico: um sistema paternalista das instituições de saúde na abordagem ao parto, adensado por níveis adicionais de medo nas gestantes. Nesse contexto, abordar o medo do parto significa não abdicar da promoção de experiências seguras e positivas de parto para as mulheres.Objetivo: Reflejar acerca de cómo la pandemia de COVID-19 desencadenó o acentuó el temor al parto en las embarazadas y afectó las prácticas de asistencia al parto. Métodos: Análisis reflexivo sobre las experiencias de embarazo y parto de mujeres, durante la actual pandemia, bajo el soporte de las más recientes evidencias científicas y recomendaciones sobre el tema. Resultados: El embarazo y el parto son acontecimientos transformadores en la vida de las mujeres, pero, en el curso del nuevo coronavirus, el temor y la incertidumbre ganaron una dimensión sin precedentes negativamente como muchas embarazadas han anticipado y experimentado el parto. Consideraciones finales: A ctualmente acentuó un problema crónico: un sistema paternalista de las instituciones de salud en el abordaje al parto, adensado por niveles adicionales de temor en las embarazadas. Así, abordar el temor al parto significa no abdicar de la promoción de experiencias seguras y positivas del parto para las mujeres.info:eu-repo/semantics/publishedVersio

Tradução, adaptação e validação do chilbirth self-efficacy inventory (CBSEI) para o idioma e cultura portuguesa

A autoe!cácia da mulher para lidar com o trabalho de parto in"uencia a forma como esta perceciona o trabalho de parto e o parto. Identi!car precocemente as grávidas com baixa autoe!cácia para lidar com o trabalho de parto, pode ajudar os enfermeiros de saúde materna e obstétrica a programar intervenções de enfermagem que deem uma resposta mais e!caz às necessidades de apoio que estas mulheres possam ter. O Childbirth Self-E#cacy Inventory (CBSEI) permite medir a con!ança da mulher nas suas capacidades para lidar com o trabalho de parto e pode constituir-se como uma ferramenta útil para a prática clínica, pelo que, este estudo teve como objetivo traduzir, adaptar culturalmente e validar para português este instrumento. A amostra de conveniência constituiu-se por 525 grávidas, com 28 ou mais semanas de gestação. Quanto à !abilidade da escala, os valores de alfa de Cronbach, superiores a 0.89, permitem concluir que esta é !ável para a população portuguesa. A análise de componentes principais suportou o facto de cada uma das subescalas ter duas dimensões, nomeadas autocontrolo/ relaxamento e distração. A forte correlação entre as subescalas nos dois estádios do trabalho de parto e valores de alfa de Cronbach superiores a 0.90 levam, também, a considerar a proposta de vários autores para reduzir de quatro para duas as subescalas do instrumentoLa autoe!cacia de la mujer para enfrentarse al trabajo de parto in"uye su percepción del nacimiento. La identi!cación precoz de mujeres embarazadas con baja auto-e!cacia para enfrentar al trabajo de parto, puede ayudar al personal de enfermería obstétrica y salud materna en la programación de intervenciones que ofrecen una respuesta más e!caz a las potenciales necesidades de apoyo a estas mujeres. El Inventario de Autoe!cacia en el Parto (CBSEI) mide la con!anza de las mujeres en su capacidad para hacer frente al trabajo de parto y puede establecerse como una herramienta útil para la práctica clínica, lo que nos conduce al objetivo de este estudio: traducir, adaptar culturalmente y validar este instrumento para el portugués. La muestra de conveniencia consistió en 525 mujeres embarazadas con 28 o más semanas de gestación. En cuanto a la !abilidad de la escala, los valores superiores a un 0,89 en el alfa de Cronbach apoyan la conclusión de que este es !able para la población portuguesa. El análisis de componentes principales sostiene el hecho de que cada una de las subescalas tiene dos dimensiones, designadas autocontrol/ relajación y distracción. La fuerte correlación entre subescalas en ambos períodos de trabajo y valores de alfa de Cronbach superiores a un 0.90 permite también considerar la propuesta de varios autoresWomen’s self-e#cacy to cope with childbirth in"uences their perception of labour and delivery. Early identi!cation of pregnant women with low self-e#cacy to cope with labour can help maternal health nurses in the development of interventions that provide a more e$ective response to the support that these women might demand. %e Childbirth Self-E#cacy Inventory (CBSEI) measures the con!dence of women in their ability to cope with labour and can be a useful tool for the clinical practice, which justi!es the aim of this study: translate, culturally adapt and validate this instrument to the Portuguese population. %e convenience sample consisted of 525 pregnant women with 28 or more weeks of pregnancy. Regarding the scale’s level of reliability, Cronbach’s alpha values higher than 0.89 substantiate the conclusion that CBSEI is reliable for this population. %e main component analysis justi!ed each of the subscales having two dimensions, namely self-control/relaxation and distraction. %e substantial correlation between the subscales in both periods of labour and Cronbach’s alpha values higher than 0.90 permitted also to consider the proposal moved forward by several authors of reducing the questionnaire subscales from four to two.info:eu-repo/semantics/publishedVersio

Associations between quality of life and central auditory processing in seniors: preliminary results

Introduction: Several health-related conditions have been reported to be important for quality of life (QoL) (Raggi et al., 2016). Central auditory processing (CAP) corresponds to the perceptual processing of the auditory information in the central nervous system (Musiek & Baran, 2007). With aging, alterations at the level of perception and detection of the sound in the central and peripheral system occur and have effects on the senior’s QoL. Objectives: To analyze associations between CAP and QoL, considering sociodemographic variables. Methods: This study was conducted in a cross-sectional and descriptive design. Ethical requirements are respected. Participants: 19 seniors with average age of 81.6 (SD=9.5), 68.4% are females and 68.4% live alone. Measures: Socio-demographic data survey, Portuguese version of World Health Organization Quality of Life Instrument-Older Adults and an audiological evaluation constituted by an otoscopy, a tympanogram, a pure tone audiogram and the speech in noise test. Statistical analysis was performed using software IBM SPSS version 24. Nonparametric test were used. Results: When the elderly live alone, results showed significant positive associations between CAP and QoL (total score). There was positive correlations between QoL and the speech in noise test in the relation signal/noise10dB (r=0.573; p=0.041), and total (r=0.573; p=0.040) for right ear. The same result was observed in the left ear when the relation signal/noise10dB (r=0.572; p=0.041), and total (r=0.583; p=0.037). No significant results were obtained when the seniors don’t live alone. Conclusion: The results evidenced the importance of sociodemographic factors, such as “live alone” in the relation between CAP and QoL in older adults. Probably when we live alone the discrimination of speaking in noisy ambiance is a predictor factor of quality of life in seniors. Future studies are needed in order to clarify this relation.info:eu-repo/semantics/publishedVersio