Cuidado de si de enfermeiras obstétricas: decisões sobre seus corpos e vidas

Exportado OPUSMade available in DSpace on 2019-08-13T20:42:57Z (GMT). No. of bitstreams: 1 ana_renata_de_moura_rabelo.pdf: 1766037 bytes, checksum: 446b3dd2d6773344dcd1e96df3e54e81 (MD5) Previous issue date: 21A realidade dos serviços de saúde e das práticas dos profissionais da saúde é marcada pela predominância de ações disciplinarizadoras e normatizadoras do comportamento das mulheres. Não obstante, no âmbito da assistência à mulher permanecem manifestações de violência institucional, alto índice de cesáreas, e outras intervenções prescindíveis. Todavia existem movimentos se efetivando em prol do respeito às decisões da mulher e do incentivo ao parto natural e humanizado, com forte participação da enfermagem obstétrica. Pressupõe-se que esta realidade está associada, em grande parte, ao cuidado de si de enfermeiras obstétricas, no que tange as decisões sobre o seu próprio corpo e vida e consequentemente das relações de poder que estabelecem com as outras mulheres de que cuidam. As decisões sobre a vida e corpos são entendidas como uma expressão, materialidade do processo de formação dos sujeitos, incluindoprocessos de objetivação e subjetivação e portanto o cuidado de si. O estudo teve como objetivo analisar o cuidado de si de enfermeiras obstétricas na conformação das decisões sobre seus corpos e vida. Trata-se de pesquisa de abordagem qualitativa, ancorada em perspectiva Pós Estruturalista e no referencial teórico-metodológico de Michel Foucault. As participantes do estudo foram 14 mulheres, enfermeiras obstétricas de nítido reconhecimento, por parte de quemas indica, na atuação do cuidado a outras mulheres. A técnica amostral utilizada foi snowball, o que resultou na construção de uma rede de entrecruzamento de histórias de vida. A produção dos dados se baseou em entrevista aberta em profundidade, enquanto a análise se sustentou no método de Análise de Discurso. Os resultados revelam que as enfermeiras obstétricas descrevem as suas decisões sobre os corpos e vida, que são subjetivamente influenciadas pelo contexto e práticas discursivas de ser mulher e enfermeira obstétrica, e tocam o corpo de si e da outra mulher de diferentes formas. Existem discursos dominantes, mas também emergentes, que atravessam as decisões sobre os corpos e vida. As narrativas foram marcadas pela dificuldade de falar de si e pela posição na sociedade contemporânea, enquanto mulher eenfermeira, permeada por relações de poder, saber e jogos de verdade. Para as participantes, a profissão não consiste apenas no meio de sustento e trabalho mas em um importante dispositivo de formação enquanto sujeitos. Além disso, parece existir possibilidades de promoção de novas práticas de cuidado às mulheres por meio da construção de redes e coletivos, pelo entrecruzamento das histórias e práticas das enfermeiras obstétricas. A analítica construída é inacabada e consiste em um recorte, bem como recomenda o referencial de Foucault, por meio da desconfiança constante sobre toda tentativa de síntese.The reality of health services and practices of health professionals is marked by the predominance of disciplinary and normative actions of women's behavior. Nonetheless, in the context of women's care they remain resulting in manifestations of institutional violence, a highrate of cesareans, and other expendable interventions. However, there are movements that are effective in order to respect women's decisions and encourage natural and humanized childbirth, with a strong participation of obstetric nursing. It is assumed that this reality is associated with the care of the obstetric nurses themselves, in regard to decisions about their own body and life and consequently the power relations they establish with the other women they care for. Decisions about life and bodies are understood as expressions, materiality in the process of subject formation, including processes of objectification and subjectivation, and therefore the care of themselves. The purpose of this study was to analyze the self care of obstetrical nurses in the conformation of decisions about their bodies and life. It is a qualitative research, anchored in Post-Structuralist perspective and in the theoretical-methodological reference of Michel Foucault. The study participants were 14 obstetrical nurses of clear recognition, by the one who indicates them, in the care of other women. The sampling technique used was snowball, which resulted in the construction of a network of intertwining of life stories. The production of the data was based on interviews in deep, while data analysis was based on the method of Discourse Analysis. The results reveal that obstetrical nurses describe their decisions about body and life, which are subjectively influenced by context and discursive practices as a woman and obstetric nurse, and touch the body of the other woman in different ways. There are dominant but also emerging discourses that go through decisions about bodies and life. The narratives were marked by the difficulty of talking about oneself and the position in contemporary society, as a woman and nurse, permeated by relations of power, knowledge and games of truth. For theparticipants, the profession consists not only in the means of sustenance and work but in an important formation device as subjects. Furthermore, there seems to be scope for promoting new practices of care for women through the construction of networks and collectives, through the intersection of the histories and practices of obstetrical nurses. I emphasize that the constructed analytic is unfinished and consists of a cut, as well as recommends the referential of Foucault, through the constant distrust on any attempt of synthesis

Cuidado de si e relações de poder: enfermeira cuidando de outras mulheres

RESUMO Objetivo: analisar o cuidado de si de enfermeiras e as relações de poder estabelecidas por elas no cuidado de outras mulheres. Método: revisão integrativa da literatura publicada entre os anos de 2005 e 2015. Compuseram a amostra 25 publicações. Resultados: estado da arte majoritariamente qualitativo com domínio de referenciais de uma perspectiva libertadora, pautada na humanização, autonomia e empoderamento como estratégia de redução de riscos na prática do cuidado à mulher. Os achados sugerem relações de poder solidificadas entre enfermeiras-mulheres, centradas no domínio profissional com forte concentração na formação da enfermeira sob o discurso patriarcal e de normalização da sociedade. Alguns estudos ponderam a importância da compreensão do poder na forma capilar, operando nos corpos dos indivíduos. Conclusão: há pouca discussão sobre o cuidado de si de enfermeiras e dos efeitos na sua prática profissional, indicando lacunas no conhecimento neste campo

A hyperoxic lung injury model in premature rabbits: the influence of different gestational ages and oxygen concentrations.

BACKGROUND: Many animal models have been developed to study bronchopulmonary dysplasia (BPD). The preterm rabbit is a low-cost, easy-to-handle model, but it has a high mortality rate in response to the high oxygen concentrations used to induce lung injury. The aim of this study was to compare the mortality rates of two models of hyperoxia-induced lung injury in preterm rabbits. METHODS: Pregnant New Zealand white rabbits were subjected to caesarean section on gestational day 28 or 29 (full term  = 31 days). The premature rabbits in the 28-day gestation group were exposed to room air or FiO₂ ≥95%, and the rabbits in the 29-day gestation group were exposed to room air or FiO₂  = 80% for 11 days. The mean linear intercept (Lm), internal surface area (ISA), number of alveoli, septal thickness and proportion of elastic and collagen fibers were quantified. RESULTS: The survival rates in the 29-day groups were improved compared with the 28-day groups. Hyperoxia impaired the normal development of the lung, as demonstrated by an increase in the Lm, the septal thickness and the proportion of elastic fibers. Hyperoxia also decreased the ISA, the number of alveoli and the proportion of collagen fibers in the 28-day oxygen-exposed group compared with the control 28-day group. A reduced number of alveoli was found in the 29-day oxygen exposed animals compared with the control 29-day group. CONCLUSIONS: The 29-day preterm rabbits had a reduced mortality rate compared with the 28-day preterm rabbits and maintained a reduction in the alveoli number, which is comparable to BPD in humans

Kaplan-Meier survival curves – A comparison between the groups ‘room air’ and ‘oxygen’ is shown with animals born at 28 (dashed lines) and 29 days of gestation (solid lines).

<p>A higher survival rate was observed in both Air Groups (*, p<0.05 vs Oxygen Groups) and a higher survival rate among O2 29 animals vs O2 28 Group (§, p<0.05)</p

The values of Lm and ISA and the number of alveoli and septal thickening are shown in the groups.

<p>*p<0.05 vs. all other groups; ^#p<0.05 vs. O₂; ^§p<0.05 vs. Air 28 and Air 29.</p>1<p>: Power of performed test with alpha  = 0,050∶0,975; ²: Power of performed test with alpha  = 0,050∶1,000; ³: Power of performed test with alpha  = 0,050∶1,000; ⁴: Power of performed test with alpha  = 0,050∶1,000; ⁵: Power of performed test with alpha  = 0,050∶0,087.</p

Elastic fibers proportion observed in the study groups.

<p>A higher proportion of elastic fibers were observed in both oxygen exposed groups compared with room air at the same gestational age (p<0.05) and a higher proportion of elastic fibers was observed among more immature animals exposed to room air (p<0.05).</p

Distribution of collagen fibers (arrows) in the study groups.

<p>Animals exposed to oxygen showed an increased proportion of collagen fibers compared to those exposed to room air.</p

Collagen fibers proportion observed in the study groups.

<p>A higher proportion of collagen fibers were observed in both oxygen exposed groups compared with room air at the same gestational age (p<0.05)</p

Distribution of elastic fibers (arrows) in the study groups.

<p>Oxygen exposed animals (right panels, upper and lower) showed an intense disorganization of elastic fibers compared to animals from the Air 28 and Air 29 group (left panels, upper and lower).</p