¿Qué conocen las matronas de atención primaria de Sevilla sobre mutilación genital femenina?

Tras la situación migratoria que está aconteciendo en Andalucía, es habitual encontrar en las consultas mujeres procedentes de países donde las prácticas tradicionales y culturales son diferentes. El creciente aumento demográfico de mujeres procedentes de países subsaharianos trae como consecuencia que, a pesar de que en nuestro país no se practique la Mutilación Genital Femenina (MGF), exista un riesgo de que las hijas de estas mujeres mutiladas lo sean..Objetivo: determinar los conocimientos, actitudes y experiencias profesionales que tienen las matronas de Atención Primaria (AP) de Sevilla con respecto a la MGF. Metodología: Cuantitativa y cualitativa. Resultados: Perfil: Han respondido 55 matronas mujeres y 12 hombres. La media de edad es de 47.05, experiencia media asistencial de 20.88 existe una percepción subjetiva de conocer en qué consiste el fenómeno no confirmada por las respuestas dadas. Las matronas no disponen de la información necesaria para el abordaje del fenómeno en la consulta. Resaltar, la discrepancia de percepciones entre mujeres matronas y hombres matronas con respecto a el hecho de ser mujer para el abordaje del fenómeno Discusión: Se hace necesario un trabajo consciente, reflexivo y riguroso de información y sensibilización de los profesionales implicados en la atención de las familia

Influence of gender on knowledge, perception and approach to harmful traditional practices: Female Genital Mutilation

Justificación: Los procesos migratorios existentes en las sociedades contemporáneas visualizan pautas culturales diferentes y para las que los profesionales sanitarios pueden no tener competencia cultural para su abordaje. La Mutilación Genital Femenina es un problema emergente, minoritario, pero que no debería ser obviado. Objetivo: Explorar la influencia del género en el conocimiento, percepción y abordaje de la Mutilación Genital Femenina. Diseño: Estudio cualitativo. Se han realizado 3 grupos de discusión. Resultados principales: Existe un desconocimiento generalizado del fenómeno. Se ha observado una clara influencia del género en el fenómeno según su género. Asimismo, los profesionales varones identifican una mayor dificultad para el abordaje. Las matronas mujeres se sienten más capacitadas para el afrontamiento del problema. Conclusiones: Es necesaria incrementar la formación de los y las profesionales matronas en el fenómeno de la MGF teniendo en consideración la influencia del género. La difusión de protocolos y guías facilitaría el abordaje.The existing migration processes in contemporary societies display different cultural patterns and for which health professionals may not have the cultural competence to deal with. Female genital mutilation is a minority emerging problem, but one which should not be ignored. Objective: To explore the influence of gender on knowledge, perception and approach to Female genital mutilation. Design: Qualitative study. There were three discussion groups. Main results: There is a widespread ignorance of the phenomenon in both midwifery and midwives. A clear influence of gender on the phenomenon according to its type was observed. Likewise, male professionals identify a greater difficulty in their approach. Female midwives are more qualified for coping with the problem. Conclusions: It is necessary to increase the training of both female and male professional midwives in the phenomenon of FGM by taking into consideration the influence of gender. The diffusion of protocols and guidelines would facilitate the approach

Nursing Students’ Knowledge, Awareness, and Experiences of Emergency Contraception Pills’ Use

The emergency contraception pill (ECP) is a non-prescribed medication in Spain. However, there is not enough evidence of its use among young people to define sex education contents. The aims of this research were to describe the experiences of the use of the ECP in university students and analyze their knowledge, attitude, and awareness regarding the ECP. The cross-sectional, analytic study was conducted with nursing degree students at the University of Seville. A total of 478 students answered the questionnaire. All of the students (100%) had heard about the ECP and had a positive attitude towards this contraceptive. A total of 25.7% had used the ECP, mainly because a condom had failed or because they did not use any contraceptive at all. Deficiencies in knowledge are related with the ECPs’ mechanism of action, efficacy after repeated use, and the type of ECP available. Female students who used no method at all or withdrawal, and who were over 20 years old, used ECP to a greater extent (p < 0.005). Further education initiatives focused on the use of the ECP, its efficacy, and typology are needed, particularly among future health professionals who will later educate other young people

Understanding the Relationship between Predictors of Alcohol Consumption in Pregnancy: Towards Effective Prevention of FASD

Prenatal alcohol exposure can produce serious changes in neurodevelopment that last a lifetime, as well as a wide range of congenital abnormalities, and is the main non-hereditary, avoidable cause of intellectual disability in developed countries. It is therefore crucial to understand the determinants of alcohol consumption during pregnancy. This study is aimed at determining the factors that predict it, as well as the interactions between them. Methods: A cross-sectional study was carried out using a random sample of 426 pregnant women being treated at the outpatient clinic of a public university hospital in Seville (Spain), when they were in their twentieth week of pregnancy. A custom-designed questionnaire was used for data collection and applied in the course of an interview administered by trained health professionals. The data collected were analyzed using hierarchical regression, moderation analysis, and a structural equations model. Results: Alcohol consumption prior to pregnancy proved to be the most powerful predictor of alcohol intake during pregnancy. Other particularly significant predictors were the percentage of professionals who gave correct advice to the expectant mother—not to consume any alcohol during pregnancy—and perception of the risk from drinking wine during pregnancy. The number of pregnancies correlates positively with alcohol intake during pregnancy, while the expectant mother’s level of education correlates negatively. Conclusions: Identifying these predictive factors will allow the design of more effective fetal alcohol spectrum disorder (FASD) prevention strategies.Universidad de HuelvaPlan Andaluz de investigación, desarrollo e innovación (PAIDI

Pregnant Women’s Risk Perception of the Teratogenic Effects of Alcohol Consumption in Pregnancy

There is ample evidence of the teratogenic effects of prenatal alcohol exposure, with long-term consequences throughout the entire life cycle. Nevertheless, research on risk perception of alcohol consumption among pregnant women is scarce. In order to analyze risk perception of alcohol consumption during pregnancy, a cross-sectional study was conducted with a random sample of 426 pregnant women (in their 20th week of gestation) receiving care at the outpatient clinics of a public university hospital in the southern European city of Seville (Spain). Data were collected through structured face-to-face interviews conducted by trained health professionals using a customized questionnaire. Data analysis included structural equation modeling. Only 48.1% of the sample indicated that the sequelae from alcohol consumption during pregnancy were life-long. The structural equation model showed that a lower risk perception about beer and wine consumption, and a lower educational level, were related to more frequent alcohol consumption. Younger participants showed lower risk perception concerning beer consumption. Higher levels of education were related to a greater risk perception of beer. Healthcare institutions should articulate programs that facilitate health advice regarding alcohol consumption during pregnancy, particularly when providing care for women with low educational levels

Challenging the status quo: Women's experiences of opting for a home birth in Andalucia, Spain

Objective: To explore the perceptions, beliefs and attitudes of women who opted for a home birth in Andalusia (Spain). Background: Home birth is currently an unusual choice among Spanish women. It is not an option covered by the Spanish National Health Service and women who opt for a home birth have to pay for an independent midwife. Design: A qualitative study with a phenomenological approach was adopted. All participants who took part in this study had chosen to have a home birth and given written consent to take part in the study. Methods: Data collection was conducted in 2015–16. Face-to-face, semi-structured interviews were undertaken with women who chose a home birth in the last 5 years. Findings: The sample consisted of thirteen women. Seven themes were created through analysis: 1. Getting informed about home birth; 2. Home birth as a choice, despite feeling unsupported; 3. The best way to have a personalized and a physiological birth; 4. Seeking a healing and empowering experience 5. The need for emotional safety, establishing a relationship and trusting the midwife; 6. Preparing for birth and working on fears; 7. Inequality of access (because of financial implications). Conclusions: Women opted to plan birth at home because they wanted a personalised birth and control over their decision-making in labour, which they felt would not have been afforded to them in hospital settings. Andalusian maternity care leaders should strive to ensure that all pregnant women receive respectful and high-quality personalised care, by appropriately trained staff, both in the hospital and in the community

Relationship between Eating Habits, Physical Activity and Tobacco and Alcohol Use in Pregnant Women: Sociodemographic Inequalities

Pregnant women must maintain or acquire healthy habits during pregnancy to protect both their own health and their child’s. Such habits include an adequate eating pattern along with good adherence to the intake of certain supplements, practice of moderate physical activity and avoiding the consumption of toxic products such as tobacco and alcohol. The objective of this study is to assess the interrelation between such habits and their association with sociodemographic variables. To such end, a cross-sectional study was conducted with a representative sample of pregnant women who attended the scheduled morphology echography consultation at the 20th gestational week in their reference public hospital in the city of Seville (Spain). Results: Younger pregnant women and with lower educational levels are the ones that present the worst eating habits and the highest smoking rate. Pregnant women with lower educational levels are the least active. Non-smoking pregnant women present better eating habits than those who smoke. Pregnant women with lower educational levels are those who accumulate more unhealthy habits during pregnancy. This should be taken into account when planning the health care provided to pregnant women and in public health intersectoral policies

Nursing Students’ Knowledge, Awareness, and Experiences of Emergency Contraception Pills’ Use

The emergency contraception pill (ECP) is a non-prescribed medication in Spain. However, there is not enough evidence of its use among young people to define sex education contents. The aims of this research were to describe the experiences of the use of the ECP in university students and analyze their knowledge, attitude, and awareness regarding the ECP. The cross-sectional, analytic study was conducted with nursing degree students at the University of Seville. A total of 478 students answered the questionnaire. All of the students (100%) had heard about the ECP and had a positive attitude towards this contraceptive. A total of 25.7% had used the ECP, mainly because a condom had failed or because they did not use any contraceptive at all. Deficiencies in knowledge are related with the ECPs’ mechanism of action, efficacy after repeated use, and the type of ECP available. Female students who used no method at all or withdrawal, and who were over 20 years old, used ECP to a greater extent (p < 0.005). Further education initiatives focused on the use of the ECP, its efficacy, and typology are needed, particularly among future health professionals who will later educate other young people

Factores socioculturales determinantes de los hábitos alimentarios de niños de una escuela-jardín en Perú : estudio cualitativo

Revista Peruana de Medicina Experimental y Salud Pública, Vol. 33, No.4, pp. 700-705Con el objetivo de explorar los factores socioculturales que determinan los hábitos alimentarios de niños menores de cinco años de una escuela inicial de Chachapoyas en Perú, realizamos un estudio cualitativo mediante entrevistas semiestructuradas a 18 padres y madres. Los factores determinantes de los hábitos alimenticios fueron: la disponibilidad y facilidad de preparación de los alimentos; horario y trabajo desempeñado por los padres; ingesta de café en niños como práctica común; falta de recursos e incertidumbre económica para la planificación alimenticia, y la falta de conocimientos nutricionales. Asimismo, se identificaron creencias que pueden explicar algunos hábitos alimenticios, como los efectos beneficiosos de la comida en familia, la lactancia materna y otros alimentos, o el papel de la alimentación para el buen desarrollo intelectual y físico de los niños. Los resultados aportan evidencia sobre el modo en que los padres afrontan y entienden la alimentación de sus hijos, determinando, a su vez, la calidad de la misma

Assessing the performance of maternity care in Europe: a critical exploration of tools and indicators

Background: This paper critically reviews published tools and indicators currently used to measure maternity care performance within Europe, focusing particularly on whether and how current approaches enable systematic appraisal of processes of minimal (or non-) intervention in support of physiological or "normal birth". The work formed part of COST Actions IS0907: "Childbirth Cultures, Concerns, and Consequences: Creating a dynamic EU framework for optimal maternity care" (2011-2014) and IS1405: Building Intrapartum Research Through Health - an interdisciplinary whole system approach to understanding and contextualising physiological labour and birth (BIRTH) (2014-). The Actions included the sharing of country experiences with the aim of promoting salutogenic approaches to maternity care. Methods: A structured literature search was conducted of material published between 2005 and 2013, incorporating research databases, published documents in english in peer-reviewed international journals and indicator databases which measured aspects of health care at a national and pan-national level. Given its emergence from two COST Actions the work, inevitably, focused on Europe, but findings may be relevant to other countries and regions. Results: A total of 388 indicators were identified, as well as seven tools specifically designed for capturing aspects of maternity care. Intrapartum care was the most frequently measured feature, through the application of process and outcome indicators. Postnatal and neonatal care of mother and baby were the least appraised areas. An over-riding focus on the quantification of technical intervention and adverse or undesirable outcomes was identified. Vaginal birth (no instruments) was occasionally cited as an indicator; besides this measurement few of the 388 indicators were found to be assessing non-intervention or "good" or positive outcomes more generally. Conclusions: The tools and indicators identified largely enable measurement of technical interventions and undesirable health (or pathological medical) outcomes. A physiological birth generally necessitates few, or no, interventions, yet most of the indicators presently applied fail to capture (a) this phenomenon, and (b) the relationship between different forms and processes of care, mode of birth and good or positive outcomes. A need was identified for indicators which capture non-intervention, reflecting the reality that most births are low-risk, requiring few, if any, technical medical procedures.COST Action IS0907, ‘Childbirth Cultures, Concerns and Consequences: Creating a dynamic EU framework for optimal maternity care’COST Action IS1405, ‘Building Intrapartum Research Through Health - an interdisciplinary whole system approach to understanding and contextualising physiological labour and birth (BIRTH