Physician-patient Communication In The Prevention Of Female Reproductive Tract Infections: Some Limitations.

The objective of this study was to describe the information that women with tubal infertility recalled having received from physicians when they consulted for a reproductive tract infection (RTI) and the information physicians reported having provided to women consulting for RTIs. Interviews were conducted with 16 women presenting primary tubal infertility selected on the basis of purposeful sampling criteria. Also, 15 physicians working in the public health network in the city of Campinas, Brazil, were selected at random and interviewed. Analysis of the women's statements concerning previous RTI-related medical consultations showed that they did not recall having received any information on either prevention or the impact of RTI on their reproductive future. Analysis of interviews with physicians showed that the information they provided to women consulting for RTIs was incomplete and unclear. The information women recalled having received and that which physicians remembered having provided at the time of treating a patient with RTI was similar. In conclusion, these women lacked adequate or complete information and that it was probably not possible for them to adopt measures to avoid repetition of RTI and minimize risk of tubal infertility.16124925

Changes In Sexual Behavior Following A Sex Education Program In Brazilian Public Schoolsm [mudanças No Comportamento Sexual De Adolescentes De Escolas Públicas No Brasil Após Um Programa De Educação Sexual]

This paper describes an evaluation of possible changes in sexual behavior in adolescents who participated in a school-based sex education program in selected public schools in four municipalities in the state of Minas Gerais, Brazil. The program is inserted within the context of reproductive rights, deals with risks involved in unsafe sexual practices and focuses on the positive aspects of sexuality. A quasi-experimental design with pre and post-tests and a non-equivalent control group was used to evaluate the intervention. A total of 4,795 questionnaires were included in this analysis. The program succeeded in more than doubling consistent condom use with casual partners and in increasing the use of modern contraceptives during last intercourse by 68%. The intervention had no effect on age at first intercourse or on adolescents' engagement in sexual activities. The sex education program was effective in generating positive changes in the sexual behavior of adolescents, while not stimulating participation in sexual activities.25511681176(2006) Promoting and Safeguarding the Sexual and Reproductive Health of Adolescents, , World Health Organization, Geneva: World Health Organization, (Policy Brief, 4. Implementing the Global Reproductive Health Strategy)Ross, J., Godeau, E., Dias, S., Sexual health (2004) Young People's Health In Context: Health Behaviour In School-aged Children (hbsc) Study. International Report From the 2001/2002 Survey, pp. 153-60. , In: Currie C, Roberts C, Morgan A, Smith R, Settertobulte W, Samdal O, et al., editors, Copenhagen: WHO Regional Office for Europe, (Health Policy for Children and Adolescents, 4)Kirby, D.B., Laris, B.A., Rolleri, L.A., Sex and HIV education programs: Their impact on sexual behaviors of young people throughout the world (2007) J Adolesc Health, 40, pp. 206-17Figueiró, N.M.D., A produção teórica no Brasil sobre educação sexual (1996) Cad Pesqui, (98), pp. 50-63Figueiró, N.M.D., Revendo a história da educação sexual no Brasil: Ponto de partida para construção de um novo rumo (1998) Nuances, 4, pp. 123-33(1998) Temas Transversais: Orientação Sexual, , Secretaria de Educação Fundamental, Ministério da Educação. Parâmetros curriculares nacionais, Brasília: Secretaria de Educação Fundamental, Ministério da EducaçãoPaiva, V., Pupo, L.R., Barboza, R., O direito à prevenção e os desafios da redução da vulnerabilidade ao HIV no Brasil (2006) Rev Saúde Pública, 40 (SUPPL.), pp. 109-19Hughes, J., McCauley, A.P., Improving the fit: Adolescents' needs and future programs for sexual and reproductive health in developing countries (1998) Stud Fam Plann, 29, pp. 233-45Díaz, M., Mello, M.B., Sousa, M.H., Cabral, F., Silva, R.C., Campos, M., Et al., Outcomes of three different models for sex education and citizenship programs concerning knowledge, attitudes, and behavior of Brazilian adolescents (2005) Cad Saúde Pública, 21, pp. 589-97(1999) Projeto Educação Afetivo-sexual: Sucessos E Desafios Na Educação Sexual De Adolescentes Da Rede Pública Estadual De Ensino De Belo Horizonte - Relatório Da Avaliação Externa, , Centro de Pesquisas em Saúde Reprodutiva de Campinas/Fundação Odebrecht, Campinas: Centro de Pesquisas em Saúde Reprodutiva de Campinas/Salvador: Fundação OdebrechtCosta, A.C.G., (2000) Protagonismo Juvenil: Adolescência, Educação E Participação Democrática, , Salvador: Fundação OdebrechtAndrade, H.H.S.M., Marques, C.M., Gouveia, M.C., Gregório, Y.M., Atendimento ambulatorial de adolescentes: A experiência do PAIA/ABEB (1996) J Pediatr (rio J), 72, pp. 319-23Cronbach, L.J., Coefficient alpha and the internal structure of tests (1951) Psychometrika, 16, pp. 297-334Mello, M.B., Fruet, M.S.B., Diaz, M., Silva, R.C., Paiva, V., Avaliação preliminar de impactos de um programa de orientação sexual de longa duração (1999) Anais Do Vii Congresso Brasileiro De Sexualidade Humana, p. 74. , Rio de Janeiro: Sociedade Brasileira de Estudos em Sexualidade HumanaFleiss, J.L., (1981) Statistical Methods For Rates and Proportions, , 2nd Ed. New York: John Wiley and SonsBertrand, J.T., Magnani, R.J., Rutenberg, N., (1996) Evaluating Family Planning Programs: With Adaptations For Reproductive Health, , Chapel Hill: Carolina Population Center, University of North Carolina at Chapel HillHosmer, D.W., Lemeshow, S., (1989) Applied Logistic Regression, , New York: John Wiley and SonsGrunseit, A., Kippax, S., (1997) Impact of Hiv and Sexual Health Education On the Sexual Behaviour of Young People: A Review Update, , Geneva: United Nations Joint Programme on HIV/AIDSKirby, D., (1995) A Review of Educational Programs to Designed to Reduce Sexual Risk-taking Behaviors Among School-aged Youth In the United States, , Santa Cruz: ETR AssociatesKirby, D., (2001) Emerging Answers: Research Findings On Programs to Reduce Teen Pregnancy, , Washington DC: National Campaign to Prevent Teen PregnancyAntunes, M.C., Peres, C.A., Paiva, V., Stall, R., Hearst, N., Diferenças na prevenção da AIDS entre homens e mulheres jovens de escolas públicas em São Paulo, SP (2002) Rev Saúde Pública, 36 (4 SUPPL.), pp. 88-95Magnani, R.J., Gaffikin, L., Aquino, E.M.L., Seiber, E.E., Almeida, M.C.C., Lipovsek, V., Impact of an integrated adolescent reproductive health program in Brazil (2001) Stud Fam Plann, 32, pp. 230-43Taquette, S.R., Vilhena, M.M., Paula, M.C., Doenças sexualmente transmissíveis e gênero: Um estudo transversal com adolescentes no Rio de Janeiro (2004) Cad Saúde Pública, 20, pp. 282-90Oliveira, F.A., Pfleger, V., Lang, K., Heukelbach, J., Miralles, I., Fraga, F., Sexually transmitted infections, bacterial vaginosis, and candidiasis in women of reproductive age in rural Northeast Brazil: A population-based study (2007) Mem Inst Oswaldo Cruz, 102, pp. 751-6(1999) Adolescentes, Jovens E a Pesquisa Nacional Sobre Demografia E Saúde: Um Estudo Sobre Fecundidade, Comportamento Sexual E Saúde Reprodutiva, , Bem-Estar Familiar no Brasil, Rio de Janeiro: Bem-Estar Familiar no BrasilAlmeida, M.C., Aquino, E.M., Barros, A.P., School trajectory and teenage pregnancy in three Brazilian state capitals (2006) Cad Saúde Pública, 22, pp. 1397-409Chalem, E., Mitsuhiro, S.S., Ferri, C.P., Barros, M.C.M., Guinsburg, R., Laranjeira, R., Gravidez na adolescência: Perfil sócio-demográfico e comportamental de uma população da periferia de São Paulo (2007) Brasil. Cad Saúde Pública, 23, pp. 177-86Baraldi, A.C.P., Daud, Z.P., Almeida, A.M., Gomes, F.A., Nakano, A.M.S., Adolescent pregnancy: A comparative study between mothers who use public and private health systems (2007) Rev Latinoam Enferm, 15, pp. 799-805. , (Spe

Stress Of Men And Women Seeking Treatment For Infertility [estresse De Homens E Mulheres Que Buscam Tratamento Para Infertilidade]

PURPOSE: To evaluate the level of stress in men and women seeking treatment for infertility and to identify the associated variables. METHODS: A cross-sectional study with 101 men and 101 women consulting for the first time at the Human Reproduction Unit. Participants completed the Brazilian version of the Fertility Problem Inventory (FPI) based on four domains: "social relationships", "life without children"; "marital relationship/sexual" and "maternity/ paternity" and a structured questionnaire with socioeconomic and reproductive variables. Bivariate analysis was performed using the Chi-square and Fisher exact tests, considering p<0.05. Afterwards the multivariate correspondence analysis was done with variables with p≤0.20. RESULTS: Overall, the participants presented a high level of stress in all domains, except in the "life without children" domain. Multivariate analysis of correspondence showed that variables associated with a high level of stress in the "social relationships" domains were: to be a woman, to have the infertility problem, and to consider the quality of the marital relationship to be regular. In the "life without children" domain the variables that approached the high stress were: to be woman, age between 18 and 24 years, and to have the infertility problem. To be a man, to consider adoption, parents/in-laws and other people knowing about the difficulty to become pregnant, and to consider the quality of the marital relationship to be excellent were the variables associated with high level of stress in "marital/sexual relationship" domain. For "maternity/paternity" domain the variables associated were to be women, consider marital relationship quality regular, age between 25 and 35 years, be evangelical or protestant were the variables associated with a high level of stress. CONCLUSION: Men and women seeking treatment for infertility present a high level of stress and it can be suggested that psychosocial support is important and should be different for men and women.356255261Rouchou, B., Consequences of infertility in developing countries (2013) Perspect Public Health., 133 (3), pp. 174-179Ombelet, W., Reproductive healthcare systems should include accessible infertility diagnosis and treatment: An important challenge for resource-poor countries (2009) Int J Gynaecol Obstet., 106 (2), pp. 168-171Shindel, A.W., Nelson, C.J., Naughton, C.K., Ohebshalom, M., Mulhall, J.P., Sexual function and quality of life in the male partner of infertile couples: Prevalence and correlates of dysfunction (2008) J Urol., 179 (3), pp. 1056-1059Síntese de indicadores sociais (2006) Estudos e pesquisas informação demográfica e socioeconômica, , http://www.mulheres.gov.br/nucleo/dados/indic-sociais2006-mulher.pdf, Instituto Brasileiro de Geografia e Estatística-IBGE [Internet]. [citado 2013 Maio 16]. Disponível em: <(2010) Mother or nothing: The agony of infertility, 88 (12), pp. 877-953. , http://www.who.int/reproductivehealth/publications/infertility/bulletin_88_12/en/, World Health Organization. Bull World Health Organization [Internet]. [cited 2013 May 16]Available from: <Lee, S.H., Wang, S.C., Kuo, C.P., Kuo, P.C., Lee, M.S., Lee, M.C., Grief responses and coping strategies among infertile women after failed in vitro fertilization treatment (2010) Scand J Caring Sci., 24 (3), pp. 507-513Makuch, M.Y., Petta, C.A., Osis, M.J., Bahamondes, L., Low priority level for infertility services within the public health sector: A Brazilian case study (2010) Hum Reprod., 25 (2), pp. 430-435Baldur-Felskov, B., Kjaer, S.K., Albieri, V., Steding-Jessen, M., Kjaer, T., Johansen, C., Psychiatric disorders in women with fertility problems: Results from a large Danish register-based cohort study (2013) Hum Reprod., 28 (3), pp. 683-690Ried, K., Alfred, A., Quality of life, coping strategies and support needs of women seeking traditional Chinese medicine for infertility and viable pregnancy in Australia: A mixed methods approach (2013) BMC Womens Health., 13, p. 17Gollenberg, A.L., Liu, F., Brazil, C., Drobnis, E.Z., Guzick, D., Overstreet, J.W., Semen quality in fertile men in relation to psychosocial stress (2010) Fertil Steril., 93 (4), pp. 1104-1111Moreira, S.N.T., Melo, C.O.M., Tomaz, G., Azevedo, G.D., Stress and anxiety in infertile women (2006) Rev Bras Ginecol Obstet., 28 (6), pp. 358-364. , PortuguesePeterson, B.D., Newton, C.R., Rosen, K.H., Skaggs, G.E., Gender differences in how men and women who are referred for IVF cope with infertility stress (2006) Hum Reprod., 21 (9), pp. 2443-2449Newton, C.R., Sherrard, W., Glavac, I., The Fertility Problem Inventory: Measuring perceived infertility-related stress (2009) Fertil Steril., 72 (1), pp. 54-62Ribeiro, A.C., (2007) Adaptação do inventário de problemas de fertilidade para homens e mulheres inférteis [Internet], , http://www.teses.usp.br/teses/disponiveis/59/59137/tde-13072007-133824/pt-br.php, Ribeirão Preto: Universidade de São Paulo[citado 2013 Maio 16]. Disponível em: <Greenacre, M.J., (1993) Correspondence analysis in practice, , London: Academic Press, Harcourt BraceCserepes, R.E., Kollár, J., Sápy, T., Wischmann, T., Bugán, A., Effects of gender roles, child wish motives, subjective well-being, and marital adjustment on infertility-related stress: A preliminary study with a Hungarian sample of involuntary childless men and women (2013) Arch Gynecol Obstet., , Apr 5. [Epub ahead of print]Vassard, D., Lund, R., Pinborg, A., Boivin, J., Schmidt, L., The impact of social relations among men and women in fertility treatment on the decision to terminate treatment (2012) Hum Reprod., 27 (12), pp. 3502-3512Obeisat, S., Gharaibeh, M.K., Oweis, A., Gharaibeh, H., Adversities of being infertile: The experience of Jordanian women (2012) Fertil Steril., 98 (2), pp. 444-449Fisher, J.R., Hammarberg, K., Psychological and social aspects of infertility in men: An overview of the evidence and implications for psychologically informed clinical care and future research (2012) Asian J Androl., 14 (1), pp. 121-129Lund, R., Sejbaek, C.S., Christensen, U., Schmidt, L., The impact of social relations on the incidence of severe depressive symptoms among infertile women and men (2009) Hum Reprod., 24 (11), pp. 2810-2820Peterson, B.D., Pirritano, M., Tucker, L., Lampic, C., Fertility awareness and parenting attitudes among American male and female undergraduate university students (2012) Hum Reprod., 27 (5), pp. 1375-1382George, K., Kamath, M.S., Fertility and age (2010) J Hum Reprod Sci., 3 (3), pp. 121-123Schmidt, L., Holstein, B.E., Christensen, U., Boivin, J., Communication and coping as predictors of fertility problem stress: Cohort study of 816 participants who did not achieve a delivery after 12 months of fertility treatment (2005) Hum Reprod., 20 (11), pp. 3248-3256Donarelli, Z., Lo Coco, G., Gullo, S., Marino, A., Volpes, A., Allegra, A., Are attachment dimensions associated with infertility-related stress in couples undergoing their first IVF treatment? A study on the individual and cross-partner effect (2012) Hum Reprod., 27 (11), pp. 3215-322

Knowledge And Feelings Of Women With Primary Infertility: Aspects To Improve Health Provider [vivências De Mulheres Com Diagnóstico De Infertilidade Primária: Significado Para O Atendimento Ambulatorial]

Objectives: To describe the knowledge and feelings of women consulting at the Human Reproduction Unit of CAISM at the State University of Campinas, related to their primary infertility diagnosis and identify aspects to improve health provider communication strategies. Subjects and methods: Interviews to assess knowledge and feelings related to primary infertility diagnosis were performed with 30 women with primary infertility, selected according to the criteria of a purposeful sample. For this selection medical records of the regularly scheduled follow-up consultations were reviewed, and the women that accepted voluntarily to participate in the study and signed an informed consent, were included in the study. Results: The women were between 32 and 37 years old and had completed 6 or more years of schooling. One third, when asked about the meaning of their infertility diagnosis, presented difficulties to explain it. However, when they were given another opportunity to talk about their diagnosis, some were able to identify aspects they understood and those they didn't, and ask questions about their doubts. For most women surprise and sadness were the first feelings after receiving the diagnosis. Some reported feeling "less woman" and others relief after receiving an explanation for their impossibility of becoming pregnant. Conclusions: Based on the analysis of the interviews, it was possible to observe that for the women of this study infertility diagnosis was a surprise and caused sadness. Some of them needed more time to express the meaning of the diagnosis and the doubts they had about it. These findings allowed the social workers of the Human Reproduction Unit to discuss new communication strategies for the women with primary infertility.172118121Bury, M., Chronic illness as a biographic disruption (1982) Soc. Health Iln., 4, pp. 167-182Burns, L.H., Infertility as boundary ambiguity: One theoretical perspective (1987) Fam. Process, 26, pp. 359-372Shapiro, C., When part of the self is lost (1993), Jossey-Bass San FranciscoBahamondes, M.Y.M., Algumas vivências das mulheres com esterilidade primária por obstrução tubária e informações recebidas sobre o risco das infecções de trato reprodutivo Campinas (1996), p. 130. , Dissertação (Mestrado em Saúde Mental) - Universidade Estadual de CampinasMahlstedt, P., The psychological component of infertility (1985) Fertil Steril, 43, pp. 335-346Shapiro, C., Infertility and pregnancy loss (1988), Jossey-Bass San FranciscoAndrews, F., Abbey, A., Halman, L., Stress from infertility, marriage factors and subjective well-being of wives and husbands (1991) Am. J. Health Behav., 32, pp. 238-242Ong, L., De Haes, J., Hoos, A., Lammes, F., Doctor-Patient Communication: A review of the literature (1995) Soc. Sci. Med., 40, pp. 903-918Weinman, J., An outline of psychology as applied to medicine (1987), Wrigth, BristolDos Santos Fernandes, A., Bahamondes, L., Incidência dos fatores etiológicos de esterilidade conjugal nos hospitais universitários de Campinas (1996) Rev. Bras. Ginec. Obstet., 18, pp. 29-32Martinelli, M.L., Pesquisa qualitativa: Um instigante desafio (1999), Veras Editora, São PauloDe Souza, M.M., O desafio do conhecimento: Pesquisa Qualitativa em Saúde. 2a Edição. São Paulo: Hucitec-Abrasco (1993)Murayama, A., Nascimento, C.S., Bahamondes, L., Hidalgo, M., Dantas, C.M., Características dos casais do Programa de Esterilização in Vitro do CAISM/UNICAMP (1995) Reprod. Clim., 10 (4), pp. 166-16

Perceptions And Actions Of Healthcare Professionals Regarding The Mother-child Relationship With Premature Babies In An Intermediate Neonatal Intensive Care Unit: A Qualitative Study

Background: The mother-child interaction after delivery may be hampered when the newborn baby is hospitalized. The objective of the study was to understand perceptions and actions of healthcare professionals (HCPs), working in an intermediate neonatal intensive care unit (NICU), regarding mother-child relationship of hospitalized premature babies in the first weeks after delivery and the professionals' support for the development of this relationship within an NICU environment. The psychoanalytic concept of holding defined by Winnicott was used as the theoretical framework.Methods: A qualitative study was conducted with 20 HCPs (physicians, medical residents, nurses, and nurse technicians) working at an intermediate NICU of a referral hospital in Brazil. Semi-structured interviews were conducted, recorded and transcribed verbatim; and thematic analysis was performed.Results: The HCPs referred to the difficulty that these mothers had to develop the mother-child relationship within this environment. If they observed that the mother had initial inhibitions to interact with her baby, they tried to facilitate this process, since they were aware of the importance of early bonding for the child's well-being. They attributed the mothers' difficulty to the fragile appearance of the premature baby, the limited contact often imposed by the routine of the unit and the lack of participation in the decisions regarding the care given to her baby. HCPs tried to help women bond with her child by giving support and encouragement. Most of the physicians reported that the nurses represented a link between physicians and the mothers of the hospitalized babies.Conclusion: The HCPs reported attitudes and actions indicative of holding. A more in-depth understanding of the relationship between HCPs and mothers of premature babies at an NICU during the first days after delivery, and the needs of the mothers and her baby to be close to facilitate bonding should be part of the routine discussions of the NICU health team.141Hoffenkamp, H.N., Tooten, A., Hall, R.A., Croon, M.A., Braeken, J., Winkel, F.W., Vingerhoets, A.J., van Bakel, H.J., The impact of premature childbirth on parental bonding (2012) Evol Psychol, 10, pp. 542-561Flacking, R., Ewald, U., Wallin, L., Positive effect of kangaroo mother care on long-term breastfeeding in very preterm infants (2011) J Obstet Gynecol Neonatal Nurs, 40, pp. 190-197. , 21410756Nicolaou, M., Rosewell, R., Marlow, N., Nicolaou, C.G., Mothers' experiences of interacting with their premature infants (2009) J Reprod Infant Psychol, 27, pp. 182-194Lasiuk, G.C., Comeau, T., Newburn-Cook, C., Unexpected: an interpretive description of parental traumas' associated with preterm birth (2013) BMC Pregnancy Childbirth, 13, p. S13. , 3561145, 23445715Montirosso, R., Provenzi, L., Calciolari, G., Borgatti, R., Measuring maternal stress and perceived support in 25 Italian NICUs (2012) Acta Paediatr, 101, pp. 136-142. , 21827551, NEO-ACQUA Study GroupKantrowitz-Gordon, I., Expanded care for women and families after preterm birth (2013) J Midwifery Womens Health, 58, pp. 158-166. , 23590487Trombini, E., Surcinelli, P., Piccioni, A., Alessandroni, R., Faldella, G., Environmental factors associated with stress in mothers of preterm newborns (2008) Acta Paediatr, 97, pp. 894-898. , 18474070Lupton, D., Fenwick, J., 'They've forgotten that I'm the mum': constructing and practising motherhood in special care nurseries (2001) Soc Sci Med, 53, pp. 1011-1021. , 11556771Merighi, M.A.B., Jesus, M.C.P., Santin, K.R., Oliveira, D.M., Caring for newborns in the presence of their parents: the experience of nurses in the neonatal intensive care unit (2011) Rev Latino Am Enfermagem, 19, pp. 1398-1404Ichijima, E., Kirk, R., Hornblow, A., Parental support in neonatal intensive care units: a cross-cultural comparison between New Zealand and Japan (2011) J Pediatr Nurs, 26, pp. 206-215. , 21601144Reis, M.D., Rempel, G.R., Scott, S.D., Brady-Fryer, B.A., Van Aerde, J., Developing nurse/parent relationships in the NICU through negotiated partnership (2010) J Obstet Gynecol Neonatal Nurs, 39, pp. 675-683. , 21039850Wigert, H., Berg, M., Hellström, A.L., Parental presence when their child is in neonatal intensive care (2010) Scand J Caring Sci, 24, pp. 139-146. , 19508328Fegran, L., Helseth, S., The parent-nurse relationship in the neonatal intensive care unit context - closeness and emotional involvement (2009) Scand J Caring Sci, 23, pp. 667-673. , 19000088Conz, C.A., Merighi, M.A.B., Jesus, M.C.P., [Promoting affective attachment at the neonatal intensive care unit: a challenge for nurses] (2009) Rev Esc Enferm USP, 43, pp. 849-855. , 20085155Martínez, J.G., Fonseca, L.M.M., Scochi, C.G.S., The participation of parents in the care of premature children in a neonatal unit: meanings attributed by the health team (2007) Rev Latino Am Enfermagem, 15, pp. 239-246Franck, L.S., Axelin, A., Differences in parents', nurses' and physicians' views of NICU parent support (2013) Acta Paediatr, 102, pp. 590-596. , 23463946Latour, J.M., Hazelzet, J.A., Duivenvoorden, H.J., van Goudoever, J.B., Perceptions of parents, nurses, and physicians on neonatal intensive care practices (2010) J Pediatr, 157, pp. 215-220. , 20359714Winnicott, D.W., The MotherInfant Experience of Mutuality 1969 (1989) Psycho-Analytic Explorations, , London: Karnac Book, Winnicott C, Shepherd R, Davis MWinnicott, D.W., The Newborn and his Mother (1987) Babies and Their Mothers, pp. 35-51. , New York: ReadingWinnicott, D.W., (1992) Through Paediatrics to Psycho-Analysis, , London: Karnac BooksWinnicott, D.W., (2001) The Family and Individual Development, , London: Taylor & Francis GroupPruebas científicas de los diez pasos hacia una feliz lactancia natural http://ww.who.int/child_adolescent_health/documents/WHO_CHD_98.9/es/index.htmlTurato, E.R., (2003) Tratado da Metodologia da Pesquisa Clínico-Qualitativa: Construção Teórico-Epistemológica, Discussão Comparada e Aplicação nas Áreas da Saúde e Humanas, , Rio de Janeiro: VozesPatton, M.C., Qualitative Designs and Data Collection (2002) Qualitative Research and Evaluation Methods, , California: Thousand Oaks, 3Strauss, A., Corbain, J., (1990) Basics of Qualitative Research: Grounded Theory Procedures and Techniques, , USA: Sage PublicationsSkene, C., Franck, L., Curtis, P., Gerrish, K., Parental involvement in neonatal comfort care (2012) J Obstet Gynecol Neonatal Nurs, 41, pp. 786-797. , 22789154Kymre, I.G., Bondas, T., Balancing preterm infants' developmental needs with parents' readiness for skin-to-skin care: a phenomenological study (2013) Int J Qual Stud Health Well-being, 8, p. 21370Conde-Agudelo, A., Belizán, J.M., Diaz-Rossello, J., Cochrane review: kangaroo mother care to reduce morbidity and mortality in low birthweight infants (2012) Evid Based Child Health, 7, pp. 760-876Nyqvist, K.H., Anderson, G.C., Bergman, N., Cattaneo, A., Charpak, N., Davanzo, R., Ewald, U., Widström, A.M., Towards universal kangaroo mother care: recommendations and report from the first european conference and seventh international workshop on kangaroo mother care (2010) Acta Paediatr, 99, pp. 820-826. , 20219044Frello, A.T., Carraro, T.E., [Nursing and the relationship with the mothers of newborns in the neonatal intensive care unit] (2012) Rev Bras Enferm, 65, pp. 514-521. , 23032345Winnicott, D.W., (1983) O Ambiente e os Processos de Maturação - Estudos sobre a Teoria do Desenvolvimento Emocional, , Artmed: Porto Alegre, 2Sanches, R.M., Peter, A.C.A., Arida, S.G.P., UTI neonatal como espaço para intervenção psicoprofilática (2005) Winnicott na Clínica e na Instituição, pp. 133-148. , São Paulo: EscutaOrzalesi, M., Aite, L., Communication with parents in neonatal intensive care (2011) J Matern Fetal Neonatal Med, 24, pp. 135-13

Characteristics Of Men And Women Seeking Infertility Treatment In A Public Health Service [características De Homens E Mulheres Que Buscam Tratamento Para Infertilidade Em Serviço Público De Saúde]

Objective: to characterize the population seeking infertility treatment at a public health service. Method: it was carried out a descriptive study with 101 men and 101 women who were consulting for the first time in a human reproduction outpatient clinic at an university hospital. A structured questionnaire was used to collect information on subjects' socioeconomic characteristics and infertility problem. Results: the most of the subjects were 25-35 years old, have at most medium level of scholarship, familiar per capita income between one to three minimum salaries, they declared they were married for more than five years and that they had the infertility problem for two years or more. A little less than half said they had never had treatment for infertility. There was a significant difference between men and women regarding age, previous marriage, paid work, previous infertility treatment, who had the infertility problem, and have children from a previous union. Conclusions: people come to the clinic after a long period of infertility. Specifically women are already at an age that often precludes admission for treatment in view of the standards of services. It is necessary to develop strategies to facilitate access to these services for reproductive rights. © 2013 Sociedade Brasileira de Reprodução Humana. Published by Elsevier Editora Ltda. All rights reserved.2811823Mother or nothing: The agony of infertility (2010) Bull World Health Organ, 88, pp. 881-882. , http://dx.doi.org/10.2471/BLT.10.011210, World Health OrganizationSíntese de indicadores sociais (2005) Estudos e Pesquisas de Informação Demográfica e Socioeconômica, 19, p. 317. , Instituto Brasileiro de Geografia e Estatística(2000) The Millennium Development Goals, , United Nations. New York: United Nations(1988) Constituição Da República Federativa Do Brasil, , Brasil. Brasília: Senado FederalMakuch, M.Y., Petta, C.A., Osis, M.J., Bahamondes, L., Low priority level for infertility services within the public health sector: A Brazilian case study (2010) Hum Reprod, 25 (2), pp. 430-435Nygren, K.G., Zegers-Hochschild, F., Documentation of infertility prevalence, treatment access, and treatment outcomes in developing countries (2008) ESHRE Monogr, pp. 5-7Correa, K.R.F.C., Vizzotto, M.M., Cury, A.F., Avaliação da eficácia adaptativa de mulheres e homens inseridos num programa de fertilização in vitro (2007) Estud Psicol, 12, pp. 363-370Montagnini, H.M.L., Blay, N.F., Freitas, V., Cedenho, A.P., Estados emocionais de casais submetidos à fertilizaçã o in vitro (2009) Estud Psicol, 4, pp. 475-481Gorayeb, R., Borsari, A.C.T., Gomes, A.C.R., Romão, A.P.M.S., Shuhama, R., Caracterização clínica e psicossocial da clientela de um ambulatório de esterilidade (2009) Estud Psicol, 26, pp. 287-296Cunha, M.C.V., Albuquerque, R.M., Ludermir, A.B., Novaes, M., Infertilidade: Associação com transtornos mentais comuns e a importância do apoio social (2008) Rev Psiquiatr, 30, pp. 201-210De Abreu, L.G., Santana, L.F., Salles, N.P.A.D.A., Dos, R.R.M., Ferriani, R.A., De Moura, M.D., The pregnancy rate in women submitted to assisted reproduction techniques is lower after the age of 30 years (2006) Revista Brasileira de Ginecologia e Obstetricia, 28 (1), pp. 32-37. , http://www.scielo.br/pdf/rbgo/v28n1/29591.pdf, DOI 10.1590/S0100-72032006000100006Silva, J.L.C.P., Surita, F.G.C., Idade materna: Resultados perinatais e via de parto (2009) Rev Bras Ginecol Obstet, 31, pp. 321-325Makuch, M.Y., Simônia De Padua, K., Petta, C.A., Duarte Osis, M.J., Bahamondes, L., Inequitable access to assisted reproductive technology for the low-income Brazilian population: A qualitative study (2011) Hum Reprod, 26, pp. 2054-2060(2010) Síntese de Indicadores Sociais. Uma Análise Das Condições de Vida Da População Brasileira, , Instituto Brasileiro de Geografia e EstatísticaBarbosa, R., Relações de gênero, infertilidade e novas tecnologias reprodutivas (2000) Rev Estud Fem, 8, pp. 212-228Trindade, Z.A., Enumo, S.R.F., Triste e incompleta: Uma visão feminina da mulher infértil (2002) Psicol USP, 13, pp. 151-182Spotorno, P.M., Silva, I.M., Lopes, R.S., Expectativas e sentimentos de mulheres em situação de reprodução medicamente assistida (2008) Aletheia, 28, pp. 104-118Medeiros, L.S., Verdi, M.I.M., Direito de acesso ao serviço de reprodução humana assistida: Discussões bioéticas (2010) Ciênc Saúde Coletiva, 15, pp. 3129-3138Filetto, J.N., Makuch, M.Y., Long-term follow-up of women and men after unsuccessful IVF (2005) Reproductive BioMedicine Online, 11 (4), pp. 458-463. , 1831Barata, R.B., Acesso e uso de serviços de saúde consideraçõ es sobre os resultados da pesquisa de condições de vida (2008) São Paulo Persp, 22, pp. 19-2

Rape-related Pregnancy In Brazil: The Experience Of Women Seeking Legal Abortion [gravidez Após Violência Sexual: Vivências De Mulheres Em Busca Da Interrupção Legal] [embarazo Tras Actos De Violencia Sexual: Experiencias De Mujeres En Búsqueda De La Interrupción Legal]

In Brazil, abortion is permitted by law in cases of rape-related pregnancy. This study reports on various aspects in the experience of women that have been sexually assaulted: diagnosis of the pregnancy, seeking legal abortion, and hospitalization in a university hospital. This was a qualitative study that interviewed ten women 18 to 38 years of age, with at least eight years of schooling, one to five years after legal abortion. The women had been previously unaware of their right to a legal abortion, were ashamed about the sexual assault, kept it secret, and had not sought immediate care. The diagnosis of pregnancy provoked anxiety and the wish to undergo an abortion. Women treated through private health plans received either insufficient orientation or none at all. Respectful treatment by the healthcare staff proved relevant for the women to cope with the abortion. The study highlights the need to publicize the right to abortion in cases of rape-related pregnancy and the healthcare services that perform legal abortion, in addition to training healthcare and law enforcement teams to handle such cases.312345353Krug, E.G., Dahlberg, L.L., Mercy, J.A., Zwi, A.B., Lozano, R., (2002) World report on violence and health, , Geneva: World Health OrganizationMason, F., Lodrick, Z., Psychological consequences of sexual assault (2013) Best Pract Res Clin Obstet Gynaecol, 27, pp. 27-37World Health Organization, (2013) Global and regional estimates of violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence, , Geneva: World Health OrganizationFavarelli, C., Giugni, A., Salvatori, S., Ricca, V., Psychopathology after rape (2004) Am J Psychiatry, 161, pp. 1483-1485(2012) Prevenção e tratamento dos agravos resultantes da violência sexual contra mulheres e adolescentes: Norma técnica, , 3a Ed. Brasília: Ministério da SaúdeChoi, D.S., Kim, M., Hwang, K.J., Lee, K.M., Kong, T.W., Effectiveness of emergency contraception in women after sexual assault (2013) Clin Exp Reprod Med, 40, pp. 126-130Anis-Instituto de Bioética, Direitos Humanos e Gênero, organizador, (2012) Aspectos éticos do atendimento ao aborto legal: Perguntas e respostas, , Brasília: LetrasLivresLoureiro, D.C., Vieira, E.M., Aborto: Conhecimento e opinião de médicos dos serviços de emergência de Ribeirão Preto, São Paulo, Brasil, sobre aspectos éticos e legais (2004) Cad Saúde Pública, 20, pp. 679-688Faúndes, A., Simoneti, R.M., Duarte, G.A., Andalaft-Neto, J., Factors associated to knowledge and opinion of gynecologists and obstetricians about the Brazilian legislation on abortion (2007) Rev Bras Epidemiol, 10, pp. 6-18Andalaft Neto, J., Faúndes, A., Osis, M.J.D., Pádua, K.S., Perfil do atendimento à violência sexual no Brasil (2012) Femina, 40, pp. 301-306Bowen, G.A., Grounded theory and sensitizing concepts (2006) Int J Qual Methods, 5, pp. 12-23Turato, E.R., (2003) Tratado de metodologia da pesquisa clínico-qualitativa: Construção teórico-epistemológica, discussão comparada e aplicação nas áreas da saúde e humanas, , Petrópolis: Editora VozesMason, M., Sample size and saturation in Phd studies using qualitative interviews (2010) Forum: Qualitative Social Research, 11 (3). , http://www.qualitative-research.net/Patton, M.Q., (1990) Qualitative evaluation and research methods, , Newbury Park: Sage PublicationsCavalcanti, L.F., Gomes, R.F., Minayo, M.C.S., Representações sociais de profissionais de saúde sobre violência sexual contra a mulher: Estudo em três maternidades públicas municipais do Rio de Janeiro, Brasil (2006) Cad Saúde Pública, 22, pp. 31-39Oliveira, E.M., Barbosa, R.M., Moura, A.A.V.M., Kossel, K., Morelli, K., Botelho, L.F.F., Atendimento às mulheres vítimas de violência sexual: Um estudo qualitativo (2005) Rev Saúde Pública, 39, pp. 376-382Bedone, A.J., Faúndes, A., Atendimento integral às mulheres vítimas de violência sexual: Centro de Assistência Integral à Saúde da Mulher, Universidade Estadual de Campinas (2007) Cad Saúde Pública, 23, pp. 465-469(1999) Prevenção e tratamento dos agravos resultantes da violência sexual contra mulheres e adolescentes: Norma técnica, , Área Técnica da Saúde da Mulher, Departamento de Ações Programáticas Estratégicas, Secretaria de Atenção à Saúde, Ministério da Saúde. Brasília: Ministério da SaúdeCacique, D.B., Passini, R., Jr., Osis, M.J.D., Opiniões, conhecimento e atitudes de profissionais da saúde sobre aborto induzido: Uma revisão das pesquisas brasileiras publicadas entre 2001 e 2011 (2013) Saúde Soc, 22, pp. 916-936Osis, M.J.D., Pádua, K.S., Faúndes, A., Limitações no atendimento, pelas delegacias especializadas, das mulheres que sofrem violência sexual. Enfrentamento da violência pela saúde (2013) Boletim do Instituto de Saúde, 14, pp. 320-328Santos, V.C., Anjos, K.F., Souzas, R., Eugênio, B.G., Criminalização do aborto no Brasil e implicações à saúde pública (2013) Rev Bioét, 21, pp. 494-508Anjos, K.F., Santos, V.C., Souzas, R., Eugênio, B.G., Aborto no Brasil: A busca por direitos (2013) Saúde e Pesquisa, 6, pp. 141-152Aléx, L., Hammarström, A., Women's experiences in connection with induced abortion - a feminist perspective (2004) Scan J Caring Sci, 18, pp. 160-168Kimport, K., Foster, K., Weitz, T.A., Social sources of women's emotional difficulty after abortion: Lessons from women's abortion narratives (2011) Perspect Sex Reprod Health, 43, pp. 103-109Porto, D., O significado da maternidade na construção do feminino: Uma crítica bioética à desigualdade de gênero (2011) Revista Redbioética/UNESCO, 2, pp. 55-66Soares, G.S., Profissionais de saúde frente a interrupção legal no Brasil: Desafios, conflitos e significados (2003) Cad Saúde Pública, 19, pp. S399-S406Farias, R.J., Cavalcanti, L.F., Atuação diante das situações de interrupção legal na perspectiva dos profissionais de saúde do Hospital Municipal Fernando Magalhães (2012) Ciênc Saúde Coletiva, 17, pp. 1755-1763Kiss, L.B., Schraiber, L.B., Temas médico-sociais e a intervenção em saúde: A violência contra mulheres no discurso dos profissionais (2011) Ciênc Saúde Coletiva, 16, pp. 1943-1952Astbury-Ward, E., Parry, O., Carnwell, R., Stigma, abortion and disclosure: Findings from a qualitative study (2012) J Sex Med, 9, pp. 3137-3147Hosseini-Chavoshi, M., Abbasi-Shavazi, M.J., Glazebrook, D., McDonald, P., Social and psychological consequences of abortion in Iran (2012) Int J Gynaecol Obstet, 118, pp. S172-S177Pedrosa, C.M., Spink, M.J.P., A violência contra mulher no cotidiano dos serviços de saúde: Desafios para a formação médica (2011) Saúde Soc, 20, pp. 124-13

The Vertical Position During Labor: Pain And Satisfaction [posição Vertical Durante O Trabalho De Parto: Dor E Satisfação]

Objectives: to evaluate the vertical position adopted by nulliparous women during labor in terms of pain and satisfaction with the position. Methods: the study was based on a secondary efficacy analysis of data from 107 nulliparous women enrolled in a randomized controlled trial in which the vertical position adopted during the dilation phase of labor was evaluated. The analysis involved comparing the median percentages of the duration for which women remained in the vertical position for each of the variables studied. The Kruskal-Wallis and Mann-Whitney tests were used to determine the differences between the groups. Statistical significance was set at p7 (p=0.02). At 4 and 6 cm of dilation, the women who reported greater satisfaction remained more than 50% of the time in the vertical position (p=0.02 and p=0.03, respectively). Conclusions: the vertical position helped relieve labor pain and increased comfort and patient satisfaction.94393398(2001) Delivery, Abortion and Post-partum: Humanized Care to Woman, , Brasil. Ministério da Saúde, Brasília, DFMiquelutti, M.A., Cecatti, J.G., Makuch, M.Y., Upright position during the first stage of labor: A randomized controlled trial (2007) Acta Obstet Gynecol Scand, 86, pp. 553-558Carlson, J.M., Diehl, J.A., Sachtleben-Murray, M., McRae, M., Friedman, E.A., Maternal position during parturition in normal labor (1986) Obstet Gynecol, 68, pp. 443-447Souza, J.P., Miquelutti, M.A., Cecatti, J.G., Makuch, M.Y., Maternal position during the first stage of labor: A syste-matic review (2006) Reprod Health, 3, p. 10Liu, Y.C., Effect of an upright position during labor (1974) Am J Nurs, 74, pp. 2202-2205Flynn, A.M., Kelly, J., Hollins, G., Lynch, P.F., Ambulation in labour (1978) Br Med J, 2, pp. 591-593Diaz, A.G., Schwarcz, R., Fescina, R., Caldeyro-Barcia, R., Vertical position during the first stage of the course of labor and neonatal outcome (1980) Eur J Obstet Gynecol Reprod Biol, 11, pp. 1-7Stewart, P., Calder, A.A., Posture in labor: Patients' choice and its effect on performance (1984) Br J Obstet Gynaecol, 91, pp. 1091-1095Andrews, C.M., Chrzanowski, M., Maternal position, labor and comfort (1990) Appl Nurs Res, 3, pp. 7-13McManus, T.J., Calder, A.A., Upright posture and the efficiency of labor (1978) Lancet, 1, pp. 72-74Williams, R.M., Thom, M.H., Studd, J.W., A study of the benefits and acceptability of ambulation in spontaneous labour (1980) Br J Obstet Gynaecol, 87, pp. 122-126Bloom, S.L., McIntire, D.D., Kelly, M.A., Beimer, H.L., Burpo, R.H., Garcia, M.A., Leveno, K.J., Lack of effect of walking on labor and delivery (1998) N Engl J Med, 339, pp. 76-79Hemminki, E., Saarikoski, S., Ambulation and delayed amniotomy in the first stage of labor (1983) Eur J Obstet Gynecol Reprod Biol, 15, pp. 129-139Hemminki, E., Lenck, M., Saarikoski, S., Henriksson, L., Ambulation versus oxytocin in protracted labour: A pilot study (1985) Eur J Obstet Gynecol Reprod Biol, 20, pp. 199-208Albers, L.L., Anderson, D., Cragin, L., Daniels, S.M., Hunter, C., Sedler, K.D., Teaf, D., The relationship of ambulation in labor to operative delivery (1997) J Nurse Midwifery, 42, pp. 4-8Read, J.A., Miller, F.C., Paul, R.H., Randomized trial of ambulation versus oxytocin for labor enhancement: A preliminary report (1981) Am J Obstet Gynecol, 139, pp. 669-672Roberts, J.E., Mendez-Bauer, C., Blackwell, J., Carpenter, M.E., Marchese, T., Effects of lateral recumbency and sitting on the first stage of labor (1984) J Reprod Med, 29, pp. 477-481Huskisson, E.C., Measurement of pain (1974) Lancet, 2, pp. 1127-1131Sampieri, R.H., Collado, C.F., Lucio, P.B., (1998) Metodologìa De La Investigacion, pp. 255-292. , Second edition. Mexico: Mc Graw-HillMéndez-Bauer, C., Arroyo, J., Garcia Ramos, C., Menéndez, A., Lavilla, M., Izquierdo, F., Villa Elízaga, I., Zamarriego, J., Effects of standing position on spontaneous uterine contractility and other aspects of labor (1975) J Perinat Med, 3, pp. 89-100Melzack, R., Bélanger, E., Lacroix, R., Labor pain: Effect of maternal position on front and back pain (1991) J Pain Symptom Manage, 6, pp. 476-480Adachi, K., Shimada, M., Usui, A., The relationship between the parturient's positions and perceptions of labor pain intensity (2003) Nurs Res, 52, pp. 47-51Spiby, H., Slade, P., Escott, D., Henderson, B., Fraser, R.B., Selected coping strategies in labor: An investigation of women's experiences (2003) Birth, 30, pp. 189-194Dundes, L., The evolution of maternal birthing position (1987) Am J Public Health, 77, pp. 636-641Russell, J., Moulding of the pelvic outlet (1969) J Obstet Gynaecol Br Commonw, 76, pp. 817-820Simkin, P., Maternal positions and pelves revisited (2003) Birth, 30, pp. 130-132Green, J.M., Baston, H.A., Feeling in control during labor: Concepts, correlates and consequences (2003) Birth, 30, pp. 235-247Slade, P., Macpherson, S.A., Hume, A., Maresh, M., Expectations, experiences and satisfaction with labour (1993) Br J Clin Psychol, 32, pp. 469-48