A influência dos factores ambientais na maternidade no Concelho de Évora: o caso particular do meio rural

O nascimento de uma criança é um marco fundamental na vida de qualquer casal/família, especialmente na vida de cada mulher. A realização deste trabalho de investigação sobre a influência dos fatores ambientais na maternidade, no âmbito da ecologia humana é justificada pelo facto de haver um envelhecimento da população a nível nacional e em particular a nível das áreas rurais no concelho de Évora. Por outro lado, a abordagem desta problemática surgiu também no âmbito da experiência profissional desenvolvida. Os profissionais de enfermagem devem estar despertos e disponíveis para compreender as práticas de saúde das diferentes culturas, de modo a poderem prestar cuidados de enfermagem de qualidade. A questão central do nosso estudo é a seguinte: De que modo o ambiente influência o comportamento da mulher na vivência da maternidade? O nosso trabalho tem como objetivos: - Analisar o tipo de interações existente entre os fatores ambientais e a maternidade; - Identificar a influência do meio rural na maternidade; - Compreender qual o significado da maternidade para algumas mulheres pertencentes ao meio rural. Será um trabalho que segue uma metodologia quantitativa. Iremos realizar um estudo descritivo - correlacional. Temos três tipos de variáveis - Variável A - Fatores ambientais - Variável B - Vivência da maternidade - Variável C - meio rural Formulámos ainda quatro questões de investigação e que são as seguintes: - Existe diferença na vivência da maternidade conforme a idade; - Existe uma relação positiva entre o ambiente e o número de filhos; - Qual a intensidade da relação que existe entre o gozo da licença de maternidade e a profissão; A influência dos fatores ambientais na maternidade no concelho de Évora - 0 caso particular do meio rural - Quais os principais fatores que interferem na vivência da maternidade. A nossa amostra é não - probabilística acidental e é constituída por todas as mulheres em idade fértil pertencentes a freguesias até 1999 habitantes do concelho de Évora, que recorreram ao Serviço de Obstetrícia do HESE durante os meses de Janeiro, Fevereiro e Março de 2003. Foi aplicado o questionário a 30 sujeitos durante o período definido. No tratamento e análise dos dados recorremos ao uso da estatística descritiva, utilizámos distribuições de frequências, assim como medidas de tendência central (média, mediana e a moda) e de dispersão (desvio padrão). Utilizámos ainda estatística comparativa (teste do Qui Quadrado e o teste de Phi) e de correlação (coeficiente de correlação r de Pearson). Em relação à vivência da maternidade conforme a idade não se verificou probabilidade de relação e o grau de associação é fraco. A correlação existente é baixa. No que concerne à relação entre o ambiente e o número de filhos também não há probabilidade de relação e o grau de associação é fraco. Existe uma correlação moderada negativa. No entanto entre a licença de maternidade e a profissão existe probabilidade de relação, mas o grau de associação é fraco. O nível de correlação é muito alto. Após a análise dos dados verificámos que os principais fatores que interferem na vivência da maternidade no meio rural são fatores físicos, sociais e psicológicos devido à complexidade que é a maternidade. Pois a relação mãe/filho e toda a sua envolvente criam emoções e condições psicológicas que afetam a vida de qualquer casal. Sendo assim é importante que as condições sociais e económicas estejam bem estabelecidas para que não se verifique uma crise familiar. A chegada de uma criança altera as rotinas da família e poderá desequilibrar a vivência do período a que nos chamamos de maternidade. Em estudos posteriores, poderá ser aprofundado quais são estes fatores, pois já há uma base para a realização do trabalho e a colocação de hipóteses. /ABSTRACT - The birth of a child is a fundamental mark in any couple/ family's life, especially in every woman's life. The realization of this investigation work on the influence of environmental factors in maternity, in the ambit human ecology is justified by the fact that the population is aging nation wide and in particular un the rural areas of the district of Évora . On the other hand, this problematic's approach also arose in the sphere of the professional experience developed. The nursing professional should be awake and available to understand the medical practices of the different cultures, in order to perform quality nursing care. The main question of our study is the following: - In what Way does the environment influence the woman’s behaviour throughout motherhood? Our work has as objectives: - Analyze the type of existing interactions between environmental factors and maternity; Identify the influence of the rural environment on maternity; Understand the meaning of maternity for some women belonging to the rural environment. This will be a work which follows a quantitative methodology. We will carry out a descriptive study - correlational. We have three types of variables: - Variable A - Environmental factors - Variable B - Maternity experience - Variable C - Rural environment Four investigation questions were formulated, which are the following:- Is there difference in maternity experience according to the age; - Is there a positive relationship between the environment and number of children; - What is the intensity of the relationship that exists between the enjoyment of maternity leave and the profession; The influences of environmental factors in maternity in the district of Évora - the particular case of the rural environment - Which are the main factors that interfere in the maternity experience. Our sample is non - probabilistic accidental and it constitutes on all women in fertile age belonging to parishes from the district of Évora with no more than 1999 inhabitants, who resorted to HESE's Obstetrics Service during the months of January, February and March 2003. The questionnaire was applied to 30 subjects during the definite period. In the treatment and analysis of the data we resorted to the use of descriptive statistics, used distributions of frequencies, as well as measures of central tendency (medium, median and the mode) and of dispersion (pattern deflection). We also used comparative (square Qui test and Phi test) and correlation statistics (correlation coefficient r Pearson). With regard to the maternity experience according to age, ratio probability was not verified and the association degree is weak. The existing correlation is low. Regarding the relation between the environment and number of children, there is also no ratio probability and the association degree is weak. A negative moderate correlation does exist. However, between maternity leave and profession, ratio probability exists but, the association degree is weak. The level of correlation is very high. Upon the data analysis, we verified that the main factors which interfere with motherhood in the rural environment are physical, social and psychological factors due to the complexity that is maternity. As the relationship mother/child and the whole involving create emotions and psychological conditions that affect the life of any couple. This being, it is important that the social and economic conditions are well established so that a family crisis does not take place. The arrival of a child alters the family routines and it might unbalance the way of living of the period we call maternity. In following studies, we could examine thoroughly what are these factors, as there is already a base to carry out the Work and to place hypothesis

Social representations of violence on the elderly: An injustice and a badness

Rationale: In contemporary society, ageing is a phenomenon that marks all developed societies. Portugal is one of the most ageing countries in Europe. Analyzing the social representations of violence on the elderly, from the current and past conceptions and daily practices of the elderly allows us to have access to the dominant constructions in society about the social phenomenon that is violence and the way it is socially and individually expressed by its main actors. Objective: To analyze the social representations of a group of elderly people about violence on the elderly and the reasons why this violence occurs. Methods: Exploratory and descriptive research with qualitative approach, supported by Theory of Social Representations. It was attended by 237 elderly people aged 65-96 years, from the project “Ageing Safely in Alentejo” from University of Évora. The Free Speech Association technique was used and data were processed through qualitative data analysis software. All the ethical procedures of human research were followed. Results: In social representations of violence on the elderly the words most evoked by the elderly were injustice, to which are added the mistreatment, badness, bad, lack of respect, sadness, horrible and abandonment. About the reasons that lead to violence on the elderly the words such as lack of respect, lack of education and badness are predominant. These terms refer to the social devaluation of the elderly and their role in today's society, as in the representations about violence. Conclusions: The social representations of these elderly people about violence and their reasons points to the stereotypes associated with the prevalent ageism in our society, where the social devaluation of the elderly dominates the daily life conceptions and practices

Cuidados de Enfermagem a Puérpera com Anemia: Relato de Caso

Objective: To develop a nursing care plan proposal focusing on anemia in a puerperal woman. Method: Case report of a 24-year-old puerperal woman, eutocic delivery at 39 weeks with a postpartum serum hemoglobin value of 7.9 g/dL. Dorothea Orem’s Theoretical Model of Self-Care Deficit and the taxonomy of the International Classification for Nursing Practice were used. Results: Nine nursing diagnoses were identified: Activity intolerance; Risk of falling; Abnormal resting pattern; Compromised family process; Anxiety; Pain; Risk of infection; Compromised breastfeeding; Low knowledge about self-care and care for the newborn after discharge. Conclusion: The development of this case study favored the identification of the care needs of the puerperal woman, and is the starting point for the development of nursing interventions, providing support for the provision of quality and individual care, making it possible to respond to the identified needs and to the particularities of puerperal women with anemia.Objetivo: Elaborar proposta de plano de cuidados de enfermagem com enfoque na anemia em uma puérpera. Método: Relato de caso referente a uma puérpera de 24 anos, parto eutócico às 39 semanas com valor de hemoglobina sérica pós-parto 7,9 gr/dL. Utilizado Modelo Teórico do Déficit de Autocuidado de Dorothea Orem e a taxonomia da Classificação Internacional para a Prática de Enfermagem. Resultados: Foram identificados 9 diagnósticos de enfermagem, Intolerância à atividade; Risco de queda; Padrão de repouso anormal; Processo familiar comprometido; Ansiedade; Dor; Risco de infeção; Amamentação comprometida; Baixo Conhecimento sobre autocuidado e cuidados com o recém-nascido após a alta. Conclusão: O desenvolvimento deste estudo de caso favoreceu a identificação das necessidades de cuidados da puérpera, sendo o ponto de partida para o desenvolvimento de intervenções de enfermagem, dando subsídio na prestação de cuidados com qualidade e individuais, possibilitando responder as necessidades identificadas e as particularidades da puérpera com anemia

Midwifery Now: Narratives about Motivations for Career Choice

Abstract: The objective of this study was to analyse nursing students’ motivation to choose the midwifery career. This is a cross-sectional study with a qualitatively driven mixed-methods approach. The settings are three higher education institutions located in Portugal. The study was conducted between September 2019 and November 2021, with the participation of 74 midwifery master’s students, through convenience sampling. The data were collected through the LimeSurvey software and were subsequently analysed in the SPSS and IRaMuTeQ software programs. The emerging thematic areas were as follows: (1) building a professional identity and (2) knowledge construction. From these two thematic areas, six classes emerged that revealed commitment to the profession. It is in Class 6 that the ancestral essence of the profession lies, revealing the meanings of competence and care perpetuation linked to gender. Midwifery is a first-line profession, and the career choice reflects a commitment to support the mother/newborn dyad in view of the inevitability of human care for the preservation of the species. Midwives with a Socratic inspiration are the model for the profession. Given the development of professional identity, it can be interesting to have an educational curriculum where human values are reinforced. A woman-centred birth environment and birth territory are elementary for midwifery education

DOMESTIC VIOLENCE IN PERSPECTIVE OF WOMEN WHO LIVED IT

Introduction: Knowing the experience of abuse, contextual determinants that led to the rupture of the situation and attempts to build a more harmonious future, it is essential to work sensitivities and better understand victims of domestic violence. Objectives: To understand the suffering of women victims of violence. Methods: This is an intentional sample of 21 women who were at shelter home or in the community. The data were collected by in- Documento descargado de http://www.elsevier.es el 13-10-2016 3rd World Congress of Health Research 21 terviews, guided by a script organized into four themes. The interviews were conducted with audio record, the permission of the participants were fully passed the text and analyzed as two different corpuses, depending on the context in which they occurred. The analysis was conducted using the ALCESTE computer program. The study obtained a favorable opinion of the Committee on Health and Welfare of the University of Évora. Results: From the irst sample analysis emerged ive classes. The association of the words gave the meaning of each class that we have appointed as Class 1 - Precipitating Events; Class 2 - Experience of abuse; Class 3 - Two feet in the present and looking into the future; Class 4 - The present and learning from the experience of abuse; and Class 5 - Violence in general. From the analysis of the sample in the community four classes emerged that we have appointed as Class 1 - Violence in general; Class 2 - Precipitating Events; Class 3 - abuse of experience; and class 4 - Support in the process. Conclusions: Women who are at shelter home have this experience of violence and its entire context a lot are very focused on their experiences and the future is distant and unclear. Women in the community have a more comprehensive view of the phenomenon of violence as a whole, they can decentralize to their personal experiences and recognize the importance of support in the future construction process

ACCESIBILIDAD Y ATENCIÓN PRIMARIA DE SALUD – LA REVISIÓN DE LOS USUARIOS

Objective: to evaluate the accessibility, based on the opinion of users of three health centers of the Regional Health Administration of the Alentejo (ARSA) where they have introduced organizational changes. Method: a descriptive study with quantitative approach, resorting to the use of a questionnaire. The sample consisted of users of three health centers. Data collection was carried out in two months. The data were analyzed with the Statistical Package for Social Sciences (SPSS ®). Consent was obtained from ARSA (No. 11/2007), with the ethical component of data collection with human beings. Results: mostly female users who are over 60 years responded. The majority has a family doctor for over 15 years, the waiting time for a routine visit ranges from one to four weeks and get an emergency appointment the same day. Conclusion: the users are satisfied with the changes in the physical structure and functioning of health centers, translating into improvements in accessibility to care. However, they mentioned the need for changes at the level of human resources, customer assistance, physical environment and utilities

Risco de Violência sobre Pessoas Idosas – Teste da Escala ARVINI

Aim: To test the Scale of Risk Assessment of Violence in non-institutionalized Elderly (ARVINI), in a group of autonomous elderly people of Alentejo. Methods: Exploratory research, with a quantitative approach. Participated 500 elderly people aged 65-96 years, from the Ageing Safely in Alentejo - Understanding to Act project at the University of Évora. Results: The ARVINI scale test is constituted by 27 items. The Cronbach Alpha Coefficient with a value of 0.727 reveals an acceptable internal consistency. The cut-off point that produces the maximum sensitivity and specificity to predict the risk of violence on the elderly was 4.5 (sensitivity= 64.9%, specificity= 80.7%) and the ROC curve area= 0.812 (0.766 - 0.702, 95% confidence intervals). Aim: To test the Scale of Risk Assessment of Violence in non-institutionalized Elderly (ARVINI), in a group of autonomous elderly people of Alentejo. Methods: Exploratory research, with a quantitative approach. Participated 500 elderly people aged 65-96 years, from the Ageing Safely in Alentejo - Understanding to Act project at the University of Évora. Results: The ARVINI scale test is constituted by 27 items. The Cronbach Alpha Coefficient with a value of 0.727 reveals an acceptable internal consistency. The cut-off point that produces the maximum sensitivity and specificity to predict the risk of violence on the elderly was 4.5 (sensitivity= 64.9%, specificity= 80.7%) and the ROC curve area= 0.812 (0.766 - 0.702, 95% confidence intervals). Conclusions: 26.7% of the elderly presented a risk of violence. It is imperative to develop and improve instruments that detect the risk of violence against the elderly so that all health professionals and others can act early and preventively in the fight against violence against the elderly. The fact of being a woman, social isolation and low income stand out as risk factors for violence

Factors that Determine the Self-Efficacy of The Maternal Care in Postpartum Women: Data for Future Memory

The birth of a child demands the provision of care. Mothers have different levels of safety or confidence when it comes to caring, which reveals the perception of self-efficacy. Our aim is to register, for future memory, the factors associated with self-efficacy in maternal care. Quantitative and cross-sectional study. It explores sociodemographic factors, factors related to the pregnancy and labor history, the newborn's characteristics, and related care environment with self-efficacy in maternal care. The study population included postpartum women from two Turkish maternity hospitals, in convenient sampling, with a response rate of 93,4%. Prudent ethical principles. The criterion variable was observed through the Perceived Maternal Parenting Self-Efficacy (PMP S-E). The statistical analysis was carried out on the SPSS software. The participants had an average age of 27.81(DP=5.13), the majority were married (95.9%) and for 40.1% this was their first child. The majority of labors were vaginal (52.4%). When it comes to the criterion variable, about 70% had a high perception regarding self-efficacy in maternal care. The univariate analysis revealed eight variables, included in the logistic regression: maternal age (p=.050), number of children (p<.001), number of prenatal appointments (p=.006), time that elapsed between the birth and the first episode of breastfeeding (p=.047), maternal safety while breastfeeding (p<.001), type of food given to the newborn p=.011), midwife support for exclusive maternal breastfeeding (p<.001) and maternal breastfeeding self-efficacy (p<.001). In the binary logistic regression, the best predictors of self-efficacy in maternal care were: midwife support for exclusive maternal breastfeeding (OR=1.092; B=0,088) and the self-efficacy in the maternal breastfeeding (OR=13.187; B=2.579). When it comes to maternal breastfeeding, both from the perspective of self-efficacy and the support offered by professionals, are the most relevant factors in the perception of maternal skills recognized by mothers. This study fills an information gap about the phenomenon, looking at it in retrospect

Atención a mujeres en situación de violencia: la construcción de un modelo de educación permanente para la salud

Objetivo: Propor um Modelo de Educação Permanente em Saúde com estratégias vinculadas ao referencial das Cinco Disciplinas para o desenvolvimento de competências dos profissionais que atuam na atenção direta às mulheres em situação de violência. Método: Pesquisa qualitativa realizada pela técnica de grupo focal, com 16 profissionais que integram uma rede intersetorial em Curitiba-PR, de agosto a outubro de 2019. Dados analisados por análise de conteúdo na modalidade temática, à luz do referencial teórico das Cinco Disciplinas: domínio pessoal; modelo mental; visão compartilhada; aprendizagem em equipe; e, pensamento sistêmico. Resultados: As Cinco Disciplinas foram evidenciadas nas categorias, bem como estratégias a serem utilizadas para desenvolvimento de competências. Utilizou-se uma representação diagramática a ser percorrida durante processo de aprendizagem. Conclusão: As estratégias sugeridas pelos profissionais que atuam na atenção às mulheres em situação de violência apoiaram a proposição de um Modelo de Educação Permanente em Saúde baseado no referencial teórico adotado

Atenção às mulheres em situação de violência: construção de modelo de educação permanente em saúde

Objetivo: Propor um Modelo de Educação Permanente em Saúde com estratégias vinculadas ao referencial das Cinco Disciplinas para o desenvolvimento de competências dos profissionais que atuam na atenção direta às mulheres em situação de violência.Método: Pesquisa qualitativa realizada pela técnica de grupo focal, com 16 profissionais que integram uma rede intersetorial em Curitiba-PR, de agosto a outubro de 2019. Dados analisados por análise de conteúdo na modalidade temática, à luz do referencial teórico das Cinco Disciplinas: domínio pessoal; modelo mental; visão compartilhada; aprendizagem em equipe; e, pensamento sistêmico.Resultados: As Cinco Disciplinas foram evidenciadas nas categorias, bem como estratégias a serem utilizadas para desenvolvimento de competências. Utilizou-se uma representação diagramática a ser percorrida durante processo de aprendizagem.Conclusão: As estratégias sugeridas pelos profissionais que atuam na atenção às mulheres em situação de violência apoiaram a proposição de um Modelo de Educação Permanente em Saúde baseado no referencial teórico adotado. Palavras-chave: Sistema de aprendizagem em saúde. Educação baseada em competências. Educação continuada. Educação interprofissional. Violência contra a mulher