Construct validity of a Portuguese version of the Female Sexual Function Index

Este trabalho teve como objetivos avaliar a validade de construto de uma versão do Female Sexual Function Index (FSFI). A versão foi inserida ao final de um questionário multidimensional e aplicada face a face em 235 mulheres esterilizadas. O índice de não resposta foi de 1,7%. A amostra apresentou-se bastante homogênea com baixa renda e nível educacional. Um coeficiente alfa de Cronbach de 0,948 indicou uma consistência interna muito alta. A análise fatorial demonstrou que o instrumento parece medir quatro fatores latentes: desejo/excitação, lubrificação, orgasmo/satisfação e dor. Isso pode referir-se a uma característica do próprio instrumento, às características da resposta sexual feminina ou ainda às peculiaridades culturais da amostra, o que pode interferir no entendimento das perguntas ou dos conceitos sobre os quais o instrumento versa. Assim aponta-se para necessidade de desenvolvimento de outros estudos na população geral para a definição do conjunto de propriedades do FSFI, como sua composição de fatores latentes e o estabelecimento de pontos de corte adequados à população brasileira.This study aimed to evaluate the construct validity of a version of the Female Sexual Function Index (FSFI). The version was inserted into a multidimensional questionnaire and applied face-to-face to 235 sterilized women. Non-response rate was 1.7%. The sample proved to be highly homogeneous, with low income and education. Cronbach's alpha of 0.948 indicated high internal consistency. Factor analysis showed that the instrument was measuring four factors: desire/arousal, lubrication, orgasm/satisfaction, and pain. This may reflect characteristics of the instrument itself, female sexual response, or even the sample's cultural peculiarities, which can affect understanding of the questions or concepts with which the instrument deals. This study emphasizes the need for further research in the general population to determine the psychometric properties of the FSFI, such as its factor composition and definition of appropriate cut-off points for the Brazilian population.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Shock index and heart rate standard reference values in the immediate postpartum period: a cohort study

To determine Shock Index (SI) reference values in the first two hours of the postpartum period after objectively measuring postpartum bleeding. Materials and methods A complementary analysis using data from a prospective cohort study at Women's Hospital of the University of Campinas, Brazil, between 1 February 2015 and 31 March 2016. It included women giving birth vaginally unless they had one of these conditions: gestational age below 34 weeks, hypertension, hypo-or hyperthyroidism without treatment, any cardiac disease, infections with fever or sepsis, history of coagulopathy or delivery by C-section. Blood loss was measured by adding the blood volume collected in the drape placed under the women's buttocks and the weight of gauzes and compresses used (excluding the dry weight). Vital signs were measured every 5-15 min after delivery. Exploratory data analysis was performed to assess the mean, standard deviation, median, and percentiles (5 th, 10th, 25th, 50th, 75th, 90th, 95th). To identify variation among the periods after delivery, the mean SI and heart rate (HR) values observed for the following intervals were used in the analysis: 0-20 min, 21-40 min, 41-60 min, 61-90 min and 91-120 min. Results One hundred eighty-six women were included. The mean age +/- SD was 24.9 +/- 6.1 years and the mean gestational age at birth was 39.2 +/- 1.8 weeks. At the puerperal period, the mean SI values ranged from 0.68 +/- 0.14 to 0.74 +/- 0.15. The percentile distribution ranged from 0.46 (5 th percentile) to 1.05 (95 th percentile). The mean HR values ranged from 80.8 +/- 12.7 bpm to 92.3 +/- 14.4 bpm. The percentile distribution ranged from 62.0 bpm (5th percentile) to 117 bpm (95 th percentile). Conclusion Reference ranges were established for SI and HR values which showed small variations throughout the postpartum period14

Cross-cultural adaptation of the Female Sexual Function Index

Ainda hoje pouco se conhece sobre a epidemiologia das disfunções sexuais femininas. O Female Sexual Function Index (FSFI) [Índice de Função Sexual Feminina] é um questionário breve, que pode ser auto-aplicado, e que se propõe avaliar a resposta sexual feminina. Este estudo teve por objetivo avaliar a adaptação transcultural da versão em português do FSFI. O processo envolveu cinco etapas: tradução, versão, apreciação formal de equivalência, revisão crítica por especialistas em sexualidade e pré-teste do instrumento. Após a identificação de problemas semânticos, concordâncias e discordâncias, foi possível propor uma versão sintética, escolhendo e incorporando itens de uma das duas versões em português. Algumas mudanças foram realizadas após o pré-teste do questionário, para tornar a versão em português mais coloquial e aceitável para a população-alvo ao utilizar termos mais corriqueiros, como opção ou complemento à linguagem científica. Ao se comparar mais de uma versão do instrumento, no processo de equivalência transcultural, foi possível detectar problemas e dificuldades na adaptação da linguagem que poderiam ter passado despercebidos, caso não se observassem todas as fases do processo.The epidemiology of female sexual dysfunctions is still not well known. The Female Sexual Function Index (FSFI) is a short questionnaire specially designed to assess female sexual response. This study aimed to evaluate the cross-cultural equivalence of the Portuguese version of the FSFI. The cross-cultural adaptation involved five steps: translation, back-translation, formal equivalence assessment, review by specialists in sexuality, and pre-testing. After identification of semantic problems, agreements, and disagreements, a brief version was proposed, selecting and incorporating items from one of the two Portuguese versions. Some changes were made after pre-testing the questionnaire, most of which to make the Portuguese version more readily comprehensible and acceptable for the target population, using ordinary words as options or to complement the scientific language. Comparing more than one version of the instrument in the process of cross-cultural equivalence allowed detecting problems and difficulties in adapting the language, which would not have been observed otherwise

Conhecimento de adolescentes gestantes sobre o papilomavírus humano

To evaluate the level of information possessed by pregnant adolescents regarding the human papillomavirus (HPV). Methods Descriptive study developed in the adolescent prenatal outpatient clinic of a tertiary hospital from the state of 55o Paulo, Brazil. Data were collected between June and December 2017 following approval from the ethics and research committee (CAAE: 1.887.892/2017). Pregnant adolescents, <= 18 years old, who attended the abovementioned outpatient section, composed the sample. Those diagnosed with a psychiatric disorder and those with hearing or cognitive disabilities were excluded. After acceptance to participate in the present study, the pregnant adolescents signed an Informed Consent Form. Regarding the statistical analysis, the chi-squared test and the Fisher exact test were used. Results Regarding the knowledge about HPV, 123 (80.92%) of the participants had already heard about the subject; for 77 (50.66%), their schools had been the source of the information; 101 (66.45%) did not know how they could be infected by the virus. Age variation did not influence their knowledge on how to prevent themselves from HPV (p = 0.2562). The variable vaccine is associated with HPV prevention (p < 0.0001). Conclusion The pregnant adolescents composing the sample have shown to have knowledge about HPV. However, they do not prevent themselves from it appropriately, given that little more than half of the sample was vaccinated, had not reported an understanding that the use of preservatives and vaccination are effective means of prevention, and did not correlate HPV with uterine cervical cancer415291297Avaliar o nível de informação que as adolescentes gestantes possuem em relação ao papilomavírus humano (HPV). Métodos Estudo descritivo desenvolvido no ambulatório pré-natal adolescente de um hospital terciário do estado de São Paulo, Brasil. Os dados foram coletados entre junho e dezembro de 2017, após a aprovação do comitê de ética e pesquisa (CAAE: 1.887.892/2017). A amostra foi composta por adolescentes gestantes com 18 anos que frequentaram o ambulatório. Foram excluídas as com transtorno psiquiátrico diagnosticado e as portadoras de deficiência auditiva ou de cognição. Após aceitarem participar do presente estudo, as adolescentes grávidas assinaram o termo de assentimento e consentimento livre e esclarecido. Para as análises estatísticas, foram utilizados os testes de qui-quadrado e exato de Fisher. Resultados Em relação ao conhecimento sobre o HPV, 123 (80,92%) já tinham ouvido falar sobre o assunto; destas adolescentes, 77 (50,66%) receberam as informações que tinham através de suas escolas, e 101 (66,45%) pacientes não sabiam como poderiam contrair o vírus. A variação da idade das adolescentes entrevistadas não influenciou se estas sabiam ou não como se prevenir contra o HPV (p ¼ 0,2562). A variável vacina está associada à prevenção contra o HPV (p < 0,0001). Conclusão As gestantes avaliadas possuem conhecimento sobre o HPV, mas não fazem a prevenção adequada, visto que um pouco mais da metade se vacinaram, não relataram o preservativo e a vacina como métodos eficazes de prevenção, e não relacionaram o HPV com o câncer de colo de útero

Maternal near miss – understanding and applying the concept

A morte materna é o evento mais raro e dramático, de uma cadeia de acontecimentos que pode acometer qualquer mulher durante o ciclo gravídico-puerperal. Esta cadeia de eventos inicia-se quando uma mulher apresenta alguma das diversas condições potencialmente ameaçadoras da vida (CPAV). Quando não adequadamente tratada, ela pode evoluir para condições ameaçadoras da vida, em que há disfunção ou falência orgânica e que se definem a partir de critérios clínicos, laboratoriais ou de manejo. Mulheres que sobrevivem a tais eventos graves serão classificadas como near miss materno. O conceito de near miss materno permite avaliação da qualidade da assistência obstétrica, representando uma ferramenta a ser utilizada na prática obstétrica rotineira, ao identificar mulheres que estejam sob maior risco de evolução para quadros graves, permitindo a rápida implementação de medidas de tratamento e suporte. O objetivo do presente artigo é revisar a construção histórica do conceito de near miss, apresentar os atuais parâmetros validados para a sua utilização e propor seu uso de forma rotineira, na prática clínica e no currículo dos cursos médicos e de especialização em Obstetrícia.Maternal death is the most rare and dramatic event among a sequence of events that may affect any woman during pregnancy or up to 40 days post-partum. This sequence of events begins when a woman presents any of the potentially life-threatening conditions (PLTC). These conditions, when not properly treated, can evolve to life-threatening conditions when organ dysfunction of failure appear, which are defined using some clinical, laboratory, or management criteria. Women who survive such serious events will be classified as maternal near miss. The concept of maternal near miss allows the assessment of the quality of obstetric care, representing a tool to be used in the routine obstetric practice, for identifying women with higher risk of developing more severe conditions and allowing the rapid implementation of treatment and support measures. The objective of the current article is to review the historical construction of the concept of maternal near miss, to present the current validated parameters for use of this concept and to propose the routine use of maternal near miss in clinical practice and in the curriculum of medical schools and courses of specialization in Obstetrics

The Use of Mid-Pregnancy Cervical Length to Predict Preterm Birth in Brazilian Asymptomatic Twin Gestations

Funding Information: This work was supported by Bill & Melinda Gates Foundation [OPP1107597], the Brazilian Ministry of Health, and the Brazilian National Council for Scientific and Technological Development (CNPq) [401615/20138]. The funders had no role in the design, development of the study, analysis, interpretation of data, writing the manuscript and in the decision to submit the article for publication. Publisher Copyright: © 2022 Georg Thieme Verlag. All rights reserved.Peer reviewedPublisher PD

Computer-assisted Telephone Interviewing (cati): Using The Telephone For Obtaining Information On Reproductive Health.

The objective of this study was to evaluate the feasibility of using computer assisted telephone interviewing (CATI) as a method for obtaining information on reproductive health in Brazil. A total of 998 eligible women for the study were selected to answer a questionnaire through computer- assisted telephone interviewing undertaken by trained interviewers. The outcomes of each telephone contact attempt were described. Differences between groups were assessed using the χ(2) test. Phone contact was made in 60.3% of the attempts and 57.5% of the interviews were completed. The success rate improved with the decrease in time from hospitalization to interview and with the higher numbers of telephones available. A total of 2,170 calls were made, comprising of one to sixteen attempts per woman. The majority of situations where extra calls were necessary were due to the number being busy or to the fact that the woman was not available at the time of the call. CATI can prove be a valuable procedure for obtaining information on reproductive health among Brazilian women, particularly for relatively recent events and when more than one alternative telephone number is available.271801-

COVID-19 and maternal death in Brazil: an invisible tragedy

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Association between cervical length and gestational age at birth in singleton pregnancies : a multicentric prospective cohort study in the Brazilian population

Bill & Melinda Gates Foundation [OPP1107597], the Brazilian Ministry of Health, and the Brazilian National Council for Scientific and Technological Development (CNPq) [401615/20138]. The funders had no role in the design, development of the study, analysis, interpretation of data, writing the manuscript and in the decision to submit the article for publication. T.V.S. was supported by Coordenação de Aperfeiçoamento Pessoal de Nível Superior—CAPES (grant number 001).Peer reviewedPublisher PD

Applying the maternal near miss approach for the evaluation of quality of obstetric care: a worked example from a multicenter surveillance study

To assess quality of care of women with severe maternal morbidity and to identify associated factors. This is a national multicenter cross-sectional study performing surveillance for severe maternal morbidity, using the World Health Organization criteria. The expected number of maternal deaths was calculated with the maternal severity index (MSI) based on the severity of complication, and the standardized mortality ratio (SMR) for each center was estimated. Analyses on the adequacy of care were performed. 17 hospitals were classified as providing adequate and 10 as nonadequate care. Besides almost twofold increase in maternal mortality ratio, the main factors associated with nonadequate performance were geographic difficulty in accessing health services (P < 0.001), delays related to quality of medical care (P = 0.012), absence of blood derivatives (P = 0.013), difficulties of communication between health services (P = 0.004), and any delay during the whole process (P = 0.039). This is an example of how evaluation of the performance of health services is possible, using a benchmarking tool specific to Obstetrics. In this study the MSI was a useful tool for identifying differences in maternal mortality ratios and factors associated with nonadequate performance of care.To assess quality of care of women with severe maternal morbidity and to identify associated factors. Method. This is a national multicenter cross-sectional study performing surveillance for severe maternal morbidity, using the World Health Organization c110CNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO402702/2008-