OBSTÉTRICIA NA ATUAÇÃO DA MELHORIA DOS RESULTADOS PSICOSSOCIAIS EM: GESTANTES, PARTURIENTES E PUÉRPERAS: REVISÃO DE LITERATURA

The role of an obstetrician plays the emphasis on the complete cycle of pregnancy and childbirth of women is due not only to the provisions of professional sports legislation, but also to the characteristics of their training. In practice, care for pregnant women, newborns and newborns can be provided in a more natural, humane and less intrusive way, focusing on the woman as the protagonist of childbirth. Nurse midwives may provide prenatal and postnatal consultations to low-risk patients in primary healthcare settings. This is a comprehensive literature review study. Articles were identified for the inclusion criteria: articles published between 2007 and 2023 (those years), in English and Portuguese and indexed in the following databases: Nursing Database (BDENF), Scientific Electronic Library Online (SCIELO ), PubMed, Latin American Caribbean Health Sciences Literature (LILACS). The data was processed through thematic analysis and the categories were highlighted: professional qualification in women's care, obstetric nurses promoting safe motherhood and essential care - specific circumstances and contexts. Based on the experience of obstetric nurses and the analysis of the results of the bibliographic search, a limited number of articles were found related to the implementation and performance of obstetric nurses in primary care and, therefore, sample volume. Additionally, there is a lack of specific protocols or regulations regarding what primary care professionals do. The lack of publications highlights the need to expand the role of obstetric care in primary care through dissemination by a women's health specialist.O papel de um obstetra desempenha a ênfase no ciclo completo de gravidez e parto das mulheres se deve não apenas às disposições da legislação esportiva profissional, mas também às características de sua formação. Na prática, o cuidado às gestantes, aos recém-nascidos e aos recém-nascidos pode ser prestado de forma mais natural, humana e menos intrusiva, tendo como foco a mulher como protagonista do parto. As enfermeiras obstétricas podem prestar consultas pré-natais e pós-natais a pacientes de baixo risco em unidades de cuidados de saúde primários. Este é um estudo abrangente de revisão de literatura. Foram identificados artigos para os critérios de inclusão: artigos publicados no período de 2007 a 2023 (dissesses anos), no idioma inglês e português e indexados nas seguintes bases de dados: Base de Dados em Enfermagem (BDENF), Scientific Electronic Library Online (SCIELO), PubMed, Literatura Latino Americana do Caribe em Ciências da Saúde (LILACS). Os dados foram processados ​​por meio de análise temática e foram destacadas as categorias: qualificação profissional no cuidado à mulher, enfermeiras obstétricas e equipe multiprofissional promotoras de maternidade segura e cuidados essenciais – circunstâncias e contextos específicos. Com base na experiência das enfermeiras obstétricas e na análise dos resultados da busca bibliográfica, foi encontrado um número limitado de artigos relacionados à implantação e atuação das enfermeiras obstétricas na atenção primária e, por tanto Volume de amostra. Além disso, faltam protocolos ou regulamentações específicas sobre o que os profissionais da atenção primária fazem. A falta de publicações destaca a necessidade de ampliar o papel da atenção obstétrica na atenção primária por meio da divulgação por um especialista em saúde da mulher

Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial

Background: Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD. Methods: In this open-label, multicenter trial conducted in 35 sites in Brazil, we randomly assigned (1:1) patients aged 45 years or older to receive either the BALANCE Program (experimental group) or conventional nutrition advice (control group). The BALANCE Program included a unique nutritional education strategy to implement recommendations from guidelines, adapted to the use of affordable and regional foods. Adherence to diet was evaluated by the modified Alternative Healthy Eating Index. The primary end point was a composite of all-cause mortality, cardiovascular death, cardiac arrest, myocardial infarction, stroke, myocardial revascularization, amputation, or hospitalization for unstable angina. Secondary end points included biochemical and anthropometric data, and blood pressure levels. Results: From March 5, 2013, to Abril 7, 2015, a total of 2534 eligible patients were randomly assigned to either the BALANCE Program group (n = 1,266) or the control group (n = 1,268) and were followed up for a median of 3.5 years. In total, 235 (9.3%) participants had been lost to follow-up. After 3 years of follow-up, mean modified Alternative Healthy Eating Index (scale 0-70) was only slightly higher in the BALANCE group versus the control group (26.2 ± 8.4 vs 24.7 ± 8.6, P <.01), mainly due to a 0.5-serving/d greater intake of fruits and of vegetables in the BALANCE group. Primary end point events occurred in 236 participants (18.8%) in the BALANCE group and in 207 participants (16.4%) in the control group (hazard ratio, 1.15; 95% CI 0.95-1.38; P =.15). Secondary end points did not differ between groups after follow-up. Conclusions: The BALANCE Program only slightly improved adherence to a healthy diet in patients with established CVD and had no significant effect on the incidence of cardiovascular events or death. © 2019 The Author