Teenage pregnancy is an ever increasing dilemma in South Africa. Dealing effectively with pregnant teenagers is a continuous challenge for the health care providers particularly the nursing staff. The present study focuses on the reproductive health care services in a Gauteng province clinic and pregnant teenagers' experiences of their interaction with the nursing staff. Six pregnant teenagers were included in the study. Data consistied of the participants' narratives regarding the health care services provided by the nursing staff. Themes from the narratives were identified and explored according to a Social Constructionism stance within the Postmodernist paradigm. Factors found to affect the experiences of the pregnant teenagers included acceptance, respect, effective communication, privacy, trust and the dedication and professionalism of the nursing staff. / Psychology / M.A. (Clinical Psychology)

The purpose of this study was to explore and describe the contributory factors to the high teenage pregnancy rate within a district hospital in the Ehlanzeni district of the Mpumalanga Province, South Africa. Quantitative, non-experimental, descriptive and exploratory research was conducted to explore the contributory factors to the high teenage pregnancy rate. Data collection was done using a self-designed structured interview schedule. The findings of the study supported the assumptions that there are factors related to biography, individual perceptions, knowledge and awareness of; and practices, perceptions regarding the use of contraception. Perceived seriousness and barriers to the use of safeguards that could have prevented pregnancy contribute to the high teenage pregnancy rate thus emphasise the need to develop strategies to prevent teenage pregnancies / Health Studies / M.A. (Health Studies)

Submitted in fulfillment of the requirements for the degree of Master of Technology: Environmental Health, Durban University of Technology, Durban, South Africa, 2016. / South Africa, like many other developed countries, is challenged by the under attendance and delay in initiation of antenatal care (ANC) services among pregnant adolescents. Adolescents are more vulnerable to pregnancy related complications, which may contribute to maternal and child mortality and morbidity. This study aimed at evaluating the under attendance and/or delay in initiation of ANC services among young pregnant adolescents (13-16 years old) as a risk for adverse maternal and birth outcomes. The research was based at a district hospital on the North Coast of Kwazulu-Natal. A retrospective review of all young adolescent (13-16 years old) maternity case records for the period from 2011-2013 was conducted. Data collected included ANC trends in attendance, obstetric and perinatal outcomes. A total of 314 pregnancies were recorded among young adolescents at this single hospital over a period of 3 years. Adolescent pregnancy was associated with a risk of late ANC booking and reduced ANC visits. The prevalence of anaemia (32%) was relatively high among the girls. Fifty percent of all adolescents received episiotomies while, 45(14%) experienced perineal tears. Logistic regression models found that the condition of perineum was significantly associated with HIV status (OR= 0.36; 95% CI=0.16; 0.84; p<0.05). HIV positive mothers were more likely to have an intact perineum post-delivery. However, HIV positive adolescents were twice as likely to be diagnosed with anaemia compared HIV negative mothers (results not significant). Underutilisation of ANC (i.e less than 4 visits) was significantly associated with lower gestational age (< 37 weeks) (OR=2.64; 95% CI=1.04; 6.74; p<0.05). Fifteen percent of young mothers delivered early (< 37 weeks), 10% delivered babies with a low birth weight (< 2500g) and 15% of the neonates suffered fetal distress. Low birth weight, low Apgar scores as well as the incidence of maternal anaemia and Pregnancy Induced Hypertension (PIH) were found to be related to late ANC booking. Qualitative findings highlighted the perceived barriers of ANC by pregnant adolescents. Interviews identified the following as factors that hindered access of care; financial barriers, attitudes of Health Care Workers (HCW), system barriers and fear of HIV testing. Urgent population based strategies are required to encourage timeous initiation of ANC among adolescents. Strengthening of health education programs on the benefits of ANC attendance among adolescents can be utilized as part of an approach to address the current public health concern. / M

The purpose of this study was to explore and describe the contributory factors to the high teenage pregnancy rate within a district hospital in the Ehlanzeni district of the Mpumalanga Province, South Africa. Quantitative, non-experimental, descriptive and exploratory research was conducted to explore the contributory factors to the high teenage pregnancy rate. Data collection was done using a self-designed structured interview schedule. The findings of the study supported the assumptions that there are factors related to biography, individual perceptions, knowledge and awareness of; and practices, perceptions regarding the use of contraception. Perceived seriousness and barriers to the use of safeguards that could have prevented pregnancy contribute to the high teenage pregnancy rate thus emphasise the need to develop strategies to prevent teenage pregnancies / Health Studies / M. A. (Health Studies)

A research report submitted to the Faculty of Humanities, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the award of Masters of Arts in Demography and Population Studies, 2017 / Background: Risky behaviours among adolescents are notably the most important factors contributing to negative health outcomes of this population group. Adolescents in South Africa are at risk of the HIV infection, unintended pregnancies, unintentional injuries (motor vehicle accidents) and substance and drug abuse. South Africa is regarded as one of the countries with nearly half adolescents living with HIV, as a result of unprotected sex. It is also regarded as one of the countries with motor accidents cases and as a result of reckless driving and substance use. To understand this, there is substantial research on the demographic and socio-demographic determinants of risky behaviour amongst adolescents but little research on the household and community factors. The main aim of this study is to determine the contextual determinants of adolescent risky behaviours in South Africa. Method: This study used data from the South African Youth Life Style Survey of 2008. The study sample size is 3336 adolescents aged 12 to 19 across all nine provinces in South Africa. Risky behaviours are organized using an ecological framework into individual, household, and community levels. Binary- multilevel logistic regression was employed to analyze the data. Results: The results indicated that age, sex, education, race, living arrangements, number of income earners, were significant, however, the relationship between risky behaviours and community level variables were negatively significant. . 3336 adolescents participated in the study, 934 (28.0%) had sexual intercourse and 158 (4.74%) had two or more sexual partners, and 234 (7.01) did not use a condom during their last sex. In terms of substance use, 34.24 % ever used alcohol and about 24.45% ever been a passenger with a driver under the influence. Adolescents who were living with their grandparents (OR=1.07), living in a household with seven or more members (OR=1.06), while residing in had a higher likelihood of engaging in risky behaviours. Findings demonstrated that community level factors were not associated with reports of risky behaviour among adolescents but were influential in shaping the risky behaviour of adolescents. Conclusion: Firstly, results from this research will provide a better understanding of the contextual factors that relate to risky behaviours. Secondly, results from this research will help inform polices such as the National Youth Policy in reducing risky behaviours. Lastly, interventions aimed at reducing risky behaviours among adolescents in South Africa should not only focus on individual level but also on the household and community engagement. / XL2018

Made available in DSpace on 2016-03-22T17:26:38Z (GMT). No. of bitstreams: 1 Tese F_bio Coelho.pdf: 893978 bytes, checksum: 2b754c3c09e0ebf28b38d7a14eb830f0 (MD5) Previous issue date: 2012-01-16 / Objective: To describe the prevalence of major depressive disorder (MDD) during pregnancy in teenager mothers, and assess its association with sociodemographic characteristics, obstetric history and psychosocial variables. Methods: A cross-sectional study with a sample of pregnant teenagers enrolled in the national public health system in the urban area of Pelotas, southern Brazil. Sample size was estimated in 871 participants. MDD was assessed with the Mini International Neuropsychiatric Interview; the Abuse Assessment Screen was used to identify physical abuse within the last 12 months and during pregnancy; social support was assessed with the Medical Outcomes Survey Social Support Scale. Results: Forty three (4.94%) refused to participate, resulting in 828 participants. Prevalence of MDD was 17.8%; violence within the last 12 months was reported by 9.2%, while 5.8% had suffering violence during pregnancy; mean (SD) overall social support score was 87.40 (±11.75). After adjustment, we found the highest prevalence ratios of MDD in adolescents with less than 8 years of education, followed by those with previous episodes of MDD and in those with lower overall social support. Conclusion: MDD is a relatively common condition in pregnant teenagers and seems to be more frequent in a group of young mothers who were both socioeconomic and psychosocially underprivileged / Objetivo: Descrever a prevalência de transtorno depressivo maior (TDM) durante a gestação em adolescentes e verificar sua associação com características sócio-demográficas obstétricas e psicossociais. Método: Estudo transversal com uma amostra de gestantes adolescentes que recebem acompanhamento pré-natal pelo sistema único de saúde na zona urbana da cidade de Pelotas, RS. O tamanho estimado da amostra foi de 871 participantes. TDM foi avaliado com o Mini International Neuropsychiatric Interview; o Abuse Assessment Screen foi utilizado para identificar abuso físico no ultimo ano e durante a atual gestação; o suporte social foi mensurado com o Medical Outcomes Survey Social Support Scale. Resultados: Quarenta e três (4.94%) recusaram-se a participar, resultando em 828 participantes. A prevalência de TDM foi de 17.8%; violência nos últimos 12 meses foi identificada em 9.2%, enquanto 5.8% sofreram violência durante a gestação; a média (DP) geral na escala de suporte social foi de 87.40 (±11.75). Após ajuste, maiores razões de prevalência de TDM foram encontradas em adolescentes com menos de 8 anos de estudo, seguidas por aquelas com episódios anteriores de depressão e por aquelas com menor suporte social. Conclusão: TDM é uma condição comum in gestantes adolescentes, sendo mais frequente em um grupo de mães desprivilegiadas do ponto de vista sócio-econômico e psicossocial

Made available in DSpace on 2016-07-27T14:20:15Z (GMT). No. of bitstreams: 1 JULIO CESAR ALVES.pdf: 1754774 bytes, checksum: 123a4b08305616de6417458f3c5b8a1d (MD5) Previous issue date: 2013-10-31 / Esta dissertação de mestrado Dimensões subjetivas de mães adolescentes em contexto de vulnerabilidade social , constitui um recorte da pesquisa, Avaliação e monitoramento dos serviços de atenção à saúde de adolescentes grávidas que sofreram violência doméstica (SANTOS et al. 2007), que pesquisou adolescentes residentes na Região Leste da Cidade de Goiânia-GO. Vinculada à linha de pesquisa: Psicologia Social, do Trabalho e das Organizações, do Programa de Pós-Graduação Stricto Sensu da Pontifícia Universidade Católica de Goiás (PUC Goiás), esta dissertação teve como objeto de estudo investigar as dimensões subjetivas de mães adolescentes em contexto de vulnerabilidade social. O objetivo geral constituiu-se em apreender os sentidos e significados de gravidez e maternidade para adolescentes que vivem em condições de vulnerabilidade social na Região Leste de Goiânia. Como objetivos específicos, o estudo buscou conhecer a história de vida das adolescentes; compreender a trajetória das adolescentes em contextos de vulnerabilidade e violência; identificar as relações familiares, escolares e de trabalho e, por fim, apreender os sentidos e significados da gravidez e maternidade construídos pelas adolescentes e buscou-se ainda, apreender as dimensões psicossociais presentes nas falas das adolescentes pesquisadas com uso da abordagem Sócio-Histórica de Vigotsky e do método do materialismo histórico-dialético. As informações foram obtidas por meio de 99 questionários e entrevistas semiestruturadas realizadas com 47 adolescentes. Nesta pesquisa, foram selecionadas, do grupo de 47, 16 adolescentes que cumpriam os seguintes critérios: estarem na faixa etária de 14 a 18 anos e apresentarem relato de vulnerabilidade social (violências físicas, psicológicas e/ou sexual). As entrevistas foram sistematizadas em quadros temáticos que organizaram os núcleos de sentidos e significados. Essa sistematização possibilitou visualizar os sentidos e significados atribuídos aos temas propostos no roteiro de entrevista. Os resultados da pesquisa possibilitam compreender diversas manifestações da violência intrafamiliar (física, sexual e psicológica) e interfamiliar (notadamente os embates com a mãe/família do pai da criança e as intrigas de parentes e vizinhos). A violência física atinge a todos os membros da família e, em especial os mais frágeis : mulheres, adolescentes e crianças. Este ciclo é repetido incessantemente: o pai bate na mãe, que bate nos filhos, filhos mais velhos batem nos mais novos. Na maioria das vezes, essas violências decorrem do uso de álcool e drogas ilícitas. A violência sexual é negada e silenciada no âmbito familiar. Quando são relatadas pelas adolescentes, traduzem medos, desconfianças e, sobretudo uma atitude de cuidado com as filhas para que elas não sofram os abusos que sofreram. Algumas adolescentes associam a vida sexual precoce (e consequentemente a gravidez/maternidade) com o abuso sexual sofrido. A violência psicológica entrelaça as outras duas modalidades e se expressa por meio dos sentimentos de medo, angústia e solidão, marcadas pelas disputas intra e extrafamiliares. Todas as violências vividas (fisicamente e/ou simbolicamente) falam do lugar social vulnerável que elas ocupam na organização social. A vivência da gravidez aparece marcada por sentimentos positivos e/ou negativos. É positiva quando possibilita que as adolescentes saíam da rua, se dedique ao cuidado do filho, recebam o apoio do companheiro e possibilitem a constituição de um novo grupo familiar. O contexto negativo materializa-se no próprio corpo das adolescentes por meio de dores, angústias, ansiedades, doenças e também pelo medo de julgamento da família. A gravidez pode provocar a ruptura do relacionamento com o pai do filho e dificultar o estabelecimento de novos vínculos afetivos e sexuais. No plano concreto, a adolescente em muitos casos, precisou sair da escola, adquirir novas responsabilidades e arrumar trabalho para manter-se e ao seu filho. A luz dos resultados encontrados, este estudo reafirma a importância da prevenção e chama a atenção das instituições sociais responsáveis pelo acompanhamento das adolescentes (família, escola, governos) para estabelecimento de diálogo com as adolescentes mediado por informações sobre sexo, sexualidade e contracepção. Após a gravidez, cabe a todos os adultos envolvidos a tarefa de apoiar e acompanhar as adolescentes e os seus filhos.

Typescript (photocopy). / Digitized by Kansas Correctional Industries

Submitted by Nilma Vanessa Nunes Portugal (nilmaportugal@uefs.br) on 2015-07-23T00:05:32Z No. of bitstreams: 1 Disserta??o Andr? WORD.pdf: 770390 bytes, checksum: 5f541379c6e4aeedcfbcb87c31a63484 (MD5) / Made available in DSpace on 2015-07-23T00:05:32Z (GMT). No. of bitstreams: 1 Disserta??o Andr? WORD.pdf: 770390 bytes, checksum: 5f541379c6e4aeedcfbcb87c31a63484 (MD5) Previous issue date: 2014-02-21 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: unplanned pregnancy among adolescents is characterized as a challenge to global public health, encompassing a broader social context, the effect of which covers a range of factors harmful to the mother and fetus. Adolescents has emerged on the agendas of political control and pregnancy prevention, national and global level, in view of the high percentage of pregnant women in this group. Objective: To analyze the association between the outcome of low birth weight and sociodemographic characteristics, prenatal and delivery of adolescent and young adult mothers in the capitals and cities of the Northeast region, between 2011 and 2012. Method: a cross-sectional analytical study, hospital and regional basis, conducted in 2011 and 2012. Information was obtained through interviews with postpartum women in the immediate postpartum maternal and data records and newborns. Multivariate analyzes obeyed three levels of hierarchy as conceptual theoretical model, being underweight the dependent variable birth. The distal level were included as variables socioeconomic aspects - origin, marital status, age, adequacy of education with age, occupation, and skin color. At the intermediate level, obstetric and prenatal characteristics - number of pre-natal, first pregnancy, smoking during pregnancy, alcohol consumption during pregnancy, and monitoring by different professionals in prenatal care. At the proximal level, factors related to obstetric characteristics - public funding for childbirth; prematurity, vaginal delivery, and complications in the current pregnancy. Results: Results: from the total of 3,906 interviewed women, 9.7% were underweight fetuses; postpartum women who had less than six prenatal consultations showed a 1.8 times greater chance of having a newborn with low birth weight; being primigravida increased the chance of the occurrence of low birth weight by 1.5 times; prematurity raised 21 times the chance of this outcome, as well as complications in the current pregnancy increased by 1.6 times. The origin and age were not maintained significant association with the outcome of low birth weight, after adjustment for the intermediate and proximal levels, however, functioned as mediating variables in explaining the phenomenon studied. Conclusions: low birth weight is an important indicator of maternal and child health, in addition to measuring social development, particularly among adolescents and young adults, where the lack of family support and the society can have negative effects on the health and survival of newborns. Associated with multiple causes, being critical, therefore, to increase access to prenatal care quality and better use of intersectionality between health services. / Introdu??o: a gravidez n?o planejada entre adolescentes caracteriza-se como um desafio para sa?de p?blica mundial, englobando um contexto social amplo, cujo efeito abrange uma gama de fatores prejudiciais para a m?e e seu concepto. As adolescentes tem se destacado nas agendas das pol?ticas de controle e preven??o da gravidez, em n?vel nacional e mundial, tendo em vista o elevado percentual de gestante neste grupo. Objetivo: analisar a associa??o entre as caracter?sticas sociodemogr?ficas, do pr?-natal e do parto de m?es adolescentes e adultas jovens com o desfecho do baixo peso ao nascer, nas capitais e munic?pios da regi?o Nordeste, no per?odo de 2011 e 2012. M?todo: estudo transversal, de base hospitalar e n?vel regional, realizado em 2011 e 2012. As informa??es foram obtidas por meio de entrevista com a pu?rpera no p?s-parto imediato e de dados dos prontu?rios maternos e dos rec?m-nascidos. As an?lises multivariadas obedeceram tr?s n?veis de hierarquia, conforme modelo te?rico conceitual, sendo a vari?vel dependente o baixo peso ao nascer. No n?vel distal, foram inclu?das como vari?veis os aspectos socioecon?micos ? proced?ncia; estado civil; faixa et?ria; adequa??o da escolaridade com a idade; ocupa??o; e cor da pele. No n?vel intermedi?rio, as caracter?sticas obst?tricas e de pr?-natal ? n?mero de consultas no pr?-natal; primigesta??o; fumo durante a gesta??o; consumo de bebida alco?lica na gesta??o; e acompanhamento pelo mesmo profissional no pr?-natal. No n?vel proximal, os fatores relacionados ?s caracter?sticas obst?tricas ? financiamento p?blico para o parto; prematuridade; tipo de parto, e intercorr?ncias na gesta??o atual. Resultados: do total de 3.906 pu?rperas entrevistadas, 9,7% apresentaram conceptos com baixo peso; as pu?rperas que realizaram menos que seis consultas no pr?-natal apresentaram uma chance 1,8 vezes maior de ter rec?m-nascido com baixo peso; ser primigesta aumentou a chance da ocorr?ncia do baixo peso em 1,5 vezes; a prematuridade elevou em 21 vezes a chance desse desfecho, assim como as intercorr?ncias na gesta??o atual elevaram em 1,6 vezes. A proced?ncia e a idade n?o mantiveram associa??o significante com o desfecho do baixo peso, ap?s ajuste pelas vari?veis dos n?veis intermedi?rio e proximal, contudo, funcionaram como vari?veis mediadoras na explica??o do fen?meno estudado. Conclus?es: os resultados indicam que a ocorr?ncia do baixo peso ? um fen?meno multicausal, sendo que a associa??o entre os indicadores socioecon?micos, obst?tricos e de pr?-natal apontam, a insufici?ncia do sistema de sa?de em atender as necessidades dessa parcela da popula??o da Regi?o Nordeste do pa?s.

O objetivo deste trabalho foi descrever as associações entre os percentuais de gravidez na adolescência e indicadores socioeconômicos e de responsabilidade social dos municípios do estado de Minas Gerais, sudeste do Brasil, no ano de 2000 a 2010. Trata-se de um estudo ecológico, utilizando dados do Sistema de Informações sobre Nascidos Vivos (SINASC). O percentual de nascidos vivos de mães adolescentes para cada município foi calculado segundo o quociente entre o número de nascidos vivos de mães com idade entre 10 e 19 anos e o número total de nascidos vivos registrados no ano de 2000 a 2010. Modelos bayesianos e modelos aditivos generalizados foram utilizados para a obtenção de percentuais de gravidez adolescente ajustados por efeitos espaciais e para avaliar as possíveis associações com os indicadores socioeconômicos e de responsabilidade social. Os percentuais brutos de gravidez adolescente em relação ao total de nascidos vivos nos municípios de Minas Gerais no ano de 2010 variaram de 0 a 46,4%, com uma mediana de 19,6%. O primeiro e o terceiro quartis são, respectivemente, 15,6% e 23,1%. O estudo evidenciou uma estreita relação entre a gravidez na adolescência e indicadores econômicos e sociais. Os percentuais de gravidez adolescente se mostraram maiores nos municípios com menor tamanho populacional, menores valores do Índice de Desenvolvimento Humano e menores valores de outros indicadores de desenvolvimento. A forte relação entre os percentuais de gravidez adolescente e os indicadores sociais e econômicos sugerem que a gravidez adolescente é muito mais um problema social que biológico. Os programas e as ações devem ir muito além de educação sexual e informações sobre métodos preventivos de saúde. / The objective of this study was to describe associations between pregnancy rates in adolescence and socio-economic and social responsibility indicators in the municipalities of the State of Minas Gerais, Southeast of Brazil, in the year of 2010- 2010. This is an ecological study using data from the Brazilian Live Birth Information System (SINASC). The percentage of live births to adolescent mothers for each municipality was calculated based on the quotient between number of born alive infants of mothers aged 10-19 years old and total number of live births in the year of 2000-2010. Bayesian models and generalized additive model were used to obtain the percentages of adolescence pregnancy adjusted for spatial effects and to assess possible associations with socio-economic and social responsibility indicators. The crude percentage of adolescence pregnancy for the total number of live births in the municipalities of Minas Gerais in 2010 ranged from 0 to 46.4%, with median percentage being 19.6% and the first and third quartiles being 15.6% and 23.1%, respectively. This study has demonstrated a close relationship between adolescent pregnancy and socio-economic indicators. Live births to adolescent mothers percentages were found to be higher in municipalities with low population density, low human development index, and other low development indicators. The strong relationship between adolescence pregnancy percentages and socio-economic indicators suggests that adolescent pregnancy is more a social than a biological problem. Therefore, programs and actions should go beyond sexual education and information on preventive health methods.