Made available in DSpace on 2014-06-11T19:29:04Z (GMT). No. of bitstreams: 0 Previous issue date: 2003-12-12Bitstream added on 2014-06-13T18:58:27Z : No. of bitstreams: 1 moura_smsr_me_assis.pdf: 747183 bytes, checksum: 1545f3f26717d129f05d202d1d54a49a (MD5) / Este trabalho problematiza as práticas discursivas e não discursivas referentes ao papel materno que circulam no âmbito da saúde pública e no contexto da família. Para isso utilizamos um programa de saúde materno-infantil - o Programa Canguru, contextualizando historicamente os elementos envolvidos tanto em sua concepção quanto em sua efetivação: o conceito de maternidade, as práticas de maternagem e as políticas de humanização ao atendimento desenvolvido nas instituições hospitalares. Nosso objetivo foi analisar como estes elementos se articulam na construção de novos sentidos para o papel materno. Para isso entrevistamos dez mulheres usuárias do Programa Canguru num hospital da rede pública e também as observamos durante esta prática. Na análise dos dados utilizamos como método a análise do discurso. A partir de núcleos de sentidos apreendidos nos discursos das entrevistadas, definimos quatro dimensões de análise: família e religião; o impacto do nascimento prematuro; desconfiança e resistência nas relações com instituições e profissionais de saúde; e a experiência com o Programa Canguru. No trabalho analítico buscamos apreender o processo de singularização e as estratégias utilizadas pelas entrevistadas na produção de sentidos sobre a maternidade e as práticas de maternagem. A família, estruturada de forma hierárquica e com rígida divisão de papéis segundo o sexo, aparece como o principal organizador das experiências das entrevistadas e dos sentidos atribuídos à maternidade. O exercício da maternidade é descrito como essencial para a constituição do papel feminino. A religião surge... / This paper question the speech practices and non speech referring at the maternal function that are around the ambit of the public health and in the family context. For that was used a health program of maternal-childish - The Kangaroo Care, putting on the historical context the elements that are involved as much the conception as the effectuation: the concept of maternity, the practices of maternal care and the policy of humanization of the service developed at the hospital institutions. Our goal was analyze how these elements are articulate at the construction of new feelings to maternal play. So we interviewed ten women that was usurers of the Kangaroo Care in a public hospital and we observed them during the practice too. At the analyze of the dates it was used as a method the analyze of the speech. From the nucleus of the senses took at the speech of the subject, were define four dimensions to analyze: family and religion; the impact of the premature birth; suspicion and resistance in relations with institutions and health workers; and the experience with the Kangaroo Care. At the analytic work we tried to took the process of the signalize and the strategies used by the subjects at the production of the feelings about the maternity and the practices of maternal care. The family that has a hierarchy structure and rigid division of places according to the sex, appears as a mainly organizer of the experiences of the subjects and of the feelings attributed to maternity. The exercise of the maternity is descript as essential to the constitution of the feminine place. Religion shows up as an important element to guarantee the emotional support to the family in situation of crises, such as a premature birth of a child... (Complete abstract, click electronic access below)

Orientador: Maria de Fátima Araújo / Banca: Hélio Rebello Cardoso Júnior / Banca: Maria Lúcia Boarini / Resumo: Este trabalho problematiza as práticas discursivas e não discursivas referentes ao papel materno que circulam no âmbito da saúde pública e no contexto da família. Para isso utilizamos um programa de saúde materno-infantil - o Programa Canguru, contextualizando historicamente os elementos envolvidos tanto em sua concepção quanto em sua efetivação: o conceito de maternidade, as práticas de maternagem e as políticas de humanização ao atendimento desenvolvido nas instituições hospitalares. Nosso objetivo foi analisar como estes elementos se articulam na construção de novos sentidos para o papel materno. Para isso entrevistamos dez mulheres usuárias do Programa Canguru num hospital da rede pública e também as observamos durante esta prática. Na análise dos dados utilizamos como método a análise do discurso. A partir de núcleos de sentidos apreendidos nos discursos das entrevistadas, definimos quatro dimensões de análise: família e religião; o impacto do nascimento prematuro; desconfiança e resistência nas relações com instituições e profissionais de saúde; e a experiência com o Programa Canguru. No trabalho analítico buscamos apreender o processo de singularização e as estratégias utilizadas pelas entrevistadas na produção de sentidos sobre a maternidade e as práticas de maternagem. A família, estruturada de forma hierárquica e com rígida divisão de papéis segundo o sexo, aparece como o principal organizador das experiências das entrevistadas e dos sentidos atribuídos à maternidade. O exercício da maternidade é descrito como essencial para a constituição do papel feminino. A religião surge... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: This paper question the speech practices and non speech referring at the maternal function that are around the ambit of the public health and in the family context. For that was used a health program of maternal-childish - The Kangaroo Care, putting on the historical context the elements that are involved as much the conception as the effectuation: the concept of maternity, the practices of maternal care and the policy of humanization of the service developed at the hospital institutions. Our goal was analyze how these elements are articulate at the construction of new feelings to maternal play. So we interviewed ten women that was usurers of the Kangaroo Care in a public hospital and we observed them during the practice too. At the analyze of the dates it was used as a method the analyze of the speech. From the nucleus of the senses took at the speech of the subject, were define four dimensions to analyze: family and religion; the impact of the premature birth; suspicion and resistance in relations with institutions and health workers; and the experience with the Kangaroo Care. At the analytic work we tried to took the process of the signalize and the strategies used by the subjects at the production of the feelings about the maternity and the practices of maternal care. The family that has a hierarchy structure and rigid division of places according to the sex, appears as a mainly organizer of the experiences of the subjects and of the feelings attributed to maternity. The exercise of the maternity is descript as essential to the constitution of the feminine place. Religion shows up as an important element to guarantee the emotional support to the family in situation of crises, such as a premature birth of a child... (Complete abstract, click electronic access below) / Mestre

Este estudo teve como foco a vivência da família no método canguru (MC) com os seguintes objetivos: identificar o significado para mãe e família dessa experiência, compreender o funcionamento da dinâmica familiar decorrente da permanência da mãe e do filho no MC, apreender as transformações familiares provenientes da permanência no método e construir um modelo teórico sobre a experiência. A coleta de dados foi realizada por meio de entrevista e observação. Entrevistou-se 26 pessoas, membros de 18 famílias assistidas na enfermaria canguru no Hospital das Clínicas – UFMG. Utilizou-se como referencial teórico o Interacionismo Simbólico e como método a Grounded Teory. Dos dados emergiram os fenômenos; TENDO EVOLUÇÃO E DESFECHO NÃO ESPERADOS NA GESTAÇÃO, que é uma fase em que os pais se deparam com a gravidez e sofrem diante da gestação interrompida; DEPARANDO COM A PREMATURIDADE DO FILHO, em que os pais entram no mundo da prematuridade, constatando a necessidade de agir pela sobrevivência do filho, e VIVENDO A DECISÃO E A EXPERIÊNCIA JUNTO DO FILHO, que revela a possibilidade ou não de entrar e permanecer no MC hospitalar. A partir desses fenômenos, foi possível chegar à categoria central Pesando riscos e benefícios entre estar com o filho no canguru ou com a família. / This study focuses on the family way of life in the kangaroo method (KM) with the following objectives: to identify the meaning of this experience for mother and family, to understand the functioning of the family dynamics resulting from the mother and child’s permanence in this method, to capture family transformations in view of the permanence in the method, and to construct a theoretical model about the experience. Data were collected by means of interviews and observation. 26 persons were interviewed, who are part of 18 families who attend kangaroo nursing care at the Hospital das Clínicas of the Federal University of Minas Gerais (UFMG), Brazil. The study used Symbolic Interactionism as a theoretical reference base and Grounded Theory as a method. The following phenomena arose from these data: HAVING UNEXPECTED EVOLUTION AND OUTCOME IN PREGNANCY, which is a phase in which the parents suddenly confront the pregnancy and have to deal with a premature birth; CONFRONTING THE PREMATURITY OF THE CHILD, in which the parents enter the world of prematurity and confirm the need to act in favor of the child’s survival; and LIVING WITH THE DECISION AND THE EXPERIENCE TOGETHER WITH THE CHILD, which reveals whether or not the parents will decide to enter and stay at the hospital’s KM. From these phenomena, we arrived at the central category: Weighing the risks and benefits between staying with the child in kangaroo method or with the family.

Este estudo teve como foco a vivência da família no método canguru (MC) com os seguintes objetivos: identificar o significado para mãe e família dessa experiência, compreender o funcionamento da dinâmica familiar decorrente da permanência da mãe e do filho no MC, apreender as transformações familiares provenientes da permanência no método e construir um modelo teórico sobre a experiência. A coleta de dados foi realizada por meio de entrevista e observação. Entrevistou-se 26 pessoas, membros de 18 famílias assistidas na enfermaria canguru no Hospital das Clínicas – UFMG. Utilizou-se como referencial teórico o Interacionismo Simbólico e como método a Grounded Teory. Dos dados emergiram os fenômenos; TENDO EVOLUÇÃO E DESFECHO NÃO ESPERADOS NA GESTAÇÃO, que é uma fase em que os pais se deparam com a gravidez e sofrem diante da gestação interrompida; DEPARANDO COM A PREMATURIDADE DO FILHO, em que os pais entram no mundo da prematuridade, constatando a necessidade de agir pela sobrevivência do filho, e VIVENDO A DECISÃO E A EXPERIÊNCIA JUNTO DO FILHO, que revela a possibilidade ou não de entrar e permanecer no MC hospitalar. A partir desses fenômenos, foi possível chegar à categoria central Pesando riscos e benefícios entre estar com o filho no canguru ou com a família. / This study focuses on the family way of life in the kangaroo method (KM) with the following objectives: to identify the meaning of this experience for mother and family, to understand the functioning of the family dynamics resulting from the mother and child’s permanence in this method, to capture family transformations in view of the permanence in the method, and to construct a theoretical model about the experience. Data were collected by means of interviews and observation. 26 persons were interviewed, who are part of 18 families who attend kangaroo nursing care at the Hospital das Clínicas of the Federal University of Minas Gerais (UFMG), Brazil. The study used Symbolic Interactionism as a theoretical reference base and Grounded Theory as a method. The following phenomena arose from these data: HAVING UNEXPECTED EVOLUTION AND OUTCOME IN PREGNANCY, which is a phase in which the parents suddenly confront the pregnancy and have to deal with a premature birth; CONFRONTING THE PREMATURITY OF THE CHILD, in which the parents enter the world of prematurity and confirm the need to act in favor of the child’s survival; and LIVING WITH THE DECISION AND THE EXPERIENCE TOGETHER WITH THE CHILD, which reveals whether or not the parents will decide to enter and stay at the hospital’s KM. From these phenomena, we arrived at the central category: Weighing the risks and benefits between staying with the child in kangaroo method or with the family.

No description available.

BACKGROUND: The prevalence of neonatal abstinence syndrome (NAS) is on the rise in the United States, as the epidemic of opioid misuse continues1. Several infants with in utero exposure to opioids are born with NAS, and exhibit symptoms of withdrawal and dependence upon birth when the maternal source of opioid is discontinued2. Due to the novelty of the syndrome, there are several knowledge gaps in current literature that remain to be explored. LITERATURE REVIEW: The exact mechanism of development of NAS in infants remains unknown, yet the clinical symptomatology and results of a few recent studies suggest that there is an association with NAS severity and dysregulation of autonomic nervous system (ANS) functioning in these infants3. In recent years, pharmacological treatments for these infants have become standardized4. However, non-pharmacological treatments have been adopted from treatment guidelines of other high-risk infant populations and their efficacy warrants further evaluation in infants with NAS. Kangaroo care (KC) is a supportive therapy commonly applied to many high-risk infant populations because of its physiologically stabilizing effects5. The therapy has been demonstrated to be especially beneficial in the treatment of preterm infants, a population that similarly requires additional maturation of their ANS upon birth,6. Neurobehavioral theories suggest ANS functioning in infancy is a strong predictor of long-term social, behavioral, and cognitive development outcomes7,8. PROPOSED PROJECT: This prospective cohort study is designed to provide pilot data to establish if KC can be utilized to mature ANS maturation in infants with NAS. CONCLUSIONS AND SIGNIFICANCE: KC is an inexpensive, readily available, low risk intervention that could improve neurobehavioral outcomes in infants with NAS. The results of this study could reduce clinical symptoms, potentiate long-term behavior outcomes, and better define treatment practices for infants with NAS by facilitating a targeted intervention to improve outcomes.

The purpose of this thesis is to provide a critical analysis of research findings about nonpharmacological techniques used independently of pharmacological techniques to prevent or reduce procedural pain for infants in the neonatal intensive care unit (NICU). A synthesis of the current research related to nonpharmacological pain relief techniques for infants was conducted for this thesis. Nonpharmacological interventions reviewed in this study include: Kangaroo Care, swaddling, facilitated tucking, positioning, music, non-nutritive sucking and sucrose. An interdisciplinary review of the research was performed using the interdisciplinary databases Cumulative Index of Nursing and Allied Health, PubMED, and PsychINFO. Inclusion criteria for this thesis consists of research focused on preterm neonates (born less than] 37 weeks gestational age) in the neonatal intensive care unit, the use of nonpharmacological interventions for procedural analgesia, peer reviewed articles, and those written in the English language. This study excludes full term neonates due to the significant number of preterm neonates in the NICU. A total of 18 studies were included in this review. All interventions except for positioning show statistically significant evidence to support their use to reduce procedural pain in preterm neonates. Findings of this thesis may promote further studies and exploration into this field. In addition, this thesis establishes the role of the nurse in providing pain relief for infants in the NICU, as well as provide for enhancement of interdisciplinary care amongst other health care providers.

The old practice of separating the mother-baby-dyad was without measurable benefits to mothers or their infants. Evidence has shown that skin-to-skin care (SSC) prevents hypothermia and hypoglycemia, decreases crying during painful procedures in newborns, and reduces maternal anxiety, stress, and postpartum depression. Rooming-in care (RIC) has been linked to an increase in the rate of breastfeeding and mother-infant interaction, as well as a decrease in the infant morbidity rate. This project assessed the effect of an educational intervention to increase rates of SSC and RIC in an obstetric unit, in addition to measuring nurses' attitudes and barriers in relation to SSC and RIC. The obstetric nurses received educational content related to SSC and RIC based on Kotter's model of change. A pre and postintervention evaluation showed a significant increase in the rates of SSC and RIC from pretest of 10%, to posttest of 96%; and RIC from pretest of 10% to posttest of 92%. Using a Wilcoxon test, a significant difference was found from pretest to posttest for every subscale score of the Mother-Newborn Skin-to-Skin Contact Questionnaire and Nurse Attitudes and Barriers to nonseparation Scale (p < 0.001), with the exception of belief about obstacles for SSC, which yielded a nonsignificant change (p = 0.57). This DNP project led to changes in the organization's culture, including the closure of the well-baby nursery. This project promoted social change across the organization, in that the team health care providers delivered evidence-based, standardized, unbiased, and family-centered care to the mother-baby dyad.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-09-14T11:20:15Z No. of bitstreams: 1 fernandabuzzinariribeirodesa.pdf: 1018276 bytes, checksum: 99f880ee779c26f3b8a92b5857085d31 (MD5) / Approved for entry into archive by Diamantino Mayra (mayra.diamantino@ufjf.edu.br) on 2016-09-26T20:17:03Z (GMT) No. of bitstreams: 1 fernandabuzzinariribeirodesa.pdf: 1018276 bytes, checksum: 99f880ee779c26f3b8a92b5857085d31 (MD5) / Made available in DSpace on 2016-09-26T20:17:03Z (GMT). No. of bitstreams: 1 fernandabuzzinariribeirodesa.pdf: 1018276 bytes, checksum: 99f880ee779c26f3b8a92b5857085d31 (MD5) Previous issue date: 2011-07-25 / Muitos bebês nascem prematuros e com baixo peso todos os anos no Brasil. O Método Canguru é um tipo de assistência neonatal voltada para o atendimento do recém-nascido prematuro que implica colocar o bebê em contato pele a pele com sua mãe (OMS, 2004). O Método abrange questões como os cuidados técnicos com o bebê, o acolhimento à família, a promoção do vínculo mãe/bebê e o aleitamento materno. O presente trabalho buscou estudar a constituição e as formas de relação estabelecidas entre mãe e bebê prematuro a partir do referencial teórico de Winnicott. Além disso, pretendeu lançar mão de algumas categorias para avaliação da relação mãe-bebê prematuro aplicadas durante as três etapas do Método Canguru e avaliar os efeitos da Enfermaria Canguru sobre o desenvolvimento da Preocupação Materna Primária. O estudo dos dados tomou por base a análise de conteúdo qualitativa. Das 20 mães estudadas, 10 passaram pela Enfermaria Canguru e 10 não passaram. Pela análise dos casos conclui-se que a EC não influenciou de modo determinante no desenvolvimento da PMP na maioria das mães, apesar de ter representado um momento de fortalecimento desta condição materna e proporcionado maior confiança e segurança nos cuidados e no conhecimento das peculiaridades dos bebês. / Many babies are born premature and underweight each year in Brazil. The Kangaroo Care Method is a kind of neonatal care focused on the treatment of premature infants that involves placing the baby in skin contact with his mother (WHO, 2004). The method covers issues such as technical care for the baby, the family support and the promotion of mother / baby link and breastfeeding. This work studied the formation and forms of relationships established between mother and premature baby from the theoretical framework of Winnicott. In addition, we intended to use some categories for the evaluation of the mother-premature infant relantionship applied during the three stages of the Kangaroo Care Method and evaluate the effects of Kangaroo Infirmary on the development of primary maternal preoccupation. Of the 20 women studied, 10 of them came throught Kangaroo Nursery, and the other 10, did not. It is concluded that the EC did not influence the way in the development of PMP most mothers, even though it represented a time of strengthening of maternal condition and provided greater confidence and security in care and knowledge of the peculiarities of the babies.

Kangaroo care (KC) is a cost-efficient method to increase infant-parent bonding and neonatal health outcomes worldwide. Despite evidence supporting KC in critically ill infants, nursing perceptions regarding patient safety and interrupted work flow continued to impede practice in the local high-tech neonatal intensive care unit (NICU). Their current policy failed to address the 2-person transfer method recommended for safe practice. In addition, both staff and parents lacked training and education regarding the benefits and feasibility of KC. This doctoral project aimed to decrease practice barriers and promote earlier and more frequent KC by developing and integrating an evidence-based clinical pathway within a multifaceted champion-based simulated educational training program for NICU staff and parents. Published outcomes and generated organizational data for program synthesis connected the gap in practice. Kolcaba's comfort theory served as the guiding framework to ensure a partnership in care. This quasi-experimental quantitative study used the generalized liner model for data analysis. Study findings indicated that KC occurred 2.4 more times after the intervention compared to before (p = 0.001). Descriptive data revealed that KC episodes for intubated patients nearly doubled after implementation (11.1% from 6.2%). Post-survey scores for nursing knowledge and comfort level also improved after the intervention. Although earlier KC practice was non-conclusive (p = 0.082), future trials should control groups for day of life since admission. Disseminating the KC pathway can have a positive social change on family-centered care by increasing NICU nurses' knowledge, comfort, and adoption of this evidence-based practice as an expected routine standard of care.