CoordenaÃÃo de AperfeiÃoamento de NÃvel Superior / As questÃes relacionadas à qualidade de vida sÃo centrais para a promoÃÃo da saÃde materna. Dentre os objetivos do estudo destaca-se: traduzir, adaptar e validar o The Mother Generated Index para a lÃngua Portuguesa no contexto brasileiro. Trata-se de um estudo metodolÃgico, realizado em uma maternidade de referÃncia do estado do CearÃ. O The Mother Generated Index passou por um rigoroso processo de adaptaÃÃo transcultural no qual foi formada a versÃo prÃ-final, aplicada no prÃ-teste com 30 puÃrperas. Um comità de especialistas realizou a validaÃÃo de conteÃdo do The Mother Generated Index-VersÃo Brasileira, para a formaÃÃo da versÃo final. Na fase de validaÃÃo, a amostra foi composta por 91 puÃrperas que foram entrevistadas no perÃodo de maio a agosto de 2012. O instrumento de coleta de dados foi um formulÃrio que abordava dados sociodemogrÃficos, obstÃtricos, alÃm do The Mother Generated Index - VersÃo Brasileira. Quanto à anÃlise do perfil sociodemogrÃfico das puÃrperas estudadas apontou para uma maioria de jovens, em uniÃo estÃvel, com poucos anos de estudo, baixa renda per capita e familiar. Quanto Ãs atividades laborais, a maioria exercia afazeres domÃsticos ou outros trabalhos que exigem pouca ou nenhuma qualificaÃÃo profissional. Dentre as oito Ãreas que interferiram na qualidade de vida observou-se que 06 foram consideradas negativas conforme os dados: alteraÃÃo do peso 28(58%); menos tempo para si 33 (82,5%); sono 41 (93,1%); lazer 31 (90,7%); cansaÃo 91 (94,4%) e trabalho 41(85,4%). Assim, observa-se que essas sÃo Ãreas que necessitam de uma melhor atenÃÃo em saÃde. Conclui-se, que o MGI à um instrumento vÃlido e confiÃvel para a mensuraÃÃo do conceito de qualidade de vida entre as puÃrperas brasileiras, pois permite de forma simples e compreensÃvel avaliar as diversas dimensÃes envolvidas na qualidade de vida das puÃrperas. Ademais o MGI pode fornecer aos profissionais de saÃde a oportunidade de apreciar todos os aspectos da vida de uma mulher que sÃo alterados com o nascimento do bebÃ.

The consumption of alcohol and smoking of cigarettes are both common practices in Australian society. With continued public health efforts exposure to both alcohol and nicotine during pregnancy has diminished, however little is known about exposure to these toxins in the postnatal period and the effect on the breastfed infant. To investigate the pattern of alcohol consumption and cigarette smoking in the postnatal period and the effect on breastfeeding outcomes, a longitudinal study was conducted in two public hospitals with maternity wards in Perth, Australia. Data for the Perth Infant Feeding Study (PIFSII) were collected from 587 mothers between mid-September 2002 and mid-July 2003. While in hospital participating mothers completed a self-administered baseline questionnaire. Follow-up telephone interviews were conducted at 4, 10, 16, 22, 32, 40 and 52 weeks. Data collected included sociodemographic, biomedical, hospital related and psychosocial factors. Further analysis of alcohol data was undertaken on the 1995 and 2001 National Health Survey (NHS) data sets to provide a national perspective. Alcohol and smoking related data were analysed and described using frequency distributions, means and medians. Univariate logistic regression was used to screen for potentially significant variables for subsequent incorporation in the multivariate analysis. Multivariate logistic regression analysis was employed to determine the effect of alcohol consumption and cigarette smoking on breastfeeding outcomes prenatally, antenatally and postnatally, after adjusting for factors identified in the literature as being associated with breastfeeding initiation and duration. The relationship between smoking status and breastfeeding duration was determined using survival analysis. / Analysis of the relationship between breastfeeding duration and the level of postpartum intake was investigated using a Cox hazards model with repeated measures for alcohol consumption. Results showed that: 1. PIFSII. During pregnancy approximately 32% of women stopped drinking alcohol. Thirty five percent of pregnant women continued to consume alcohol during their pregnancy with 82.2% of these women consuming two or fewer standard drinks per week. At 4, 6 and 12 months postpartum, 46.7%, 47.4% and 42.3% of breastfeeding women were consuming alcohol, respectively. 2. NHS. Sixteen point four percent and 1.3% of pregnant women from the 1995 and 2001 NHS, respectively were consuming more than that recommended in ‘Guideline 11’ from the National Health and Medical Research Council of Australia (ie >7 standard drinks/week). 3. NHS. Thirteen percent of lactating mothers from the 1995 NHS and 16.8% from the 2001 NHS were consuming seven or more standard drinks of alcohol in the reference week, thus exceeding the NHMRC recommended level. 4. PIFSII. After 6 months of follow up, women who consumed alcohol at levels of more than two standard drinks per day were almost twice as likely to discontinue breastfeeding earlier than women who drank below these levels (HR 1.9, 95% CI 1.1, 3.0). 5. PIFSII. With regard to smoking, 226 (39%) of mothers reported smoking pre- pregnancy. Mothers who smoked were more likely to have a partner who smoked, to have consumed alcohol prior to pregnancy and less likely to attend antenatal classes. / They were also less likely to know how they were going to feed their baby before conception and be more inclined to consider stopping breastfeeding before four months postpartum. 6. PIFSII. Women who smoked during pregnancy had a lower prevalence and shorter duration of breastfeeding than non-smoking mothers (28 weeks versus 11 weeks, 95% CI: 8.3-13.7). This effect remained even after adjustment for age, education, income, father’s smoking status, mother’s country of birth, intended duration of breastfeeding >6 months and birth weight (risk ratio HR 1.59, 95% CI 1.22 to 2.08). 7. PIFSII. Two hundred and twenty six (39%) mothers reported smoking prior to pregnancy and 77 (34%) of these stopped smoking during pregnancy. Quitting smoking during pregnancy was significantly associated with breastfeeding for longer than six months (OR = 3.70, 95% CI 1.55 to 8.83; p<0.05). The results of the present study suggest a negative association between drinking alcohol in the postpartum period and breastfeeding outcomes. Similarly, smoking cigarettes before, during and after pregnancy negatively affects breastfeeding. There is a need for guidelines outlining the safe intake of alcohol during lactation and for the cessation of cigarette smoking in the prenatal and antenatal period.

Tyrimo tikslas - nustatyti psichologinės adaptacijos ir socialinių, demografinių bei sveikatos veiksnių sąsajas pogimdyminiu laikotarpiu. Tyrime dalyvavo 200 tiriamųjų. Tiriamųjų grupę sudarė pagimdžiusios moterys, gulinčios po gimdymo Vš.Į. Ukmergės ligoninės akušerijos skyriuje ir Kauno Vš.Į. 2-os klinikinės ligoninės filialo P.Mažylio gimdymo namuose. Siekiant nustatyti psichologinės adaptacijos ir socialinių, demografinių bei sveikatos veiksnių sąsajas pogimdyminiu laikotarpiu buvo naudoti šie klausimynai: „Savęs vertinimo klausimynas po gimdymo“, „Edinburgo pogimdyminės depresijos skalė“, „Spilbergerio C. D. Nerimo skalė“. Demografiniams, socialiniams ir sveikatos veiksniams nustatyti buvo naudojami Ž. Jankauskienės ir tyrimo autorės sudaryti klausimai. Tyrimo rezultatai parodė, kad moterų psichologinė adaptacija pogimdyminiu laikotarpiu yra susijusi su demografiniais rodikliais: vyresnio amžiaus moterys, ištekėjusios, turinčios aukštąjį išsilavinimą bei gyvenančios mieste yra geresnės psichologinės adaptacijos. Darbo ir vaikų turėjimas, didesnės pajamos, planuotas nėštumas, partnerio parama nėštumo metu, sveikatai palankus elgesys siejasi su geresne moterų psichologine adaptacija pogimdyminiu laikotarpiu. Šio tyrimo rezultatai parodė, kad nėštumo komplikacijos siejasi su blogesne psichologine adaptacija pogimdyminiu laikotarpiu. Gimdymo sužadinimas, gimdymo skausmo malšinimas yra susiję su moterų psichologine adaptacija pogimdyminiu laikotarpiu, tačiau natūralus... [toliau žr. visą tekstą] / The task of this study – to determine correlations between psychological adaptation, socio-demographic and health factors during postnatal period. The group of 200 women participated in this study. The group consisted of women after childbearing in Ukmergė hospital midwifery department and Kaunas 2nd hospital chapter, P.Mažylis midwifery house. Determining the correlations between psychological adaptation, socio-demographic and health factors was done by using The Postpartum self-evaluation questionnaire, Edinburgh Postnatal Depression Scale (EPDS), and Spielberger C.D. Stait Trait Anxiety Scale. Socio-demographic and health factors were determined using the questionnaire developed by Ž. Jankauskienė and the author of this study. The results of this study showed that psychological adaptation of women during the postnatal period is correlative with demographic factors: older, married and having a high school education women, living in bigger towns show better psychological adaptation. A better psychological adaptation is also correlated with having a job, children, bigger income, planned childbearing, help of the partner and healthy habits. The results of this study also shoved that complications during pregnancy correlate with poorer psychological adaptation during postnatal period. The stimulation of labour, using anesthetics during labour correlate with psychological adaptation during postnatal period. Natural childbirth, Cesarean section and childbirth with the help of... [to full text]

Bakgrunn: Bakgrunn for studien er Barsel hjemme, et prosjekt som har sett på en helhetlig modell for svangerskap, fødsel og barselomsorg. Det har vært et samarbeid mellom Ullevål universitetssykehus og Bydelene Sagene/St.Hanshugen. Kvinnene som har deltatt har gått til jordmødre fra prosjektet som er/har vært ansatt på sykehuset i svangerskapet, født på Ullevål og reist tidlig hjem i barsel med besøk fra samme gruppe jordmødre. Hensikt: Evaluere Barsel hjemme ved å se på pasienterfaringer med prosjektet og undersøke kvinnenes opplevelse og ønsker når det gjelder kontinuitet og helhet i svangerskap, fødsel og barselomsorg. Metode: En triangulering av metoder er brukt: Dette inkluderer en pasienterfaringsundersøkelse, en anonym spørreundersøkelse som er sammenliknet med en liknende undersøkelse fra en barselavdeling, og fokusgruppediskusjon med kvinner fra prosjektet som er analysert med inneholdsanalyse. Funn: Kvinnene som har deltatt i Barsel hjemme er svært fornøyd med prosjektet, gjennomgående mer fornøyd enn kvinner som har hatt vanlig barselopphold ved sykehuset. De hadde deltatt igjen om det hadde vært mulig. De er ikke opptatt av kontinuitet i den forstand at samme person trenger å følge de i hele forløpet. Her spiller forventninger en viktig rolle. Personalets evne til å skape en god relasjon, en følelse av trygghet og se individuelle behov er mer viktig. De ønsker mer kontinuitet i informasjonen de får under svangerskap, fødsel og barseltid. Konklusjoner: Barsel hjemme er et prosjekt som kvinnene anbefaler, og som de skulle ønske fortsatte. Når det gjelder kontinuitet og helhet er dette avhengig av forventinger. Det at personalet kan skape personlige relasjoner og møte kvinnene på deres individuelle behov er det viktigste. / Background: This study is based on a project known as “Barsel hjemme” (“postnatal careat home”), whose main goal has been to develop a model for prenatal, birth, and postnatalcare, focusing particularly on continuity. Participants had prenatal check-ups with projectmidwives, delivered their babies at Ullevål University Hospital, and were discharged fromthe hospital early in the postnatal period. Project midwives visited all participants at home. Aim: This study aimed to evaluate Barsel hjemme by examining patient satisfaction andassessing their experiences and desires through the prism of continuity. Methods: A triangulation of methods was used. This included a patient satisfaction survey;an anonymous survey that was then compared with a similar survey from a standardpostnatal department; and content analysis of focus group discussions. Findings: Women who participated in Barsel hjemme were very satisfied, generally moresatisfied than women from a standard postnatal department. They would participate again ifpossible. They did not define continuity of care as being cared for by the same person.Expectations played an important role in how they experienced the project. Midwives’ability to create a personal connection and treat participants as individuals were paramount.Participants wanted greater continuity in the information given during pregnancy, birth, andthe postnatal period. Conclusions: Women recommend the Barsel hjemme project and want it to continue.Continuity of care hinges on individual expectations. Personal relationships and recognitionof individuality are of primary importance. / <p>ISBN 978-91-85721-94-8</p>

Tyrimo tikslas : nustatyti moterų emocinės būklės kitimo ypatumus nėštumo metu ir pogimdyminiame laikotarpyje, atsižvelgiant į asmenybės bruožus ir informuotumą apie gimdymą. Tyrime dalyvavo 142 moterys, lankiusios ir nelankiusios nėščiųjų mokymo kursus Kauno ir Vilniaus miestuose. Tiriamosios buvo apklausiamos du kartus : nėštumo metu ir po gimdymo. Tiriamųjų apklausai buvo naudoti šie klausimynai : lietuviškas H. ir S. Aizenkų (Eysenck) klausimynas (EPQ), Edinburgo pogimdyminės depresijos skalės klausimynas (EPDS), C.D. Spilbergo (Spielberger) nerimo skalė (STAI). Socialiniams, demografiniams bei subjektyvios sveikatos rodikliams nustatyti buvo naudojami bendrosios apklausos klausimai, sudaryti A.Masiukienės. Tyrimo rezultatai parodė, kad nėščiųjų informuotumas gerina emocinę būklę po gimdymo, įskaitant ir pažeidžiamų savybių turinčias moteris. Neurotiško tipo moterų lankiusių nėščiųjų kursus emocinės būklės pokytis pogimdyminiame laikotarpyje geresnis, lyginant su neurotiško tipo moterimis nelankiusiomis nėščiųjų kursų. Asmenybės bruožas gali nulemti nėščiųjų kursų lankomumą, neurotiškos moterys linkusios nelankyti neščiųjų kursų. Asmenybės bruožai, tokie kaip introversija ir neurotiškumas, yra svarbus veiksnys susijęs su prasta emocine būkle po gimdymo, bet tai ne svarbiausias veiksnys. Su prasta emocine būkle pogimdyminiame laikotarpyje turi ryšį ir kiti psichosocialiniai veiksniai, tokie kaip žemas išsimokslinimas, prasta emocinė būklė prieš... [toliau žr. visą tekstą] / The Purpose of The Study: To analyse the connection between changes in emotional wellbeing during and post pregnancy periods in women whilst observing their personality traits and obtained antenatal education levels. The study was conducted among 142 women, who have or have not attended antenatal courses in the cities of Kaunas and Vilnius. The participants were questioned twice: during pregnancy and after the childbirth. For the Survey were used: The H. and S. Eisenck Questionnaire (EPO), The Edinburgh Questionnaire of The Scale of Postnatal Depression (EPDS), The C.D. Spielberger Scale of Anxiety (STAI). The questionnaire that helped to assess the social, demographic and subjective health aspects in the study was constructed by A.Masiukiene. The study results showed that the level of antenatal education positively effects postnatal emotional wellbeing, including the wellbeing of vulnerable women. The positive change in the emotional wellbeing of the neurotic type is also noticed between those who attended the antenatal courses, compared to women of the neurotic type who did not attend the courses. Personality Traits, such as introversion and neuroticism, is an important factor that can determine a lower level of emotional wellbeing after childbirth, but is not the most important one. Low emotional wellbeing can be caused by other psychosocial conditions, such as poor education, lower emotional wellbeing before pregnancy, social support after childbirth. Antenatal education... [to full text]

Women’s procreative capacities and the appreciation of birth experiences have always been recognised in civil society and the early days of psychology. Given that our culture is one that emphasises a woman’s capacity to bear children as one of the greatest social achievements, the social responsibility to procreate and ensure collective survival becomes a potent mandate, especially so for Black African women. To fulfil this social responsibility, traditional African culture dictates a very specific process of pregnancy which involves a series of watershed moments, each of which requires that social support, of whatever form, should be available. This study explored the role that social support from significant others and health professionals play in mediating psychological issues during pregnancy, childbirth and postnatally among Black African women in Madadeni Township in KwaZulu-Natal. The study was rooted in the interpretive, qualitative paradigm and a phenomenological research design was used. Purposive sampling was used to select participants who were aged from 18 to 25 years with a baby older than two weeks but less than six months. Semi structured interviews were conducted in the mother tongue of the participants until the point of saturation where no new information arose from the six participants interviewed. Thematic content analysis was used to extract recurrent themes across participants. The results indicate that social support, especially from parents and partners, plays a defining role in helping women to cope with the stress experienced during pregnancy, childbirth and postnatally. / Psychology / M.A. (Psychology: Research Consultation)

Women’s procreative capacities and the appreciation of birth experiences have always been recognised in civil society and the early days of psychology. Given that our culture is one that emphasises a woman’s capacity to bear children as one of the greatest social achievements, the social responsibility to procreate and ensure collective survival becomes a potent mandate, especially so for Black African women. To fulfil this social responsibility, traditional African culture dictates a very specific process of pregnancy which involves a series of watershed moments, each of which requires that social support, of whatever form, should be available. This study explored the role that social support from significant others and health professionals play in mediating psychological issues during pregnancy, childbirth and postnatally among Black African women in Madadeni Township in KwaZulu-Natal. The study was rooted in the interpretive, qualitative paradigm and a phenomenological research design was used. Purposive sampling was used to select participants who were aged from 18 to 25 years with a baby older than two weeks but less than six months. Semi structured interviews were conducted in the mother tongue of the participants until the point of saturation where no new information arose from the six participants interviewed. Thematic content analysis was used to extract recurrent themes across participants. The results indicate that social support, especially from parents and partners, plays a defining role in helping women to cope with the stress experienced during pregnancy, childbirth and postnatally. / Psychology / M. A. (Psychology: Research Consultation)