Magister Artium (Psychology) - MA(Psych) / Fatherhood and masculinity have been studied globally, and these constructs are used to make sense of a variety of realities of men. In South Africa, traditional constructions of fatherhood and masculinity persist. Given the unique history of men in South Africa, it allows researchers to investigate a plethora of phenomena relating to how men experience them, including fatherhood. Having a premature baby is fraught with medical and physical problems, which disrupts the fathers’ transition to fatherhood. The experience of the transition to parenthood is exacerbated by the sudden premature birth of a child, which leaves fathers and mothers particularly vulnerable to intense emotional experiences. Much has been documented about fathers’ subjective experiences of pregnancy, as well as fathers’ experiences of having a premature infant.

O presente estudo buscou investigar a experiência de tornar-se mãe de um bebê prematuro na adolescência, em particular, a relação que a mãe adolescente estabelece com o bebê prematuro, durante a internação hospitalar do bebê. Participaram quatro mães adolescentes entre 17 e 18 anos de idade, que tiveram seus bebês prematuros em dois hospitais públicos de Porto Alegre, as quais foram entrevistadas em três momentos da internação do bebê na UTI Neonatal (aproximadamente no 15º dia de vida do bebê, uma semana após este contato e no momento de pré-alta hospitalar do bebê). Os resultados apontaram para um somatório de crises concomitantes como a adolescência, a maternidade e a prematuridade, o que representou um impacto importante neste momento de transição para as adolescentes. Para algumas mães foi possível recuperar-se do choque inicial causado pelo nascimento prematuro de seu bebê, fato relacionado à variação no grau de desenvolvimento individual e nos modos de funcionamento psíquico de cada uma. Além disso, aspectos típicos do funcionamento adolescente mostraram-se evidenciados, mesmo com a exigência de que as mães interrompessem seu processo de adolescer para cuidar do bebê na UTI Neo. Assim também, notou-se que há diferentes tempos que marcaram esta transição para a maternidade: o tempo da UTI, o tempo do bebê e o tempo da adolescente, muito distintos e com características próprias. Outros estudos devem ser realizados nesta temática específica, uma vez que não se conhece os efeitos a médio e longo prazo deste tipo de transição para a maternidade para a mãe e para o bebê. Espera-se que este estudo possa contribuir para se considerar as especificidades do momento da adolescência no contexto da UTI Neo. / The present study investigates the experience of giving birth to a premature baby in adolescence, specifically examining the relationship the adolescent mother establishes with the premature baby during its hospital internment. Four adolescent mothers between 17 and 18 years old took part in the research. They gave birth to their premature babies in two different public hospitals of Porto Alegre and were interviewed at three moments of the babies' internment in the NICU (about 15 days after the babies were born, a week after this first contact and right before the babies' hospital discharge). The results pointed to a sum of simultaneous crisis, such as adolescence, motherhood and prematurity, which represented a major impact at this time of transition for adolescents. For some mothers it was easy to recover from the initial shock caused by the premature birth of their babies, and this fact is related to variations in the degree of individual development as well as to the different modes of psychic functioning of each one of them. Furthermore, some typical aspects of adolescence were shown, even though the adolescents were demanded to interrupt their process of being adolescents to take care of a premature baby in NICU. Thus, it was possible to notice that there were different times that marked the transition to motherhood: the time of NICU, the babies' and the adolescents' time, which were very distinct from each other, showing specific characteristics. Other studies should be conducted in this specific area, since the medium and long term effects of this kind of transition to motherhood, regarding the adolescent mother and the baby, are not known. It is expected that this study contributes to better understanding the specificities of adolescent mothers in the NICU.

O presente estudo buscou investigar a experiência de tornar-se mãe de um bebê prematuro na adolescência, em particular, a relação que a mãe adolescente estabelece com o bebê prematuro, durante a internação hospitalar do bebê. Participaram quatro mães adolescentes entre 17 e 18 anos de idade, que tiveram seus bebês prematuros em dois hospitais públicos de Porto Alegre, as quais foram entrevistadas em três momentos da internação do bebê na UTI Neonatal (aproximadamente no 15º dia de vida do bebê, uma semana após este contato e no momento de pré-alta hospitalar do bebê). Os resultados apontaram para um somatório de crises concomitantes como a adolescência, a maternidade e a prematuridade, o que representou um impacto importante neste momento de transição para as adolescentes. Para algumas mães foi possível recuperar-se do choque inicial causado pelo nascimento prematuro de seu bebê, fato relacionado à variação no grau de desenvolvimento individual e nos modos de funcionamento psíquico de cada uma. Além disso, aspectos típicos do funcionamento adolescente mostraram-se evidenciados, mesmo com a exigência de que as mães interrompessem seu processo de adolescer para cuidar do bebê na UTI Neo. Assim também, notou-se que há diferentes tempos que marcaram esta transição para a maternidade: o tempo da UTI, o tempo do bebê e o tempo da adolescente, muito distintos e com características próprias. Outros estudos devem ser realizados nesta temática específica, uma vez que não se conhece os efeitos a médio e longo prazo deste tipo de transição para a maternidade para a mãe e para o bebê. Espera-se que este estudo possa contribuir para se considerar as especificidades do momento da adolescência no contexto da UTI Neo. / The present study investigates the experience of giving birth to a premature baby in adolescence, specifically examining the relationship the adolescent mother establishes with the premature baby during its hospital internment. Four adolescent mothers between 17 and 18 years old took part in the research. They gave birth to their premature babies in two different public hospitals of Porto Alegre and were interviewed at three moments of the babies' internment in the NICU (about 15 days after the babies were born, a week after this first contact and right before the babies' hospital discharge). The results pointed to a sum of simultaneous crisis, such as adolescence, motherhood and prematurity, which represented a major impact at this time of transition for adolescents. For some mothers it was easy to recover from the initial shock caused by the premature birth of their babies, and this fact is related to variations in the degree of individual development as well as to the different modes of psychic functioning of each one of them. Furthermore, some typical aspects of adolescence were shown, even though the adolescents were demanded to interrupt their process of being adolescents to take care of a premature baby in NICU. Thus, it was possible to notice that there were different times that marked the transition to motherhood: the time of NICU, the babies' and the adolescents' time, which were very distinct from each other, showing specific characteristics. Other studies should be conducted in this specific area, since the medium and long term effects of this kind of transition to motherhood, regarding the adolescent mother and the baby, are not known. It is expected that this study contributes to better understanding the specificities of adolescent mothers in the NICU.

O presente estudo buscou investigar a experiência de tornar-se mãe de um bebê prematuro na adolescência, em particular, a relação que a mãe adolescente estabelece com o bebê prematuro, durante a internação hospitalar do bebê. Participaram quatro mães adolescentes entre 17 e 18 anos de idade, que tiveram seus bebês prematuros em dois hospitais públicos de Porto Alegre, as quais foram entrevistadas em três momentos da internação do bebê na UTI Neonatal (aproximadamente no 15º dia de vida do bebê, uma semana após este contato e no momento de pré-alta hospitalar do bebê). Os resultados apontaram para um somatório de crises concomitantes como a adolescência, a maternidade e a prematuridade, o que representou um impacto importante neste momento de transição para as adolescentes. Para algumas mães foi possível recuperar-se do choque inicial causado pelo nascimento prematuro de seu bebê, fato relacionado à variação no grau de desenvolvimento individual e nos modos de funcionamento psíquico de cada uma. Além disso, aspectos típicos do funcionamento adolescente mostraram-se evidenciados, mesmo com a exigência de que as mães interrompessem seu processo de adolescer para cuidar do bebê na UTI Neo. Assim também, notou-se que há diferentes tempos que marcaram esta transição para a maternidade: o tempo da UTI, o tempo do bebê e o tempo da adolescente, muito distintos e com características próprias. Outros estudos devem ser realizados nesta temática específica, uma vez que não se conhece os efeitos a médio e longo prazo deste tipo de transição para a maternidade para a mãe e para o bebê. Espera-se que este estudo possa contribuir para se considerar as especificidades do momento da adolescência no contexto da UTI Neo. / The present study investigates the experience of giving birth to a premature baby in adolescence, specifically examining the relationship the adolescent mother establishes with the premature baby during its hospital internment. Four adolescent mothers between 17 and 18 years old took part in the research. They gave birth to their premature babies in two different public hospitals of Porto Alegre and were interviewed at three moments of the babies' internment in the NICU (about 15 days after the babies were born, a week after this first contact and right before the babies' hospital discharge). The results pointed to a sum of simultaneous crisis, such as adolescence, motherhood and prematurity, which represented a major impact at this time of transition for adolescents. For some mothers it was easy to recover from the initial shock caused by the premature birth of their babies, and this fact is related to variations in the degree of individual development as well as to the different modes of psychic functioning of each one of them. Furthermore, some typical aspects of adolescence were shown, even though the adolescents were demanded to interrupt their process of being adolescents to take care of a premature baby in NICU. Thus, it was possible to notice that there were different times that marked the transition to motherhood: the time of NICU, the babies' and the adolescents' time, which were very distinct from each other, showing specific characteristics. Other studies should be conducted in this specific area, since the medium and long term effects of this kind of transition to motherhood, regarding the adolescent mother and the baby, are not known. It is expected that this study contributes to better understanding the specificities of adolescent mothers in the NICU.

Health literacy represents the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health, according to WHO. Common health literacy level may be sufficient in the case of smooth pregnancy and natural childbirth. However, if there are some health problems, it is necessary to support an increase in health literacy level of mothers. Main objective of this thesis is to describe the objective health literacy level of mothers with premature baby and to identify areas that are for these mothers most problematic. The theoretical part deals with demographic data related to premature births, the basic definition of prematurity, an essential characteristic of neonatology and organization of care, premature baby, the most common medical complications and prognosis. Defines and operationalizes health literacy of mothers with premature baby. Research used a qualitative methodology. Data were collected using semi-structured interviews. Respondents for interview were physicians who care for preterm infants. The selection of respondents was conducted using the snowball sampling to facilitate data analysis, were interviews transcribed and then analyzed using the cluster analysis. Results were...

In a theoretical part of the paper, the main focus is on characteristics and terminology of premature babies, breastfeeding, classification systems NANDA International, NIC and NOC, about also management which is an integral part of nursing process. Both quantitative and qualitative researches were used to obtain and process all data. In quantitative method was used a method of document was used, content analysis and quasiexperiment. Results of quantitative research were processed in SPSS software, version 16.0 Statistical Package for Social Sciences, where a method of nonparametric correlation was used. A pen and paper interview with open questions was used in qualitative section of research. Before the research itself, a deputy of nursing care in hospital Nemocnice České Budějovice, a.s. was addressed. The research was implemented between February 2013 and April 2013. First research cluster consisted of nine mothers and eleven premature babies in which two of the mothers had twins. Basic criteria for entering the research, was a necessary hospitalization of both the mother and the child, which the hospital Nemocnice České Budějovice, a. s. offers. The major criterion was an initiated lactation. Second research sample consisted of nurses working at Stanice intermediární péče II. (IMP II ? rooming) of Nemocnice České Budějovice a. s. First of goals was to create files from classification systems NANDA International, NIC, NOC for development and support of breastfeeding for premature babies. The main goal of this work was to create a comprehensive documentation mediated by classification systems NANDA International, NIC, NOC for growth and support of premature babies. The theoretical content of the paper itself was used to create documentation and its usage in praxis. It was not mentioned to create new, but to apply already well known, verified and proven classification systems, which can make not only breastfeeding, but also the daily routine of a nurse more efficient. The suggested documentation solves the issues of breastfeeding of premature babies to help mothers, but also to increase a professional prestige of nurses. Documentation was compiled to include all the necessary information needed for the correct nursing process method. Significant part of documentation is a preliminary case history of mother and child, which offered valuable information. Further attribute were nursing diagnoses dealing with breastfeeding issues of premature babies and intervention realized during hospitalization. It was necessary to address each entry concerned with premature babies individually, based on complex evaluation of overall condition. Many pieces of knowledge from specialized literature on the topic of premature babies and personal experience of doc. PhDr. Mária Bolendovičová, PhD. were used to create the documentation. Second aim of the study was verification of selected specimens on clinical praxis. Third aim was to monitor nurses in Stanice intermediární péče II. (IMP II ? rooming) and their attitude to usage of classification systems NANDA International, NIC and NOC. Based on interviews with nurses it was proven that nurses have better knowledge of NANDA Internationals classification systems than knowledge of NIC and NOC. Final documentation was tested in the perspective of medical staff and its exploitability in clinical praxis. It was found that nurses sense the classification systems NANDA International, NIC and NOC as an appropriate tool, but only with more staff present to work on station. From statements of nurses was clear that establishing a diagnoses is a responsibility of each nurse taking part in nursing process.

Submitted by Ana Carla Almeida (ana.almeida@ucsal.br) on 2017-03-21T15:28:52Z No. of bitstreams: 1 Marcia Cristina Sousa Fonseca Dissertacao_V3.pdf: 2468543 bytes, checksum: 0106305f0507b539a4193e32fc414e57 (MD5) / Approved for entry into archive by Rosemary Magalhães (rosemary.magalhaes@ucsal.br) on 2017-03-21T16:02:17Z (GMT) No. of bitstreams: 1 Marcia Cristina Sousa Fonseca Dissertacao V3.pdf: 2468543 bytes, checksum: 0106305f0507b539a4193e32fc414e57 (MD5) / Made available in DSpace on 2017-03-21T16:02:17Z (GMT). No. of bitstreams: 1 Marcia Cristina Sousa Fonseca Dissertacao V3.pdf: 2468543 bytes, checksum: 0106305f0507b539a4193e32fc414e57 (MD5) Previous issue date: 2016-12-02 / Esta pesquisa objetiva compreender de que forma é vivenciada a relação de humanização mãe/pai/bebê prematuro durante a hospitalização do recém-nascido na Unidade de Terapia Intensiva Neonatal. Buscou-se conhecer a construção de subjetividades, a partir da hospitalização e afastamento abrupto dos bebês. Foi utilizada uma abordagem descritiva, qualitativa, de cunho etnográfico. O material foi coletado por meio de observação no campo em uma instituição materno-infantil e pela realização de entrevistas utilizando-se um roteiro semiestruturado. A escolha das mães, dos pais e profissionais que participaram da pesquisa ocorreu por conveniência e na própria unidade de terapia intensiva. Foram realizadas entrevistas com sete mães, sete pais e sete profissionais que acompanharam e vivenciaram a experiência da separação precoce com seu recém-nascido, assim como o cuidado em sua prática cotidiana com neonatos prematuros, além de uma entrevista coletiva e não diretiva, com quatro mães que se encontravam no “Espaço Mãe”. O fundamento teórico foi o referencial de Winnicott, uma abordagem Psicanalítica de como se dá a construção do vínculo materno. As discussões e resultados permitiram: compreender os desafios encontrados pelas mães, pais e profissionais de saúde no processo de vinculação com o bebê internado; os sentimentos diante da separação precoce; as relações construídas entre as mães, pais e equipe de saúde no contexto hospitalar; questões atinentes à comunicação entre os profissionais com as mães, pais e familiares; estratégias de enfrentamento utilizadas pelas mães na aproximação com seu filho, bem como na travessia do sofrimento vivido. Procurou compreender a relação de humanização e o acolhimento direcionado às mães e aos pais pela equipe de saúde, ofertando estratégias de atenção mais humanizadas. Conclui-se que a intervenção oportuna, incorporada ao cuidado humanizado estabelecido pelo diálogo constante com a equipe de saúde, pode construir redes de apoio direcionadas à reaproximação do bebê com seus principais cuidadores no momento da separação, o que possivelmente resultará na redução da sua permanência na unidade hospitalar e de uma melhor qualidade do vínculo parental. / This research aims to understand how is experienced the relationship of humanization of the mother / father / premature baby during the hospitalization of newborns in the Neonatal Intensive Care Unit. This study aimed to know the construction of subjectivities since the hospitalization and the abrupt separation of the babies. A descriptive qualitative and ethnographic approach, was used. The material was collected by observation in the field in the Institution and by conducting interviews using a semi-structured script. The choice of mothers, parents and professionals who participated in the survey was for convenience and occurred in the intensive care unit. Interviews were conducted with seven mothers, seven fathers and seven professional who followed and lived the experience of the early separation of the newborn as well as took care of premature infants in their daily practice. The theoretical foundation was Winnicott reference, a Psychoanalytic approach of how is the construction of the maternal bond. The discussions and results allowed to: understand the challenges faced by mothers, parents and health professionals in the binding process with the hospitalized baby; feelings about the early separation; the relationships built between mothers, fathers and health professionals in the hospital setting; issues related to communication between professionals and the mothers, fathers and families; coping strategies used by mothers to approach their child, as well as the suffering experienced. The research looked for understanding the humanizing relationship and the support directed to mothers and fathers by the health team, offering more humanized care strategies. It concluded that early intervention, incorporated into the humanized care established by the constant dialogue with the healthcare team, can build support networks aimed at baby rapprochement with their primary caregivers at the moment of separation, which might result in a reduction of their stay in hospital and a better quality of parental bonding.

This Master's thesis deals with the topic of impaired communication skills in premature infants. The thesis is divided into theoretical and practical parts. The theoretical part consists of three main chapters devoted to the development of children's speech, premature babies and care for premature babies. The first chapter describes speech and language, the ontogenetic development of speech, language levels in the ontogenesis of speech and impairment of communication skills in childhood. The second chapter defines a premature baby and discusses the most common postpartum complications. The third chapter is devoted to the care of premature babies in the Czech Republic, describes the logopaedic care regarding such children and their prognosis. The practical part is based on the methods of qualitative research. A triangulation of research methods was chosen - document analysis, observation and interview. The main goal was to describe how impaired communication skills are manifested in premature infants. The partial goal was to find out what postpartum complications occur in premature infants. To achieve the goals of the research, five research questions were formulated. Five respondents were included in the survey, namely four boys and one girl. Based on the obtained data, case studies of individual...

Made available in DSpace on 2016-04-28T18:23:56Z (GMT). No. of bitstreams: 1 Ana Lucia Franco Nobile Girardi.pdf: 669046 bytes, checksum: fbe687059ad42c383dedc998f2b27284 (MD5) Previous issue date: 2008-12-12 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / This doctorate thesis brings on a reflection on the clinic with babies prematurely born. That reflection derived from my professional path itself, in which, since 1994, I ve taken part of a central program of maternal-infantile attendance, the Kangaroo Mother Method, in a hospital of the interior of Sao Paulo State, Regional Hospital of Assis. The starting point of this work is the discussion of the phonoaudiologic clinic that operates by the risk notion, understood in the clinical environment as much as origin of disturbances, as well as parameter to measure a normal pattern of the organism. It is then as scale for the definition of the pathological that the risk notion acts in the phonoaudiologic practice; and it is exactly from this perspective that we stay away from. From the beginning, 14 years ago, the phonoaudiologic actions in clinic practice with babies have been linked to the parents, more specifically to the mother, since the maternal presence was needed in hospital during the baby s recovery period in order to reach the goals of the Kangaroo Mother Method. As a professional involved in that hospital project, was I affected not only by the movements of the premature birth, but by the parents speech that convey the significance of their encounter with their child as well, crucial data that produced effects in clinic practice. I understand that such practice caused my distance from the speech centered in the organic conditions of the premature, consequently engendering the bet in the decisive power of the language in the subjective structuring, i.e., in the strength of the speech as a possible source of a come-to-being subject of the human baby, acting as an anticipation position introduced by the bond of parenthood. In this work I aim at showing that the issues about clinic with babies, mainly those considered of risk activity bounded in the period of hospital internment and in the following accompaniment , are not being sufficiently discussed in the phonoaudiological field and in this sense I indicate an alternative direction, the establishment of the conjunction between the two moments of phonoaudiologic activity based in only one commitment, the premature body in an entrance process into the symbolic, through the effects of the language. The promoted discussions fit in this theorization about the Clinic of Language, under the coordination of Maria Francisca Lier- DeVitto and on Claudia Lemos thought; more precisely the structural and the unfolding reflection, starting from the Lacanian Psychoanalysis, in the statute of pulsing body. It has to be mentioned, however, that another step will be taken, the approach of the Lacanian Psychoanalysis starting with Freud that the clinic with babies will demand a theoretical effort on the subject in relation with parenthood / Esta tese de doutorado traz uma reflexão sobre a clínica com bebês nascidos prematuramente. Essa reflexão nasceu a partir de minha trajetória profissional, em que desde 1994, faço parte de um programa central de atendimento materno-infantil, o Método Mãe-Canguru, em um hospital do interior do Estado de São Paulo Hospital Regional de Assis. O ponto de partida deste trabalho é a discussão da clínica fonoaudiológica que opera pela noção de risco, entendido no espaço clínico tanto como origem de distúrbios, quanto como parâmetro para medir um padrão normal do organismo. É, então, como escala para a definição do patológico que a noção de risco atua na prática fonoaudiológica; e é justamente desta perspectiva que nos afastamos. Desde o início, há 14 anos, as ações fonoaudiológicas na prática clínica com bebês estiveram atadas aos pais, mais especificamente à mãe, já que para viabilizar as metas do Método Mãe-Canguru se fez necessária a presença da mãe na unidade hospitalar durante o período de recuperação do bebê. Como profissional envolvida nesse projeto hospitalar fui afetada não só pelos movimentos do nascimento prematuro, bem como pelo discurso dos pais que portam a significância do encontro deles com o filho, dado crucial que produziu efeitos na prática clínica. Entendo que esse fazer ocasionou o meu afastamento do discurso centrado nas condições orgânicas do prematuro, conseqüentemente, engendrando a aposta na força determinante da linguagem na estruturação subjetiva, isto é, na força do discurso como fonte de possibilidade de um vir-a-ser-sujeito da cria humana, atuando como posição de antecipação introduzida pelo laço com a parentalidade. Neste trabalho procuro mostrar que as questões sobre a clínica com bebês, sobretudo aqueles considerados de risco atuação circunscrita no período de internação hospitalar e também no acompanhamento ambulatorial , não estão sendo suficientemente debatidas no campo fonoaudiológico e, neste sentido, indico uma direção alternativa, a partir do estabelecimento da conjunção entre os dois momentos de atuação fonoaudiológica assentada em um só compromisso, o corpo prematuro em processo de entrada no simbólico pelos efeitos da linguagem. As discussões promovidas inserem-se no interior da teorização sobre a Clínica da Linguagem, sob a coordenação de Maria Francisca Lier-DeVitto e do pensamento de Claudia Lemos, mais precisamente a reflexão estrutural e do desdobramento, a partir da psicanálise lacaniana, no estatuto de corpo pulsional. Cabe, porém, dizer que um outro passo será realizado, a aproximação a Psicanálise lacaniana a partir de Freud na medida em que a clínica com bebês exigirá um esforço de teorização sobre o sujeito na relação com a parentalidade

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