Thesis (M.S.)--University of Michigan, 1997. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1997. / Includes bibliographical references.

O autor se propõe a medir o tempo que decorre entre à inscrição e a primeira consulta médica de gestantes que curam os centros de saúde para assistência pré-natal. O propósito do estudo é dar subsídios para a identificação de instrumentos de medida da qualidade da assistência prestada a gestantes por instituições de saúde pública. Para tanto, foram desenvolvidas algumas ações básicas. Considerando a medida desse tempo, um evento sem significação quando estudado isoladamente, o autor se propos testar a hipótese de haver alguma correlação entre aquele tempo e outros eventos administrativos. O autor fez as seguintes verificações: - o tempo de espera apresenta algumas variações,segundo a região onde se localizam os centros de saúde, sendo maior em duas das focalizadas; - segundo a classificação dos centros de saúde: a variação é significativamente maior nos centros de saúde de tipo mais complexo, isto é, no tipo I, onde o atendimento é igualmente intensificado; - segundo a cobertura: foi verificado que o tempo de espera tende a crescer nas áreas onde a cobertura é maior. Quanto à idade da gestação não houve variação sob essa rubrica. O autor concluiu que a medida de tempo de espera para a primeira consulta médica de gestantes em centros de saúde pode indicar um problema de atendimento quando sua grandeza, ultrapassando o período considerado parâmetro de normalidade - O à 7 dias - estaria ligado a: cobertura aquém da meta esperada, demanda excessiva, deficiência quantitativa e/ou qualitativa da hora/instrumento responsável pela consulta e, especialmente, quando a demora se relacionasse também com inscrições feitas a partir do segundo trimestre da gestação. / The author\'s purpose is to measure the time lag between the registration on the clinic and the prenatal first visit by the pregnant woman. The study\'s purpose is to provide subsidies for the identification of quality standars in relation to the care provided to the future mothers by the public health institutions. For this purpose some basic steps were developed. Considering this time lag as non significant by itself, theauthor\'s purpose isto show the correlation between it and other administrative events, as well. The author made the folowing verifications: - the vaiting time according to the region on where the centers are located is greater, as it happened in two of the observed Regions; - in relation to the classification of the health center, the variation is significant: the lag is larger in the more complex type of heal th centers where the assistance is intensified; - according to the coverage it was verified that the waiting time increases in the areas where the coverage is larger; - as related to the age of pregnancy, there was no variation on waiting time. Considering the time lag by itself the conclusion is that the too small intervals observed are not significant because of its correlation with a too small coverage score observed all over the health centers. The author concludes that the waiting time for the pregnant woman first visit to prenatal clinic can indicate a problem at assistance when it is longer than the standard time lag -O to 7 days; when it is conected to a coverage too much behind or too much beyond objective expectations; an excessive demand; a quantitative or qualitative deficiency in instrument productivity and, specialy, when the delay was related also to the registrations starting at the second trimester ofpregnancy.

O autor se propõe a medir o tempo que decorre entre à inscrição e a primeira consulta médica de gestantes que curam os centros de saúde para assistência pré-natal. O propósito do estudo é dar subsídios para a identificação de instrumentos de medida da qualidade da assistência prestada a gestantes por instituições de saúde pública. Para tanto, foram desenvolvidas algumas ações básicas. Considerando a medida desse tempo, um evento sem significação quando estudado isoladamente, o autor se propos testar a hipótese de haver alguma correlação entre aquele tempo e outros eventos administrativos. O autor fez as seguintes verificações: - o tempo de espera apresenta algumas variações,segundo a região onde se localizam os centros de saúde, sendo maior em duas das focalizadas; - segundo a classificação dos centros de saúde: a variação é significativamente maior nos centros de saúde de tipo mais complexo, isto é, no tipo I, onde o atendimento é igualmente intensificado; - segundo a cobertura: foi verificado que o tempo de espera tende a crescer nas áreas onde a cobertura é maior. Quanto à idade da gestação não houve variação sob essa rubrica. O autor concluiu que a medida de tempo de espera para a primeira consulta médica de gestantes em centros de saúde pode indicar um problema de atendimento quando sua grandeza, ultrapassando o período considerado parâmetro de normalidade - O à 7 dias - estaria ligado a: cobertura aquém da meta esperada, demanda excessiva, deficiência quantitativa e/ou qualitativa da hora/instrumento responsável pela consulta e, especialmente, quando a demora se relacionasse também com inscrições feitas a partir do segundo trimestre da gestação. / The author\'s purpose is to measure the time lag between the registration on the clinic and the prenatal first visit by the pregnant woman. The study\'s purpose is to provide subsidies for the identification of quality standars in relation to the care provided to the future mothers by the public health institutions. For this purpose some basic steps were developed. Considering this time lag as non significant by itself, theauthor\'s purpose isto show the correlation between it and other administrative events, as well. The author made the folowing verifications: - the vaiting time according to the region on where the centers are located is greater, as it happened in two of the observed Regions; - in relation to the classification of the health center, the variation is significant: the lag is larger in the more complex type of heal th centers where the assistance is intensified; - according to the coverage it was verified that the waiting time increases in the areas where the coverage is larger; - as related to the age of pregnancy, there was no variation on waiting time. Considering the time lag by itself the conclusion is that the too small intervals observed are not significant because of its correlation with a too small coverage score observed all over the health centers. The author concludes that the waiting time for the pregnant woman first visit to prenatal clinic can indicate a problem at assistance when it is longer than the standard time lag -O to 7 days; when it is conected to a coverage too much behind or too much beyond objective expectations; an excessive demand; a quantitative or qualitative deficiency in instrument productivity and, specialy, when the delay was related also to the registrations starting at the second trimester ofpregnancy.

published_or_final_version / Nursing Studies / Master / Master of Nursing

Adolescent pregnancy is an important public health issue. The purpose of this mixed-methods study was to examine factors related to inadequate use of prenatal care (PNC) among adolescents living in inner-city Winnipeg. The quantitative component consisted of a secondary analysis of data from 92 adolescents (<20 years of age) who participated in a larger case-control study. Adolescents who were of First Nations ethnicity, single, multiparous, and who had low interpersonal support were more likely to receive inadequate PNC. Barriers, facilitators and motivators to PNC utilization were also identified. The qualitative component consisted of open-ended interviews with ten inner-city pregnant adolescents to examine how social support affected their use of PNC. Results showed that material, emotional and informational support were important factors affecting use of PNC. The most important source of material and emotional support was the adolescent’s mother, and the main source of informational support was the PNC provider.

Adolescent pregnancy is an important public health issue. The purpose of this mixed-methods study was to examine factors related to inadequate use of prenatal care (PNC) among adolescents living in inner-city Winnipeg. The quantitative component consisted of a secondary analysis of data from 92 adolescents (<20 years of age) who participated in a larger case-control study. Adolescents who were of First Nations ethnicity, single, multiparous, and who had low interpersonal support were more likely to receive inadequate PNC. Barriers, facilitators and motivators to PNC utilization were also identified. The qualitative component consisted of open-ended interviews with ten inner-city pregnant adolescents to examine how social support affected their use of PNC. Results showed that material, emotional and informational support were important factors affecting use of PNC. The most important source of material and emotional support was the adolescent’s mother, and the main source of informational support was the PNC provider.

Thesis (M.S.)--West Virginia University, 2000. / Title from document title page. Document formatted into pages; contains vi, 57 p. Vita. Includes abstract. Includes bibliographical references (p. 38-42).

Thesis (D.S.)--Harvard School of Public Health. / Photocopy of typescript. Boston, Mass. : Harvard School of Medicine, 1977. -- 29 cm. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 284-289).

Background: It is well accepted that gestational weight gain (GWG) outside of the Institute of Medicine recommendations is a modifiable risk factor for pregnancy complications, regardless of a woman’s pre-pregnancy body mass index. Objectives: Given that not all prenatal healthcare providers (HCPs) are aware of these guidelines nor discuss them with their patients, this thesis sought to examine counselling practices and evaluate a pilot knowledge translation tool for the improvement of such counselling. Methods: 1) A literature review was conducted to assess current prenatal GWG counselling practices between patients and HCPs; 2) an electronic survey was conducted to determine patients’ perceptions of GWG counselling and whether certain patient characteristics increase chances of counselling; 3) a quasi-experimental study was implemented to evaluate the Canadian Obesity Network’s 5As of Healthy Pregnancy Weight Gain tool. Results: GWG counselling was often infrequent and inaccurate. Women of higher socioeconomic status, older age, nulliparous, history of dieting, low physical activity and those categorized with overweight/obesity were more likely to receive GWG advice. The 5As of Healthy Pregnancy Weight Gain Tool is effective at initiating Ask and Advise components of HCP-mediated GWG counselling, but work is still needed to improve all other components of the 5As (Assess, Agree, Assist). Conclusions: Weight gain counselling is an essential component of prenatal healthcare, but discussions between HCPs and patients is inconsistent. Future steps include the development of GWG knowledge translation tools and improving GWG education for HCPs.