Submitted by Ronildo Prado (ronisp@ufscar.br) on 2017-08-10T13:18:07Z No. of bitstreams: 1 DissSM.pdf: 2427457 bytes, checksum: 6699f0dd25ae20371fc7c51dba314abb (MD5) / Approved for entry into archive by Ronildo Prado (ronisp@ufscar.br) on 2017-08-10T13:18:17Z (GMT) No. of bitstreams: 1 DissSM.pdf: 2427457 bytes, checksum: 6699f0dd25ae20371fc7c51dba314abb (MD5) / Approved for entry into archive by Ronildo Prado (ronisp@ufscar.br) on 2017-08-10T13:18:25Z (GMT) No. of bitstreams: 1 DissSM.pdf: 2427457 bytes, checksum: 6699f0dd25ae20371fc7c51dba314abb (MD5) / Made available in DSpace on 2017-08-10T13:18:35Z (GMT). No. of bitstreams: 1 DissSM.pdf: 2427457 bytes, checksum: 6699f0dd25ae20371fc7c51dba314abb (MD5) Previous issue date: 2017-02-18 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Introduction: The World Health Organization defines adolescence, chronologically, as an age group between 10 and 19 years. In this work, a perspective of the term’s plurality is adopted, since adolescents are shaped by concrete conditions of life and trajectories, with the purpose of defending the development of adolescents’ potentials. Studies on teenage pregnancy have reported diverging views of gestation and of motherhood. In this sense, we verified the need to broaden the understanding of the diversity and uniqueness that encompasses this phenomenon through the lenses of occupational therapy, investigating from the conceptual framework of the occupational identity. Objective: to understand how adolescent pregnant women construct maternal occupational identities. Method: applied field research using exploratory qualitative methods, undertaken in five Health Units of a municipality of São Paulo state. The study included 10 adolescent pregnant women, three of them in the first trimester of gestation, two in the second and five in the third. The study took place in two stages: 1) obtaining sociodemographic and occupational data; 2) understanding the process of construction of the maternal occupational identity. Instruments for data collection: Brazilian Sociodemographic Classification Criterion – Abep; occupational journal linked to occupational inquiry list; and semi-structured interview script. For the analysis, we categorized and presented data of the first stage descriptively and those of the second stage through Collective Subject Discourse Methodology (DSC). Results: the results were organized in three dimensions: general characterization of the participants; the process of discovering pregnancy; the process of constructing the maternal occupational identity. Dimension I shows that the age of participants varies between 14 and 19 years and most of them are of low-middle class. None of them wanted to get pregnant at this point in their lives. Dimension II shows different positions and opinions in face of the discovery of a pregnancy, which demonstrates the plurality and the individuality of the representation of this phenomenon. The main source of support for adolescents is family. Dimension III reflects on the construction of the maternal occupational identity, identifying activities performed before gestation that may help in the future care of the baby as well as revealing activities performed during gestation that characterize occupational changes related to the care of the woman herself alongside the baby’s care. Discussion: knowing the life history of pregnant adolescent women as well as explaining the creation and construction of occupational identities allows ponderation on the plurality of perceptions about pregnancy and accessing what makes sense to them. Daily occupational choices express who they want to become and how they would like others to see them. Final considerations: the study contributes to ponder the integral health care of pregnant adolescents parting from their context, providing answers to their needs and providing subsidies for the planning of intersectorial actions and strategies that promote youth participation and protagonism. This perspective expands development of the adolescent’s autonomy for self-care and childcare and the process of constructing the maternal occupational identity. / Introdução: a Organização Mundial de Saúde define adolescência, cronologicamente, como a faixa etária entre 10 e 19 anos. Neste trabalho adota-se uma perspectiva de pluralidade do termo, por entender que as adolescências são modeladas por condições e trajetórias de vida, com o propósito de defesa do desenvolvimento das potencialidades das adolescentes. Estudos sobre a gravidez na adolescência apresentaram visões divergentes da vivência do processo gestacional e da maternidade. Nessa direção, constatou-se a necessidade de ampliar a compreensão da heterogeneidade e singularidade que abarcam este fenômeno pelas lentes da terapia ocupacional, partindo do marco conceitual da identidade ocupacional. Objetivo: compreender como gestantes adolescentes constroem identidades ocupacionais maternas. Método: pesquisa aplicada, de campo, exploratória, qualitativa, desenvolvida em cinco Unidades de Saúde de um município em São Paulo. Participaram do estudo dez gestantes adolescentes, estando três delas no primeiro trimestre de gestação, duas no segundo e cinco no terceiro. O estudo ocorreu em duas etapas: 1) obtenção de dados sociodemográficos e ocupacionais; 2) compreensão do processo de elaboração da identidade ocupacional materna. Instrumentos para coleta de dados: formulário sociodemográfico; Critério de Classificação Econômica Brasil – Abep; diário de ocupações atrelado com lista de inquérito ocupacional; roteiro de entrevista semiestruturado. Para a análise, os dados da primeira etapa foram categorizados e apresentados descritivamente; os da segunda etapa, por meio da técnica do Discurso do Sujeito Coletivo (DSC). Resultados: os resultados foram organizados em três dimensões: caracterização geral das participantes; processo de descoberta da gravidez; processo de construção da identidade ocupacional materna. A dimensão I apresenta que a idade das participantes varia entre 14 e 19 anos, e a maioria delas é da classe média baixa. Nenhuma delas queria engravidar nesse momento da vida. A dimensão II mostra diferentes posicionamentos e opiniões diante da descoberta da gravidez, demonstrando a pluralidade e a individualidade da representação deste fenômeno. A principal fonte de suporte das adolescentes é a família. Na dimensão III reflete-se sobre a construção da identidade ocupacional materna. Identificam-se atividades realizadas anteriormente à gestação, que podem ajudar no futuro cuidado do bebê, bem como revelam-se atividades realizadas durante a gestação que caracterizam mudanças ocupacionais relacionadas ao cuidado da própria mulher concomitante ao do bebê. Discussão: conhecer a história de vida das gestantes adolescentes, explicitando a criação e construção das identidades ocupacionais, permite refletir sobre a pluralidade de percepções sobre a gravidez e acessar aquilo que faz sentido para elas. As escolhas ocupacionais diárias expressam quem elas querem se tornar e como gostariam que os outros as vissem. Considerações finais: o estudo contribui para a reflexão da atenção à saúde integral das adolescentes a partir de seu contexto, oportunizando respostas às suas necessidades e fornecendo subsídios para o planejamento de ações intersetoriais e sistematização de estratégias que ampliem a participação e o protagonismo juvenil. Nesta perspectiva, amplia-se o desenvolvimento da autonomia da adolescente para o cuidado de si e do bebê, além de estimular seu processo de construção da identidade ocupacional materna.

Despite all the legislative efforts regarding child protection and campaigns to prevent and combat early marriage and maternity, Mozambique was ranked 9th globally in terms of the prevalence of early marriage, with 48% of girls aged 20-24 marrying before the age of 18 years. The aim of this study was to develop a strategic alignment framework for the prevention and combat of early marriage and maternity in Zambézia Province, Mozambique. This study used a two-stage equal-status concurrent sequential mixed-method design. Data were collected through a cross-sectional survey, administered to 383 early married, maternity and pregnant girls; life story interviews with early married, maternity and pregnant girls (25) aged 10-19 years; semi-structured interviews with professionals from the education and health sectors, local authorities, families of the early married, maternity and pregnant girls (37), and group discussions with members of a child committee (16). The results indicated that the majority of early married, maternity and pregnant girls only completed primary education (55.9%), followed by secondary education (39.9%), and higher education (2.9%). About 65% of adolescent girls became pregnant at the age of 15-17. Among adolescent girls, 18.8% had their first baby before the age of 15 years and 99.2% had their first baby before they were 18 years old. Among the early maternity girls (362), 24.3% responded “yes” to the questions about health complications during their first baby’s birth and 75.7% of the respondents said “no”. Socio-cultural meanings, such as socialisation into roles, legitimising having children, the value and benefits of the bridewealth, the role of initiation, the social meaning of the first menstruation, geographical and transport issues were the main drivers for school dropout, forcing adolescent girls to marry. Engaging in sexual practices was found to provide the girls a sense of meaning and purpose, or as a result of poverty. Physical aspects, interpersonal relations, education, work, and emotional distress were some of the negative consequences of early marriage and maternity. There were some relevant interventions and efforts to prevent and combat early marriage and maternity in Maganja da Costa and Morrumbala districts in Zambézia Province, Mozambique. However, the alignment of the activities implemented by different NGOs and CBOs to MNSPCM (2016-2019) was still a challenge. Only World Vision was implementing programmes aligned to the National Strategy. Based on the results, I developed a strategic alignment framework for the prevention and combat of early marriage and maternity in Zambézia Province, Mozambique. / Health Studies / D. Litt. et Phil. (Health Studies)

The purpose of this study was to explore possible problems associated with pregnancy amongst student nurses in the Northern Province, and to determine whether their studies were adversely affected by their pregnancies. This study was designed as a quantitative, exploratory descriptive survey to look into the pregnancies of a specific group of students exploring their experiences in the classrooms and in the clinical areas. During 1998 data was collected by distributing questionnaires to ninety three pregnant . student nurses. Sixty-seven (71,0%) of student nurses fell pregnant because they lacked knowledge about contraceptives. Four-six (49,5%) of the respondents delayed seeking antenatal care, although they needed advice and support. Whilst fifty-eight (62,4%) of the respondents suffered from minor ailments such as tiredness, pre-eclampsia, early bleeding prior to three months pregnancy, and dizziness. Fifty-eight (62,4%) of the respondents encountered problems with their academic progress, as revealed by decreasing marks scored before, during, and after delivery. Student nurses would willingly avail themselves of guidance, advice and support during their pregnancies if they could access such services. / Advanced Nursing Science / M.A.(Nursing Science)

The purpose of this study was to explore possible problems associated with pregnancy amongst student nurses in the Northern Province, and to determine whether their studies were adversely affected by their pregnancies. This study was designed as a quantitative, exploratory descriptive survey to look into the pregnancies of a specific group of students exploring their experiences in the classrooms and in the clinical areas. During 1998 data was collected by distributing questionnaires to ninety three pregnant . student nurses. Sixty-seven (71,0%) of student nurses fell pregnant because they lacked knowledge about contraceptives. Four-six (49,5%) of the respondents delayed seeking antenatal care, although they needed advice and support. Whilst fifty-eight (62,4%) of the respondents suffered from minor ailments such as tiredness, pre-eclampsia, early bleeding prior to three months pregnancy, and dizziness. Fifty-eight (62,4%) of the respondents encountered problems with their academic progress, as revealed by decreasing marks scored before, during, and after delivery. Student nurses would willingly avail themselves of guidance, advice and support during their pregnancies if they could access such services. / Advanced Nursing Science / M.A.(Nursing Science)

This study seeks to describe the factors contributing to high adolescent pregnancy rate in Kinondoni Municipality, Dar-es-Salaam. Through the study we get to know the social economic characteristics of adolescents, the adolescents' general knowledge of reproductive health issues and the source of this knowledge. The major discoveries made from this study are that the educational status and knowledge of reproductive health of these adolescents is low, some are already dropouts from school, and others were deprived of the chance to continue with secondary education. They have nothing tangible to do because of their low education and coupled with their low economic status, they are at risk of being involved in sexual activities at an early age, ending in pregnancies. In addition, their parents' educational and economic status was also found to be low. It is important then, parents, teachers and the community in general to arrest the rate of adolescent pregnancies. / HEALTH STUDIES / MA (HEALTH STUDIES)

This study seeks to describe the factors contributing to high adolescent pregnancy rate in Kinondoni Municipality, Dar-es-Salaam. Through the study we get to know the social economic characteristics of adolescents, the adolescents' general knowledge of reproductive health issues and the source of this knowledge. The major discoveries made from this study are that the educational status and knowledge of reproductive health of these adolescents is low, some are already dropouts from school, and others were deprived of the chance to continue with secondary education. They have nothing tangible to do because of their low education and coupled with their low economic status, they are at risk of being involved in sexual activities at an early age, ending in pregnancies. In addition, their parents' educational and economic status was also found to be low. It is important then, parents, teachers and the community in general to arrest the rate of adolescent pregnancies. / HEALTH STUDIES / MA (HEALTH STUDIES)