Dissertação(mestrado) - Universidade Federal do Rio Grande, Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, 2005. / Submitted by eloisa silva (eloisa1_silva@yahoo.com.br) on 2012-10-30T14:40:56Z No. of bitstreams: 1 patriciadasilva.pdf: 907631 bytes, checksum: 0d9864df80aaed22f5d58742aa1f439c (MD5) / Approved for entry into archive by Bruna Vieira(bruninha_vieira@ibest.com.br) on 2013-06-13T17:26:52Z (GMT) No. of bitstreams: 1 patriciadasilva.pdf: 907631 bytes, checksum: 0d9864df80aaed22f5d58742aa1f439c (MD5) / Made available in DSpace on 2013-06-13T17:26:52Z (GMT). No. of bitstreams: 1 patriciadasilva.pdf: 907631 bytes, checksum: 0d9864df80aaed22f5d58742aa1f439c (MD5) Previous issue date: 2005 / Com a intenção de contribuirmos para o conhecimento dos riscos da exposição ambiental e a influência de outros fatores sobre a saúde, realizou-se este estudo transversal, com mulheres em idade fértil (15-49 anos)residentes nas comunidades próximas ao parque industrial do município do Rio Grande/RS, sendo identificado a prevalência de abortos espontâneos e os fatores relacionados a este desfecho. A amostra compreendeu 565 mulheres, residentes nas áreas consideradas exposta (E) e não exposta(NE), de acordo com a distância do parque industrial e a análise do mapa dos ventos do município. Foram entrevistadas 285 mulheres da área E e 280 da área NE. Para avaliação dos fatores de risco, foi aplicado um questionário, o qual contemplava as condições socioeconômicas, os fatores ambientais e as condições de moradia, a história reprodutiva prévia e morbidades. Para análise dos dados foram utilizados o teste qui-quadrado e regressão logística não-condicionada. Das mulheres entrevistadas que já gestaram (n=412) 17,7% referiram ocorrência de aborto espontâneo. Na análise bivariada verificou-se que o desfecho estudado mostrou associação significativa com idade da menarca, apresentando-se como fator de proteção(OR=0,26 (IC=0,11-0,55); p=0,0008) a idade da menarca entre 11 e 13 anos. O número de filhos também mostrou associação com a ocorrência de aborto espontâneo, apresentando um aumento do risco para três ou mais filhos (OR=4,00 (IC=1,86-8,58); p=0,001). A história de doença sexualmente transmissível(DST) também apresentou tendência à significação (OR=2,01 (IC=0,97-4,15); p=0,06). Após ajuste com as variáveis do modelo teórico hierarquizado, a presença de três ou mais filhos (OR=2,94(IC=1,28-6,77); p=0,009) e a história de DST(OR=2,55 (IC=1,13-5,77); p=0,02) permaneceram significativamente associados ao desfecho estudado. Nesta análise, o fato da mulher não possuir água encanada dentro de casa mostrou uma tendência de associação com a ocorrência de aborto espontâneo (OR=4,01 (IC=0,85-18,87); p=0,08). Não foi observada associação significativa entre o local de moradia nas proximidades do parque industrial e o desfecho investigado. Além desta análise, este estudo também mostrou dados importantes sobre a saúde reprodutiva dessas mulheres: 51,2% (E) e 40,6% (NE) das mulheres tiveram a primeira gestação entre 12 e 19 anos (n=412); 30,5% possuíam três ou mais filhos (n=393); 13,6% (E) e 8,3% (NE) das mulheres que não menstruavam era devido à menopausa precoce (n=80); 72,7% utilizavam algum método contraceptivo (n=513), sendo 52,3% de pílula e 23,6% de laqueadura (n=373); 56,0% das esterilizações ocorreram entre 19 e 30 anos (n=75); 39,5% nunca realizaram preventivo de câncer uterino (n=565). Quanto à influência da exposição ambiental sobre o desfecho estudado, sugerimos a realização de outros estudos com o uso de biomarcadores, para identificar uma possível influência do ambiente sobre a saúde reprodutiva nessa população ou para afastar definitivamente essa suspeita. Os resultados desse estudo poderão subsidiar novas políticas de saúde, relacionadas com a saúde da mulher neste município. Contribuirão também para uma nova prática assistencial dos profissionais de enfermagem/saúde, onde a questão ambiental seja levada em consideração e priorizada a educação em saúde, sobretudo com relação às questões que se referem aos resultados encontrados. / With the intention of contributing for the knowledge of risks of environmental exposure and the influence of other factors on health, this cross-section study hás been done, with women in fertile age (15-49 years)living in communities close to the industrial district in the city of Rio Grande/RS, being identified the prevalence of spontaneous abortion and the factors related to this result. The sample involved 565 women, all living in the areas considered as exposed(E) and non exposed (NE), according to the distance of the industrial district and the analysis of the map of winds in the city. 285 women of the E area were interviewed as well as 280 from the NE area. For the evaluation of risk factors, a questionnaire was applied, which involved the socioeconomic conditions, environmental factors and housing conditions, the previous reproductive history and sicknesses. In order to analyse the data collected the qui-squared test and thenon-conditioned logistic regression were used. Among the interviewed women who have already given birth (n=412) 17,7% referred occurrence of spontaneous abortion. In the bivaried analysis it was noticed that the result studied showed significative association with the age of the first menstruation, presenting itself as a protection factor (OR=0,26 (IC=0,11- 0,55); p=0,0008) the age of the first menstruation between 11 and 13 years of age. The number of children also presented association with the occurrence of spontaneous abortion, presnting an increase of risk for three or more children (OR=4,00 (IC=1,86-8,58); p=0,001). The history of sexually transmissible disease (STD) also presented a tendency to signification (OR=2,01 (IC=0,97-4,15); p=0,06). After adjusting with the variables of the hierarchized theoretical model, the presence of three or more children (OR=2,94 (IC=1,28-6,77); p=0,009) and the history of STD (OR=2,55 (IC=1,13-5,77); p=0,02) remained significantly associated to the result studied. In this analysis, the fact that the woman does not have canalized water at home showed a tendency of association with the occurrence of spontaneous abortion (OR=4,01 (IC=0,85-18,87); p=0,08). It was not observed a significative association between the place of residence close to the industrial district and the result investigated. Besides this analysis, this study hás also shown important data about the the reproductive health of these women: 51,2% (E) and 40,6% (NE) of the women had their first pregnancy between 12 and 19 years of age (n=412); 30,5% had three or more children (n=393); 13,6% (E) and 8,3% (NE) of the women who did not menstruate was due to the precocious menopause (n=80); 72,7% used some kind of contraceptive method (n=513), being 52,3% the pill and 23,6% the ligature (n=373); 56,0% of the sterilizations took place when they were between 19 and 30 years of age (n=75); 39,5% have never done any preventive exam of uterine cancer(n=565). In terms of the influence of the environmental exposure on the result studied, we suggest that other studeis are done with the usage of biomarkers, in order to identify a possible influence of the environment on the reproductive health of this population or to definitely put away this suspicion. The results of this study may give a subsidy to new policies on health, related to the health of the women in this city. This will also contribute for a new assistance practice of the professionals of nursing / health, where the environmental matter will be taken into consideration and made a priority for the education in health, specially in which it relates to questions referring to the results found. / Con la intención de contribuir al conocimiento de los riesgos de la exposición ambiental y la influencia de otros factores sobre la salud, se realizó este estudio transversal, con mujeres en edad fértil (15-49 años) residentes en las comunidades cercanas al parque industrial de la ciudad de Rio Grande/RS, siendo identificado la prevalencia de abortos espontáneos y los factores relacionados a este desenlace. La muestra comprendió 565 mujeres, residentes en las áreas consideradas expuestas (E) y no expuesta (NE), de acuerdo con la distancia del parque industrial y el análisis del mapa de los vientos de la ciudad. Fueron entrevistadas 285 mujeres del área E y 280 del área NE. Para evaluación de los factores de riesgo, fue aplicado un cuestionario, lo cual contemplaba las condiciones socioeconómicas, factores ambientales y condiciones de vivienda, la historia reproductiva previa y morbilidades. Para análisis de los datos fueron utilizados el test Qui-cuadrado y regresión logística no condicionada. De las mujeres entrevistadas que ya gestaron (n=412) 17,7% refirieron ocurrencia de aborto espontáneo. En el análisis bivariado se verificó que el desenlace estudiado mostró asociación significativa con edad de la menarquia, presentándose como factor de protección (OR=0,26 (IC=0,11-0,55); p=0,0008) la edad de la menarquia entre 11 y 13 años. El número de hijos también mostró asociación con la ocurrencia de aborto espontáneo, presentando un aumento del riesgo para tres o más hijos (OR=4,00 (IC=1,86-8,58); p=0,001). La historia de enfermedad transmisible sexualmente (ETS) también presentó tendencia a la significación (OR=2,01 (IC=0,97-4,15); p=0,06). Después de ajuste con las variables del modelo teórico jerarquizado, la presencia de tres o más hijos (OR=2,94 (IC=1,28-6,77); p=0,009) y la historia de ETS (OR=2,55 (IC1,13-5,77); p=0,02 permanecieron significativamente asociados al desenlace estudiado. En este análisis, el factor de la mujer no poseer agua potable dentro de casa mostró una tendencia de asociación con la ocurrencia de aborto espontáneo (OR=4,01(IC=0,85-18,87); p=0,08). No fue observada asociación significativa entre el lugar de vivienda en las proximidades del parque industrial y el desenlace investigado. Además del análisis, este estudio también mostró datos importantes sobre la salud reproductiva de esas mujeres: 51,2% (E) y 40,6% (NE) de las mujeres tuvieron la primera gestación entre 12 y 19 años (n=412); 30,5% poseían tres o más hijos (n=393); 13,6% (E) y 8,3% (NE) de las mujeres que no menstruaban era debido a la menopausia precoz (n=80); 72,7% utilizaban algún método contraceptivo (n=513), siendo 52,3% de píldora y 23,6% de ligadura (n=373); 56,0% de las esterilizaciones ocurrieron entre 19 y 30 años (n=75);39,5% nunca realizaron preventivo de cáncer uterino (n=565). Con relación a la influencia de la exposición ambiental sobre el desenlace estudiado, sugerimos la realización de otros estudios con uso de biomarcadores, para identificar una posible influencia del ambiente sobre la salud reproductiva en esa población o para alejar definitivamente esa sospecha. Los resultados de ese estudio podrán subsidiar nuevas políticas de salud, relacionadas con la salud de la mujer en esta ciudad. Contribuirán también para una nueva práctica asistencial de los profesionales de enfermería/salud, en la que la cuestión ambiental sea considerada y priorizada la educación en salud, sobretodo con relación a las cuestiones que se refieren a los resultados encontrados.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-01-12T14:06:16Z No. of bitstreams: 1 danielaaparecidaalmeidaduque.pdf: 7167497 bytes, checksum: 5b7bfb55788189e04021e22e65904660 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-02-02T12:04:08Z (GMT) No. of bitstreams: 1 danielaaparecidaalmeidaduque.pdf: 7167497 bytes, checksum: 5b7bfb55788189e04021e22e65904660 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-02-02T12:04:19Z (GMT) No. of bitstreams: 1 danielaaparecidaalmeidaduque.pdf: 7167497 bytes, checksum: 5b7bfb55788189e04021e22e65904660 (MD5) / Made available in DSpace on 2017-02-02T12:04:19Z (GMT). No. of bitstreams: 1 danielaaparecidaalmeidaduque.pdf: 7167497 bytes, checksum: 5b7bfb55788189e04021e22e65904660 (MD5) Previous issue date: 2016-09-28 / O objetivo desta pesquisa consistiu em adaptar uma ficha clínica para a consulta de enfermagem no pré-natal às gestantes de risco habitual na Atenção Primária à Saúde e validá-la como uma tecnologia para a consulta de enfermagem. O nível de concordância adotado para inclusão ou exclusão dos itens foi de 80% entre os especialistas que participaram da avaliação. Tratou-se de uma pesquisa metodológica com emprego da Técnica Delphi para validar o instrumento. A coleta de dados ocorreu por meio de amostragem não probabilística por julgamento. Os critérios de inclusão para participar da pesquisa consistiram em ser enfermeiro (a) docente e especialista em enfermagem obstétrica, grau acadêmico de Doutor, atuando em universidades públicas do país, de forma que se obteve representantes de todas as regiões, como requisito para validar o instrumento e garantir construtos compatíveis com as variâncias regionais. Foram considerados participantes os(as) enfermeiros(as) especialistas com, no mínimo, 02 anos de ensino na área de saúde da mulher, identificados através do currículo na plataforma Lattes e por meio da técnica de bola de neve (snowball). A construção da ficha clínica ocorreu após revisão minuciosa de literatura e da observação dos instrumentos recomendados pelo Centro Latino-Americano de Perinatologia Saúde da Mulher e Reprodutiva da Organização Pan Americana da Saúde/Organização Mundial da Saúde e Ministério da Saúde do Brasil. Dessa forma, estabeleceram-se as informações relevantes e definiu-se os conteúdos que passaram pelo processo de validação. A avaliação dos indicadores empíricos pelos especialistas ocorreu através de uma plataforma construída nos formulários do Google Docs, via internet. O instrumento foi submetido à validação de forma e conteúdo pelos especialistas que analisaram o grau de relevância de cada item do instrumento considerando os conceitos de clareza e pertinência/ representatividade. O painel 1 e 2 ocorreu entre os meses de fevereiro e junho de 2016. A amostra final do primeiro painel foi constituída por 18 professores doutores, porém 3 foram excluídos por não se enquadrar nos critérios de inclusão, finalizando o primeiro painel com 15 juízes. No segundo painel participaram 13 docentes dos 15 anteriores. Os dados foram tabulados com o auxílio do programa Microsoft Excel e analisados quantitativamente por meio do coeficiente de validade de conteúdo. A inclusão dos itens respeitou o cálculo do Coeficiente de Validação de Conteúdo adotado de 80% de concordância entre os especialistas e a sugestão de cada professor que, ao discordar ou solicitar a inclusão de um item, subsidiaram a sistematização do segundo painel que originou a ficha final validada. A validação da maioria dos constructos foi alcançada no primeiro painel enquanto no segundo foi realizada a validação dos itens que não atingiram o índice de 80 % na primeira fase ou que receberam sugestões para ser aprimorado na ficha clínica. Os itens que compuseram o segundo painel e as sugestões contribuíram para o delineamento das informações imprescindíveis no contexto do pré-natal e nascimento, como forma de qualificar e humanizar a assistência, além de ter potencial para reduzir a morbimortalidade materna e neonatal através de uma tecnologia proposta por enfermeiras passível de ser utilizada por outras categorias profissionais. / The objective of this research was to adapt a medical record for nursing appointments during the regular-risk prenatal according to the Primary Healthcare and validate it as a technology for nursing appointments. The agreement level chosen for the inclusion or exclusion of the items was 80% between the experts that have participated of the study. It was a methodological research that has applied the Delphi Technique to validate the instrument. The data collection occurred through Judgmental Sampling. According to the inclusion criteria adopted, the participant of the study should be a nurse specialized in obstetrical nursing. Moreover, this specialist should be PHD who teaches in a Brazilian public university. Therefore, it was attained representatives of all regions of the country in order to validate the instrument and assure that the results would be compatible with the regional diversities. It was considered as participants the nurses with an experience of at least 02 years teaching about women healthcare. These participants were identified by their resume at the Lattes platform using the Snowball technique. The assembling of the medical record followed the rigorous review of the literature and the observation of the instruments recommended by the Latin American Center of Perinatology Women’s Health and Reproductive of the Pan American Health Organization / World’s Health Organization and Brazilian Health Ministry. As a result, the relevant information were stablished and the content that have passed by the validation process were defined. The specialists’ evaluation of the empirical indicators occurred by a platform assembled using the Google Forms, through the Internet. The specialists subjected the instrument to a form and content validation. These experts also analyzed the relevance degree of each item of the instrument; it was considered the concept, clarity and applicability/representability of the instrument. The scenery 1 and 2 of the research took place during the months of February and June of 2016. The final sample of the first scenery was composed by 18 PHD professors. However, 3 were excluded once they did not fit on the inclusion criteria. Then, the first scenery was finalized with 15 judges. Subsequently, the second scenery were attended by 13 of the 15 previous specialists. The data were tabbed using the software Microsoft Excel then; they were analyzed quantitatively by means of the Content Validity Coefficient. The inclusion of the items has respected the calculation of the Coefficient Content Validation, which has considered 80% of agreement between the experts. Furthermore, it also pondered the specialists’ suggestions, that disagreeing or requesting the inclusion of other items, assisted the systematization of the second scenery, resulting in the final validated medical record. The validation outcomes’ majority were reached at the first scenery. At the second scenery, it was performed the validation of the items which have not reached the index of 80% at the first scenery or the items that have received suggestions to be improved on the medical record. Finally, the suggestions and the items that have composed the second scenery have contributed to the delimitation of the essential information regarding the prenatal and birth context. These items contribution acts improving the quality and humanizing the nursing care. Moreover, they have the potential to reduce the neonatal and maternal morbimortality through a technology proposed by nurses that can be used by other professional categories.

Philosophiae Doctor - PhD / Background:The Project reported on in this thesis took place between 2003 and 2006 and focused on the problem of high rates of low birth weight in the West Coast /Winelands area of the Western Cape Province, South Africa. A 32 page woman’s health handbook (WHH) was developed and field-tested using a participatory action research approach. The purpose of the WHH was to provide a health promotion tool that would increase the likelihood of satisfactory birth outcomes in future by: improving the continuity of care for women, especially in pregnancy; improving the interaction between health service providers and women during health consultations; and enabling women to improve their broader health literacy.Methods:The Project used both qualitative and quantitative methods and was carried out in three phases following steps in strategic communication development: situational and audience analysis; strategic design and development; and,field testing. The process involved three levels of stakeholders, or audiences: primary (women working on farms); secondary (local health service providers); tertiary (regional and provincial health department officials).Phase I began with a situational analysis of the two research sites in 2003 - Vredendal and Stellenbosch areas. Data was collected through key informant interviews, secondary data and general observations. The information on the two sub-districts was summarised. In order to understand the lifestyle and contextual issues facing the primary audience focus group discussions and key informant interviews with all three levels of the audience were carried out in 2004. The analysis utilised an inductive approach to generate themes that integrated the information from all sources and a framework for understanding substance use was developed. Ideas for the format and contents of the WHH were collected utilising the same methods and were summarised into categories.Phase II utilised the findings of Phase I to develop the first version of the WHH. This was pre-tested with all levels of the audience in individual interviews or focus groups to assess its accessibility, contents and appropriateness. The findings were used to prepare the second version of the WHH for Phase III.In Phase III the second version of the WHH was tested by recruiting a cohort of 103 participants who were utilising the antenatal clinic services in the two sites in 2005. A pre- and post-intervention questionnaire was used to collect qualitative and quantitative data to characterise the participants and, assess if the WHH that was given to them to keep had influenced their health knowledge and substance use behaviour. Analysis included simple frequencies, and a comparison of key outcome measures from the pre- and post-intervention questionnaires. Secondary level audience representatives were also interviewed, and content analysis carried out to identify theirperceptions of the WHH and any potential barriers to its future use in the clinics. A final version of the WHH was developed and 10 000 copies made available through a resource centre. The dissemination of a batch of the final version was followed up in 2006.Results:The first phase identified the extent to which environmental and health-related behaviour contributed to low birth weight, as well as, other negative consequences in the lives of the primary audience. Important factors noted included the resource poor and stressful environment in which farm-based women live and work, and the high rates of women smoking cigarettes and drinking alcohol in general, and through pregnancy.A first version of the WHH was developed and pre-tested in the second phase by applying principles of designing health education materials for audiences with mid to low literacy levels. Results from this stage led to the development of the second version of the WHH.Although the evaluation of the second version of the WHH did not show any significant change in the health knowledge of the participants on the pre- and post-test analysis, there was a reduction in the use of alcohol, and very positive feedback on utilisation issues from all audiences. There was widespread dissemination of the final version of the WHH, however, neither the provincial nor the regional health authorities had incorporated it into their annual health promotion plan or budget.Conclusion:The participatory action research approach in the development of the WHH ensured that the form and contents was appropriate for most of the primary audience and that the secondary and tertiary audiences were supportive of its potential to positively women’s health in the region in the future. The main factors that limited the impact of the WHH include the need for the health service providers to consistently practice interactive health consultations using the WHH, and the need for the reproduction and dissemination of the WHH to be led by the provincial health department.It is recommended that brief training of health service workers is required in order to ensure that the final version of the WHH is utilised to its full potential and, that the provincial and regional health authorities devise a reproduction and dissemination plan to ensure that all women using the public health services receive their own copy of the WHH.

The following study is a phenomenological inquiry into five white, middle classwomen's experiences living with HIV and AIDS in British Columbia. The purpose, rather than describing AIDS as a medical phenomenon, is to document how being diagnosed HIV positive has affected the women's lives, health, relationships and livelihoods. A context for the women's stories is provided through a critical review of the biomedical model, as well as biomedical and community organizing perspectives on women and AIDS. Mostly verbatim accounts drawn from taped interviews conducted with the five women describes their lives with HIV and AIDS. Experiences surrounding their diagnosis, sources of information about their illness, strategies for coping, management of health, and management of personal and social identities are the themes explored. The women's participation, the role of the researcher, and the work produced are considered parts of an interactive process, demonstrating shared authority between the researcher and participants in the ethnographic process. Documentation of the women's experiences leads to a discussion of the ways in which they successfully manage and control their own health care and well being within the context of larger social forces of sexism, medical bias and stigma. The women are given the last word in the study. In conclusion, a review oftheir situations three years after their initial interviews contributes a significant emotional and descriptive time-depth to the study. / Arts, Faculty of / Sociology, Department of / Graduate

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-01-06T11:35:43Z No. of bitstreams: 1 jorgeluistavaresdeoliveira.pdf: 1915583 bytes, checksum: 1dd0c5e4947234b8435ef2baf3097ca7 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-01-25T16:09:58Z (GMT) No. of bitstreams: 1 jorgeluistavaresdeoliveira.pdf: 1915583 bytes, checksum: 1dd0c5e4947234b8435ef2baf3097ca7 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-01-25T16:10:44Z (GMT) No. of bitstreams: 1 jorgeluistavaresdeoliveira.pdf: 1915583 bytes, checksum: 1dd0c5e4947234b8435ef2baf3097ca7 (MD5) / Made available in DSpace on 2016-01-25T16:10:44Z (GMT). No. of bitstreams: 1 jorgeluistavaresdeoliveira.pdf: 1915583 bytes, checksum: 1dd0c5e4947234b8435ef2baf3097ca7 (MD5) Previous issue date: 2015-06-26 / Trata-se de uma investigação de natureza qualitativa do tipo exploratória e descritiva, cujo objeto consiste nas intervenções de enfermeiros na atenção primária à saúde para prevenção do câncer de colo de útero, embasado no Modelo de Promoção de Saúde de Nola Pender. Os objetivos da pesquisa são: identificar as intervenções realizadas pelos enfermeiros na prevenção do câncer de colo de útero na atenção primária à saúde; classificar as intervenções em comportamentais, cognitivas e sociais e analisar as intervenções realizadas pelos enfermeiros na atenção primária à saúde que podem proporcionar mudanças de comportamentos, hábitos e estilos de vida na prevenção do câncer de colo de útero e promoção da saúde. O cenário da pesquisa foram duas unidades de atenção primária à saúde, em um município da Zona da Mata Mineira. As participantes foram dezoito mulheres cadastradas e assistidas na estratégia da saúde da família das unidades de atenção primária à saúde que estavam na faixa etária de 25 a 64 anos e que foram atendidas por enfermeiros para prevenção do câncer de colo de útero. Os dados foram obtidos por meio de entrevista estruturada com aplicação de um questionário contendo questões fechadas e abertas. Foram gravadas em gravador digital e transcritas na íntegra para posterior análise das informações. Foram atendidas todas as exigências da Resolução 466/2012, do Conselho Nacional de Saúde. O processo de análise foi baseado nos pressupostos do diagrama do Modelo de Promoção da Saúde de Nola Pender. Os dados foram organizados em quatro categorias apriorísticas: Características (Comportamento Anterior e Fatores Pessoais); Comportamento Específico (Benefícios, Barreiras, Percepções e Influências); Resultado do Comportamento e Experiências Individuais e a Enfermagem na Prevenção do câncer de colo de útero: Intervenções Comportamentais, Cognitivas e Sociais. Foi possível identificar que o Modelo de Promoção da Saúde de Nola Pender é capaz de iluminar a relação entre as dificuldades, facilidades e as percepções das mulheres para a prevenção do câncer de colo de útero, assim como, apontar e reforçar as ações do enfermeiro no rastreamento do câncer de colo de útero e promoção da saúde da mulher. / This is a qualitative exploratory and descriptive research focusing nursing interventions in primary health care for cervical cancer prevention based on health promotion model proposed by Nola Pender. The aims of the research are: identify nursing interventions to prevent cervical cancer in primary health care; classify interventions in behavioral, cognitive and social levels and analyze the interventions performed by nurses in primary health care especially those that may lead to changes in behaviors, habits and lifestyles in health promotion and prevention regarding cervical cancer. Research setting was two primary health care units in a city of Zona da Mata Mineira. The participants were eighteen women enrolled and assisted in family health strategy performed at primary health care units. These women were aged 25-64 years and they were assisted by nurses focusing cervical cancer prevention. Data were collected through structured interviews with a questionnaire with open and closed questions. These interviews were recorded with digital recorder and transcribed for further analysis. All requirements of the Resolution 466/2012 from National Health Council have been met. The analysis process was based on the assumptions from the diagram of Health Promotion Model by Nola Pender. Data were organized into four a priori categories: Characteristics (Previous Behavior and Personal Factors); Specific behavior (Benefits, Barriers, Perceptions and Influences); Result of the Behavior and Individual Experiences and Nursing in the Prevention of cervical cancer: Behavioral, Cognitive and Social Interventions. It was possible to identify that Nola Pender's Health Promotion Model may clarify the relationship between difficulties, facilities and women perceptions for cervical cancer prevention. It may also indicate and enhance nursing actions in cervical cancer screening and health promotion among women.

Introduction: Women exposed to intimate partner violence is common and a major healthproblem globally. It is considered one of the biggest causes of illness in women, which can beof a physical, mental or psychosomatic nature. Identifying these women in health care istherefore of the utmost importance in order to be able to implement health-promotingmeasures from a person-centered perspective. Aim: The aim was to describe women's experiences of living with intimate partner violence. Method: A literature review based on 18 qualitative original articles from 2016-2021 viaPubMed and CINAHL that have been quality reviewed and analyzed with qualitative contentanalysis. Findings: After analysis, three themes were identified: Living under threat, Scarred for lifeand Sense of hope and six subcategories: Fear, Isolation, Physical illness, Mental illness,Hope for change and Hopelessness. Conclusion: Intimate partner violence occurs all over the world. The women feel threatened,which leads to fear and isolation from the outside world. Some have feelings of hope forchange, while others experience hopelessness. The injuries that occur as a result of violenceare not always visible, many women live with mental and psychosomatic disorders. / Introduktion: Kvinnor som utsätts för våld i nära relationer är vanligt förekommande och ettstort hälsoproblem globalt. Det räknas som en av de största orsakerna till ohälsa hos kvinnoroch kan vara av fysisk, psykisk eller psykosomatisk karaktär. Det är av största vikt attidentifiera dessa kvinnor i hälso- och sjukvården för att kunna sätta in hälsofrämjandeåtgärder ur ett personcentrerat perspektiv. Syfte: Syftet var att beskriva kvinnors upplevelser av att leva i en våldsnära relation.Metod: En litteraturstudie baserad på 18 kvalitativa originalartiklar från 2016-2021 viaPubMed och CINAHL som kvalitetsgranskats och analyserats med kvalitativ innehållsanalys. Resultat: Efter analys identifierades tre teman: Att leva under hot, Men för livet och Känslaav hopp samt sex underkategorier: Rädsla, Isolering, Fysisk ohälsa, Psykisk ohälsa, Hopp omförändring och Hopplöshet. Slutsats: Våld i nära relationer förekommer över hela världen där kvinnorna upplever sighotade, vilket leder till rädsla och isolering från omvärlden. Vissa har känslor av hopp omförändring, medan andra upplever hopplöshet. De skador som uppkommer till följd av våldetär inte alltid synliga, utan många kvinnor lever även med psykiska och psykosomatiskabesvär.

Purpose: To describe the experience of managing relapsing-remitting multiple sclerosis among adult women users of injectable disease modifying drugs, including day-to-day management, medication beliefs, and health care provider influence. Rationale/Significance of the study:Approximately 85% of the 400,000 Americans with multiple sclerosis have relapsing-remitting multiple sclerosis (RRMS), characterized by unpredictable relapses and partial or full remissions of neurological symptoms. Untreated, RRMS may progress to permanent, irreversible disability and decreased quality of life. Current guidelines recommend immediate and sustained treatment with injectable disease modifying drugs (DMDs). However, despite pronounced modest benefits, approximately 30%-62% of patients are not undergoing DMD therapy. A small number of quantitative studies have identified factors that predict adherence to injectable DMDs. However, little is known about injectable DMDs from patients’ perspectives. It is important to develop an understanding of the experience of managing RRMS among adult users of injectable DMDs in order for health care providers to provide ongoing education, counseling, and support. Organizing Framework:The framework, Beliefs About Medicines, was used to guide the study. Design: Qualitative descriptive design. Setting: Data were collected from adult women with RRMS who received care from an MS clinic, a neurology practice, and through snowball sampling. Sample: Purposive and theoretical sampling was used to recruit 32 women with RRMS. Maximum variation sampling ensured the appropriate breadth and depth of experiences. Women currently undergoing injectable DMD therapy (n = 25), as well as women who either discontinued (n = 6), or never used (n = 1) injectable DMDs were interviewed. Methods: A qualitative descriptive design was utilized. Verification occurred through trustworthiness of data, including rich, thick description from qualitative interviews; field notes and memoing; and member checks. Simultaneous data collection, analysis, and interpretation facilitated interview revision in order to elicit or expand emerging themes. Content analysis inductively derived themes and patterns within and across categories. Participant quotes substantiated particular themes. Confirmability of the data analysis process was undertaken in consultation with the research advisor. Implications: Findings elucidated adult women’s subjective experiences concerning management of RRMS among users of DMDs, including day-to-day management, medication beliefs, and health care provider influence. Results from this study can be used to educate, counsel, and support women in the management of RRMS.

Bakgrund: Förlossningsskador kan leda till fysiska och psykiska besvär. Det finns brister och stora variationer i förlossningsvården i Sverige. Det saknas evidensbaserade riktlinjer för fysioterapi inom området och vilka insatser som har effekt är inte helt klarlagt. Kvinnornas egna upplevelser och erfarenheter spelar stor roll i arbetet för att fylla de kunskapsluckor som finns idag.  Syfte: Syftet med studien var att undersöka fem kvinnors personliga upplevelser och erfarenheter av fysioterapeutiska åtgärder efter att de drabbats av förlossningsskador grad 3–4 och på så sätt öka förståelsen för fysioterapeutiska åtgärder hos fysioterapeuter inom detta område.  Metod: Studien hade en kvalitativ deskriptiv design. Deltagarna var fem kvinnor som drabbats av förlossningsskador av grad 3–4. Rekryteringen skedde via Facebook-gruppen ”Allt om förlossningsskador”. Semistrukturerade intervjuer genomfördes och intervjumaterialet bearbetades genom en kvalitativ innehållsanalys. Resultat: Analysen resulterade i fyra kategorier: Minskad funktion i det vardagliga livet, Brister inom förlossningsvården, Upplevelser av fysioterapeutiska åtgärder och Informanternas förslag till förbättring inom kvinnohälsa samt tio subkategorier.   Konklusion: Studien visade att kvinnorna upplevde att det saknas kunskap och kompetens gällande fysioterapi vid förlossningsskador. Resultatet tyder på att de viktigaste faktorerna i mötet med dessa kvinnor är utförligt information, tydliga instruktioner och bra bemötande av patienten. Behovet av vidare forskning och nya riktlinjer gällande fysioterapi vid förlossningsskador är stort och den fysioterapeutiska grundutbildningen bör inkludera en mer omfattande del om kvinnohälsa. / Background: Women with perineal tears after childbirth often suffer from physical and psychological issues. There are some varieties and deficiencies in the Swedish health care system of maternity care, and there is an absence of evidence-based guidelines in the physiotherapeutic field of maternity care. The women’s perspectives play a major role to fill the gaps of knowledge that exist today.  Purpose: The purpose of this study was to investigate views and experiences of physiotherapy from women with third- and fourth-degree perineal tears to establish a higher knowledge for physiotherapeutic methods.   Method: The study was a semi-structured qualitative interview study that included five women with third- and fourth-degree perineal tears. The participants were recruited through the Facebook group “Allt om förlossningsskador”. Analyzing of the interview material was done through a qualitative content analysis.  Results: The analysis resulted in four categories: Reduced function in everyday life, Deficiencies in maternity care, Experiences of physiotherapeutic measures and The informants’ proposals for improvement in women’s health with ten subcategories.  Conclusion: The study showed that the women felt that there is a lack of knowledge and competence regarding physiotherapy after perineal tears. The results indicate that the most important factors in the meeting with these women are detailed information, clear instructions and good treatment of the patient. Further research and new guidelines regarding physiotherapy for women with perineal tears is needed and the physiotherapeutic education should involve more about women health and rehabilitation of pelvic floor injuries.

Bakgrund Våld i nära relationer utgör ett stort globalt problem för individer men även samhället i stort. Kvinnor drabbas av våld i nära relationer i mycket större utsträckning än vad män gör. De som är utsatta för våld i nära relationer kan drabbas av både fysisk och psykisk ohälsa och våldet har även en negativ påverkan på andra faktorer i det vardagliga livet. Begreppet våld som används i den här studien inkluderar fysiskt, psykiskt och sexuellt våld. Syfte Syftet med studien var att beskriva hur kvinnors hälsa påverkas av våld i nära relationer. Metod En icke-systematisk litteraturöversikt utfördes baserat på sammanlagt 21 vetenskapliga artiklar. Artiklarna hämtades från databaserna PubMed och Cinahl och i databaserna gjordes sökningar med hjälp av relevanta Mesh-termer samt Subject Headings. De inkluderade artiklarna är primära källor som var högst tio år gamla och som kvalitetsgranskats till hög och medelkvalitet. Med hjälp av de inkluderade artiklarna sammanställdes det två huvudkategorier till resultatet: fysisk hälsa och psykisk hälsa. Resultat Litteraturöversiktens resultat presenterades i form av två huvudkategorier. Den första huvudkategorien var fysisk hälsa med underkategorierna fysiska besvär, långvariga hälsokonsekvenser och missbruk. Den andra huvudkategorien var psykisk hälsa med underkategorierna ångest, depression och PTSD, självskadebeteende, suicid och suicidförsök, samt slutligen psykosocialt välmående. Våld i nära relationer bidrog till att kvinnor drabbades av fysisk och psykisk ohälsa samt att livskvaliteten försämrades. Kvinnor som varit utsatta för våld i nära relationer hade sämre hälsa än kvinnor som aldrig upplevt våld i nära relationer. Våld i nära relationer kunde leda till långvariga fysiska och psykiska hälsokonsekvenser. Att uppleva en kombination av olika typer av våld samtidigt ledde till en större negativ hälsopåverkan jämfört med att endast uppleva en typ av våld. Slutsats Våld i nära relationer påverkade kvinnors hälsa negativt och våldsutsatta kvinnor hade generellt sämre hälsa än icke-våldsutsatta kvinnor. Alla typer av våld bidrog till en försämring av kvinnors hälsa. Resultatet tyder på att våldsutsatta kvinnor i stor utsträckning drabbas av både fysiska och psykiska besvär till följd av våldet och att även deras livskvalitet försämras. Den negativa hälsopåverkan som våldet för med sig i form av både fysiska och psykiska hälsobesvär kan bestå lång tid efter att en relation har upphört, alternativt plåga kvinnan resten av livet. / Background  Intimate partner violence is a major global problem for individuals but also for society at large. Women are affected by violence in close relationships to a much greater extent than men. Those who are exposed to intimate partner violence can suffer from both physical and mental illness and the violence also has a negative impact on other factors in everyday life. The term violence used in this study includes physical, psychological and sexual violence. Aim  The aim of the study was to describe how women's health is affected by intimate partner violence. Method A non- systematic literature review was performed based on a total of 21 scientific articles. The articles were retrieved from the databases PubMed and Cinahl. Searches were made on the databases using relevant Mesh terms and Subject Headings. The included articles are primary sources that were a maximum of ten years old, and they had been quality reviewed to high and medium quality. Using the included articles two categories were compiled for the results: physical health and psychological health. Results  The results of the literature review were presented in the form of two main categories. The first main category was physical health with the subcategories physical ailments, long-term health consequences and addiction. The second main category was mental health with the subcategories anxiety, depression and PTSD, self harm, suicide and suicide attempts and lastly psychosocial well-being. Intimate partner violence contributed to women suffering from physical and mental illness and the quality of life deteriorating. Women who were exposed to intimate partner violence had poorer health than women who never experienced violence in close relationships. Intimate partner violence could lead to long-term physical and mental health consequences. Experiencing a combination of different types of violence at the same time led to a greater negative health impact compared to only experiencing one type of violence. Conclusions  Intimate partner violence had a negative effect on women’s health, and abused women generally had poorer health than non-abused women. All types of violence contributed to the deterioration of women’s health. The results indicate that women who were exposed to violence to a large extent suffer from both physical and mental health problems as a result of the violence and that their quality of life also deteriorates. The negative health impact that violence leads to in the form of both physical and mental ailments can persist long after a relationship has ended, or alternatively torment the woman for the rest of her life.

Bakgrund: Cirka en av tio kvinnor har sjukdomen endometrios. Endometrios innebär att livmoderslemhinna börjat växa på andra platser än i livmodern, detta skapar en kronisk inflammation som ofta orsakar buksmärta. Smärta hos kvinnor normaliseras ofta inom vården vilket leder till att diagnos av endometrios tar åratal att fastställa. Syfte: Syftet var att beskriva hur kvinnor med endometrios upplever bemötandet i vården. Metod: Som metod valdes en litteraturöversikt där resultatet baserades på tio kvalitativa vetenskapliga artiklar som hämtades från databaserna PubMed och Cinahl Complete samt från en manuell sökning. Resultat: Tre huvudteman identifierades: Att behöva kämpa för sin vård, Lång väntan på diagnos och Att tvivla på sjukvården. Sammanfattning: Kvinnor med kronisk smärta blir inte tagna på allvar inom vården. Smärta normaliseras både i samhället och i vården, kvinnorna med endometrios tvingas gång på gång söka sjukvård då ingen tar dem på allvar. Kvinnorna upplever överlag negativt bemötande inom vården och att de behöver kämpa för att bli lyssnade till och få den vård de desperat behöver. / Background: One of ten women suffer from endometriosis. Endometriosis is a condition where the lining of the womb starts to grow outside the uterus, thus creating a cronic inflammation that leads to severe abdominal pain. Womens pain is often normalized in healthcare which leads to years of struggle before she finally get the diagnosis. Aim: The aim was to decribe how women with endometriosis experience the personal treatment in healthcare. Method: A literature study was chosen where the result is based on ten qualitative scientific articles that were found in the databases: PubMed and Cinahl Complete, along with a manual search. Results: Three main findings were identified: The need to fight for healthcare, Long wait for diagnosis and To question the healthcare. Summary: Women with cronic pain are not being taken serious by healthcare. Pain is being normalized in our society but also in healthcare. The women with endometriosis are forced to repeatedly search for help, but without being heard. The women experience mainly negative personal treatment in healthcare and the need to fight to make someone listen to finally get the help they desperately need.