Experiência da gravidez após os 35 anos de mulheres com baixa renda

Objetivou-se apreender as representações sociais sobre gravidez após os 35 anos a partir de mulheres com baixa renda que vivenciaram essa experiência. A abordagem qualitativa foi empregada com base na Teoria das Representações Sociais. Foram realizadas entrevistas semiestruturadas com 25 gestantes usuárias de um serviço público de referência do interior paulista. Os dados foram sistematizados pela técnica do Discurso do Sujeito Coletivo. Verificou-se que a opção pela gravidez tardia se atrela ao desejo da mulher de consolidar suas relações em novas uniões conjugais, à estabilidade financeira e à maturidade do casal. As mulheres representam esta experiência como positiva, se houver planejamento prévio, envolvimento do companheiro e se for bem aceita pela família, após sua constatação. Sem a satisfação destas condições, as representações revestem-se de sentimentos negativos ligados a dor, sofrimento e morte. As conclusões deste estudo enfatizam a importância de os serviços públicos de saúde considerarem estes aspectos.

Associação da catastrofização da dor com a incidência e a intensidade da dor perineal aguda e persistente após parto normal: estudo longitudinal tipo coorte

BACKGROUND AND OBJECTIVES: Vaginal birth delivery may result in acute and persistent perineal pain postpartum. This study evaluated the association between catastrophizing, a phenomenon of poor psychological adjustment to pain leading the individual to magnify the painful experience making it more intense, and the incidence and severity of perineal pain and its relationship to perineal trauma. METHOD: Cohort study conducted with pregnant women in labor. We used the pain catastrophizing scale during hospitalization and assessed the degree of perineal lesion and pain severity in the first 24 hours and after 8 weeks of delivery using a numerical pain scale. RESULTS: We evaluated 55 women, with acute pain reported by 69.1%, moderate/severe pain by 36.3%, and persistent pain by 14.5%. Catastrophizing mean score was 2.15 ± 1.24. Catastrophizing patients showed a 2.90 relative risk (RR) for perineal pain (95% CI: 1.08-7.75) and RR: 1.31 for developing persistent perineal pain (95% CI: 1.05-1.64). They also showed a RR: 2.2 for developing acute and severe perineal pain (95% CI: 1.11-4.33). CONCLUSIONS: The incidence of acute and persistent perineal pain after vaginal delivery is high. Catastrophizing pregnant women are at increased risk for developing acute and persistent perineal pain, as well as severe pain. Perineal trauma increased the risk of persistent perineal pain.

Validez y confiabilidad de la versión en español de la escala multidimensional de la UNESP-Botucatu para evaluar el dolor postoperatorio en gatos

This study focused on the validation of the Spanish version of the UNESP-Botucatu multidimensional composite pain scale to assess postoperative pain in cats. The original scale in Portuguese was translated into Spanish by two independent translators, and summarised in one version by a third individual. The summarised version was back-translated and minor adjustments were made. The scale was reviewed by three anesthesiologists with Spanish as their first language, and the final version was submitted to psychometric testing. Thirty cats undergoing ovariohysterectomy were video recorded during the perioperative period. Six observers from different spanish speaking countries, who had Spanish as the first language watched the videos and determined the pain scores using the Spanish version of the scale, identifying the cats that should receive analgesics. Videos were reanalysed in a different order about 2 months after the first assessment. The sensitivity to change, content and construct validity were established by the significant change in pain scores in response to surgery and analgesics. The agreement between the evaluations of the 'gold standard'(researcher that developed the scale) and the other observers confirmed the criterion validity. Inter- and intra-rater reliability, evaluated by intra-class correlation coefficient, ranged from good to very good for all scale items. The cut-off point for rescue analgesia identified by Receiver Operating Characteristic curve was > 7 with 92% of sensitivity and 91% of specificity. The Spanish version of the UNESP-Botucatu multidimensional composite pain scale is interpretable (has an optimal analgesic intervention score), valid and reliable instrument for assessing acute pain in cats undergoing ovariohysterectomy.