Maternidade e sindrome do down: Um estudo sobre o sentimento vinculado frente ao diagnóstico

Trata-se de um estudo de delineamento transversal de caráter multidisciplinar, o qual conta com um estatístico que contribuiu para o delineamento do estudo, realizando o cálculo amostral e contribuindo efetivamente para análise dos dados e alunos de psicologia e pediatrias que contribuíram para a coleta de dados. A literatura aponta que a transmissão inadequada do diagnóstico da Síndrome de Down pode prejudicar o vínculo mãe-bebê e o posterior desenvolvimento da criança. Sendo assim, este estudo objetivou analisar os sentimentos maternos frente a este diagnóstico, verificando diferentes formas de transmissão e possíveis facilitadores da aceitação da Síndrome. A amostra foi constituída por 20 mães cujos filhos apresentam Síndrome de Down, na faixa etária de 0 à 03 anos e que recebem atendimento em ambulatório de um Hospital Universitário de Pediatria. Para coleta dos dados fez-se uso de um questionário, após a assinatura do Termo de Consentimento Livre e Esclarecido. Os dados foram analisados através de dois softwares de processamento de dados, o SPSS e o ALCESTE (Análise Lexical por Contexto de um Conjunto de Segmento de Texto). Os dados indicaram que 90% das mães receberam o diagnóstico de Síndrome de Down depois do parto. 75% dos diagnósticos foram comunicados pelo médico pediatra e 15% pelas enfermeiras. As mãe referiram que o diagnóstico foi tardio, inadequado e insuficiente no informativo. Observouse que as entrevistadas viveram os mesmos sentimentos observados na literatura como: choque, negação, tristeza e ira, adaptação e reorganização. Tais resultados permitem concluir que o diagnóstico de SD nas mães investigadas foi em sua maioria tardio, realidade comum no Brasil, principalmente quando se trata de classes econômicas baixas. As mães apontam que percebem este diagnóstico como tardio, inadequado e insuficiente no informativo, e gera sentimentos que a literatura já cita como comuns frente a esse tipo de diagnóstico. Portanto, observamos que a notícia pode ser um fator que dificulte ou facilite o estabelecimento do vínculo mãe-bebê, comprometendo a busca de recursos para o desenvolvimento da criança

Maternidade na adolescência: significados e repercussões

From evidence of an existing divergence of opinion among professionals and adolescents using the prenatal and delivery services at a Public Health Unit, aimed to study meanings and consequences of adolescent motherhood among 26 adolescent mothers living in Felipe Camarão, low income district of Natal, capital do Estado do Rio Grande do Norte. Living in a peripheral neighbourhood with a high rate of adolescent mothers in relation to the total new-born, those girls, with offspring among 8 and 12 months age, during interview and focus groups, expressed a different appreciation of their experience than the hegemonic idea among professionals that considers pregnancy and motherhood as unwanted or undesired. With age among 15 and 20 years old, having 53,8% initiated sexual activity before being 15 years old, revealed that the pregnancy was desired in 73,1% of cases, but showing at the same time a social context marked by strong gender oppression and lack of opportunities as consequence of social class deprivation. Life projects, almost always limited to the constitution of a traditional nuclear family, with a purveyor father and care giver mother, appears with very limited possibilities: 46,2% already lived with her partner before becoming pregnant and for 50% of the participants, the birth of the child did not provoke changes in plans and projects. Lack of economical recourses and precarious public services available, together with an idealized maternity role seems to produce extra apprehension among those girls, resulting in frustration and disillusion. As a fact, 92,3% of those adolescents would recommend other adolescent to postpone the maternity project

Lócus de controle e conceito de maternidade e paternidade em adolescentes

Locus of control is a construct that seeks to explain people's perceptions about the source of control of events, if the subject's own - internal - or belonging to some element outside of oneself - external. The location of individual s locus of control will suffer influence of their developmental period. During adolescence, individuals turn to the construction of their identity, and the structuring of sexual identity is a relevant part of this process, since the roles of males and females are the most important from the socio-cultural point of view. One of the roles that adolescents can take is the mother or father. We chose to head the adolescents who are not mothers and fathers, and question them about their concepts of parenthood. It is hypothesized that adolescents with internal locus of control will probably develop concepts of maternity and paternity in which they attach to themselves the responsibility for children. The aim of this study was to relate the locus of control s predominant dimension in adolescence and the way that these young people conceptualize parenthood. This is an exploratory analytical cross-sectional study accomplished with 400 adolescents from the classes of the sixth to ninth grade of high school at public schools in Natal / RN. We used as protocols: structured questionnaire involving sociodemographic questions and questions about the concept of parenthood, and the Multifactorial Scale of Locus of Control. Data were analyzed using descriptive and inferential statistics, with the aid of statistical package SPSS 18.0. The results regarding questions about the concept of maternity and paternity were analyzed using the analysis program often ALCESTE 4.7. The results showed that for boys and girls, maternity and paternity were characterized by the acquisition and assumption of responsibilities of adulthood. This concept is supported by the locus of control s classification of individuals, since most of the subjects of this study was characterized as individuals who tend to take responsibility for their life's events. For young people from lower classes (as the subjects of this research), the project of autonomy and social mobility is realized by the constitution of his own family and the ability to sustain it

A humanização no parto e no nascimento: os saberes e as práticas no contexto de uma maternidade pública brasileira

The practice of medicine related to the gestational processes tend to be organized according to the context and the place of work, being thus dependent of the conditions both social and economical, and of the physical structure and the functionality of the services. The high mortality rate in this process has diminished, since 1986, the study made by the World Health Organization (WHO) as to the technical aspects and the social inequalities that influence this situation in different geographical contexts. This culminated recommendations that proposed the reorientation of the dynamical practice of medicine, with a focus on the safety of maternities. Brazil adopted, in the year 2000, the suggestions of the OMS, emphasizing the humanization as the main reason for these actions. However, this discussion tends to not consider the problems caused by the social inequalities and the epidemiological and social conditionings that define the actions of the Unified Health System (Sistema Único de Saúde SUS). In this area, this research seeks to analyze the practices, cares taken, and the universal symbol that promotes and rewards the assistance to the birth of children by the SUS. Besides the analysis of the public documents that deal with this subject, an ethnographic study was developed in a maternity in Natal/RN, considered a model of humanization after receiving the Galba de Araújo prize in 2002. In this stage, the methodological strategies were observed, and the focus of the individual interviews with workers and users of this service. In the analysis of the data, it became evident that the different professional workers and women who gave birth, tend to show concern of the standards the delimit production and reproduction of the practice of medicine, as they favor the absence of a critical posture of the actions destined to the population. Besides this, if became evident that the institutional difficulties associated to the economical, cultural, and political problems also difficult the involvement and the reflection of the workers in favor of assisting changes of the process. There is also a utilization of a perspective prescriptive of humanization in the everyday life of the social workers, without reflection of its meaning. Some workers present, in their statements, a preoccupation with the social and economical aspects that affect the practice of medicine, and with the limitations of the humanization discourse that disarticulates the necessities of those involved in the process of formation, and soon tend to return to the discussion of humanization while a kind practice characterized by the minimization of the interventionist actions. Now the users of the system show themselves before the dynamic of the services, submitting themselves to what is offered while assistance, without questioning and/or reflecting about their usual shortages. Therefore, to think of changes in the know and do of the practice of medicine destined to the birth of children implies reflection on the quotidian production of these practices and of the social contexts that influence the process of assistance in the practice of medicine. Herein it would be possible to predict the appropriation, by different workers concerning their exasperations and necessities, making them active in the pursuit of their rights as citizens

Sobre a constituição do sujeito: uma análise comparativa entre a psicologia sócio-sociologia do conhecimento de berger e luckmann

This study investigated how the process of the constitution of the subject is interpreted in the formulations of the founders of socio-historical psychology (Lev S. Vigotski, Alexei N. Leontiev and Alexander R. Luria) and in the sociology of knowledge of Peter Berger and Thomas Luckmann. These two theoretical perspectives, despite having different philosophical formulations as ontological and epistemological intentions (socio-historical psychology, historical dialectical materialism; the sociology of Berger and Luckmann and phenomenology) arrive, however, at the same basic conclusion about the social nature of the subject. The objective of the study, therefore, was that of identifying the differences and convergences between the two perspectives and then, try to determine the possibility of a theoretical synthesis between them in relation to the constitution of the subject. At the same time, we intended to analyse the implications of this possible synthesis in order to comprehend the manner in which the ideology functions in human societies as thought by Louis Althusser and Alípio de Sousa Filho. We arrived at the conclusion that, despite being incompatible from the ontological and epistemological points of view, a synthesis is possible between socio-historical psychology and the sociology of knowledge of Berger and Luckmann in relation to the conception of society and the comprehension of the process of the constitution of the subject. Starting from the philosophical intentions of socio-historical psychology, it is possible to incorporate, enriching points such as: Berger s and Luckmann sconception of society and the interpretation of the process of constitution of the subject. This possible synthesis, when interpreted in light of the reflections of Althusser and Sousa Filho on the phenomenon of ideology in human societies, is constituted in a real unveiling of the concrete provisos by which the ideology acts in human societies in order to transform biological examples of the human species in specific social subjects

Clima e cultura de segurança do paciente em uma maternidade escola: percepção dos profissionais de enfermagem em terapia intensiva

Since the publication of the report "To Err is Human" by the Institute of Medicine (IOM) , which estimated that between 44.000 to 98.000 Americans die annually as a result of errors in health care, patient safety spent gaining prominence, emerging studies assess the safety culture by measuring the safety climate. In this context, the aim of this study was to identify safety culture perceived by nursing professionals working in the intensive care unit of a maternity school in Natal/RN through the Security Attitudes Questionnaire (SAQ). This was a descriptive study, cross-sectional and quantitative approach undertaken in the Intensive Care Unit Maternal and Neonatal a maternity school in Natal/RN. The project was submitted to and approved by Brazil Platform Zip/UFRN under number 309 540 and CAAE 16489713.7.0000.5537. It was used to collect data two instruments: a questionnaire in order to collect socio-demographic data of the subjects and the Questionário Atitudes de Segurança , a cultural adaptation to Portuguese of the instrument of the World Health Organization titled Safety Attitudes Questionnaire - (SAQ ) Short Form 2006. The collected data were analyzed quantitatively by the organization in electronic databases in Microsoft Excel 2010 spreadsheet and exported to statistical software for free access to be coded, tabulated and analyzed using descriptive statistics. The study included a total of 50 nurses, 31 and 19 of the NICU Maternal ICU, predominantly female, mean age 35 years, median time of 10 years training and working in maternity, mostly, less than 05 anos. As a result, two articles were produced. The first refers to the first two domains of the instrument entitled "climate of teamwork" and "climate security" . The scores of the two areas were slightly higher in Maternal ICU compared to the NICU, but no sector has reached the ideal minimum score of 75: in the first domain Maternal ICU had an average of 74.77, with medians of 75 and 100, while Neonatal ICU reached an average of 69.61 with median also 75 and 100, while the second field means were 69.35 and 66.01 for Maternal and Neonatal ICUs respectively, with a median of 100 in the two sectors. The second article relates to the field "Perception Management Unit and Hospital", which 9 assessed the perception of management units and motherhood by professionals. In general, the items of the domain in question also obtained scores below the ideal minimum: 63.68 to 51.02 and maternal ICU for neonatal, featuring a clear separation between the management and the professionals who work in direct care. These findings indicate a warning sign for the institution and point to the need to implement actions aimed at patient safety

Influência do estado nutricional materno em vitamina A sobre os níveis de imunoglobulina A no colostro humano

Mothers with good vitamin A nutritional status during gestation and lactation are better able to nourish and protect their infant with maternal milk. Our hypothesis is that women with more serum retinol have more retinol and secretory immunoglobulin A in colostrum. 190 healthy puerperal women from a Brazilian public maternity were recruited and divided according to the cutoff point for serum retinol (30 μg/dL). A number of the women was supplemented with 200000 UI (60 mg) of retinyl palmitate in the immediate postpartum. Serum and colostrum were collected on the 1st day postpartum and colostrum again on the following day. Retinol (serum and colostrum) was analyzed by HPLC and SIgA (colostrum) by turbidimetry. The mothers presented with adequate biochemical indicators of nutritional status, according to serum retinol (44.6 μg/dL). There were significant differences (p= 0.0017 and p= 0.043, respectively) in retinol and SIgA levels in the colostrum of mothers with serum retinol > 30 μg/dL and < 30 μg/dL. The concentration of SIgA in the colostrum of non-supplemented mothers on the 1st day postpartum was 822.6 mg/dL, decreasing after 24 hours to 343.7 mg/dL. Supplemented mothers showed levels of SIgA in colostrum of 498.9 mg/dL on the 2nd day postpartum (p= 0.00006). The colostrum of women with good vitamin A nutritional status had more retinol and SIgA. Additionally, maternal supplementation increases the levels of SIgA in colostrum. The higher levels of SIgA on the 1st day postpartum showed the importance of early breastfeeding, given that it provides considerable immunological benefits to newborn infants

Ausência do pai ao longo do desenvolvimento ontogenético e indicadores de desconto de futuro: uma contribuição da psicologia evolucionista

The new Evolutionary Psychology (E. P.) paradigm has been trying to understand how the human beings make their decisions over time regarding the most diverse variables, always bearing in mind that such a cognitive process is due to a complex natural selection process that occurred millions of years ago. One of the main topics discussed by this new paradigm is the issue of parental investment, i.e., the care the parents provide to an offspring at the expense of the investment into a new one. The present work sought to integrate these two topics, trying to understand how some variables modulate the process of decision making in a sample of the city of Natal, Rio Grande do Norte state. It was investigated the hypothesis that the presence of both parents, along the individual development, could signal a more favorable environment, providing clues to the individual that he could assume a competitive position at the socio-biological market. His decisions, therefore, could be guided by long-term investments with aims to obtain more robust rewards. On the contrary, those who has suffered for some moment the absence of one the parents could develop theirselves in a not so competitive way, starting to choose immediate benefits - but lesser ones -, since the future would be less predictable due to their worse development conditions. This study involved 152 individuals from three higher education institutions, one of them being public and the others being private ones. In the results found, there was no difference between children of coupled parents and children of deceased or divorced parents concerning discount rates. The levels of hopelessness did not affect the discount rates of children of single parents when compared to children of coupled parents. Not having one of the parents because of divorce made the child to tend to present lower scores in the domain of social relations of WHOQOL - Bref, whilst the absence of the father by death made the scores lower in the domain of environment. The results indicate that loosing one of the parents along the development influences the individual's quality of life perception, but the measurement method of future discounting rates by means of financial choices is not sensitive to this variation

Estilos de aprendizagem sob a ótica da Psicologia Evolucionista

Among a variety of learning conceptions, David Kolb´s Experiential Learning Theory proposes four different learning styles: diverging, characterized by orientation towards people and multi-perspective vision; assimilating, concerned with ideas and abstract concepts as well as theory formulation; converging, expert in dealing with technical tasks and problem solving; and accommodating, risk taker and good at getting things done. Interesting correlations have been pointed out between Kolb s learning styles, professional careers and genders. With respect to behaviors, specific cognitive skills and interests, sex differences are widely known, and explained by Evolutionary Psychology as the result of distinct selective pressures acting on each gender. The aim of this research was to assess adolescents learning styles and their relation with interests on school and career choices, analyzing possible gender differences. We distributed questionnaires to 221 senior high school students to research their preferences for school disciplines, professional activities and career choices. The Learning Style Inventory specified the learning style of each individual. Our results showed a high frequency of reflective styles, with predominance of females as diverging and males as assimilating. Concerning school and professional interests, there were correlations between styles oriented towards the abstract and technical interests. Moreover, females preferred disciplines related to languages and interpersonal activities while males preferred disciplines related to science and technical activities. There were more males in exact science and engineering careers, and more females in social science and applied social science. Correlations found between learning styles, school and professional interests corroborate Kolb´s propositions, and the findings about gender differences are supported by Evolutionary Psychology theories

Motivações para adoção: uma perspectiva da Psicologia Evolucionista

Parental investment increases the offspring s survival, though it decreases the opportunities for the parents to invest in a future progeny. In a broad sense, this investment is directed to one s own descendant, but in some cases, such as in adoption, resources are directed to non-relatives even in the absence of fitness benefits. Once there are many factors involved in adoption, this study investigated adopters candidates, aiming to analyze aspects considered by them for adopting, based on the Evolutionary Psychology s perspective. We analyzed the judicial proceedings´ files people who had been inlisted for adoption at the 2ª Childhood and Adolescence Law Court, Natal-RN. The adopter s motivations were classified into biological or social reasons. A relationship between adopters´ age and kind of motivation was found: requirements of young people were related to biological reasons while requirements of the old ones were related to social reasons. Fertility, mainly female requirer´s fertility, underlie this relationship, considering that women fertility is strongly influenced by age. The reasons to adopt were also related to the age of the desired child, once that people who wanted children older than 25 months alleged social reasons while those that wanted younger babies alleged biological reasons. There are lots of motives to adopt a child, but the phenomenon of adoption is broadly acknowledged by society as an act of love and the adoptive parents are often regarded as kind and generous people. It was observed, instead, that the reasons to adopt comes from the adopters themselves, related to the fulfillment of personal needs, such as increasing the family, carrying out mother/father role or having a company or someone to care form them in elderly age

A formação graduada em psicologia no Brasil: reflexão sobre os principais dilemas em um contexto pos-DCN

Criticism done to the undergraduate training process of the psychologist in Brazil raised debates known as "dilemmas of training". In recent years the classic training model, based on the Minimum Curriculum has undergone a series of changes after the National Curriculum Guidelines (DCN), modifying the context of courses. Thus, this paper aimed to investigate, in a post- DCN context how undergraduate courses in Psychology in Brazil have been dealing with the dilemmas of training. So, we decided to analyze the Course Pedagogical Projects (CPPs) of Psychology in the country. Forty CPPs, selected by region, academic organization and legal status were collected. The data was grouped into three blocks of discussions: theoretical, philosophical and pedagogical foundations; curriculum emphases and disciplines; and professional practices. The results were grouped into four sets of dilemmas: a) ethical and political; b) theoreticalepistemological; c) professional practice of the psychologist and d) academic-scientific. Courses claim a socially committed, generalist, pluralistic training, focusing on research, non-dissociation of teaching-research-extension, interdisciplinary training and defending a vision of man and of critical and reflective and non-individualistic psychology. The curriculum keeps the almost exclusive teaching of the classical areas of traditional fields of applied Psychology. Training is content based. The clinic is hegemonic, both in theory and in application fields. The historical debate is scarce and themes linked to the Brazilian reality are missing, despite having social policies present in the curricula. Currently, DCNs have a much greater impact on courses due to the influence of the control agencies, fruit of current educational policy, and the result is felt in the homogenization of curriculum discourses

Do útero à adoção: a experiência de mulheres férteis que adotaram uma criança

Even with all changes and ruptures related to the social roles that woman had performed, the literature had confirmed that the motherhood still configures it like one of the main roles that she hopes to play in some moment of her life. When the woman did not get pregnant or take ahead a pregnancy, some women find in adoption an alternative to play this role. This research aimed to understand the experience of being mother for adoption in the case of fertile women, but whose partner is infertile. Supported by existential-phenomenological theory, used it the narrative, how methodological instrument. Participated five women, whose adoption process followed the legal ways in the Youngness and Infancy Judgeship of Natal/RN. The results showed that in the selfish training, the woman to see herself how whose role principal is to generate children, although, she think that is natural her participation in others activities go out home too. In male infertile case is a tendency that the woman strikes the infertile status too. The adoption is an alternative to fulfill her desire of being a mother and, meanwhile, please her husband and guarantee the continuity of her love relationship. Through motherly care, the woman discover herself as a mother, what brings a new meaning for her live, independent of to generate a child. Though, exit frustration, sometimes, in association with suffering, on account of the pregnancy and childbirth absence. The end of the research suggests reflections that to become fulfilled herself as mother, the woman does not need, necessarily, to generate a child, being the maternity one of the uncountable possibilities that are shown, and that she can choose, or not, accomplish it

Prática de coordenação pedagógica e concepções acerca da atuação em psicologia escolar: desvendando um contexto, repensando caminhos

Considering the necessary approaches with the quotidian of the pedagogical field mentioned in the recent productions in Psychology about the insertion of psychologists in the school field, the objective of this work was to know and to understand the dynamics of functioning of a team of pedagogical coordination, intending to produce reflections on the possibilities of action in school psychology with these professionals. Our field of research was the Municipal School Teacher Emília Ramos (EMPER), considering its peculiar history, distinguished by a constant effort of achievement of the school success by its pupils. As subject of the study, six pedagogical coordinators participated, who worked at the school in the diurne turns, where regular classrooms of 1º cycle of basic education functioned. As procedures, we use participant observations and open interviews, focusing the activities performed by the coordinators and its possible demands to psychology. We use the analysis of content for the production of results. These results evidenced a work of coordination realized on a structured routine, but flexible, centered around the activity of conduction of groups of studies with the teachers. We grouped the demands to psychology in four thematic groups: diagnosis and attending the pupils; orientation to the families, contribution in the formation of the professionals and clinical listening of the professionals of the school. In this way, it is made clear that, in a context where happens a well articulated and consistent pedagogical work, the possible performance in school psychology is not scrumbled or confused with social and pedagogical practical others which many times takes attendance. With these information, we expect to contribute for the theoretical and practical elaborations, in Psychology and the Pedagogy, compromised with the success of the educative work realized in the public schools

Publicação e avaliação de periódicos científicos: paradoxos da classificação Qualis em Psicologia

Recently, Brazilian scientific production has increased greatly, due to demands for productivity from scientific agencies. However, this high increases requires a more qualified production, since it s essential that publications are relevant and original. In the psychological field, the assessment scientific journals of the CAPES/ANPEPP Commission had a strong effect on the scientific community and raised questions about the chosen evaluation method. Considering this impact, the aim of this research is a meta-analysis on the assessment of Psychological journals by CAPES to update the Qualis database. For this research, Psychology scientific editors (38 questionnaires were applied by e-mail) were consulted, also 5 librarians who work with scientific journals assessment (semi-structured interviews) and 8 members who acted as referees in the CAPES/ANPEPP Commission (open questions were sent by e-mail). The results are shown through 3 analysis: general evaluation of the Qualis process (including the Assessment Committee constitution), evaluation criteria used in the process and the effect of the evaluation on the scientific community (changes on the editing scene included). Some important points emerged: disagreement among different actors about the suitability of this evaluation model; the recognition of the improvement of scientific journals, mainly toward normalization and diffusion; the verification that the model does not point the quality of the journal, i.e., the content of the scientific articles published in the journal; the disagreement with the criteria used, seemed necessary and useful but needed to be discussed and cleared between the scientific community. Despite these points, the scientific journals evaluation still is the main method to assure quality for Psychology publications

A psicologia e o programa de saúde da família :novas possibilidades, velhos dogmas?

The model of attention to health has been suffering alterations due to the difficulty faced to put into practice its universal, democratic and institutional layout. Since the movement of Sanitary Reform, which focused in the demands of a new health context and the process of work in the area of health, one seeks uninterruptedly, to find a way which leads to the execution of the principles of SUS. Despite having tried, the model of Sanitary Vigilance centered within the work of a multi-professional team has shown fragmentation and little adequacy to the necessity of health in the population. Whilst inserting himself in the field of health, the psychology professional has taken with him his clinic way of attending to individuals being one more in the team to act in a de-contextualised and little critical way. In virtue of this framework, the Ministry of Health invests in the Family Health Program as a new guide in the health system, restructuring the basic attention at a new logic of action. In this way, the municipality of Natal-RN implants, in the year 2002, the PSF in the Northern Sanitary District, a context in which professional teams are created where there is not an inclusion of a psychologist. Consequently, this professional is excluded of his work space in the previous Basic Unities of Health. This piece of work constitutes in the investigation of the implementation and instrumentalization of the Northern Sanitary District PSF of Natal-RN, having as its objective to analyze the implications of this execution for the structuring of the health network services and more specifically the alterations that this implementation could be making to the practice of the Psychology Professionals, emphasizing its advances, obstacles and limitations. To make this work feasible it was necessary to search for data and information from the implementation and execution of the PSF in the DSN, carrying interviews from a semi-structured guide, with 21 institutional actors (members of the team, coordinators and directors of the unities and psychologists)