RESUMO
Objetivo: conhecer as representações sociais sobre o planejamento reprodutivo entre mulheres em gravidez não planejada na Estratégia Saúde da Família. Método: estudo qualitativo, orientado pela Teoria das Representações Sociais, realizado com 15 gestantes, entre abril e maio de 2019. Utilizou-se a entrevista semiestruturada. Os dados foram organizados por meio do Discurso do Sujeito Coletivo, com auxílio do software DSCsoft©. Protocolo de pesquisa aprovado pelo Comitê de Ética em Pesquisa. Resultados: as representações sociais das mulheres em gravidez não planejada evidenciadas pelo Discurso do Sujeito Coletivo foram representadas por oito ideias centrais, a saber: "eu não me preveni, nem ele", "nós nos prevenimos", "eu comprava", "pegava no posto", "construir uma família", "ter esse acesso", "estou por fora" e "eu sei que é disponível". Conclusão: as representações sociais nos discursos das mulheres em gravidez não planejada estavam pautadas no desconhecimento acerca do planejamento reprodutivo, dos anticoncepcionais disponíveis e seu uso correto.
Objective: to understand the social representations of reproductive planning among women with unplanned pregnancies in the Family Health Strategy. Method: qualitative study, guided by the Theory of Social Representations, carried out with 15 pregnant women between April and May 2019. Semi-structured interviews were used. The data was organized using the Discourse of the Collective Subject, with the aid of DSCsoft© software. Research protocol approved by the Research Ethics Committee. Results: the social representations of women with unplanned pregnancies as evidenced by the Collective Subject Discourse were represented by eight central ideas, namely: "I didn't prevent myself, nor did he", "we prevented ourselves", "I would buy it", "I would get it at the health center", "build a family", "have this access", "I am not aware" and "I know it is available". Conclusion: the social representations in the women's speeches about unplanned pregnancies were based on a lack of knowledge about reproductive planning, the contraceptives available and their correct use.
Objetivo: conocer las representaciones sociales sobre la planificación reproductiva de las mujeres con embarazo no planificado en la Estrategia Salud de la Familia. Método: estudio cualitativo, basado en la Teoría de las Representaciones Sociales, realizado con 15 mujeres embarazadas, entre abril y mayo de 2019. Se utilizaron entrevistas semiestructuradas. Los datos fueron organizados mediante el Discurso del Sujeto Colectivo, con ayuda del software DSCsoft©. El protocolo de investigación fue aprobado por el Comité de Ética en Investigación. Resultados: las representaciones sociales de las mujeres con embarazo no planificado reveladas por el Discurso del Sujeto Colectivo fueron representadas por ocho ideas centrales, a saber: "yo no me cuidé y él tampoco", "nos cuidamos", "yo los compraba", "los buscaba en el centro de salud", "construir una familia", "tener acceso", "no participo" y "sé que está disponible". Conclusión: las representaciones sociales en los discursos de las mujeres con embarazo no planificado se basaron en la falta de conocimiento sobre la planificación reproductiva, en los anticonceptivos disponibles y su uso correcto.
RESUMO
Objetivo: avaliar o tônus do corpo perineal em mulheres jovens nulíparas e correlacionar com as funções sexuais e a presença de disfunção sexual. Método: foi realizado um estudo descritivo, observacional, transversal utilizando uma amostra de conveniência incluindo mulheres adultas jovens nulíparas. A avaliação das participantes consistiu na aplicação dos questionários socioclínico, Pelvic Organ Prolaps / Urinary Incontinence Sexual Questionnaire (PISQ-12), Female Sexual Function Index (FSFI) e exame físico do tônus do corpo perineal. Os dados foram analisados pelo programa Statistical Package for the Social Sciences (SPSS®), versão 23, adotando um nível de significância de 5%. Resultados: participaram 77 mulheres jovens nulíparas (21,68 ± 2,94 anos), destas 77, 92% apresentavam vida sexual ativa e 66,03% tônus normal do corpo perineal. Dentre as alterações tônicas, o aumento do tônus predominou (33,76%). Houve alta prevalência de disfunção sexual (87,01%) pelo FSFI (23,38 ± 7,21) com maior queixa de dispareunia. Mulheres com tônus aumentado apresentaram maior disfunção sexual em relação a desejo e estímulo subjetivo (p=0,04), à excitação (p=0,01), satisfação (p=0,04) e dor ou a desconforto (p=0,03). Houve correlação inversa entre a presença de aumento do tônus e os domínios FSFI desejo e estímulo subjetivo (R= - 0,56) e excitação (R= - 0,34) e correlação direta para dor ou desconforto (R= 0,30). Conclusão: o aumento do tônus do corpo perineal piora a função sexual de mulheres jovens nulíparas.
Sexual Function Index (FSFI) and physical examination of the tone of the perineal body. The data were analyzed using the Statistical Package for the Social Sciences (SPSS®), version 23, adopting a significance level of 5%. Results: 77 young nulliparous women (21.68 ± 2.94 years) participated, of which 77, 92% had an active sexual life and 66.03% had normal tone of the perineal body. Among the tonic changes, increased tone predominated (33.76%). There was a high prevalence of sexual dysfunction (87.01%) according to the FSFI (23.38 ± 7.21) with greater complaints of dyspareunia. Women with increased tone had greater sexual dysfunction in relation to desire and subjective stimulation (p=0.04), excitement (p=0.01), satisfaction (p=0.04) and pain or discomfort (p=0.03). There was an inverse correlation between the presence of increased tone and the FSFI domains desire and subjective stimulus (R= - 0.56) and excitement (R= - 0.34) and a direct correlation for pain or discomfort (R= 0.30). Conclusion: increased perineal body tone worsens sexual function in young nulliparous women.
Assuntos
Humanos , Feminino , AdultoRESUMO
BACKGROUND: Complementary and alternative (CAM) cancer treatment is often expensive and not covered by insurance. As a result, many people turn to crowdfunding to access this treatment. OBJECTIVE: The aim of this study is to identify the rationales of patients with cancer seeking CAM treatment abroad by looking specifically at crowdfunding campaigns to support CAM cancer treatment in Tijuana, Mexico. METHODS: We scraped the GoFundMe.com and GiveSendGo.com crowdfunding platforms for campaigns referencing CAM cancer clinics in Tijuana, initiated between January 1, 2022, and February 28, 2023. The authors created a coding framework to identify rationales for seeking CAM treatment in Tijuana. To supplement campaign metadata, we coded the beneficiary's cancer stage, type, age, specific treatment sought, whether the beneficiary died, gender, and race. RESULTS: Patients sought CAM cancer treatment in Tijuana because the (1) treatment offers the greatest efficacy (29.9%); (2) treatment offered domestically was not curative (23.2%); (3) the clinic treats the whole person, and addresses the spiritual dimension of the person (20.1%); (4) treatments are nontoxic, natural, or less invasive (18.2%); and (5) clinic offers the newest technology (8.5%). Campaigns raised US $5,275,268.37 and most campaign beneficiaries were women (69.7%) or White individuals (71.1%). CONCLUSIONS: These campaigns spread problematic misinformation about the likely efficacy of CAM treatments, funnel money and endorsements to CAM clinics in Tijuana, and leave many campaigners short of the money needed to pay for CAM treatments while costing beneficiaries and their loved one's time, privacy, and dignity. This study affirms that Tijuana, Mexico, is a very popular destination for CAM cancer treatment.
RESUMO
BACKGROUND: Digital technology and gamified apps can be useful in the health care context. Gamification uses technology to influence users' actions and motivations through experiences that resemble games. Patient adherence to the enhanced recovery after surgery (ERAS) program is crucial for achieving early recovery after surgery and continuous monitoring is essential for obtaining good results. OBJECTIVE: This study aimed to describe the development and validation of a mobile app for enhanced recovery after surgery (MobERAS), a gamified mobile health app for telemonitoring patients in the postoperative period based on the ERAS program, and to evaluate its functionality and usability and the experience of patients, health care professionals, and computer professionals with its use. METHODS: We developed MobERAS for postoperative telemonitoring, with active participation of patients in the process, and offering availability of real-time information for the health team. The app development process included idealization, interdisciplinary team formation, potential needs assessment, and product deployment. Usability tests were conducted throughout the development process with improvements, technical adjustments, and updates. After finalization, comprehensive verification tests were performed. The parameters evaluated are those that can influence the length of hospital stay, such as nausea, vomiting, pain scales, return to normal gastrointestinal function, and thromboembolic events. MobERAS was designed to be downloaded by users on their phones, tablets, or other mobile devices and to provide postoperative data. The app has a GPS that monitors the patient's walking time and distance and is connected to a virtual database that stores the collected data. RESULTS: Women undergoing medium and major gynecologic oncologic surgeries were included. We included 65 patients with an average age of 53.2 (SD 7.4, range 18-85) years. The time of use ranged from 23.4 to 70 hours (mean 45.1, SD 19.2 hours). Regarding adherence to the use of MobERAS, the mean fill rate was 56.3% (SD 12.1%, range 41.7%-100%), and ambulation data were obtained for 60 (92.3%) of the 65 patients. The researcher had access to the data filled out by the patients in real time. There was good acceptance of the use of MobERAS by the patients, with good evaluation of the app's usability. MobERAS was easy to use and considered attractive because of its gamified design. The app was rated as good or very good in all items by health care professionals (n=20) and professionals specializing in technological innovation (n=10). CONCLUSIONS: MobERAS is easy to use, safe, well accepted by patients, and well evaluated by experts. It can be of great use in clinical surgical practice and an important tool for greater engagement of patients and health care professionals with the ERAS program.
RESUMO
Although women with schizophrenia face significant lifelong challenges due to their diagnosis and sex-related issues, those challenges are seldom taken into consideration in their medical treatment and general care. In order to report the needs and desires of a group of women with schizophrenia, we conducted a series of semistructured interviews with nine women diagnosed with schizophrenia and attending outpatient clinics at the Hospital Del Salvador in Valparaíso. Our qualitative study followed a phenomenological design. Using ATLAS.ti software, we performed a content analysis of the interview transcripts, developed a coding frame for each major topic addressed in the interviews, and triangulated the results. Despite presenting with psychotic symptoms, some women received different diagnoses. Although acknowledging the benefits of medication, women also reported concerns about weight gain and body image. All women reported experiences with stigma and self-stigma related to the diagnosis of schizophrenia, and most had experienced childhood trauma, including sexual abuse, parental violence, and/or bullying. Young women with schizophrenia also feared that if they become mothers, then their children might also have schizophrenia and/or that they would be unable to adequately care for them. Women with schizophrenia have different experiences and play different roles in society beyond their psychoses, an understanding that should integrated into more personalized treatments for schizophrenia that consider individual characteristics and needs.
RESUMO
Gender relations are a set of socially determined norms and rules that assign values, characteristics, and expectations to individuals based on their biological sex. These aspects also influence the clinician-patient relationship, since it has been for a long time based on cisheteronormativity. However, this attitude alienated the LGBTQIA+ community from health services. Global and specific gynecologic care needs to be offered to the LGBTQIA+ population, which has demands for sexual and reproductive health care. In this narrative review, we bring conceptual aspects, gender identity and expression, sexual history, screening for cancer and other care to the community.
RESUMO
AIMS: To evaluate the prevalence, molecular characteristics, antimicrobial susceptibility, and epithelial invasion of Streptococcus agalactiae strains isolated from pregnant women and newborns in Rio de Janeiro, Brazil. METHODS AND RESULTS: A total of 67 S. agalactiae isolates, 48 isolates from pregnant women and 19 from neonates, were analyzed. Capsular type Ia and V were predominant (35.8%/each). The multilocus sequence typing analysis revealed the presence of 19 STs grouped into 6 clonal complexes with prevalence of CC17/40.3% and CC23/34.3%. The lmb and iag virulence genes were found in 100% of isolates. Four S. agalactiae strains, belonging to CC17/ST1249 and CC23/ST23, were able to adhere to A549 respiratory epithelial cells. Antimicrobial resistance was verified mainly to tetracycline (85%), erythromycin (70.8%), and clindamycin (58.3%). Four S. agalactiae isolates were multidrug resistant. The resistance genes tested were found in 92.5% of isolates for tetM, 58.2% for ermB, 28.4% for mefAE, and 10.4% for tetO. CONCLUSION: The study showed a high prevalence of virulence and antimicrobial genes in S. agalactiae strains isolated from pregnant women and newborns, supporting the idea that continued surveillance is necessary to identify risk factors and perform long-term follow-up in pregnant women and neonates in Rio de Janeiro.
Assuntos
Antibacterianos , Células Epiteliais , Testes de Sensibilidade Microbiana , Tipagem de Sequências Multilocus , Infecções Estreptocócicas , Streptococcus agalactiae , Streptococcus agalactiae/genética , Streptococcus agalactiae/efeitos dos fármacos , Streptococcus agalactiae/isolamento & purificação , Feminino , Humanos , Brasil , Gravidez , Infecções Estreptocócicas/microbiologia , Antibacterianos/farmacologia , Recém-Nascido , Células Epiteliais/microbiologia , Farmacorresistência Bacteriana/genética , Adulto , Fatores de Virulência/genética , Complicações Infecciosas na Gravidez/microbiologia , Farmacorresistência Bacteriana Múltipla/genética , Virulência/genéticaRESUMO
Background: Obesity creates a burden of disease that affects the health-related quality of life (HRQoL) of women and in those between 20 to 59 years of age it implies greater morbidity and mortality compared to men or other age groups. Objective: To evaluate the HRQoL of Mexican women aged 20 to 59 years with obesity. Material and methods: Observational, cross-sectional, prospective, and retrospective study. It was obtained a sample of 104 women from 20 to 59 years of age diagnosed with obesity according to the NOM-008-SSA3-2017 Standard. The participants' main clinical and sociodemographic characteristics were collected, and their HRQoL was evaluated with the SF-36 questionnaire. For the analysis of the collected variables, descriptive statistics were used. To identify the association of these variables with HRQoL, the Kruskal-Wallis test was used. Results: 104 women with a median age of 40.0 years participated. Of these, 66.3% had grade I obesity, 21.2% grade II, and 12.5% grade III. In the overall sample, general health and vitality were the lowest dimensions. In the comparison by groups, the physical role and the emotional role had statistically significant differences (p = 0.007 and p = 0.009, respectively), with the most affected group being obesity grade II. Conclusions: Obesity mainly affected the perception of general health and vitality; likewise, those with grade II had a greater impact on the physical role and the emotional role.
Introducción: la obesidad crea una carga de enfermedad que afecta la calidad de vida relacionada con la salud (CVRS) de las mujeres y en aquellas de 20 a 59 años implica una mayor morbilidad y mortalidad respecto a los hombres u otros grupos etarios. Objetivo: evaluar la CVRS de mujeres mexicanas de 20 a 59 años con obesidad. Material y métodos: estudio observacional, transversal, prospectivo y retrolectivo. Se obtuvo una muestra de 104 mujeres de 20 a 59 años, diagnosticadas con obesidad según la NOM-008-SSA3-2017. Se recabaron las principales características clínicas y sociodemográficas de las participantes y se evaluó su CVRS con el cuestionario SF-36. Para analizar las variables recogidas, se usó estadística descriptiva. Para identificar la asociación de estas variables con la CVRS, se usó la prueba Kruskal-Wallis. Resultados: participaron 104 mujeres con una mediana de edad de 40.0 años. De estas, 66.3% tuvieron obesidad grado I, 21.2% grado II y 12.5% grado III. En la muestra general, la salud general y la vitalidad fueron las dimensiones más bajas. En la comparación por grupos, el rol físico y el rol emocional tuvieron diferencias estadísticamente significativas (p = 0.007 y p = 0.009, respectivamente), y el grupo más afectado fue el de obesidad grado II. Conclusiones: la obesidad afectó principalmente la percepción de la salud general y de la vitalidad; asimismo, aquellas con grado II tuvieron una mayor repercusión en los roles físico y emocional.
Assuntos
Obesidade , Qualidade de Vida , Humanos , Feminino , México , Adulto , Estudos Transversais , Obesidade/psicologia , Pessoa de Meia-Idade , Adulto Jovem , Estudos Retrospectivos , Estudos Prospectivos , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: Despite cervical cancer (CC) being a preventable disease, its incidence remains high in marginalized communities due to inequalities that restrict access to health services. This article investigates the experiences, perceptions, and attitudes regarding the screening of indigenous women in a region of the Colombian Amazon during a cervical cancer prevention initiative facilitated by community participation. DESIGN: Qualitative study based on interviews conducted with women and indigenous leaders from Paujil reserve. They participated in research focused on cervical cancer prevention, which employed a methodology of collaboration between academia and communities aimed at enhancing women's health and reducing inequalities in access to healthcare services. The analysis utilized a deductive and inductive approach. RESULTS: Five main themes were addressed: 'Barriers within health services'; 'Individual and cultural constraints'; 'Motivations and facilitators'; 'Positive experiences within the research framework'; and 'Suggestions for encouraging women's participation.' Challenges related to appointment scheduling and result delivery were frequently cited as obstacles to access. Misinformation, feelings of shame, fear, and distrust towards health services played significant roles in the reluctance to undergo screening. Factors such as support from family and community networks, respectful treatment, ease of scheduling appointments, the presence of female healthcare professionals, and involvement of leaders fluent in indigenous languages were identified as positive facilitators of screening acceptance. CONCLUSION: Understanding the factors that influence access to screening is crucial for reducing inequalities in service delivery for indigenous women. The involvement of trained leaders who can identify these factors and motivate women can have a positive impact on the acceptance and guidance of cervical cancer prevention programs.
RESUMO
PURPOSE: To evaluate the impact of levonorgestrel-releasing intrauterine device (LNG-IUD) use on the incidence of acne in adolescents and young women. METHODS: A narrative review was conducted in PubMed, Embase, Cochrane, and SciELO assessing the incidence of acne in adolescents and young women using LNG-IUD (13.5, or 19.5 mg, or 52 mg). Cohort, cross-sectional studies, clinical trials, and meta-analyses were included, without a date limit. Studies that didn't evaluate women in the age of interest were excluded. Only articles in English were selected. RESULTS: Nine articles were included in this narrative review. Only clinical trials, cohort studies, and cross-sectional studies were evaluated. Two cross-sectional studies evaluated the incidence of acne in women using any contraceptive methods, with the incidence of acne being 36% in women aged 17 to 47 using LNG-IUD in one study. In another study, acne incidence ranged from 2 to 8% in women using any contraceptive methods, with higher rates in younger women and LNG-IUD users. The incidence of acne varies and participants between 16 to 35 years were more likely to report new acne or worsening of pre-existing acne. In a prospective cohort study of women between 16 and 24 years, acne was a common adverse effect, with 44% in the first year. CONCLUSION: The data indicate variability in the incidence of acne among LNG-IUD users, with a higher prevalence observed in younger women. Further research should focus on the effects of LNG-IUD on acne in young populations, with rigorous study designs and consideration of previous contraceptive use.
The levonorgestrel-releasing intrauterine device (LNG-IUD) is an important tool in the prevention of unplanned pregnancies in adolescents and young women. Acne is a possible adverse effect that could lead to discontinuation of the method.