RESUMO

Qualitative research on malaria in pregnancy (MiP) is incipient, therefore its contextual, experiential and symbolic associated factors are unknown. This study systematizes the qualitative research on MiP, describes knowledge, perceptions and behaviors about MiP, and compiles individual, socioeconomic, cultural and health system determinants of MiP through a meta-synthesis in 10 databases. A total of 48 studies were included with 2600 pregnant women, 1300 healthcare workers, and 2200 relatives or community members. Extensive knowledge was demonstrated on ITN and case management, but it was lacking on SP-IPTp, risks and consequences of MiP. Attitudes were negative towards ANC and MiP prevention. There were high trustfulness scores and preference for traditional medicine and distrust in the safety of drugs. The main determinants of the Health System were rationing, copayments, delay in payment to clinics, high out-of-pocket expenses, shortage, low workforce and work overload, shortcomings in care quality, low knowledges of healthcare workers on MiP and negative attitude in care. The socioeconomic and cultural determinants were poverty and low educational level of pregnant women, distance to the hospital, patriarchal-sexist gender roles, and predominance of local conceptions on maternal-fetal-neonatal health. The meta-synthesis demonstrates the difficulty to detect MiP determinants and the importance of performed qualitative research before implementing MiP strategies to understand the multidimensionality of the disease.

RESUMO

BACKGROUND: Alcohol consumption is a social phenomenon that involves society, groups, and individuals from different cultures around the world. Among some Indigenous groups located in Colombia, South America, alcohol consumption has been present in their lives, where contradictory processes occur and generate public health attention. We aimed to analyze qualitative research findings on alcohol consumption among Indigenous peoples in Colombia. METHODS: This article used the qualitative meta-synthesis methodology, which included: (a) comprehensive search strategy, (b) appraisal of qualitative research reports, (c) findings classification, and (d) synthesis. Databases were searched for papers published from 2004 to 2019 in SCOPUS, LILACS, PROQUEST, and JSTOR, among other sources of information. A total of 2,159 papers were reviewed and finally, 13 studies were included in this meta-synthesis. The synthesis of findings included a constant comparative analysis and also aimed for the articulation of its findings to alternative perspectives in a predefined matrix. RESULTS: Nine Indigenous ethnic groups of Colombia were represented in the 13 articles analyzed. From the analysis emerged the symbolic approach "Alcohol: a chameleon that unpredictable society colors" as the meta-theme of this research. This reflects four social processes that influence interaction with alcohol: Dynamic Systems Mergers (Indigenous system, influence of non-Indigenous system); Diverse Authority Spheres (parenting, Indigenous authority, school, university, religious and spiritual, traditional medicine); Between Transculturation and Interculturality (cultural crises effects and dynamism); and the Paradoxes of the Normalization of Alcohol (reasons, functions, and types of alcohol consumption). Likewise, these results support the social determination of health and sociocultural epidemiology perspectives, as being an adequate way of explaining a complex phenomenon. CONCLUSION: Alcohol consumption among Indigenous peoples in Colombia is a social construction. Alcohol acts as an instrument, which is present in the changing relationships and tensions of social processes. This is reflected in harmonies, or disharmonies, in the life of Indigenous Colombians, which take place in a historical, sociocultural, economic, and political context. The results provide a reference point to guide practice and research but also reiterate the need to include the social determination of health perspective in public policies, as a path to the understanding of alcohol consumption.

Assuntos

RESUMO

Resumo Objetivo Compreender as experiências e as práticas alimentares a partir do diagnóstico de câncer. Método: Trata-se de uma pesquisa bibliográfica, do tipo metassíntese qualitativa. Utilizou-se a diretriz ENTREQ como protocolo, tendo como pergunta norteadora: "Quais são as experiências e as práticas alimentares de indivíduos após o diagnóstico de câncer?". A busca foi realizada nas bases de dados Lilacs, Pubmed, Embase e Food Science and Techonology, a partir da combinação de palavras-chave relacionadas à alimentação e nutrição, ao adoecimento por câncer e à pesquisa qualitativa, publicados entre 2015 e 2020, em português, inglês e espanhol. Método Foram encontrados 414 artigos e excluídos 396, após leitura dos títulos e resumos. Além dos 18 artigos potenciais, foram incluídos cinco artigos de outras fontes, totalizando 23. Foram identificadas três categorias empíricas: ruptura da trajetória alimentar e estratégias de adaptação; reconstrução da identidade; e vicissitudes da comensalidade. Conclusões As perdas relacionadas à alimentação impactam na existencialidade do ser, na expressão da identidade e nas relações sociais, podendo levar ao isolamento e a desritualização da alimentação. As mudanças físicas podem levar a distúrbios de imagem corporal e sofrimento psíquico. Em decorrência dos sintomas de impacto nutricional, a família é o suporte emocional para reorganização da alimentação.

Abstract Objective To understand the experiences and eating practices from the diagnosis of cancer. Method This is a bibliographic research, of the qualitative meta-synthesis type, using the ENTREQ guideline as a protocol, with the guiding question: "What are the experiences and eating practices of individuals after being diagnosed with cancer?". The search was carried out in the Lilacs, Pubmed, Embase and Food Science and Techonology databases based on the combination of keywords related to food and nutrition, illness from cancer and qualitative research, published between 2015 and 2020, in Portuguese, English and Spanish. Results 414 articles were found and 396 were excluded after reading the titles and abstracts. In addition to the 18 potential articles, 5 articles from other sources were included, totaling 23. Three empirical categories were identified: disruption of the food trajectory and adaptation strategies; reconstruction of identity; and vicissitudes of commensality. Conclusions Losses related to food impact the existentiality of being, the expression of identity and social relationships, which can lead to the isolation and de-ritualization of food. Physical changes can lead to body image disorders and psychological distress. Due to the symptoms of nutritional impact, the family is the emotional support for the reorganization of food.

RESUMO

Gynecological cancers have an impact on women's psychosexual health in which results vary from adjuvant cancer therapy, such as loss of pleasure, to anxious symptoms. This study aimed to present a meta-synthesis of qualitative primary studies on the sexual experience of women with gynecological cancer. The SPIDER tool and the PRISMA guidelines were used to recover evidence from the databases Web of Science, SCOPUS, PubMed/MedLine, CINAHL, PsycINFO and LILACS. Twenty articles were included. The thematic synthesis showed that alterations in sexual functions can be mitigated by direct involvement and dialogue with a sexual partner and the resignification of sexual intimacy.

Assuntos

RESUMO

INTRODUCTION: The research about malaria in Colombia has centered mainly on the biomedical (clinical, parasitological, epidemiological and entomological) field, with little focus on qualitative research. PURPOSE: Analyzing social categories related to malaria in Colombia, based on qualitative studies published among scientific literature. METHODS: Systematic review following Cochrane and PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) recommendations. An ex-ante protocol was applied, comprehensive and reproducible for the search, screening, and extraction of information. Methodological quality was evaluated through SRQR (Standards for Reporting Qualitative Research). RESULTS: 10 studies complied with the protocol; these studies interviewed 500 infected or exposed subjects, program administrators, health professionals, and indigenous people. 40 categories were identified, which account for social-economical, cultural and ecological determiners of malaria; insights and ways to understand the disease at an individual level; malaria consequences, and medical attention, disease control and elimination actions. CONCLUSION: A wide variety of populations and subjects was considered. They show similar qualitative evidence on structural determiners, family-individual effects, and ways to understand malaria. Motivations to participate in disease interventions are less known, and they constitute the central axis for subsequent studies aimed to improve community engagement in disease control and elimination initiatives.

RESUMO

O presente estudo traz uma sistematização acerca de experiências de atenção à saúde a pessoas que fazem uso prejudicial de álcool e outras drogas que têm por base as diretrizes da redução de danos no Brasil e no mundo. Foi realizado um levantamento bibliográfico em publicações de língua portuguesa e inglesa dos últimos dez anos hospedadas nas bases de dados SciELO, Lilacs, Medline e PsycINFO. Após a seleção do corpus, recorreu-se à metassíntese a fim de integrar o material obtido. Foi possível identificar e analisar avanços e impasses na implantação de estratégias de redução de danos, bem como comparar as diferentes abordagens identificadas nos serviços e ações de cuidado oferecidas aos usuários. Nota-se que a Redução de Danos tem se consolidado como estratégia de prevenção e tratamento e, dessa forma, torna-se imprescindível ampliar as produções acadêmica e científica na área.

Abstract The present study attempts to systemize the experiences of those that have been treated in the primary health care system for alcohol and drug abuse with a view to obtaining reductions in the damages caused to Brazil and the world at large. A bibliographical study was conducted of publications in Portuguese and in English over the past ten years on the following databases SciELO, Lilacs, Medline and PsycINFO. After the selection of the corpus, meta-synthesis was carried out in order to integrate the material obtained. It was possible to identify and analyze advances and impasses in the implementation of harm reduction strategies, and to compare the different approaches identified in the services and care activities offered to users. We noticed that Harm Reduction has become consolidated as a prevention and health care strategy; therefore, it is essential that more academic and scientific research in this area is conducted.

Assuntos

RESUMO

BACKGROUND: Many healthcare stakeholders view nurse practitioners (NPs) as an important workforce resource to help fill the anticipated shortage of 20,400 ambulatory care physicians that is expected by 2020. Multiple quantitative studies revealed the attributes of NPs' practice autonomy and roles. However, there is no qualitative meta-synthesis that describes the experiences of NPs' practice autonomy and roles. AIM: To describe and understand the experiences of NPs regarding their practice autonomy and roles in various ambulatory settings through the exploration of existing qualitative studies: meta-synthesis. DESIGN: A qualitative meta-synthesis was conducted to gain insight into ambulatory NPs' practice autonomy and roles through content analysis and reciprocal translation. METHODS: Articles published between 2000 and 2017 were retrieved by searching 7 databases using the following key words: U.S. qualitative studies, advance practice nurses, NP role in ambulatory care, NP autonomy, and outpatient care. RESULTS: Autonomy, NPs' roles and responsibilities, practice relationships, and organizational work environment pressures are the four main themes that emerged from the content analysis of the nine selected qualitative studies. CONCLUSION: Within and between states, NPs' experiences with autonomy and NPs' roles are multifaceted depending on state regulations, practice relationships, and organizational work environments.

Assuntos

RESUMO

O presente estudo realizou uma pesquisa qualitativa de tipo bibliográfica utilizando o método da metassíntese. Objetivou-se conhecer e analisar os pressupostos epistemológicos que alicerçam as teses desenvolvidas na área da saúde mental e trabalho no âmbito da pós-graduação brasileira. A investigação foi desenvolvida em cinco fases: exploração, refinamento, cruzamento, descrição e análise. A análise de 16 teses consolida a metassíntese e apresenta os seguintes resultados: a área de conhecimento da saúde mental e trabalho fundamenta-se nos pressupostos epistemológicos do campo da saúde do trabalhador. Observa-se, porém, um hibridismo de conceitos com implicações políticas e ideológicas. Assim, faz-se necessário investigar e assumir uma posição política. Caso contrário, o uso indevido de conceitos pode ser interpretado como uma incoerência epistemológica; ou seja, expressar uma postura, mas assumir outra, em sentido contrário. Os conceitos ocultam, portanto, um posicionamento político implícito no desenvolvimento da pesquisa. É, pois, o campo da saúde do trabalhador que alicerça a produção científica da área da saúde mental e trabalho; essa coerência epistemológica é condição imprescindível para o êxito nos processos investigativos e, consequentemente, nos resultados apresentados por essa área do conhecimento.

The present study carried out a qualitative research of the bibliographical type using the meta-synthesis method. The objective was to know and analyze the epistemological assumptions that underpin the theses developed in the area of Mental health and work within the Brazilian postgraduate education. It was developed in five phases: Exploration, Refinement, Crossing, Description and Analysis. The analysis of 16 theses consolidates the meta-synthesis and shows the following results: the Mental Health and Work area of knowledge is based on the epistemological presuppositions on the field of Occupational Health. It is observed, however, a hybridism of concepts with political and ideological implications. Therefore, it is necessary to investigate and take a political position. Otherwise, the misuse of concepts can be interpreted as an epistemological inconsistency, in other words, they express a posture, but assume other, in the opposite direction. They mask, therefore, an implicit political positioning in the research. It is because the field of Occupational Health underpins the scientific production Mental Health and Work area that this epistemological coherence is essential to the success in investigative processes and, consequently, the results presented by this area of knowledge.

En este estudio se llevó a cabo una investigación cualitativa de tipo bibliográfica utilizando el método de Metasíntesis. El objetivo fue conocer y analizar los presupuestos epistemológicos que sustentan las tesis desarrolladas en el ámbito de la Salud mental y trabajo, en el nivel de post graduación brasileña. La investigación se desarrolló en cinco fases: Exploración, Refinamiento, Cruzamiento, Descripción y Análisis. El análisis de 16 tesis consolida la metasíntesis y muestra los siguientes resultados: el área de conocimiento de la salud mental y el trabajo se basa en los presupuestos epistemológicos de la esfera de la salud del trabajador. Se observa, sin embargo, unos conceptos híbridos con implicaciones políticas e ideológicas. Por lo tanto, es necesario investigar y tomar una posición política. De lo contrario, el uso indebido de los conceptos puede ser interpretado como una inconsistencia epistemológica, o sea, expresan una postura, pero asumen otra en la dirección opuesta. Los conceptos ocultan, por lo tanto, un posicionamiento político implícito en el desarrollo de la investigación. Es debido a que, el campo de la salud en el trabajo, sustenta la producción científica en el área de la salud mental y trabajo, que esta coherencia epistemológica es condición esencial para el éxito en los procesos de investigación y, por consiguiente, los resultados presentados por esta área del conocimiento.

RESUMO

AIMS AND OBJECTIVES: To explore the men's beliefs, values, attitudes and experiences towards contraceptives. BACKGROUND: The promotion of male participation in contraceptive practices requires the knowledge and consideration of the beliefs, values, attitudes and experiences involved. The systematic review of the literature focusing on these themes can be useful for the evidence-based health care. DESIGN: A systematic review of qualitative studies. METHODS: Studies published between 1994 until 2011 (inclusive) were included. The participants included men from all cultures, ethnic backgrounds and religions who have expressed their beliefs, values, attitudes and experiences regarding male contraceptives. The databases CINAHL, PubMed, PsycINFO, SciELO, LILACS and MedCarib were explored. The appraisal of primary studies, carried out through the JBI-QARI (Qualitative Assessment and Review Instrument) resulted in the inclusion of 16 studies in this systematic review. RESULTS: The set of statements of beliefs, values, attitudes and experiences regarding contraceptives resulted in five synthesis: (1) contraceptive behaviour is influenced by religious, family and social backgrounds; (2) gendered, male-centred values predominate in contraceptive behaviours; (3) the sense of invulnerability influences contraceptive behaviours; (4) strong obstacles should be overcome to use contraceptives; (5) behaviours, decision-making and experiences regarding male contraceptives. CONCLUSIONS: The male beliefs and values regarding contraceptives are strongly influenced by religious, family and social backgrounds, and their attitudes in this scope are male centred. RELEVANCE TO CLINICAL PRACTICE: A deeper male consciousness regarding contraceptive responsibility should be promoted. It requires the knowledge of the men's personal backgrounds regarding contraceptives because they can be diverse according to family, social and cultural contexts. The consideration of the men's personal perspective is essential in the planning and implementation of reproductive health care. These aspects are essential for the concretisation of the evidence-based health care, a current challenge worldwide.

Assuntos