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Abstract(s)
Introdução: É consensual que a insatisfação com o parto está intimamente relacionada com a dor e com o método utilizado para o seu alívio, como foi já demonstrado em tese anterior, no Centro Hospitalar da Cova da Beira. Não menosprezando também outros fatores, como o tipo de parto, o suporte emocional, a empatia entre a grávida e a equipa obstétrica entre outras variáveis individuais, sociais e situacionais. A dor do parto é uma realidade com base somática, aliada ao componente subjetivo e influenciada por fatores socioculturais. Para isso é de fundamental importância que as mulheres possam fazer uso de métodos farmacológicos e não farmacológicos no alívio da dor, assim como dispor de um suporte nutricional adequado e contar com a retoma de mecanismos auxiliares de desmedicalização do envolvimento do parto.
Materiais e Métodos: Estudo de metodologia quantitativa, observacional descritivo transversal, aprovado pela Comissão de Ética da Faculdade de Ciências da Saúde da Universidade da Beira Interior, tendo, como instrumento de investigação, um questionário disponibilizado eletronicamente aos Serviços de Ginecologia e Obstetrícia dos diversos Centros Hospitalares Nacionais, após envio de pedido de autorização aos Conselhos de Administração. Todos os dados foram submetidos a uma análise estatística descritiva que envolveu a distribuição de frequências. A aplicação de software utilizada foi o Statistical Package for the Social Sciences.
Resultados: Participaram 27 dos 34 (79,4%) centros hospitalares com partos em 2012. Destes, 37% (n=10) utilizam sempre escalas estandardizadas para a avaliação da dor durante o trabalho de parto (TP), enquanto 33% (n=9) não as empregam. A maioria disponibiliza sistematicamente a analgesia epidural (89%; n=24) e os restantes em mais de 50% dos casos (11%; n=3), praticando-a na maioria (59%; n=16) entre 76-95%. Apenas 15% (n=4) não utilizam métodos complementares à epidural, mas todos utilizam outros meios farmacológicos quando a analgesia epidural não é realizável. A maioria dos centros (88,9%;n=24) usa métodos não farmacológicos que são promovidos durante as aulas de preparação para o parto, sendo que os exercícios respiratórios (n=23), relaxamento muscular (n=15), musicoterapia (n=14) são os 3 mais praticados.
A nutrição é assegurada excluindo a via oral, apenas endovenosa em 44% (n=12) dos casos e Per os mas apenas líquida em 41% (n=11) dos casos.
A maioria (86%; n=23) dos hospitais em estudo permite a deambulação durante o TP.
Conclusão: A analgesia epidural tem uma elevada prevalência nos hospitais em estudo. São praticados também outros métodos não farmacológicos de ajuda à parturiente e a maioria permite a deambulação durante o TP. Os critérios para a sua permissão não são consensuais enquanto se constata uma estratégia restritiva em relação à alimentação oral traduzindo a divergência de opiniões e a indefinição de um modelo ideal.
Introduction: There is a consensus that dissatisfaction with labour is closely related to the pain and the method used for its relief, as was shown in a previous thesis in Centro Hospitalar da Cova da Beira. Not belittling other factors, such as the type of delivery, emotional support, empathy between the pregnant and the obstetric team, among other individual, social and situational variables. Labour pain is a reality with somatic base, coupled with the subjective component and influenced by sociocultural factors. For that, is crucial that women can make use of pharmacological and non-pharmacological methods in pain relief, as well as they have a proper nutritional support and rely on the return of auxiliary mechanisms for unmedicalization of labour involvement. Materials and methods: Observational descriptive transversal and quantitative study. The project was approved by the Ethics Committee of the Faculdade de Ciências da Saúde da Universidade da Beira Interior, which included as research instrument a questionnaire available electronically to the Gynecology and Obstetrics Services of National Hospitals, once a request for authorization was sent to the Board of Administration. All data were analyzed with descriptive statistics, involving frequency distribution. Statistical Package for the Social Sciences was the software application used. Results: The sample included 27 of the 34 (79.4%) centers with births in 2012. From this 79.4%, 37% (n=10) always use standardized scales to evaluate the pain during labour, while 33% (n = 9) do not use them. Most hospitals systematically provide the epidural (89%, n=24) and the remaining provide in more than 50% of the cases (11%, n=3). In the majority (59%; n=16) the prevalence is between 76-95%. Only 15% (n=4) did not use complementary methods to epidural, but all of them use other pharmacological methods when epidural analgesia is not feasible. The majority (88.9%;n=24) use non-pharmacological methods that are promoted during the labour preparation classes, being the breathing exercises (n=23), muscular relaxation (n=15) and music therapy (n=14) the three most popular. Nutrition is ensured excluding oral administration and only intravenous in 44% (n=12) of the cases and per os but only liquids in 41% (n=11) of the cases. The majority (86%, n=23) of the hospitals in this study allow deambulation during the labour. Conclusion: Epidural analgesia is highly prevalent in the hospitals considered in this study. Other non-pharmacological methods are also employed to help the parturient and most of the hospitals allow deambulation during labor. The criteria for this permission are not consensual, and there is also a restrictive strategy in relation to oral feeding, reflecting the divergent opinions and elusiveness of an ideal model.
Introduction: There is a consensus that dissatisfaction with labour is closely related to the pain and the method used for its relief, as was shown in a previous thesis in Centro Hospitalar da Cova da Beira. Not belittling other factors, such as the type of delivery, emotional support, empathy between the pregnant and the obstetric team, among other individual, social and situational variables. Labour pain is a reality with somatic base, coupled with the subjective component and influenced by sociocultural factors. For that, is crucial that women can make use of pharmacological and non-pharmacological methods in pain relief, as well as they have a proper nutritional support and rely on the return of auxiliary mechanisms for unmedicalization of labour involvement. Materials and methods: Observational descriptive transversal and quantitative study. The project was approved by the Ethics Committee of the Faculdade de Ciências da Saúde da Universidade da Beira Interior, which included as research instrument a questionnaire available electronically to the Gynecology and Obstetrics Services of National Hospitals, once a request for authorization was sent to the Board of Administration. All data were analyzed with descriptive statistics, involving frequency distribution. Statistical Package for the Social Sciences was the software application used. Results: The sample included 27 of the 34 (79.4%) centers with births in 2012. From this 79.4%, 37% (n=10) always use standardized scales to evaluate the pain during labour, while 33% (n = 9) do not use them. Most hospitals systematically provide the epidural (89%, n=24) and the remaining provide in more than 50% of the cases (11%, n=3). In the majority (59%; n=16) the prevalence is between 76-95%. Only 15% (n=4) did not use complementary methods to epidural, but all of them use other pharmacological methods when epidural analgesia is not feasible. The majority (88.9%;n=24) use non-pharmacological methods that are promoted during the labour preparation classes, being the breathing exercises (n=23), muscular relaxation (n=15) and music therapy (n=14) the three most popular. Nutrition is ensured excluding oral administration and only intravenous in 44% (n=12) of the cases and per os but only liquids in 41% (n=11) of the cases. The majority (86%, n=23) of the hospitals in this study allow deambulation during the labour. Conclusion: Epidural analgesia is highly prevalent in the hospitals considered in this study. Other non-pharmacological methods are also employed to help the parturient and most of the hospitals allow deambulation during labor. The criteria for this permission are not consensual, and there is also a restrictive strategy in relation to oral feeding, reflecting the divergent opinions and elusiveness of an ideal model.
Description
Keywords
Analgesia Deambulação Dor Nutrição Parto