Conhecimento de gestantes e puérperas sobre o atendimento na atenção primária do município de Ananindeua, estado do Pará / Knowledge of pregnant and postpartum women about care in primary care in the city of Ananindeua, state of Pará

Objetivo: Analisar o impacto das orientações médicas recebidas durante o pré-natal sobre o conhecimento adquirido de puérperas e gestantes, a respeito da importância dos principais exames solicitados para a assistência do pré-natal em uma Unidade Básica de Saúde (UBS). Métodos: Trata-se de um estudo observacional, descritivo, com grupo de comparação. A pesquisa foi realizada na UBS Júlia Seffer, localizada no município de Ananindeua, Pará, Brasil. A coleta de dados foi realizada mediante a aplicação de questionário a 50 mulheres, 25 gestantes e 25 mulheres pós-parto, que tinham entre 18 e 49 anos e fizeram o pré-natal de agosto de 2019 a agosto de 2020. Resultados: Entre os dados analisados, apenas 52% das gestantes e 44% das puérperas conseguiram descrever a medição da altura uterina. Em relação ao processo educativo durante o pré-natal, pode-se evidenciar que 88% das gestantes e 72% das puérperas não estavam envolvidas em nenhuma atividade educativa. Em relação à avaliação pré-natal, apenas 32% das gestantes e 44% das mulheres pós-parto avaliaram como excelente o atendimento realizado na UBS. Conclusão: Observou-se a presença de falhas no processo educativo, que indica a necessidade de maior cuidado e investimentos na atenção primária direcionada ao cuidado e orientação das mulheres no ciclo gravídico-puerperal.(AU)

Objective: To analyze the impact of medical guidance received during prenatal care on the knowledge acquired by postpartum and pregnant women regarding the importance of the main tests requested for prenatal care in a Basic Health Unit (BHU). Methods: This is an observational, descriptive study, with comparison group. The research was conducted at UBS Júlia Seffer, located in the municipality of Ananindeua, Pará, Brazil. Data collection was performed by applying a questionnaire to 50 women, 25 pregnant and 25 postpartum women, who were between 18 and 49 years old and had prenatal care from August 2019 to August 2020. Results: Among the data analyzed, only 52% of pregnant women and 44% of puerperal women were able to describe the measurement of uterine height. Regarding the educational process during prenatal care, it can be evidenced that 88% of pregnant women and 72% of puerperal women were not involved in any educational activity. Regarding prenatal evaluation, only 32% of pregnant women and 44% of postpartum women evaluated as excellent the care provided in the BHU. Conclusion: It was observed the presence of flaws in the educational process that indicate the need for greater care and investment in primary care directed to the care and guidance of women in the gravidic-puerperal cycle.(AU)

Recommendations of physical activity and rest in a Colombian prenatal control program / Recomendaciones de actividad física y reposo en un programa de control prenatal colombiano

ABSTRACT OBJECTIVE To determine the frequency of the registry of physical activity and rest recommendations made to pregnant women and to explore their associated factors in a prenatal care program of primary care public institutions in Bucaramanga, Colombia. METHODS An observational study was conducted. The sampling frame consisted of the medical records of the pregnant women who attended at least one prenatal care program between January 1 and December 31, 2012 (n = 2.932), in 21 primary care health centers. We analyzed sociodemographic variables, prenatal and clinical antecedents, and information related to health personnel and the organization of health centers as possible factors associated with the recommendations of physical activity and rest recorded in the clinical history. Logistic regression models were applied to explore associations with α = 0.10. RESULTS There was a frequency of 26.1% of PA recommendations and 3.6% of rest recommendation on record, issued by nutrition (97.3%) and medical (86.7%) professionals, respectively. The factors associated with the registration of physical activity recommendations were: being nulliparous pregnant (OR = 1.7), attending more than four Prenatal Care Attention Programs (OR = 2.2), having high or medium obstetric risk in the first prenatal care program (OR = 0.6), and being attended in the western (OR = 0.5) and eastern (OR = 0.2) administrative areas health centers. CONCLUSIONS The low frequency of physical activity recommendations found in the records makes it necessary to reinforce the management strategies of health centers and strengthen the monitoring and accompaniment to comply with the care protocols. In addition, it is necessary to train health teams on the benefits of physical activity and their proper prescription, considering the multiple benefits derived from their practice on the maternal-fetal health.

RESUMEN OBJETIVO Determinar la frecuencia del registro de recomendaciones de actividad física y reposo realizadas a las gestantes y explorar sus factores asociados, en un programa de atención de control prenatal de instituciones públicas de primer nivel de atención en Bucaramanga, Colombia. MÉTODOS Se realizó un estudio observacional. El marco muestral estuvo conformado por los registros médicos de las gestantes que asistieron al menos a un programa de atención de control prenatal entre el 1º de enero y 31 de diciembre de 2012 (n = 2,932), en 21 centros de salud de primer nivel de atención. Se analizaron variables sociodemográficas, antecedentes prenatales, antecedentes clínicos, e información relacionada con el personal de salud y la organización de los centros de salud como posibles factores asociados con las recomendaciones de actividad física y reposo registrados en la historia clínica. Se aplicaron modelos de regresión logística para explorar las asociaciones con un α = 0.10. RESULTADOS Se observó una frecuencia de 26.1% de registro de recomendaciones de AF y 3.6% de reposo, emitidas por parte de profesionales de nutrición (97.3%) y medicina (86.7%), respectivamente. Los factores asociados al registro de las recomendaciones de actividad física fueron: ser gestante nulípara (OR = 1.7), asistir a más de cuatro Programas de Atención de Control Prenatal (OR = 2.2), tener riesgo obstétrico alto o medio en el primer programa de atención de control prenatal (OR = 0.6) y ser atendidas en los centros de salud de las zonas administrativas de occidente (OR = 0.5) y oriente (OR = 0.2). CONCLUSIONES La baja frecuencia del registro de recomendaciones de actividad física encontrada, genera la necesidad de reforzar las estrategias de gestión de los centros de salud y fortalecer el monitoreo y acompañamiento en el cumplimiento de los protocolos de atención. Adicionalmente, es necesario capacitar a los equipos de salud sobre los beneficios de la actividad física y su prescripción adecuada, atendiendo a los múltiples beneficios derivados de su práctica sobre la salud materno-fetal.

Efectividad de intervención educativa en conocimientos de embarazadas sobre factores de riesgo maternos de bajo peso al nacer / Effectiveness of educational intervention in knowledge of pregnant women on maternal risk factors of under weight to be born

Introducción: el bajo peso al nacer guarda relación con la morbilidad, mortalidad y bienestar del binomio madre-hijo, el desconocimiento sobre sus factores de riesgo requiere de intervenciones educativas en las gestantes. Objetivo: evaluar la efectividad de intervención educativa en el nivel de conocimientos de embarazadas sobre factores de riesgo maternos de bajo peso al nacer. Métodos: estudio de intervención educativa con diseño preexperimental, con pre y post-test en gestantes del Policlínico Felipe Poey Aloy en Nueva Paz, Mayabeque, de abril 2013 hasta junio 2014. Universo de 32 gestantes con tiempo gestacional inferior a 26 semanas y factores maternos asociados, se aplicó un cuestionario inicial, se implementó la intervención y se evaluó su efectividad. Se utilizaron distribución de frecuencia absoluta y valor porcentual, la comparación de proporciones se realizó mediante medida de resumen para variables cualitativas. Se calculó la razón de las variables dependientes explicada por las diferencias entre los grupos. Resultados: el nivel de conocimientos sobre la edad óptima para el embarazo, el peso adecuado y la alimentación apropiada antes de la intervención eran insuficientes en 68,75 por ciento, 84,37 por ciento y 53,12 por ciento respectivamente, después de la intervención se elevó en 100 por ciento, 87,50 por ciento y 84,37 por ciento. Los conocimientos sobre las enfermedades maternas asociadas y los suplementos vitamínicos que se deben ingerir eran deficitarios en 59,37 por ciento y 62,50 por ciento elevándose en 68,75 por ciento y 90,62 por ciento en cada caso. Conclusiones: la intervención educativa fue efectiva en la modificación del nivel de conocimientos sobre factores de riesgo maternos de bajo peso al nacer de las embarazadas estudiadas(AU)

Introduction: Low birth weight is related to morbidity, mortality and welfare of mothers and children, the lack of knowledge about their risk factors requires educational interventions in pregnant women. Objective: evaluating the effectiveness of educational intervention in the level of knowledge of pregnant women on maternal risk factors of underweight when being born. Methods: study of educational intervention with pre experimental pre-test post-test in pregnant Polyclinic Felipe Poey Aloy" in Nueva Paz, Mayabeque, from April 2013 to June 2014. Universe less than 32 pregnant women with gestational time design with and 26 weeks and associated maternal factors, an initial questionnaire was applied, the intervention was implemented and its effectiveness was evaluated. Distribution of absolute frequency and percentage value was used; the comparison of proportions was performed using summary measure for qualitative variables. The reason for the dependent variables explained by differences between groups was calculated. Results: the level of knowledge on the optimal age for pregnancy, the adequate weight and the nutrition adapted before intervention were insufficient in 68.75 percent, 84.37 percent and 53.12 percent respectively, after intervention rose in 100 percent, 87.50 percent and 84.37 percent. The knowledge on the maternal correlated diseases and the vitamin supplements that should be taken in were showing a deficit in 59.37 percent and 62.50 percent rising in 68.75 percent and 90.62 percent in each case. Conclusions: the educational intervention was effective in the modification of the level of knowledge on maternal risk factors of underweight to be born of the studi ed pregnant women(AU)