Emotional distress and its care in empowered indigenous women exposed to domestic violence and the demands of child rearing / Malestares emocionales y su atención en mujeres indígenas empoderadas expuestas a violencia doméstica y exigencias de crianza de los hijos

Abstract Introduction Indigenous girls and women in Mexico suffer emotional distress due to marital violence and adherence to gender roles. They are unlikely to denounce violence or treat their health in a timely manner. Women can cope with their distress by participating in empowerment processes. Objective Describe in indigenous empowered women the emotional distress caused by domestic violence in their childhood and the current demands of raising their children and the actions they take to cope with them. Method Qualitative and phenomenological qualitative research, in-depth interviews, and participant observation were conducted with nine migrant indigenous women to explore experiences during their upbringing, emotional reactions, and current mental health problems. Results The software Atlas. ti V 7 was used to undertake a theoretical categorization of the data. Findings included exposure to violence, the influence of a good mother, and past and present emotional distress overcome through empowerment and professional care. Discussion and conclusion Participating in urban empowerment activities enables participants to reflect on the violence experienced and the attendant distress, identify them as gender violence, and use them in their favor. They are strategic when coping with current distress due to the conflictive upbringing of their children, using psychological services and the urban upbringing prescriptions of children's rights, and incorporating indigenous parenting practices, which encourage community commitment, responsibility, and early self-sufficiency in children. Empowerment is suggested as an effective means of improving the health of indigenous women in Mexico.

Resumen Introducción En México, niñas y mujeres indígenas padecen malestares emocionales por la violencia conyugal y el cumplimiento de roles de género. No es común que se denuncie la violencia o se atienda oportunamente su salud. Las mujeres pueden emprender la atención de sus malestares al participar en procesos de empoderamiento. Objetivo Describir en mujeres indígenas empoderadas los malestares emocionales causados por la violencia doméstica en su niñez; por las exigencias actuales en la crianza de sus hijos/as y las acciones que realizan para atenderlos. Método Mediante una investigación cualitativa situada y fenomenológica, se realizaron entrevistas en profundidad y observación participante con nueve mujeres indígenas migrantes. Con estas herramientas se exploraron experiencias durante su crianza; reacciones emocionales y problemas actuales de salud mental. Resultados Mediante el software Atlas. ti V 7, se realizó una categorización teórica de los datos. Así se encontraron: exposición a la violencia; la influencia de la buena madre; malestares emocionales antiguos y actuales sobrellevados con el empoderamiento y la atención profesional. Discusión y conclusión Participar en actividades urbanas de empoderamiento lleva a las participantes a reflexionar sobre la violencia vivida y sus malestares asociados; resituarlos como violencia de género, y usarlos en su favor. Se muestran estratégicas al enfrentar malestares actuales por la conflictiva crianza de su hijos/as, usando servicios psicológicos y las prescripciones de crianza urbana del derecho infantil, e integrando prácticas de crianza indígenas, que estimulan el compromiso comunitario, responsabilidad y autosuficiencia temprana en los hijos/as. Se sugiere aprovechar la eficacia del empoderamiento para mejorar la salud de las mujeres indígenas del país.

Development and Application of Professional Care APP for Stroke Patients at Home / 中国康复理论与实践

Objective:To develop and evaluate the effect of Professional Care APP for stroke patients at home. Methods:Professional Care APP 1.0 was developed by reviewing literature, analyzing APP function and consulting expert, and combined with the findings at the early stage. And then it was upgraded to APP 2.0 after a 4-week trial in 10 stroke patients at home, which included two parts: patient-side and medical-side. The patient-side provided health education, rehabilitation guidance, medication reminder, online consultation and so on. From December, 2017 to June, 2018, 77 stroke patients in a community in Zhengzhou, China were conveniently selected and randomly divided into control group (n = 39) and intervention group (n = 38). The control group received routine community follow-up, and the intervention group received Professional Care APP 2.0, for 12 weeks. Results:After a 12-week intervention, the level of knowledge and medication compliance was significantly higher in the intervention group than in the control group (t > 4.205, P < 0.001). The score of demand for professional care was significantly lower in the intervention group than in the control group (t = -18.183, P < 0.001). The intervention group made a good evaluation for APP in usefulness, ease of learning, usability, credibility, acceptability and satisfaction. Conclusion:Professional Care APP can meet the professional care needs, and improve the level of knowledge on disease and medication compliance for stroke patients at home. The patients' evaluation for APP is ideal.

Amor materno e cuidado profissional / Maternal love and professional care / Amor materno y cuidado profesional

Este artigo visa trazer uma reflexão acerca dos cuidados profissionais direcionados à primeira infância, especialmente os cuidados oferecidos por babás, tão comum no contexto brasileiro. Primeiramente, foi proposta uma discussão acerca da importância do cuidado para o desenvolvimento emocional do bebê, bem como as distinções existentes entre as relações que a cuidadora estabelece com o bebê, daquela estabelecida entre a díade mãe-bebê. Partindo dessas considerações, um estudo de caso foi apresentado. Este foi realizado com uma mãe e seus três bebês trigêmeos, acompanhados por uma observadora durante os dois primeiros anos de vida dos bebês através do método Bick de observação de bebês.

This article aims at bringing a reflection about the professional early childhood care, especially the nannies, so common in the Brazilian context. First, a discussion was proposed about the importance of care for the emotional development of the baby, as well as the distinction between the relationship the caregiver establishes with the baby and that established between the mother and baby. From these considerations, a case study was presented, referring to a mother and her three triplet babies, accompanied by an observer during the first two years of the babies' life, through the Bick method of infant observation.

Este artículo pretende reflexionar sobre los cuidados profesionales dirigidos a la primera infancia, especialmente de las niñeras, muy común en el contexto brasileño. Se propone una discusión acerca de la importancia de los cuidados en el desarrollo emocional del bebé, así como las distinciones existentes entre las relaciones que la cuidadora establece con el bebé y las relaciones madre-bebé. Desde estas consideraciones, se realizó un estudio de caso con una madre y sus tres bebés trillizos, acompañados por una observadora durante los dos primeros años de vida de los bebés a través del método Bick de observación de bebés.

Actualizaciones en depresión posparto / Updates on postpartum depression

La depresión posparto es el trastorno del ánimo más prevalente asociado al nacimiento, sin embargo su diagnóstico y tratamiento presenta ciertas dificultades. El objetivo de este artículo es revisar aspectos generales de la depresión posparto, los factores asociados al cuadro clínico, su diagnóstico y tratamiento y las implicancias para la madre y su hijo(a). La metodología empleada fue la revisión de la literatura entre los años 2001- 2011 en español e inglés en distintas bases de datos. A partir de ella se identificaron factores con distintos grados de asociación con la enfermedad, como también estrategias para su detección, entre las cuales está el uso de la Escala de Depresión de Edimburgo y alternativas terapéuticas para su tratamiento. Su impacto en la relación madre-hijo(a) y en el desarrollo del niño(a) se relaciona directamente con la duración e intensidad del cuadro, asociándose al establecimiento de apegos inseguros, deterioro del desarrollo psicomotor y cese precoz de la lactancia materna, además del deterioro de la calidad de vida de las puérperas. Todo lo anterior hace que este sea un problema relevante para abordar por los profesionales de la salud vinculados al cuidado de la madre y su bebé, debido a lo cual se proponen recomendaciones respecto de los cuidados que debieran otorgarse a quienes cursan con este trastorno y a sus familias.

Postpartum depression is the most prevalent mood disorder associated with birth, but its diagnosis and treatment presents certain difficulties. The aim of this paper is to review general aspects of postpartum depression, the factors associated with clinical symptoms, diagnosis and treatment, and the implications for the mother and her child. The methodology used was a review of the literature from 2001 - 2011 in Spanish and English in different databases. Then, we identified factors with varying degrees of association with this disease, as well as strategies for detection, including the use of Edinburgh Depression Scale and therapeutic alternatives for its treatment. Its impact on the mother-child relationship and child development is directly related to the duration and intensity of the case, associating the establishment of insecure attachments, impaired psychomotor development and early cessation of breastfeeding, further deterioration in the postpartum women quality of life. All the above mentioned make it a relevant problem to address by health professionals involved in the mother and child care, thus it is proposed recommendations for the care that should be given to those who suffering this disorder and their families.