ABSTRACT
INTRODUCTION: Photobiomodulation (PBM) using low-level laser can affect tissue repair mechanisms and seems promising in reducing pain intensity. However, few studies support the effectiveness of PBM on postpartum period complications, such as nipple and/or perineal trauma and pain, probably due to the low doses used. The primary objective of this study is to analyse the effectiveness of PBM on pain intensity in the nipple and perineal trauma in women in the immediate postpartum period. Secondary objectives are to evaluate the effect on tissue healing and the women's satisfaction. METHODS AND ANALYSIS: A double-blind, multicentre, parallel-group, randomised controlled trial will be performed in two public referral maternity hospitals in Brazil with 120 participants, divided into two arms: 60 participants in the nipple trauma arm and 60 participants in the perineal trauma arm. Participants will be women in the immediate postpartum period, who present with nipple trauma or perineal trauma and report pain intensity greater than or equal to 4 points on the Numerical Rating Scale for Pain. Block randomisation will be performed, followed by blinding allocation. In the experimental group, one application of PBM will be performed between 6 hours and 36 hours after birth. For the sham group, the simulation will be carried out without triggering energy. Both participants and the research evaluator will be blinded to the allocation group. Intention-to-treat method and the between-group and within-group outcome measures analysis will be performed. ETHICS AND DISSEMINATION: This research protocol was approved by the Research Ethics Committees of the University of Campinas, Brazil, and of the School Maternity Assis Chateaubriand, Brazil (numbers CAAE: 59400922.1.1001.5404; 59400922.1.3001.5050). Participants will be required to sign the informed consent form to participate. Results will be disseminated to the health science community. TRIAL REGISTRATION NUMBER: Brazilian Registry of Clinical Trials (RBR-2qm8jrp).
Subject(s)
Low-Level Light Therapy , Humans , Pregnancy , Female , Nipples , Pain Measurement , Postpartum Period , Pain/etiology , Pain/radiotherapy , Randomized Controlled Trials as Topic , Multicenter Studies as TopicABSTRACT
OBJECTIVE: To evaluate the knowledge, attitude, and practice (KAP) of pelvic floor muscle (PFM) preparation for birth among postpartum women, and its related factors. METHODS: Cross-sectional study conducted in a maternity unit among Brazilian women aged 14 years or older during the first 72 h postpartum, who desired and had vaginal birth. Sociodemographic, clinical, and obstetric data were collected using a standardized form from medical charts. A 15-question questionnaire was used to measure the KAP of PFM preparation for birth. Knowledge was categorized as: poor, average, and good. RESULTS: In all, 326 women completed the survey (mean age 24.3 ± 6.2 years) and 167 (51.2%) women had poor knowledge. The attitude of searching for information on how to prevent perineal trauma was reported by 14 (4.3%) women. Only 13 (4.0%) participants reported that they had practiced at least one session of PFM preparation during pregnancy (PFM training, perineal massage, etc.) Multivariate analysis showed that lower educational level was associated with poor knowledge (P < 0.05). CONCLUSION: The KAP of PFM preparation for birth is inadequate among postpartum women. Health education regarding PFM care during pregnancy and postpartum should be addressed among pregnant women, specifically younger women with lower levels of education and income.
Subject(s)
Health Knowledge, Attitudes, Practice , Pelvic Floor , Pregnancy , Female , Humans , Adolescent , Young Adult , Adult , Male , Cross-Sectional Studies , Pelvic Floor/physiology , Parturition , Postpartum Period/physiology , Perineum/injuriesABSTRACT
Avaliar o desenvolvimento neuropsicomotor de crianças de 0-18 meses de determinada microárea assistida por uma Unidade Básica de Saúde da Família (UBASF). Realizou-se um estudo descritivo, observacional e longitudinal com estratégia de análise quantitativa dos resultados em uma UBASF localizada na cidade de Maracanaú/CE. Para coleta de dados, utilizou-se a ficha de avaliação presente na Caderneta de Saúde da Criança (CSC) agregada a outra ficha elaborada pelos autores onde continham dados sociodemográficos. Participaram do estudo 17 crianças. Foi possível evidenciar que nove (53%) crianças apresentaram todos os marcos esperados para a idade de acordo com a tabela de acompanhamento do desenvolvimento presente na CSC. Das crianças que não apresentaram todos os marcos para a faixa etária, sete (87,5%) estavam entre um a seis meses e um (12,5%) entre 13 a 18 meses. Entretanto, nenhuma criança foi considerada com atraso no desenvolvimento, pois estavam dentro dos períodos específicos para realizar cada marco. Evidenciou-se que nenhuma criança apresentou atraso no desenvolvimento neuropsicomotor. Por fim, ressalta-se a importância da realização da triagem completa durante as consultas de puericultura e da utilização do instrumento já presente na CSC.
The neuropsychomotor development of 0-18-monthold children of a micro-area attended by a family basic health unit in Maracanau CE Brazil, is evaluated by a descriptive, observational and longitudinal study. Data were collected by the assessment of the Children´s Health Sheet coupled to another form with sociodemographic data prepared by the authors. Seventeen children participated in the study. Nine (53%) children had all the marks expected for their age according to the follow-up development table. Seven (87.5%) out of the children, who did not present all the marks, were aged between 1 and 6 months, and one child (12.5%) was aged between 13 and 18 months. No child had development delays since they were all within the specific periods for each mark. No child had any delay in neuropsychomotor development. Results reveal the importance of complete selection during puericulture attendance and the employment of the CHS.
ABSTRACT
RESUMO A intervenção precoce no desenvolvimento, por meio de atividades parentais, favorece ganhos cognitivos, físicos, sociais e emocionais da criança, que são determinantes da saúde infantil. Contudo, estudos com intervenção precoce com atividades parentais são escassos. Assim, o objetivo deste estudo foi analisar o efeito da intervenção parental precoce no desenvolvimento motor de lactentes em seguimento em ambulatório de risco. Este é um estudo de série de casos, longitudinal e intervencionista, em 100 lactentes, com idade entre 0-18 meses, provenientes de um ambulatório de risco. O desenvolvimento motor dos lactentes foi avaliado pela escala motora infantil de Alberta. Foram transmitidas orientações aos pais, a depender do atraso motor observado. Não houve relação dos fatores de risco com o desenvolvimento motor. Porém, esses fatores apresentaram relação com a idade gestacional, que teve, por sua vez, relação com o desenvolvimento motor. Após intervenção precoce parental, a frequência amostral aumentou de 45% para 69% no grupo de crianças com desenvolvimento motor normal. No grupo com atraso no desenvolvimento, a frequência amostral reduziu de 55% para 31%. Fatores de risco pré-natal e/ou perinatal podem acarretar prematuridade e consequentemente atraso no desenvolvimento motor infantil. Para esses lactentes, protocolos de intervenção precoce com atividades parentais são efetivos para promover um desenvolvimento motor normal de crianças em seguimento em ambulatório de risco.
RESUMEN Por intermedio de actividades parentales, la intervención precoz en el desarrollo favorece logros cognitivos, físicos, sociales y emocionales a los bebés, factores determinantes para la salud infantil. Pero son pocos los estudios sobre la intervención precoz con actividades parentales. Así en este estudio se propone analizar los resultados de la intervención parental precoz para el desarrollo motor de lactantes en ambulatorio de una maternidad. Estudio de tipo serie de casos, longitudinal e intervencionista, del cual participaron cien lactantes, entre 0 y 18 meses de edad, provenientes del ambulatorio de la maternidad. Se evaluó el desarrollo motor de los lactantes por intermedio de la escala Alberta. Dependiendo del retraso motor observado en los bebés, se hicieron recomendaciones a los padres. No se encontró relaciones entre los factores de riesgo y el desarrollo motor. Sin embargo, estos factores presentaron relación con la edad gestacional, que se relacionó, a su vez, con el desarrollo motor. Tras la intervención precoz parental, la frecuencia del muestreo aumentó del 45% al 69% en el grupo de bebés con desarrollo motor normal. El grupo con retraso en el desarrollo sufrió una disminución en la frecuencia de la muestra del 55% al 31%. Los factores de riesgo prenatal y/o perinatal pueden implicar precocidad y, por consiguiente, retraso en el desarrollo motor infantil. Para lactantes en ambulatorios, estos protocolos de intervención precoz con actividades parentales son eficaces para promocionar su desarrollo motor normal.
ABSTRACT Early intervention based on parental activities promotes cognitive, physical, social, and emotional development, which are determinants for the child's health. However, studies about early intervention with parental education are scarce. The objective of this study was to analyze the effect of parental intervention in the motor development of infants. This is a case series, longitudinal, and interventional study, with 100 infants at risk, aged 0-18 months. Motor development of infants was assessed by the Alberta Infant Motor Scale, and the parents received information about positioning and exercises depending on the child's motor score. Risk factors were not related to infants' motor development. However, these risk factors were related to gestational age, which was related to motor development. After parental early intervention, the sample frequency increased from 45% to 69% in the group of children with normal motor development. Frequency was reduced from 55% to 31% in the group with delayed development. Prenatal and/or perinatal risk factors can cause prematurity, and consequently, delays in children's motor development. For these infants, early intervention protocols with parental education are effective to stimulate a normal motor development of children at risk in follow-up in outpatient clinics.
