Non-pharmacological and non-surgical treatments for female urinary incontinence: an integrative review.

REVIEW AIM: To explore the outcomes of non-pharmacological and non-surgical resources used to treat female urinary incontinence (UI). DESIGN: It is an integrative review (IR) of literature. METHODS: The databases CINAHL, PubMed, PsycINFO, Sociological Abstracts, The Cochrane Library, Scopus, Lilacs, Scielo, IBECS, BDENF, and Medcarib were explored. The grey literature, hand searching, and backtracking of references of primary studies were also explored. The fifteen studies that fulfilled the inclusion criteria were submitted to appraisal of methodological quality and one was excluded, resulting in 14 empirical studies included in this IR. RESULTS: All the treatments, the corresponding instrumental resources, and the support provided by health care providers resulted in the improvement or cure of UI. The pelvic floor muscle training (PFMT) exercise was the main way to treat UI. The multiprofessional involvement, close relationship with patients, continuous monitoring and support associated with PFM training were the factors associated with better adherence to UI treatment and its outcomes.

Birth Care Providers' Experiences and Practices in a Brazilian Alongside Midwifery Unit: An Ethnographic Study.

The implementation of a new birthing facility in a country such as Brazil requires an extensive in-depth analysis of the challenges faced. The aim of this study was to explore beliefs, values, experiences, and practices related to the provision of birthing and neonatal care with the implementation of a new birth care facility structure called alongside midwifery units in Brazil. The study utilizes an ethnographic method to evaluate members of a Brazilian public hospital's midwifery unit. The ethnographic study focuses on the cultural theme of "between the proposed and the possible": the following birthing care guidelines require overcoming numerous obstacles, and four other cultural subthemes toward revealing the analyzed birth care team's perspectives. The study found that prior training and preparation of all members of the care team, as well as the provision of adequate institutional infrastructure are essential for the implementation of a new and innovative birthing care center.

"Not worth doing prenatal care": an ethnographic study of a low-income community.

OBJECTIVE: The aim of this study was to explore the reasons why pregnant women do not seek prenatal care (PNC). METHODOLOGY: The ethnographic method was used in a low-income Brazilian community. Ethnographic interviews were performed with 11 postpartum women who did not seek PNC in their last pregnancy. RESULTS: The cultural sub-themes used to express reasons for not seeking PNC included: "I found out I was pregnant too late and did not have enough time to receive PNC," "I did not receive PNC because I had to hide the pregnancy to avoid problems," "I had to address urgent issues and could not seek PNC," "The services are not good and going to the doctor when not ill is only for rich people," and cultural theme: "PNC is not worth pursuing: it is unnecessary and there are too many obstacles to receiving it." CONCLUSION: The main strategies that should be considered to increase adherence to PNC are better access and integrality through the use of adequate management criteria.

"Not worth doing prenatal care": an ethnographic study of a low-income community / "No vale la pena hacer prenatal": estudio de una comunidad de bajos recursos / "Não vale a pena fazer pré-natal": estudo de uma comunidade de baixa renda

Objective. The aim of this study was to explore the reasons why pregnant women do not seek prenatal care (PNC). Methodology. The ethnographic method was used in a low-income Brazilian community. Ethnographic interviews were performed with 11 postpartum women who did not seek PNC in their last pregnancy. Results. The cultural sub-themes used to express reasons for not seeking PNC included: "I found out I was pregnant too late and did not have enough time to receive PNC," "I did not receive PNC because I had to hide the pregnancy to avoid problems," "I had to address urgent issues and could not seek PNC," "The services are not good and going to the doctor when not ill is only for rich people," and cultural theme: "PNC is not worth pursuing: it is unnecessary and there are too many obstacles to receiving it." Conclusion. The main strategies that should be considered to increase adherence to PNC are better access and integrality through the use of adequate management criteria.

Objetivo. Explorar las razones por que las mujeres gestantes no buscaron asistencia prenatal. Metodología. Se empleó el método etnográfico en una comunidad de bajos recursos en el Brasil. Se realizaron entrevistas etnográficas a 11 puérperas que no buscaron asistencia prenatal en la última gravidez. Resultados. Las razones para no buscar la atención prenatal fueron: me di cuenta del embarazo muy tarde y no dio tempo de hacer prenatal; no hice prenatal porque tuve que esconder el embarazo para evitar problemas; tuve que resolver problemas urgentes y no pude hacer prenatal; el servicio no es bueno e ir al médico sin estar enfermo es sólo para los ricos; y: "no vale la pena hacer prenatal: esta asistencia no es esencial y hay muchos obstáculos que enfrentar". Conclusión. La importancia de la facilidad de acceso y la integridad de la atención prenatal, desarrollada a través de los principios de buena gestión, son los principales aspectos a considerar en la promoción de la adhesión a la atención prenatal.

Objetivo. Explorar as razões para as mulheres grávidas não procurarem assistência pré-natal. Metodologia. O método etnográfico foi desenvolvido em uma comunidade de baixa renda no Brasil. Entrevistas etnográficas foram desenvolvidas com 11 puérperas que não procuraram assistência pré-natal na última gravidez. Resultados. As razões para a não busca pela assistência pré-natal foram: Percebi a gravidez muito tarde e não deu mais tempo para fazer pré-natal; Não fiz pré-natal porque tive que esconder a gravidez para evitar problemas; Tive que resolver problemas urgentes e não pude fazer pré-natal; O atendimento não é bom e ir ao médico sem estar doente é só para ricos; e "Não vale a pena fazer pré-natal: esta assistência não é essencial e há muitos obstáculos a enfrentar". Conclusão. A importância da facilidade de acesso e da integralidade da assistência pré-natal, desenvolvida por meio de princípios de boa gestão, são os principais aspectos a considerar na promoção da aderência à assistência pré-natal.

Adult men's beliefs, values, attitudes and experiences regarding contraceptives: a systematic review of qualitative studies.

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.

Mothers' birth care experiences in a Brazilian birth centre.

OBJECTIVE: to explore the reasons why women with previous hospital experience seek care at a birth centre, and their perceptions related to the care received in both settings. DESIGN, SETTING AND PARTICIPANTS: in-depth interviews focusing on the care experiences of 18 women who received birth care in a birth centre of the Brazilian public health system. FINDINGS: three key themes emerged from the analysis: 'Confrontation with strong problems in the hospital setting', 'Reasons to seek the birth centre' and 'Satisfaction related to birth centre care'. The main aspects that the mothers mentioned in the first and third themes were related to the institutional structure and system of care. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: mothers' narratives suggested that their previous experience of problems in the hospital setting was the main motive for seeking care at the birth centre. The most important components of birth care were attention, meeting personal care demands and establishment of an adequate interpersonal relationship. More sensitive birthing care in the hospital setting is necessary, and this can be promoted through continuing professional education.