Depressão em gestantes cardiopatas e sua influência no vínculo materno-fetal / Depression on pregnant woman with heart disease and it's influence on maternal-fetal bonding

Objetivo: Avaliar a presença ou não de depressão em gestantes cardiopatas; avaliar o vínculo materno-fetal existente entre gestantes cardiopatas e verificar se o vínculo materno-fetal pode ser fator de risco para depressão. Método: foram entrevistadas 20 gestantes cardiopatas, sendo 10 de ambulatório e 10 internadas na enfermaria da Divisão de Clínica Obstétrica - HCFM USP, através da aplicação de entrevista semi-dirigida e Prime-MD. Resultados: 75 por cento do total das pacientes entrevistadas relataram aspectos positivos em relação aos sentimentos associados ao momento em que o bebê se mexe, o que provavelmente demonstra um bom vínculo mãe-bebê. Com relação ao diagnóstico de depressão, a avaliação do Prime-MD mostrou que 90 por cento das mulheres não apresentaram sintomas suficientes para caracterizar a doença. Conclusão: Não foi diagnosticada depressão entre as gestantes cardiopatas, o que possivelmente se relacione ao desenvolvimento de um bom vínculo mãe-bebê. Desta forma, conclui-se que o vínculo afetivo mãe-bebê pode estar associado à depressão.(AU)

Objective: To evaluate the presence or not of depression, the existent of maternal-fetal bond and to verify if the maternal-fetal bond can be a risk factor for depression in pregnant women with heart disease. Method: We interviewed 20 pregnant women with heart disease, being 10 of clinic and 10 hospitalized in the nursery of the Obstetric Clinic Division - HCFMUSP, through the application of semi-driven interview and Prime-MD. Results: 75 percent of the patients interviewed reported positive aspects in relation to the feelings associated to the moment that the baby moves, what probably demonstrates a good mother-baby bond. Regarding the depression diagnosis, the evaluation of Prime-MD showed that 90 percent of the women didn't present enough symptoms to characterize the disease. Conclusion: Depression was not diagnosed among the pregnant woman with heart disease, what possibly links to a good mother-baby bond's development. This way, it was concluded that the affection bond between mother and can be associated to the depression.(AU)

[Effectiveness of learning of nursing-work as early exposure by the 1st year medical students at a university hospital].

We conducted a half day program included in the subject of "nursing and care" as early exposure at clinical sites for the 1st year medical students at a university hospital. This program aimed at understanding what nursing is through visit for study and what patients expect through doctor-patient communication. In order to evaluate the program and to clarify problems to be solved, comments and impressions reported by the medical students were analyzed qualitatively and inductively. As a result, we found that the students recognized the importance of communication with patients and of mental care for them. As for nursing, the students also realized the characteristics and significance of nursing. It is noteworthy that they acquired clear images of a medical doctor, including their roles in team-based medical care. We conclude that this program of early exposure to clinical sites is instructive for 1st year medical students.

Ultrassonografia bidimensional e tridimensional e o vínculo materno fetal: um estudo comparativo / Ultrasound two-and three-dimensional and maternal-fetal bonding: a comparative study

Este estudo busca descrever o relacionamento materno-fetal antes e após a realização da ultra-sonografia bidimensional (US2D) e tridimensional (US3D) e comparar o vínculo estabelecido após a realização dos exames. Foram entrevistadas antes e após a realização do US2D e US3D, 50 gestantes primigestas. Verificou-se que para 72 por cento das gestantes, o exame, quer seja o US2D ou US3D aumenta o vínculo materno-fetal. Constatou-se que 90 por cento das gestantes afirmaram ser melhor a visualização do feto no US3D. Observou-se que as gestantes que relatavam ter vínculos ambivalentes (16 por centoUS2D) ou negativos (24 por centoUS2D) alteraram este sentimento imediatamente após a visualização das imagens fetais no exame. Conclui-se que o exame de US favorece a criação do vínculo materno-fetal independentemente do tipo de US realizado.(AU)

This study aimed to describe the maternal-fetal attachment before and after obstetric bidimensional (US2D) and tridimensional (US3D) ultrasound and to compare the bond established following the exams performed. Fifty primigravidas were interviewed before and after US2D e US3D. The maternal-fetal attachment was improved after US2D o US3D (72 percent). Ninety percent of pregnant women expressed that the fetal image was better in the US3D than US2D. The women with ambivalent bond (16 percent US2D) or negative bond (24 percent US2D) changed this feeling immediately after perceive the fetal image at ultrasound exam. In conclusion, the ultrasound improves the maternal-fetal attachment independently of type of ultrasound performed.(AU)

[The effects of an exercise program for the female elderly in the community].

In Mizumaki-cho, Fukuoka, a "School of muscle-building for the elderly" was held by the self-help group "MIZUMAKI Iki-iki senior club" once a week from Sep. 2002 to Mar. 2004. This school program included stretching, aerobics and resistance exercises. In this study, we clarified the effect of exercise for the 38 elderly females in this school. Their average age was 65.8 years old. Blood pressure, BMI, body %Fat, VO2 max, grasping power, time of standing on one leg with eyes open, anteflexion while sitting, time of walking for 10 m and time of standing up from sitting on a chair were measured before starting school, after 6 months, 12 months and 18 months. Every measured value except BMI and VO2 max was improved, and these improvements continued for 18 months. Especially, it was shown that time of standing on one leg with eyes open, time of standing up from sitting on a chair and time of walking for 10 m improved by 121.6%, 112.7%, 30.4%, respectively, compared with each measured value at the start. These improvements might produce the effect of fall prevention for the elderly. From the results of this study, it was clarified that regular exercise builds up the muscles of the female elderly, and continuation of exercise also extends the effect of exercise for the female elderly.

[Peer education by medical students in a public health course].

Sex education by peers is becoming popular in Japan. To improve youth's reproductive health by continuous peer education and to encourage medical students to obtain the methodology necessary for health promotion, we started peer sex education by medical students in the annual public health course. One junior high school and one senior high school in Kitakyushu City in Japan asked medical students to conduct peer sex education classes at their schools. Medical students planned and carried out these classes based on the results of a questionnaire that they gave to the junior high school and senior high school students before the peer education. After the class, the students' responses to the class were investigated by another questionnaire. In this questionnaire, over 90% of the students answered that they were interested in talking about sexual issues with medical students. As for the medical students, they said that they could understand better the methodology of health promotion and also gained confidence by this experience. We will continue to carry out peer education in the medical school's public health course, and we intend to research further how junior high school and senior high school students' sexual behavior may change in the future.

[A sexual health study of high school students at the 3 high schools in Kitakyushu City].

OBJECTIVES: The purpose of this study was to clarify the actual sexual behavior and attitudes of high school students in Kitakyushu city, Fukuoka and then to develop effective sex education methods for high school students in this region. METHODS: This study investigated the sexual behavior and attitudes of 1,297 high school students in Kitakyushu by self-administered questionnaire. The differences in their answers by sex, prevalence of sexual intercourse and change in sexual behavior and attitude before and after the sex education lecture were examined. RESULT: 39.3% of the students had had sexual intercourse and 74.1% answered that they might have sex, if it were with a partner whom they loved. However, they did not have enough knowledge about contraception and sexually transmitted diseases. This result shows that they did not recognize the risks accompanying sexual intercourse. There are significant differences between male and female students in their sexual attitudes. Male students tend to permit premarital sexual intercourse, unfaithfulness, prostitution, hiring a prostitute and abortion. Male students tend to give more approval to the following opinions: both men and women should agree to sexual contact if the partner wants it; men should take the initiative in sexual contact; women should not talk about sex. Many female students answered that women should make their own decisions to have or not to have sex, however a considerable number of female students answered that for their first intercourse, they just agreed with their partner even though they really did not want to do so. After the sex education lecture, the students have more knowledge about contraception and STDs. However, there is no significant difference in their sexual attitudes before and after the lecture. CONCLUSION: In order to facilitate more desirable and safer sexual behavior among the younger generation, it is not enough to simply give them knowledge about contraception or STDs, etc. To organize more comprehensive sex education, it is also important to pay enough attention to gender problems and other social factors such as family background or regional background, etc.