scholarly journals Case management as a high-risk prenatal care strategy

2019 ◽  
Vol 72 (3) ◽  
pp. 692-699
Author(s):  
Leticia Gramazio Soares ◽  
Ieda Harumi Higarashi

ABSTRACT Objective: to discuss the benefits of using high-risk prenatal case management. Method: a qualitative, convergent care study with six high-risk pregnant women, performed in a municipality in the south of Brazil. Data were produced by case management from April to August of 2017 through observation-participant. Analysis followed the processes of Convergent Care Research: apprehension, synthesis, theorization and transfer. Results: case management identified important elements in the care of pregnant women, which denoted a greater complexity to the cases; was shown as a relevant space for nurses to act, because it is an intervention that requires knowledge and specific skills. Final considerations: case management provides differentiated management in complex cases, facilitates the flow between health services, concretizing the comprehensiveness and equity of the care. It was found, in the convergence between research and care, that participants were benefited by case management.

1997 ◽  
Vol 3 (2) ◽  
pp. 27-36 ◽  
Author(s):  
LaVohn Josten ◽  
Lorene Wedeking ◽  
Derryl E. Block ◽  
Kay Savik ◽  
Pauline Vincent

2016 ◽  
Vol 21 (5) ◽  
pp. 1647-1658 ◽  
Author(s):  
Katrini Guidolini Martinelli ◽  
Edson Theodoro dos Santos Neto ◽  
Silvana Granado Nogueira da Gama ◽  
Adauto Emmerich Oliveira

Abstract Aim This article aims to evaluate access to prenatal care according to the dimensions of availability, affordability and acceptability in the SUS microregion of southeastern Brazil. Methods A cross-sectional study conducted in 2012-2013 that selected 742 postpartum women in seven hospitals in the region chosen for the research. The information was collected, processed and submitted to the chi-square test and the nonparametric Spearman’s test, with p-values less than 5% (p < 0.05). Results Although the SUS constitutionally guarantees universal access to health care, there are still inequalities between pregnant women from rural and urban areas in terms of the availability of health care and among families earning up to minimum wage and more than one minimum wage per month in terms of affordability; however, the acceptability of health care was equal, regardless of the modality of the health services. Conclusion The location, transport resources and financing of health services should be reorganised, and the training of health professionals should be enhanced to provide more equitable health care access to pregnant women.


2006 ◽  
Vol 12 (4) ◽  
pp. 35-50 ◽  
Author(s):  
Patricia A. Doyle ◽  
Barbara C. Bird ◽  
Steve Appel ◽  
Donna Parisi ◽  
Perdietha Rogers ◽  
...  

2020 ◽  
pp. 66-70
Author(s):  
Jessica Galvan ◽  
Danielle Bordin ◽  
Cristina Berger Fadel

Introduction: Conducting dental consultations during pregnancy is considered an important challenge in the context of Maternal and Child Health Policies, as it is surrounded by myths rooted among users and health professionals. In this sense, it is important to identify barriers and facilitators to the search for dental assistance in this period, in order to support strategies that make this practice feasible. Objective: To analyze the search for dental care during high-risk pregnancies, according to sociodemographic, gestational and health characteristics. Methods: Observational study with a cross-sectional design, carried out with high-risk pregnant women referred to a teaching hospital in southern Brazil, from January to May 2018. Data collection was performed using an unprecedented structured form and considered as a dependent variable the search for dental care during pregnancy and as independent variables sociodemographic, gestational and dental characteristics. Pearson's chi-square association test and Fisher's exact test were used. Results: To reach the sample of 190 pregnant women at high gestational risk, a total of 230 women considered valid were approached, counting on the following losses: refusal to participate (n=23), no answer to any question (n=10), duplicity in participant approach (n=7). Advanced maternal age (p=0.000) and history of premature birth in previous pregnancies (p=0.047) were factors associated with a lower frequency of seeking dental care in the current pregnancy. On the other hand, the habit of dental consultation prior to the gestational period (p=0.001), the knowledge about the importance of this monitoring (p=0.050), as well as the safety (p=0.000) in performing dental prenatal care, were related positively to the search during pregnancy. Conclusion: Specific incentive strategies and access to dental prenatal care are necessary to neutralize barriers that may compromise the search for oral health services during pregnancy. For this reason, identifying the facilitators and hinders to the dental service is essential for planning effective actions related to prenatal care.


2007 ◽  
Vol 20 (3) ◽  
pp. 311-315 ◽  
Author(s):  
Enilda Rosendo do Nascimento ◽  
Quessia Paz Rodrigues ◽  
Mariza Silva Almeida

OBJECTIVE: To analyze prenatal care quality indexes of public health services in Salvador, Bahia following the implementation of the Prenatal and Birth Humanization Program (PBHB). METHODS: This quantitative descriptive study was conducted in primary care units in Salvador that adopted the Prenatal and Birth Humanization Program. RESULTS: Few pregnant women registered in the Prenatal and Birth Humanization Program had the benchmark of six prenatal consultations (9.76%). More than half of these registered pregnant women received all basic exams. However, only few women received puerperal consultations (5.66%), which conclude their maternal care. CONCLUSION: Prenatal care in Salvador, carried out through the Prenatal and Birth Humanization Program in 2002, had a low performance in basic exams, and in prenatal and puerperal consultations.


2020 ◽  
Author(s):  
Sarahn M. Wheeler ◽  
Kelley E. C. Massengale ◽  
Konyin Adewumi ◽  
Thelma A. Fitzgerald ◽  
Carrie B. Dombeck ◽  
...  

Abstract Background: Pregnant women with a history of preterm birth are at risk for recurrence, often requiring frequent prenatal visits for close monitoring and/or preventive therapies. Employment demands can limit uptake and adherence to recommended monitoring and preterm birth prevention therapies. Method: We conducted a qualitative descriptive study using in-depth interviews (IDIs) of pregnant women with a history of preterm birth. IDIs were conducted by trained qualitative interviewers following a semi-structured interview guide focused on uncovering barriers and facilitators to initiation of prenatal care, including relevant employment experiences, and soliciting potential interventions to improve prompt prenatal care initiation. The IDIs were analyzed via applied thematic analysis. Results: We described the interview findings that address women’s employment experiences. The current analysis includes 27 women who are majority self-described as non-Hispanic Black (74%) and publically insured (70%). Participants were employed in a range of professions; food services, childcare and retail were the most common occupations. Participants described multiple ways that being pregnant impacted their earning potential, ranging from voluntary work-hour reduction, involuntary duty hour reductions by employers, truncated promotions, and termination of employment. Participants also shared varying experiences with workplace accommodations to their work environment and job duties based on their pregnancy. Some of these accommodations were initiated by a collaborative employee/employer discussion, others were initiated by the employer’s perception of safe working conditions in pregnancy, and some accommodations were based on medical recommendations. Participants described supportive and unsupportive employer reactions to requests for accommodations. Conclusions: Our findings provide novel insights into women’s experiences balancing a pregnancy at increased risk for preterm birth with employment obligations. While many women reported positive experiences, the most striking insights came from women who described negative situations that ranged from challenging to potentially unlawful. Many of the findings suggest profound misunderstandings likely exist at the patient, employer and clinical provider level about the laws surrounding employment in pregnancy, safe employment responsibilities during pregnancy, and the range of creative accommodations that often allow for continued workplace productivity even during high risk pregnancy.


Author(s):  
Jessica Galvan ◽  
Danielle Bordin ◽  
Cristina Berger Fadel ◽  
Alessandra Martins ◽  
Fabiana Bucholdz Teixeira Alves

Introduction: Conducting dental consultations during pregnancy is considered an important challenge in the context of Maternal and Child Health Policies, as it is surrounded by myths rooted among users and health professionals. In this sense, it is important to identify barriers and facilitators to the search for dental assistance in this period, in order to support strategies that make this practice feasible. Objective: To analyze the search for dental care during high-risk pregnancies, according to sociodemographic, gestational and health characteristics. Methods: Observational study with a cross-sectional design, carried out with high-risk pregnant women referred to a teaching hospital in southern Brazil, from January to May 2018. Data collection was performed using an unprecedented structured form and considered as a dependent variable the search for dental care during pregnancy and as independent variables sociodemographic, gestational and dental characteristics. Pearson's chi-square association test and Fisher's exact test were used. Results: To reach the sample of 190 pregnant women at high gestational risk, a total of 230 women considered valid were approached, counting on the following losses: refusal to participate (n=23), no answer to any question (n=10), duplicity in participant approach (n=7). Advanced maternal age (p=0.000) and history of premature birth in previous pregnancies (p=0.047) were factors associated with a lower frequency of seeking dental care in the current pregnancy. On the other hand, the habit of dental consultation prior to the gestational period (p=0.001), the knowledge about the importance of this monitoring (p=0.050), as well as the safety (p=0.000) in performing dental prenatal care, were related positively to the search during pregnancy. Conclusion: Specific incentive strategies and access to dental prenatal care are necessary to neutralize barriers that may compromise the search for oral health services during pregnancy. For this reason, identifying the facilitators and hinders to the dental service is essential for planning effective actions related to prenatal care.


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