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      From suffering to resignation: Grounded Theory approach to maternal experience with newborn in phototherapy Translated title: Do sofrimento à resignação: experiência materna com recém-nascido em fototerapia na abordagem Grounded Theory

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          Abstract

          Abstract Objectives: understanding the experience of puerperal womenwith newborn in phototherapy treatment in rooming-in care. Methods: qualitative research analyzed according to the Grounded Theory and the results discussed in the light of Symbolic Interactionism. The interviews were audiotaped and transcribed in full. The theoretical saturation was based on the analysis of the 15th interview with puerperal women, undergoing the experience in the maternity of the Public Hospital of São Paulo State. Results: from the analysis emerged four categories (sub processes): getting disappointed with the bad news; feeling recluse, separated from her baby, accountable and with not enough support for care; resigning to the protective role of mother of a baby in suffering and at risk; seeking strategies to deal with the situation. From the realignment of these categories (sub processes) emerged the core category (process): from suffering to resignation in order to deal with the maternal experience with NB in phototherapy. Conclusions: the symbolic intervening component, mother's protective role, prompted her to attempt to cope with the challenging experience by feeling compelled to exercise the function of caretaker. The same way that the rooming-in care team emerged in the experience of the mother, using the same symbol, to hold her accountable for constant vigilance in maintaining the integrity of baby's vision.

          Translated abstract

          Resumo Objetivos: compreender a experiência de puérperas com recém-nascido em tratamento fototerápico em alojamento conjunto. Métodos: pesquisa qualitativa analisada segundo a Teoria Fundamentada nos Dados e os resultados discutidos à luz do Interacionismo Simbólico. As entrevistas foram audio-gravadas e transcritas na íntegra. A saturação teórica deu-se a partir da análise da 15ª entrevista com puérperas, vivenciando a experiência em maternidade de Hospital Público do Estado de São Paulo. Resultados: da análise emergiram quatro categorias (subprocessos): decepcionando-se com a má notícia; sentindo-se reclusa, apartada do bebê, responsabilizada e com apoio insuficiente para o cuidado; resignando-se ao papel protetor de mãe de bebê em sofrimento e em risco; buscando estratégias para lidar com a situação. Do realinhamento dessas categorias (subprocessos) emergiu a categoria central (processo): do sofrimento à resignação para enfrentar a experiência materna com recém-nascido em fototerapia. Conclusões: o componente interveniente simbólico, papel protetor de mãe, impulsionou-a a tentativas de lidar com a experiência desafiante ao se sentir compelida ao exercício de cuidadora. Da mesma forma que, a equipe do alojamento conjunto emergiu na vivência dessa mãe, utilizando-se do mesmo símbolo, para responsabilizá-la pela vigilância constante na manutenção da integridade da visão do bebê.

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          State of the art and recommendations. Kangaroo mother care: application in a high-tech environment.

          Since Kangaroo Mother Care (KMC) was developed in Colombia in the 1970s, two trends in clinical application emerged. In low income settings, the original KMC model is implemented. This consists of continuous (24 h/day, 7 days/week) and prolonged mother/parent-infant skin-to-skin contact; early discharge with the infant in the kangaroo position; (ideally) exclusive breastfeeding; and, adequate follow-up. In affluent settings, intermittent KMC with sessions of one or a few hours skin-to-skin contact for a limited period is common. As a result of the increasing evidence of the benefits of KMC for both infants and families in all intensive care settings, KMC in a high-tech environment was chosen as the topic for the first European Conference on KMC, and the clinical implementation of the KMC model in all types of settings was discussed at the 7th International Workshop on KMC. Kangaroo Mother Care protocols in high-tech Neonatal Intensive Care Units (NICU) should specify criteria for initiation, kangaroo position, transfer to/from KMC, transport in kangaroo position, kangaroo nutrition, parents' role, modification of the NICU environment, performance of care in KMC, and KMC in case of infant instability. Implementation of the original KMC method, with continuous skin-to-skin contact whenever possible, is recommended for application in high-tech environments, although scientific evaluation should continue.
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            Infants at risk of significant hyperbilirubinemia in poorly-resourced countries: evidence from a scoping review.

            Neonatal hyperbilirubinemia is frequently associated with disproportionately high rates of bilirubin-induced mortality and long-term morbidities in low- and middle-income countries (LMICs). This scoping review aimed to identify possible etiological/risk factors for clinically significant hyperbilirubinemia in LMICs so as to guide intervention and future research priorities.
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              ENFERMAGEM E O CUIDADO HUMANÍSTICO: PROPOSTA DE INTERVENÇÃO PARA A MÃE DO NEONATO SOB FOTOTERAPIA

              Este estudo objetivou descrever intervenções de Enfermagem baseadas em estratégias e técnicas de comunicação com a mãe do neonato em uso de fototerapia. Estudo qualitativo, exploratório-descritivo. Os sujeitos foram cinco mães cujos recém-nascidos encontravam-se sob fototerapia em uma maternidade publica em Fortaleza-CE. Os dados foram coletados em novembro e dezembro de 2003 mediante entrevista semi-estruturada e foram analisados à luz da Teoria Humanística de Enfermagem de Paterson e Zderad. Os resultados demonstraram que a mãe apresenta déficit de conhecimento acerca da fototerapia e a comunicação entre a equipe de saúde e a mãe é deficiente. As intervenções de Enfermagem envolveram a busca do diálogo genuíno entre enfermeiro e o binômio mãe-filho, aplicação de painéis ilustrados sobre a história e o tratamento sob fototerapia e a formação de grupos de encontro de saúde
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                rbsmi
                Revista Brasileira de Saúde Materno Infantil
                Rev. Bras. Saude Mater. Infant.
                Instituto de Medicina Integral Prof. Fernando Figueira (Recife, PR, Brazil )
                1519-3829
                1806-9304
                March 2018
                : 18
                : 1
                : 143-151
                Affiliations
                [2] Botucatu SP orgnameUniversidade Estadual Paulista Júlio de Mesquita Filho orgdiv1Faculdade de Medicina orgdiv2Departamento de Enfermagem Brazil
                [1] Botucatu SP orgnameHospital das Clínicas de Botucatu Brazil
                Article
                S1519-38292018000100143
                10.1590/1806-93042018000100007
                6cd66c7f-fa34-40e6-8ef7-67e4febb4d52

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 24 April 2017
                : 07 December 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 24, Pages: 9
                Product

                SciELO Brazil


                Pesquisa qualitativa,Saúde materno-infantil,Alojamento conjunto,Fototerapia,Icterícia neonatal,Qualitative research,Maternal and child health,Rooming-in care,Phototherapy,Jaundice neonatal

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