GLAUCIA ROSANA GUERRA BENUTE
Projetos de Pesquisa
Unidades Organizacionais
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- When One Knows a Fetus Is Expected to Die: Palliative Care in the Context of Prenatal Diagnosis of Fetal Malformations(2017) CATANIA, Taisa Rocha; BERNARDES, Lisandra Stein; BENUTE, Glaucia Rosana Guerra; GIBELI, Maria Augusta Bento Cicaroni; NASCIMENTO, Nathalia Bertolassi do; BARBOSA, Tercilia Virginia Aparecida; KREBS, Vera Lucia Jornada; FRANCISCO, Rossana P. V.Background: Fetal malformations occur in 2% of gestations and are the fifth most common cause of neonatal death in the world. In many cases, fetal malformations result in neonatal death or long stay in intensive care facilities. Families that continue the pregnancy in such a situation need to make choices and cope with an overwhelming number of potential issues. Palliative care starting at the prenatal period is a growing field that allows the entire family to prepare for this difficult situation. Objective: To perform a systematic review of published data on palliative care in the prenatal period. Design: PubMed and the Cochrane Library were searched using the keywords (""perinatal"" OR ""prenatal"" OR ""fetal"") AND ""palliative care"" and also (""perinatal"" OR ""prenatal"" OR ""fetal"") AND ""hospice."" Setting/Subjects: Studies focusing on the long-term impact of prenatal palliative care published up to December 2015 were used. Measurements: Quantitative and qualitative studies. Results: In total, 541 studies were retrieved; 29 articles met the inclusion criteria. Studies were organized into different categories according to the design or main focus. The majority of studies retrieved were reflexives or presented a narrative proposal on palliative care started in the prenatal period (45%). Clinical studies comprised 17% of all articles found. No studies were found on the long-term impact of prenatal palliative care. Conclusions: Prenatal palliative care is a growing field and an important supportive care measure that can help grieving parents and families who do not want to or cannot interrupt their pregnancy. More studies should be carried out, specifically concerning long-term impact of prenatal palliative care. Guidelines and training of health professionals must be developed so that more families can benefit from this type of care.
- Pictures as mementos after perinatal death: a case study(2022) JESUS, Roberta Carolina de Almeida; BENUTE, Glaucia; BERTOLASSI, Nathalia; BARBOSA, Tercilia; BOLIBIO, Renata; FIGUEIREDO, Fernanda; SETUBAL, Maria Silvia; GIBELLI, Maria Augusta; GOMES, Ana; FERREIRA, Raquel; FRANCISCO, Rossana; BERNARDES, LisandraBackground: The grieving process following perinatal loss caused by life-limiting conditions presents some particularities associated with the family's culture and the symbolic relationship with the deceased. Objective: To reflect on the symbolic meaning attributed to mementos, particularly pictures taken immediately after birth. Method: Case study-a qualitative analysis of the data collected through semidirected interviews. Results: Of the three women that took part in the study, one woman chose not to take a picture but opted to take home the hat with her son's name on it that was provided as a regular procedure for every birth at the maternity centre. During the interview, she questioned her decision. The two other women took pictures and still look at them affectionate. One of the women keeps the picture of her child in a shrine at home, thus attributing a symbolic religious meaning to the whole experience that alleviates her pain. Conclusion: The symbolic meaning attributed to pictures of the deceased can help parents process grief.
- A systematic review of instruments measuring grief after perinatal loss and factors associated with grief reactions(2021) SETUBAL, M. S.; BOLIBIO, R.; JESUS, R. C.; BENUTE, G. G.; GIBELLI, M. A.; BERTOLASSI, N.; BARBOSA, T.; GOMES, A.; FIGUEIREDO, F.; FERREIRA, R.; FRANCISCO, R.; BERNARDES, L. SteinObjective Expectant parents who live through perinatal loss experience intense grief, which is not always acknowledged or accepted. A screening tool to detect bereaved parents' grief reactions can guide professionals, including perinatal palliative care teams, to provide follow-up for those in need. This review's goal is to identify and synthesize the international published literature on existent instruments specifically measuring the grieving process after any perinatal loss and to identify factors that could moderate grief reactions. Method Systematic review (PROSPERO # CRD42018092555) with critical synthesis. PUBMED, Cochrane, and PsycINFO databases were searched in English language articles using the keywords ""perinatal"" AND (""grief"" OR ""bereavement"" OR mourning) AND (""scale"" OR ""questionnaire"" OR ""measure"" OR ""assessment"") up to May 2018. Eligibility criteria included every study using a measure to assess perinatal grief after all kinds of perinatal losses, including validations and translations to other languages and interventions designed to alleviate grief symptoms. Results A total of 67 papers met inclusion criteria. Seven instruments measuring perinatal grief published between 1984 and 2002 are described. The Perinatal Grief Scale (PGS) was used in 53 of the selected studies. Of those, 39 analyzed factors associated with grief reactions. Six articles used PGS scores to evaluate pre- and post-bereavement interventions. Studies in English language only might have limited the number of articles. Significance of results The PGS is the most used standardized measures to assess grief after perinatal loss. All parents living through any kind of perinatal loss should be screened.
- Palliative Care After Prenatal Diagnosis of Life-limiting Malformations: A Model of Care(2018) BERNARDES, Lisandra Stein; GIBELLI, Maria Augusta B. C.; FIGUEIREDO, Fernanda; BERTOLASSI, Nathalia; BARBOSA, Tercilia; BOLIBIO, Renata; GOMES, Ana; JESUS, Roberta; VILHEGAS, Andresa; ROCHA, Luana; ROSA, Gladys; SETUBAL, Maria Silvia; BENUTE, Glaucia; FRANCISCO, Rossana
- Breaking Bad News: A Study on Formal Training in a High-Risk Obstetrics Setting(2020) OLIVEIRA, Fernanda F.; BENUTE, Glaucia R. G.; GIBELLI, Maria Augusta B.; NASCIMENTO, Nathalia B.; BARBOSA, Tercilia V. A.; BOLIBIO, Renata; JESUS, Roberta C. A.; GAIOLLA, Paula V. V.; SETUBAL, Maria Silvia V.; GOMES, Ana L.; FRANCISCO, Rossana P.; BERNARDES, Lisandra SteinBackground: Breaking bad news is a frequent task in high-risk obstetrics clinics. Few studies have examined the role of training in improving such a difficult medical task. Aim: To evaluate the influence of a training program on the participants' perceptions of bad news communication at a high-risk obstetrics center. Design: This prospective study was conducted at the Department of Obstetrics/Gynecology, Hospital das Clinicas, from March 2016 to May 2017. Setting/Participants: Maternal-fetal health specialists were invited to complete an institutional questionnaire based on the SPIKES protocol for communicating bad news before and after training. The training consisted of theoretical lectures and small group practice using role play. The questionnaire responses were compared using nonparametric tests to evaluate the differences in physicians' perceptions at the two timepoints. The questionnaire items were evaluated individually and in groups following the communication steps of the SPIKES protocol. Results: In total, 110 physicians were invited to participate. Ninety completed the pretraining questionnaire and 40 answered the post-training questionnaire. After training, there were significant improvements in knowing how to prepare the environment before delivering bad news (p=0.010), feeling able to transmit bad news (p<0.001), and to discuss the prognosis (p=0.026), feeling capable of discussing ending the pregnancy (p=0.003), and end-of-life issues (p=0.007) and feeling confident about answering difficult questions (p=0.004). The comparison of the grouped responses following the steps of the SPIKES protocol showed significant differences for ""knowledge"" (p<0.001), ""emotions,"" (p=0.004) and ""strategy and summary"" (p=0.002). Conclusion: The implementation of institutional training in breaking bad news changed the perception of the physicians in the communication setting.
- Family Conferences in Prenatal Palliative Care(2020) BERNARDES, Lisandra Stein; OLIVEIRA, Fernanda Figueiredo; JESUS, Roberta Carolina de Almeida; BENUTE, Glaucia Rosana Guerra; GIBELLI, Maria Augusta Bento Cicaroni; NASCIMENTO, Nathalia Bertolassi; BOLIBIO, Renata; BARBOSA, Tercilia Virginia Aparecida; SETUBAL, Maria Silvia Vellutini; GOMES, Ana Lucia; ROCHA, Luana Sarmento Neves; ROSA, Gladys Ribeiro; FRANCISCO, Rossana PulcinelliBackground: Fetal malformations are diagnosed prenatally in nearly 3% of pregnancies, and similar to 1.2% are major malformations. After prenatal diagnosis, it is imperative to consider families' values and to support their decision-making process. Prenatal palliative care is a growing field mainly based on family conferences. The prenatal care setting is unique and differs from postnatal and adult care. There are no descriptions of family conferences in prenatal palliative care. The descriptions of themes that emerge from the prenatal care conference charts may guide professionals in this delicate task, and help determine the causes of suffering and identify family values before the birth of the infant. Aim: To perform a content analysis of medical records of family conferences and to describe the main themes observed during prenatal palliative care follow-up after the diagnosis of a life-limiting fetal condition. Design: This is a retrospective study of medical records of family conferences from a perinatal palliative care group, the GAI group, between May 2015 and September 2016. Setting/Participants: Families with estimated perinatal mortality >50% and eligibility for follow-up at our tertiary fetal medicine center were enrolled. We included women who participated in at least one family conference with the GAI group and who had given birth at the clinic or delivered at another center and returned for the postnatal family conference. Results: Fifty women met the inclusion criteria. Five main themes and 18 categories emerged from the charts and are described in detail. A model of follow-up in prenatal palliative care is proposed based on the themes and categories identified. Conclusions: This analysis may guide health professionals who seek to better identify family needs and values and organize follow-up during prenatal palliative care.