MARA CRISTINA SOUZA DE LUCIA
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- Abortion: a review of women's perception in relation to their partner's reactions in two Brazilians cities(2014) NONNENMACHER, Daniele; BENUTE, Glaucia Rosana Guerra; NOMURA, Roseli Mieko Yamamoto; AZEVEDO, George Dantas de; DUTRA, Elza Maria do Socorro; REBOUAS, Melina Sefora Souza; LUCI, Mara Cristina Souza de; FRANCISCO, Rossana Pulcineli VieiraObjective: to analyze women's perception in relation to their partner's reaction and behavior during the abortion process in two Brazilian capitals, associating the variables from women who suffered a spontaneous abortion with those from women who induced it. Methods: semi-structured, questionnaire-based interviews were conducted with 285 women who underwent spontaneous abortion and 31 who reported having induced it. The data were analyzed using the thematic analysis technique, and, subsequently, by the IBM SPSS Statistics Standard Edition software program. The significance level was set at p < 0.05. Results: in both capitals, the women who induced an abortion referred to the partner as the person who could not find out about the abortion (p<0.01 in Natal; p = 0.02 in Sao Paulo-SP) and, simultaneously, as the one who could have avoided it (p < 0.01 in Natal; p = 0.03 in Sao Paulo). In Natal-RN, induced abortion was associated with the partner's absence at the time pregnancy was confirmed (p = 0.02) and, in Sao Paulo-SP, with their negative reaction to news of the pregnancy (p = 0.04) and lack of participation in the abortion process (p < 0.01). Conclusion: despite having achieved independence, women still regard male participation in the abortion process as an important factor. The specifics of each capital denote the influence of the geographic and cultural dimension, indicating the need to take into account the particulars of each region in Brazil while considering a holistic approach to women's health.
- Pica and Eating Attitudes: A Study of High-Risk Pregnancies(2016) SANTOS, Amanda M.; BENUTE, Glaucia R. G.; NOMURA, Roseli M. Y.; SANTOS, Niraldo O.; LUCIA, Mara C. S. De; FRANCISCO, Rossana P. V.Objective To describe and determine the association between the occurrence of pica and eating attitudes in women with high-risk pregnancies and to determine the prevalence of pica during pregnancy. Methods A cross-sectional and prospective 24-month study was conducted with 913 women with high-risk pregnancies. Structured interviews were carried out and the Eating Attitudes Test was applied. Results Pica was diagnosed in 5.7 % of the pregnant women, and its most commonly practiced type was geophagia (57.7 %). The association between pica and signs related to the eating attitudes: ""to be considered too thin by others'' (p < 0.02), and ""to spend too much time thinking about food'' (p = 0.05); and the association between pica and the risk of both anorexia nervosa and bulimia nervosa (p < 0.01) were statistically significant. Conclusions The absence of validated instruments in the literature for assessing pica reinforces the difficulty of investigating this practice and the need for further studies. Moreover, additional efforts need to focus in the improvement of screening for other eating disorders with obstetric consequences associated with pica and be incorporated into the routine of healthcare professionals.
- Influência da percepção dos profissionais quanto ao aborto provocado na atenção à saúde da mulher(2012) BENUTE, Gláucia Rosana Guerra; NONNENMACHER, Daniele; NOMURA, Roseli Mieko Yamamoto; LUCIA, Mara Cristina Souza de; ZUGAIB, MarceloPURPOSE: To identify the knowledge and awareness of health professionals regarding the Brazilian legislation on induced abortion. METHODS: Unidentified sealed envelopes containing the questionnaires were sent to all professionals (n=149) working in the Obstetrics Department of a university hospital and public hospital at the periphery of São Paulo (SP), Brazil. A total of 119 professionals responded to the questionnaire. The 0.05 confidence interval and the Fisher exact test and χ² test were used for data analysis. RESULTS: Of the respondents, 48.7% were physicians, 33.6% were nursing professionals and 17.6% were professionals from other fields (psychologists, nutritionists, physiotherapists, laboratory technicians and administrators). There was a significant difference (p=0.01) in the proportion of professionals who believe that abortion for non-lethal fetal malformation and due to unplanned pregnancies should be included in the Brazilian legislation. It was observed that the knowledge about the law and the description of the circumstances allowed by law on abortion was significantly different when comparing health professionals (p=0.01). When asked about the situations in which Brazilian law allows abortion, 32.7% of physicians, 97.5% of nursing professionals and 90.5% of other professionals were unaware of the law. CONCLUSION: This study demonstrated the lack of of knowledge of Brazilian law among health professionals, to a lesser extent among obstetricians and a to a greater extent among nursing professionals. Attitudes of discrimination and prejudice were observed regarding the care provided to women who induce an abortion.
article 7 Citação(ões) na Scopus Depressão, aspectos emocionais e sociais na vivência do aborto: comparação entre duas capitais brasileiras(2011) NOMURA, Roseli Mieko Yamamoto; BENUTE, Glaucia Rosana Guerra; AZEVEDO, George Dantas de; DUTRA, Elza Maria do Socorro; BORSARI, Cristina Gigliotti; REBOUCAS, Melina Sefora Souza; LUCIA, Mara Cristina Souza de; ZUGAIB, MarceloDepression, emotional and social aspects in the abortion context: a comparison between two Brazilian capitals Objective: To assess emotional and social aspects in the experience of abortion and the diagnosis of major depression, comparing women from two Brazilian cities (Sao Paulo - SP, Natal - RN). Methods: A transversal study was carried out from January 2009 to May 2010, through semi-directed interviews with women undergoing an abortion (up to 22 weeks gestation) treated at university hospitals in Sao Paulo - SP (n = 166) and Natal - RN (n = 150). The Portuguese version of the Primary Care Evaluation of Mental Disorders (PRIME-MD) instrument was applied for the diagnosis of depression. Results: There was no significant difference (p = 0.223) in the proportion of induced abortions when comparing the two capital cities: Natal (7.3%) and Sao Paulo (12.0%). The diagnosis of depression was high among women undergoing an abortion and was significantly higher in Natal than in Sao Paulo (50.7% vs. 32.5%, p < 0.01). Regarding emotional aspects, there was no difference in the occurrence of guilt feelings (Natal 27.7%; Sao Paulo 23.3%; p = 0.447). The partner's involvement was considered satisfactory by women in similar proportions in the two capitals (Natal 62.0%; Sao Paulo 59.0%, p = 0.576). No difference was found in the proportion of women who reported violence, related or not to the abortion (Natal 22.9%; Sao Paulo 16.6%; p = 0.378). Conclusion: Although there was no difference between the emotional and social aspects in the comparison between the two capitals, there was a high proportion of women with major depression, more frequent in the city of Natal than in Sao Paulo, which demonstrates the importance of psychosocial support in the women's healthcare system.article 21 Citação(ões) na Scopus Risco de suicídio em gestantes de alto risco: um estudo exploratório(2011) BENUTE, Glaucia Rosana Guerra; NOMURA, Roseli Mieko Yamamoto; JORGE, Vanessa Marques Ferreira; NONNENMACHER, Daniele; FRAGUAS JUNIOR, Renerio; LUCIA, Mara Cristina Souza de; ZUGAIB, MarceloRisk of suicide in high risk pregnancy: an exploratory study Objective: To identify the risk of suicidal behavior in high-risk pregnant women at a public hospital in Sao Paulo. Methods: We conducted a semi-structured interview with each of the participants (n = 268) through a previously prepared questionnaire. Risk of suicidal behavior was assessed by the Portuguese version of PRIME-MD. Results: The mean age of patients was 29 years (SD = 0.507) and gestation period was 30 weeks (SD = 0.556). Of the total sample, specific risk of suicide was found in 5% (n = 14). Of these, 85% have a stable relationship (married or cohabitating), the pregnancy was planned in 50% of cases, and 71% have no religion or professional activities. The correlation of risk of suicide with data from marital status, planned birth, age, education, professional practice, risk of prematurity, and religion showed that having a religion is statistically significant (p = 0.012). There were no positive associations for any of the other selected variables when compared with the risk of suicide. By correlating the risk of suicide with other characteristic symptoms of major depression, there was statistical significance in the sample with regard to insomnia or hypersomnia (p = 0.003), fatigue or loss of energy (p = 0.001), decreased or increased appetite (p = 0.005), less interest in daily activities (p = 0.000), depressed mood (p = 0.000), feelings of worthlessness or guilt (p = 0.000), decreased concentration (p = 0.002), and agitation or psychomotor retardation (p = 0.002). Conclusion: We found that religion can be a protective factor against suicidal behavior. Besides providing a social support network needed by women during pregnancy, religion supports belief in life after death and in a loving God, giving purpose to life and self esteem and providing models for coping with crises. The results show the importance of prevention and early diagnosis of suicidal behavior, since suicide is an attempt to move from one sphere to another by force, seeking to solve what seems impossible.- Preferência pela via de parto: uma comparação entre gestantes nulíparas e primíparas(2013) BENUTE, Gláucia Rosana Guerra; NOMURA, Roseli Yamamoto; SANTOS, Amanda Maihara dos; ZARVOS, Mariana Arena; LUCIA, Mara Cristina Souza de; FRANCISCO, Rossana Pulcineli VieiraPURPOSE: It was to describe and compare the preference of nulliparous and primiparous women for a particular mode of delivery and to determine whether the previous experience of childbirth influences the delivery process. METHODS: We conducted a prospective cross-sectional study. One-hundred interviews were held with 56 nulliparous and 44 primiparous women using previously prepared questionnaires. The quantitative and categorical data were evaluated by the chi-square or Fisher's Exact Test. RESULTS: 60.7% of nulliparous women and 70.5% of primiparous women reported to prefer vaginal delivery. When analyzing the answers about receiving sufficient information about the type of delivery, the presence or absence of influence on the choice of route of delivery and the preferred route of delivery by the partner, there were no statistically significant differences between the two groups. The level of significance used for the tests was 0.05. CONCLUSIONS: This study permitted us to conclude that the previous experience of delivery does not influence the expectation of the delivery process or the choice for a specific mode of delivery. When choosing the route of delivery, women seek to ensure the health of mother and neonate, as well as to avoid the process of pain and suffering.
- Feelings of women regarding end-of-life decision making after ultrasound diagnosis of a lethal fetal malformation(2012) BENUTE, Glaucia R. G.; NOMURA, Roseli M. Y.; LIAO, Adolfo W.; BRIZOT, Maria de Lourdes; LUCIA, Mara C. S. de; ZUGAIB, M.Objective: this study investigated the feelings of women regarding end-of-life decision making after ultrasound diagnosis of a lethal fetal malformation. The aim of this study was to present the decision making process of women that chose for pregnancy termination and to present selected speeches of women about their feelings. Design: open psychological interviews conducted by a psychologist immediately after the diagnosis of fetal malformation by ultrasound. Analysis of the results was performed through a content analysis technique. Setting: the study was carried out at a public university hospital in Brazil. Participants: 249 pregnant women who had received the diagnosis of a severe lethal fetal malformation. Findings: fetal anencephaly was the most frequent anomaly detected in 135 cases (54.3%). Termination of pregnancy was decided by 172 (69.1%) patients and legally authorised by the judiciary (66%). The reason for asking for termination was to reduce suffering in all of them. In the 77 women who chose not to terminate pregnancy (30.9%), the reasons were related to feelings of guilt (74%). Key conclusions: the results support the importance of psychological counselling for couples when lethal fetal malformation is diagnosed. The act of reviewing moral and cultural values and elements of the unconscious provides assurance in the decision-making process and mitigates the risk of emotional trauma and guilt that can continue long after the pregnancy is terminated.
- Presence of eating disorders and its relationship to anxiety and depression in pregnant women(2017) SANTOS, Amanda Maihara dos; BENUTE, Glaucia Rosana Guerra; SANTOS, Niraldo Oliveira dos; NOMURA, Roseli Mieko Yamamoto; LUCIA, Mara Cristina Souza de; FRANCISCO, Rossana Pulcineli VieiraBackground: women who have inadequate nutrient intake are more likely to develop a risky pregnancy. The purpose of this study was to determine the presence of eating disorders and its association with anxiety and depression symptomatology in high-risk pregnancies. Methods: this is a cross-sectional and prospective study conducted at the tertiary university hospital in the city of Sao Paulo, Brazil. 913 pregnant women waiting for the Obstetrics' outpatient appointment were invited to participate in the study on their 2nd and 3rd trimester of pregnancy. Structured interviews were carried out and the Structured Clinical Interview for DSM Disorders and Hospital Anxiety and Depression Scale were applied. Findings: prevalence of eating disorder (ED) during pregnancy was 7.6% (n=69) (95% CI: 5.84% -9.28%), 0.1% (n=1) for anorexia nervosa; 0.7% (n=6) for bulimia nervosa; 1.1% (n=10) for binge eating disorder, and 5.7% (n=52) for pica. A statistically significant difference was found between the anxiety (p < 0.01) and depressive symptoms (p < 0.01). Conclusions: the prevalence of ED ( 7.6%) and its association with anxiety and depression symptoms during pregnancy highlights the need for specialist care for prevention, diagnosis and treatment. Given the importance of proper nutrition during pregnancy, both with regard to maternal health and fetal development, it is necessary to have specific predetermined evaluation protocols implemented by health care professionals for the diagnosis of ED during pregnancy.
- Aborto provocado em mulheres da periferia da cidade de São Paulo: vivência e aspectos socioeconômicos(2013) BORSARI, Cristina Mendes Gigliotti; NOMURA, Roseli Mieko Yamamoto; BENUTE, Gláucia Rosana Guerra; LUCIA, Mara Cristina Souza de; FRANCISCO, Rossana Pulcineli Vieira; ZUGAIB, MarceloPURPOSE: To compare and analyze socioeconomic aspects and the emotional experience of women with spontaneous or induced abortion and in women living in the outskirts of São Paulo. METHODS: A prospective case-control study carried out from July 2008 to March 2010, involving semi-structured interviews with women who presented a previous diagnosis of abortion and who had been admitted to two public hospitals in the outskirts of São Paulo. The study included 100 women with diagnosis of abortion and were hospitalized for curettage. Eleven women who reported induced abortion (11%) represented the case group. The control group (n=22) was selected at a 2:1 ratio according to the following procedure: for every case of induced abortion, the next two cases of spontaneous abortion at the same hospital. A semistructured interview was conducted with questions regarding emotional aspects and family, social and economic context. RESULTS: The women with induced abortion compared to the group with spontaneous abortion had lower educational level, with more frequent elementary level (82 versus 36%, p=0.04), lower income (median, R$ 1,000.00 versus R$ 1,400.00, p=0.04), lower personal income (median, R$ 200.00 versus R$ 333.00, p=0.04), higher frequency of negative feelings upon suspicion (82 versus 22%, p=0.004) and confirmation (72 versus 22%, p=0.03) of pregnancy. CONCLUSION: Among women looking for health care in hospitals in the outskirts of São Paulo, induced abortion is related to unfavorable socioeconomic conditions, which affects the emotional experiences of suspicion and confirmation of pregnancy.