Fragilidades na continuidade do cuidado de puérperas: Revisão integrativa de literatura

Petersen, Ane Gabriele Poli; Kolankiewicz, Adriane Cristina Bernat; Casagrande, Denise; Pluta, Pâmella; Winter, Vanessa Dalsasso Batista; de Carvalho, Fernanda Fernandes; Tronco, Caroline Sissy

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Revista Brasileira de Ginecologia e Obstetrícia

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Sumário

Review Article • Rev Bras Ginecol Obstet 45 (7) • 2023 • https://doi.org/10.1055/s-0043-1772185 copiar

Fragilidades na continuidade do cuidado de puérperas: Revisão integrativa de literatura

Autoria SCIMAGO INSTITUTIONS RANKINGS

Resumo

O objetivo do presente estudo foi identificar como ocorre a transição do cuidado do hospital para a comunidade na perspectiva de puérperas de risco. Foi realizada uma revisão integrativa da literatura, com a questão: “Como ocorre a transição do cuidado das puérperas de risco do hospital para a comunidade?” A pesquisa foi realizada com recorte temporal de 2013 a 2020, nas bases de dados: PubMed, LILACS, SciELO e Scopus. Utilizou-se MESH, DECS e operadores booleanos “OR” e “AND” resultando nos seguintes cruzamentos:patient transfer ORtransition care ORcontinuity of patient care ORpatient discharge ANDpostpartum period, com análise final de 6 artigos. Os achados denotam descontinuidade do cuidado, visto a frequência de não adesão à consulta puerperal. Estudos de transição do cuidado no puerpério não foram encontrados, o que requer que novos estudos sejam propostos.

Palavras-chave
cuidado transicional; período pós-parto; continuidade da assistência ao paciente

First Author, Year, Country and Title		Type of study and number of participants	Contribution of the study
1.	WOODWARD, B.M. 2016. Australia. Beyond birth: Women's concerns about post-birth care in an Australian urban community.¹⁴14 Woodward BM, Zadoroznyj M, Benoit C. Beyond birth: Women's concerns about post-birth care in an Australian urban community. Women Birth. 2016;29(02):153–159. Doi: 10.1016/j.wombi.2015.09.006 https://doi.org/10.1016/j.wombi.2015.09....	Qualitative study, through semi-structured interviews. 15 participants.	There is a gap in the postpartum period characterized by a lack of information and psychosocial care, both in the public and private sectors, to guarantee the continuity of care. The highest levels of satisfaction occurred in women who opted for home birth.
2.	BARIMANI, M. 2016. Sweden. Support and continuity during the first 2 weeks postpartum.¹⁵15 Barimani M, Oxelmark L, Johansson SE, Hylander I. Support and continuity during the first 2 weeks postpartum. Scand J Caring Sci. 2015;29(03):409–417. Doi: 10.1111/scs.12144.10.1111/scs.12144 https://doi.org/10.1111/scs.12144.10.111...	Cross-sectional study, with mixed methodology. 363 participants.	Part of the puerperal women pointed out the lack of continuity, the insufficient support in relation to the physical and emotional health of the women. The level of satisfaction was related to the time the women stayed in the hospital, that is, they were given direct postpartum care. Mothers who sought emergency care showed lower satisfaction with puerperal care. The assistance sought in the emergency triggered the need for support and continuity of care.
3.	YANIKKEREM, E. 2017. Turkey. Factors affecting readiness for discharge and perceived social support after childbirth.¹⁶16 Yanıkkerem E, Esmeray N, Karakuş A, Üstgörül S, Baydar Ö, Göker A. Factors affecting readiness for discharge and perceived social support after childbirth. J Clin Nurs. 2018;27(13-14):2763–2775. Doi: 10.1111/jocn.14248 https://doi.org/10.1111/jocn.14248...	Descriptive and cross-sectional method, cross-sectional study. 610 participants.	The information provided by professionals about postpartum care and social support is important for women and their families. Especially for the primiparous group, women who had complications during or after childbirth or who for some reason could not attend childbirth classes. Women in socially vulnerable conditions have less information about the postpartum period and were not prepared for hospital discharge. There is a need for special intervention programs that inform this population about postpartum care
4.	WEN, T. 2020. United States. Fragmentation of postpartum readmissions in the United States.¹⁷17 Wen T, Krenitsky NM, Clapp MA, D'alton ME, Wright JD, Attenello F, Mack WJ, Friedman AM. https://doi.org/Fragmentation of post-partum readmissions in the United States. Am J Obstet Gynecol. 2020;223(02):252.e1–252.e14. https://doi.org/10.1016/j.ajog.2020.01.022 https://doi.org/10.1016/j.ajog.2020.01.0...	Cohort study, retrospective 21,789 participants.	Reducing care fragmentation can represent an important objective to improve postpartum care and reduce the risk of severe morbidity, high costs, and long hospital stays.
5.	ASRATIE, M.H. 2020. Ethiopia. Completion of maternity continuum of care among in the post-partum period: Magnitude and associated factors in the north west, Ethiopia.¹⁸18 Asratie MH, Muche AA, Geremew AB. Completion of maternity continuum of care among women in the post-partum period: Magnitude and associated factors in the northwest, Ethiopia. PLoS One. 2020;15(08):e0237980. Doi: 10.1371/journal.pone.0237980 https://doi.org/10.1371/journal.pone.023...	Cross-sectional study 819 participants	Fragility in the continuity of maternity care, with less than half of the women having a puerperal consultation. As associated factors, we identified the fact that the majority live in rural areas and low schooling.
6.	BITTENCOURT, S.D.A. 2020. Brazil.Nascer no Brasil: continuity of care during pregnancy and postpartum period for women and newborns.¹⁹19 Bittencourt SDA, Cunha EM, Domingues RMSM, Dias BAS, Dias MAB, Torres JA, et al. Nascer no Brasil continuidade de cuidados durante a gravidez e puerpério para mulheres e recém-nascidos. Rev Saude Publica. 2020;540:100. Doi: 10.11606/s1518-8787.2020054002021 https://doi.org/10.11606/s1518-8787.2020...	Cross-sectional, quantitative study 16,220 participants.	Only 32.2% of the study population had a postpartum consultation. The coordination of care is still a challenge in the health care of women and children in the pregnancy-puerperal period, especially in the north and northeast states.

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[1] Address for correspondence Adriane Cristina Bernat Kolankiewicz, PHD, Universidade Regional do Noroeste do Estado do Rio Grande do Sul, Rua do Comércio 3000, 98700-000, Ijuí, RS Brazil. (e-mail: adriane.bernat@unijui.edu.br).