Objective: to understand mothers' bereavement experiences regarding the loss of their newborn child in the Neonatal Intensive Care Unit of a Brazilian university hospital. Methods: the study was designed by the clinical-qualitative method to understand the meaning of the emerging relationships of health scenarios. Sample consisted of six mothers. The sufficiency of the sample was verified through the saturation of the data. The data collection instrument was a semistructured interview with script of open questions, the collected material was recorded and transcribed in full. Thematic analysis was performed by two independent authors. Results: feelings and perceptions of the grieving process gave rise to three categories: 1. Guilt and fantasy of bereavement related to the death and grief for their children; 2. Relationships and ambiguities - the relationship between internal concerns and perception of external relations; 3. Fear, disbelief, abandonment and loneliness - questions about perception of the external environment. Conclusions: mothers' bereavement experience is mainly permeated by loneliness and abandonment related to feelings of guilt for not being able to keep their children alive. The difficult and definitive separation in the postpartum period, caused by death, brings fantasies of reunion with their child. Women show the need to realize grief, especially by recognizing their baby's identity.
Objectives: To identify prevalence rates and related patient characteristics associated with depression, alcohol use disorders (AUD), and nicotine dependence among individuals admitted to a university general hospital. Methods: 4352 consecutively admitted patients were assessed using the HAD scale and AUDIT. They were also asked on daily cigarette smoking during the previous month. Multivariate logistic regression analyses were performed. Results: 56.6% were male. The average age was 49.3. Prevalence rates of depressive disorder, AUD and nicotine dependence were, respectively, 14%, 9.8% and 16.9%. In the multivariate analysis depression was associated with previous suicide attempt (OR = 8.7), less schooling (3.6), prior use of psychotropic medicines (3.1), cancer (1.7) and pain (1.7). AUD were associated with male sex (OR = 6.3), smoking (3.5), admission for an external cause (2.4), mainly road accidents, and previous suicide attempt (2.3). Nicotine dependence was associated with AUD (OR = 3.4), young adulthood (2.3), widowhood (2.2) and previous suicide attempt (1.8). Conclusions: This is the largest sample of medical and surgical inpatients surveyed by standardized screening instrument, for 13 months, in a Brazilian general hospital. High prevalence rates of psychiatric disorders and respective patient profiles highlight the need to develop more effective methods for detecting and managing these disorders. Hospital admission should be considered a milestone in a person's life from which a psychiatric disorder is detected and specific treatment strategies are implemented.
IntroductionThe relationship between parents and children is a complex link. In the process of pregnancy-birth-puerperium, frequent feelings such as responsibility, love, fear, uncertainty, generate strong expectations at birth. The death of a newborn may not be perceived as natural by the parents, considering the local culture and the context of great technological development of neonatology.ObjectiveTo explore possible guilt and fantasies in life experiences of parents during mourning process due to death of their newborn.MethodClinical-qualitative design, a particularization of qualitative methods here applied in clinical assistance settings with highlight to psychological aspects. Data collection with the technique of semi-directed interview with open-ended questions, in-depth. Sample intentionally constructed, with closure by theoretical saturation of information. The participants were 7 parents, mourning by the death of their child at the neonatal intensive care unit, in a university hospital of Campinas, São Paulo State.ResultsFeelings of guilt - conscious or not - lead to an internal and particular movement so that mourning can be lived. The participants showed certain embarrassment, accompanied by natural suffering facing to the cultural pattern that permeates the emotional experience. It predicts types of psychological meanings that the experience will give to the person.ConclusionHealth professionals working with bereaved parents should consider more deeply the moment these one experienced, with emphasis on the details of the death scenery, beside the problems of illness and death properly so called.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Introduction: chronic pain (CP) is seen currently as a multidetermined phenomenon that involves an interaction of physical, social, cultural, and psychological factors. This conception makes clear how important it is for scientific research. Therefore, it is so importante to provide an integrated view of meanings attributed to life experiences for patients with CP, going beyond the fragmented reflections on body, mind, and social dimension. Objective: to discuss the meanings brought to emotional experiences reported by CP patients. Method: Clinical-Qualitative, a particularization of generic qualitative methods from the Humanities. The sample of participants was intentional and closed by the criterion of information saturation with 17 patients. The technique of semi-directed interview with open-ended questions in depth was used followed by transcription of the interviews. Qualitative Content Analysis has included both: free-floating rereading to unveil cores of meanings from interviewees' discourse and categorization in topics for discussion. Results: an accurate analysis has made emerge four categories. 1) The Mystery: portraits the difficult understanding and description from where the pain is and how it is. 2) The Chronicity: it takes account the awareness that there is no cure for their pain. 3) The Limitations: it represents the losses experienced in everyday, emotional and social life caused by the CP. 4) The Metaphors: it shows representations of this entity that causes so many problems on patient's lives. Conclusions:the mystery, the chronicity and the limitations from the pain seems to improve its meaning. This is expressed through the metaphors that reflects the suffering experienced.
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