(Dis)continuation of care of the pre-term newborn at the border

Abstract

Objectives: to understand how continuation of care for the preterm newborn in the health care network at the border. Methods: the Grounded Theory was the methodological framework. Data were collected through 17 semi-structured interviews between July 2016 and March 2017. Results: “Describing the structure and functioning of the Child Nutrition Center” represents the context; “Experiencing and signifying premature birth” are the causal conditions; “Identifying conditions that intervene in the process of continuation of care for the preterm newborn” are the intervening conditions; “Ensuring continuation of care for the preterm newborn” are strategies; “Identifying (dis)continuation of care flows for the preterm newborn at the border” are the study’s consequences and phenomenon. Final Considerations: there is a need to plan referral and counter-referral flows of the preterm newborn and the commitment of public health managers to ensure continuation of care.

Análise temporal do nascimento e hospitalização de crianças prematuras em município brasileiro de fronteira

“…2020255.1703 what is expected, which despite the efforts to improve health care, obstacles still prevent the implementation of an effective network of services, including obstetrics and neonatology services [23][24][25] . The main difficulties involve the programming of health promotion and disease prevention actions, due to differences in the health policies of the countries involved and the lack of human and structural resources for integrated health actions, especially for the most vulnerable segments 12 .…”

“…Considering the risks that premature birth can trigger, this study proposal is justified by seeking to identify the (in)evolution of prematurity and the need for hospitalization for this segment in a Brazilian triple border municipality, considering that early birth may become a problem for the immediate health of the baby, a risk for family formation and community organization. And because it is a vulnerable scenario for belonging to a border region, health promotion and disease prevention may be compromised, considering the high population mobility in these regions, leading to unattended prenatal care and health follow-up of the prematurely born child 11,12 .…”

Cultural adaptation and assessment of the reliability of the Special Needs Kids Questionnaire for the Brazilian context

“…Furthermore, in the pilot test stage, 74 (83%) of the participants in the test stage and 38 (86%) of the participants in the retest stage chose the "not applicable" answer option. Thus, this discussion is based on the perspective that home visits were not perceived as a follow-up strategy by the families, although the literature reiterates the benefits of home visits in promoting the strengthening of the bonds between health professionals and the families and consequently, ensuring continuity of care (2,9) .…”

“…Due to the potential frailty of these children and the specific demands of care, continuity of care after hospital discharge is essential (9) , especially because this can minimize injuries and hospital readmissions, as well as to strengthen the family's adaptation process to care (5) . On the other hand, discontinuity of care can put the child's health at risk due to the need for constant hospitalizations and the family's difficulty in having autonomy and security to manage prematurity (5) .…”

Percepções maternas sobre o cuidado com o recém-nascido prematuro / Maternal perceptions about the care of the premature newborn

“…Como observado, algumas dessas mães não conseguem prestar os cuidados devidos adequadamente, quando possível, delegam os mesmos a um parente que tenha disponibilidade em ajudar, na maioria dos casos a avó materna. Nessa situação, o apoio das equipes de saúde, durante as visitas domiciliares é fundamental para a manutenção da saúde do recém-nascido prematuro e sua família, inclusive no arranjo alternativo da promoção do aleitamento materno neste contexto 25,26. 5 CONCLUSÕES E IMPLICAÇÕES PARA A PRÁTICAEssa pesquisa teve como finalidade compreender as percepções das mães sobre os cuidados junto aos recém-nascidos prematuros, não só durante a internação, mas também após a alta.…”