Cuidado domiciliar na prematuridade: vivência materna

Abstract

Pregnancy is a physiological process. However, few pregnant women are more likely to develop unfavorably to the mother-fetus binomial. Among the complications of gestation, premature birth is the most important one, since it is considered a risk factor for the survival of the baby. The objectives were to understand how mothers performed the home care of the premature newborn and to describe how this care occurred through their speeches. This is a qualitative study with an ethnographic approach. It was also adopted the method of the Ethnographic study, in order to facilitate the discovery of data focused on the Theory of Diversity and Universality of Leininger Cultural Care. The inclusion criteria were as follows: to be a mother of preterm infants, that is, delivery with gestational age before 37 weeks of gestation, between January 2014 and June 2016. Data collection included: participant observation, workshops and semi-structured interviews with the guiding inquiries: Tell me about your arrival at home after childbirth; tell me how the first weeks have passed. For each collaborator, authorization was requested for participation in the study, by means of the Informed Consent Form, guaranteeing autonomy, safety, well-being and the ethical principles of the research. This study was approved with Technical Advice 1.774.512. Seven mothers of preterm new born babies participated in the study. The Participating Observations lasted two months with the preparation of the Field Book, which were grouped in Observation Notes; Theoretical Notes; Methodological Notes and Personal Notes. The Field Book contains the record of the data with annotations that resulted from the participating contact and the careful observation of the social universe in which they are inserted, all of which was intended to be investigated. The data collection phase began in November 2016 and ended in April 2017, totaling six months. The narratives transcribed from the interviews were categorized, in a process that required data systematization. The reading of the narratives evidenced the movement of the lines that intertwined the vital tones, the concepts and the attitudes of the collaborators. The thematic analysis of the data originated seven categories: Identification and Family Situation; Pregnancy and Childbirth, which was divided into five subcategories: Pregnancy Planning; Complications; Childbirth experience; Postpartum and Maternal discharge; Prematurity, which was divided into four subcategories: Maternal feelings towards the premature child, Maternal conflicts, Mother's experience in the ICU, and Faith; Maternal Care, which was divided into the following subcategories: Hospital discharge of the new born and maternal feelings, Maternal home care, Experience in child care and Intercurrences of the baby at home; Breast-feeding; Family Support; and Resilience. Prematurity makes the family live a new reality, generating different feelings from happiness and suffering, which range from joy for the birth of the child and his or her being alive to fear and anguish for not knowing what will happen to him or her. With a great deal of responsibility for the care of the premature infant, the family needs a support network, with the primary care nurse being the protagonist of this new stage.