Social representations of women submitted to mastectomy and the implications for self-care

The purposes of this research was to identify the social representations of women on breast mastectomy and to analyze the implications of these social representations to care for self-care. This is a qualitative study using the Theory of Social Representations as theoretical reference. For data collection it was employed two techniques: the free association of ideas and observation. For data analysis the thematic analysis was used. The research resulted in two thematic units: the breast and its representations of social change in the body and social representations of women mastectomy: implications for self care. In the study, showed that women objected care of the breasts through the realization of self-examination.     

Social representations of teenagers with their first-born child on maternal care to newborns

This qualitative study aimed to analyze the social representation of teenagers who had their first child and about maternal care to newborns in the home environment. Participants were eight teenagers with their newborns. Data were collected at their homes by means of projective techniques and semi-structured interviews. Analysis was based on social representation theory, demonstrating that the teenagers represent maternal care in figurative centers of affection, family integration and maternal fulfillment. The maternal care is symbolically anchored in the appearance of a family, in the continuum of feelings and in the commitment to the psychomotor progress of the child. The teenagers who had their first child gave more value to belonging to a family than to the losses resulting from early motherhood. Maternal care is a conflictive exercise. On the one hand, it represents the status of being an adult and responsible but, on the other, it marks insecurity, lack of preparation and immaturity, which affect care to the newborn.     

Social representations of women who live with high blood pressure

The Arterial Hypertension is considered as a serious Public Health problem that affects most of the world population and presents difficulties to control.This study dealt with the social representations of the women carriers of Arterial Hypertension about what it is like to be carriers of the disease in the family context, and the health services provided by the professionals that care for them and exploring the psychosocial aspects related to their feelings and behavior that might interfere in their treatment and control of the disease. It was performed in Teresina - PI with 25 women assisted in the Health Center. The data collected was organized in a "corpus" and submitted to the ALCESTE software 4.5, which produced three initial context units, showing the manifestations and feelings of the carriers. The social representations influence the process of knowledge production and circulation that guide and define the behavior and conducts of the hypertensive disease carrier.     

Social representations of the care given to the elderly by health professionals in a nursing home

This study aimed at identifying the social representations of the care given to the elderly by caregivers in a nursing home. Fifteen caregivers aged 28 to 32 years old who worked in a nursing home in the city of Ribeir?o Preto, S?o Paulo, Brazil were subjects for this work and the Theory of Social Representations was used as reference. Data were collected by means of semi-structured interviews and analyzed by content analysis, which enabled the elaboration of categories, thus facilitating comprehension. Among such categories are: informal education, formal education, satisfaction, sadness, modes of confrontation and denegation.     

Depression: viewpoints and knowledge of the nurses in th basic health network

This study aimed at identifying the viewpoints and the knowledge on depression of nurses working in the basic health network. The 73 participants who answered two self-applicable questionnaires were distributed in 28 health units. The general results concerning their viewpoints and knowledge are, in most answers, in accordance with what was expected and showed average knowledge related to depression. However, the individual analysis of such answers indicate that these professionals are not in direct contact with and do not know how to identify depressed patients. They do not observe these indicators in the patients that they assist or do not understand that it is their task to do so. Reflections appeared concerning the possible relationship between mental health actions and their professional education. In this way, undergraduate and continuing education become more important in the development of nursing actions for mental health.     

Social representations about humanization of care: ethical and moral implications

This research aimed at identifying the ethical aspects in the social representations of clients on the humanization and to argue the implications of these for the nursing care. A qualitative study was carried out whose data collection was by means of semi-structured interview and participant observation with 24 patients hospitalized in a public institution. The social representations about humanization of care gain contours of the ethics and the moral, in the establishment of gradients of merit of the good treatment, and resolute actions, clinical evaluation and respect to the right of the client. The right to the good treatment is not equal for all, what indicates the possible differentiations in social representations about citizenship.     

Evaluating the impact of physicians' provision on primary healthcare: Evidence from Brazil's More Doctors Program

This study aims to evaluate the More Doctors Program (Programa Mais Médicos) in terms of the provision of physicians, presenting estimates of its impact on hospitalization for ambulatory care sensitive conditions. The differences‐in‐differences method was used with propensity score matching (double difference matching), using 3 specifications, a falsification test, and also a dynamic endogeneity test to confirm the robustness of the results. For the application of this methodology, a panel of municipal data was constructed covering several variables related to socioeconomic, demographic, and public health infrastructure characteristics in the cities for the period from 2010 to 2016. The results show a significant reduction in hospital admissions in treated municipalities with an increasing and perceptible effect in the second year of the program.     

Social representations on the diet of nursing mothers

This is a qualitative study that sought to establish the significance attributed by women to adequate eating habits with respect to prohibited, permitted and breastmilk-enhancing products during breastfeeding. It was based on the Theory of Social Representations described by Moscovici (2003) and Minayo (2006). 58 mothers of children up to 2 years of age living in the city of Coimbra in Minas Gerais state participated in the survey. Comprehensive analysis of feeding revealed that the new mothers interviewed understood the need for a special diet during postpartum based on healthy, fortified and lactose-rich food, as well as the need for ingesting liquids. Breatfeeding mothers appreciated the need to avoid hot, creamy and fatty food. In this perspective, feeding during this physiological phase implies an understanding of cultural, social and historical aspects which dictate eating habits. This assists in understanding customs and beliefs in order to provide professional assistance geared to the group being assisted in its proper context.     

Cooperation and conflict in childbirth care: representations and practices of nurses and obstetricians

In Brazil, where birthing generally occurs in hospitals and under the care of obstetricians, the incorporation of nurses is a strategy that has been used recently in an attempt to improve obstetric care. This study, conducted in two maternity hospitals in Rio de Janeiro, focuses on representations of obstetricians and nurses regarding teamwork and analyzes how the dimensions of power, cooperation/conflict, and technical autonomy are permeated by dualistic conceptions which influence the quality of health care for women during childbirth. On the one hand, the results show a consensus regarding the advantages of professional cooperation in the improvement of health care, assuming the existence of a clear definition of professional roles. At the same time, conflicts regarding therapeutic conduct during the birth process reflect the professionals' perceptions of autonomy and the influence of professional hierarchies, in which obstetric care is seen to depend on the "objective observation" of the women giving birth. The degree of conflict is differentiated according to the institutional context and related to dualistic conceptions such as objective/subjective, rational/emotional, and male/female.     

Social representations and the experience of illness

This article analyzes the relationship between social representations and the experience of illness. The study is a critical review of the debate on illness. The work focuses on (a) a review of the concept of "social representations of illness"; (b) key aspects of the experience of illness and; (c) principles for understanding the illness process. The authors also emphasize the necessary link between the experience of illness and the context of its material and symbolic production.     

Reflections on the psychoanalytic representations of nurses about themselves and about nursing

This study describes some reflections on the representations of nurses about themselves and about nursing, in order to analyze them within a psychoanalytic framework of the constitution of the subject in the sphere of the desire which motivates them, at the levels of the imaginary and the symbolic. The analysis adopted was the discursive practices proposed by Spink, using association of ideas in the hermeneutical tradition. Considering the subject, eight nurses were interviewed whose interpretations were displayed on graphs and tables. From discourse analysis emerged meanings in the symbolic sphere and the production of meanings. It is possible to understand that the desire of the nurse shows itself as the desire of others' desire, an imaginary desire and therefore, it is imaginary and to be constituted. This object which appears identified with the self, may appear over-valued or commonplace, depreciated or punished. From this point of view, new horizons may open up in practice and professional training for nurses, which brings them together around a signifier which can give them a meaning, enabling them to see themselves as subjects in their professional expressiveness.     

Assessment of the association between the qualification of physicians and nurses in primary healthcare and the quality of care

This study sought to establish the association between the attributes of primary healthcare (PHC) and the professional qualification of physicians and nurses. For data collection, the child version of the Primary Care Assessment Tool (Child PCA-Tool) was applied to the caregivers of children resident and registered in the areas covered by the family health teams. The attributes of PHC were evaluated using the scores of the caregivers in the test. After bivariate analysis, seeking an association between the degree of orientation to the PHC and the socioeconomic and demographic characteristics, as well as the professional characteristics of the health units, a multivariate model was established using Poisson regression. The teams in which there were professionals with residence in family health or family and community medicine achieved higher scores than those in which the professionals did not have this qualification. The authors concluded that specialization in residence in family and community medicine for physicians, and residence in family health for nurses, have higher potential for the transformation of the care model, based on the attributes of the PHC.     

The public healthcare system in the context of Brazil's demographic transition: current and future demands

This paper assesses inpatient and outpatient care and their capacity to respond to changing demands in the context of the demographic transition in Brazil. The data were obtained from studies by the Brazilian Institute of Geography and Statistics (IBGE) and databases in the National Health System (CNES, SIH, and SIA). The reduction in birth, fertility, and infant mortality rates and the increase in life expectancy at birth are still driving population growth, while decreasing the dependency rate, thereby providing the opportunity to make necessary adjustments. The population increased by more than 27.5 million from 1999 to 2009, with a 26.7% reduction in hospital beds and 947,000 hospitalizations, with distortions in the distribution by specialty, but with increases in high-complexity outpatient and inpatient care. The results show that Brazil is undergoing a transition in the healthcare model, requiring greater capacity for future planning of a more complex system and revising the model to prepare for a larger elderly population in the coming decades.     

Profound barriers to basic cancer care most notably experienced by uninsured women: Historical note on the present policy considerations

America is considering the replacement of Obamacare with Trumpcare. This historical cohort revisited pre-Obamacare colon cancer care among people living in poverty in California (N = 5,776). It affirmed a gender by health insurance hypothesis on nonreceipt of surgery such that uninsured women were at greater risk than uninsured men. Uninsured women were three times as likely as insured women to be denied access to such basic care. Similar men were two times as likely. America is bound to repeat such profound health care inequities if Obamacare is repealed. Instead, Obamacare ought to be retained and strengthened in all states, red and blue.