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      A gestante e o processo de viver com diabetes mellitus Translated title: The pregnant woman and the process of living with diabetes mellitus

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          Abstract

          Resumo Introdução Gestação está associada à vida e saúde, mas pode acompanhar algum processo de adoecimento, como é o caso do diabetes mellitus, na condição prévia (tipo 1 ou 2) ou gestacional. Compreender a vivência dessas gestantes pode instrumentalizar para a construção de uma proposta de atenção pré-natal especializada e humanizada. Objetivo interpretar os sentidos e significados da gestação com diabetes, sob a perspectiva de mulheres no ciclo gravídico-puerperal. Métodos Estudo de natureza qualitativa com o objetivo de retratar o processo de viver com diabetes mellitus (DM) na gestação, sob a perspectiva das gestantes. Participaram 17 puérperas adultas, com diagnóstico de DM prévio ou gestacional, que realizaram o pré-natal e tiveram seus filhos em uma maternidade pública do Rio de Janeiro. Foram adotadas as técnicas de observação sistemática, bem como entrevistas semiestruturadas e levantamento de dados de prontuário institucional. A interpretação dos dados foi realizada por meio de uma aproximação com o referencial da hermenêutica de profundidade, com adaptação de suas fases, utilizando-se da análise de conteúdo temática, adaptada de Bardin. Resultados Foram identificadas duas categorias, extraídas do corpus das entrevistas: (1) refém do diabetes, relacionando o DM a situações irreversíveis que comprometem a qualidade de vida; e (2) doença da vigilância, associando o DM ao conjunto de medidas terapêuticas necessárias ao seu gerenciamento, como restrição e privação alimentares. Conclusão Concluiu-se que o processo de gestar com DM é permeado por sentidos que merecem ser compreendidos, pois exercem influências sobre o autocuidado e o desfecho da gestação.

          Translated abstract

          Abstract Background Pregnancy is associated with life and health, but it can accompany some illness process, such as diabetes melittus, in the previous (type 1 or 2) or gestational condition. Understanding the experience of these pregnant women can provide instruments for the construction of a proposal for specialized and humanized prenatal care. Objective to interpret the senses and meanings of pregnancy with diabetes, from the perspective of women in the pregnancy-puerperal cycle. Method A qualitative study aimed to bring forward the process of living with diabetes mellitus (DM) during pregnancy, from the perspective of pregnant women. Participants were 17 postpartum women, diagnosed with DM and who underwent prenatal care and had their children in public maternity in Rio de Janeiro. The techniques of systematic observation, semi-structured interviews, and data collection of institutional records were adopted. The interpretation of the data was carried out using an approximation with the reference of the Depth Hermeneutics, with an adaptation of its phases, using Thematic Content Analysis, adapted from Bardin. Results Two categories were identified, extracted from the interview corpus: (1) diabetes hostage, linking DM to irreversible situations that impair quality of life, and (2) disease of surveillance, associating DM with the therapeutic measures necessary for its management, as food restriction and deprivation. Conclusion It was concluded that the process of gestation with DM is permeated by senses, which deserve to be understood since they exert influence on self-care and the outcome of gestation.

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          Experiences of gestational diabetes and gestational diabetes care: a focus group and interview study

          Background Gestational diabetes mellitus (GDM) is an increasingly common condition of pregnancy. It is associated with adverse fetal, infant and maternal outcomes, as well as an increased risk of GDM in future pregnancies and type 2 diabetes for both mother and offspring. Previous studies have shown that GDM can result in an emotionally distressing pregnancy, but there is little research on the patient experience of GDM care, especially of a demographically diverse UK population. The aim of this research was to explore the experiences of GDM and GDM care for a group of women attending a large diabetes pregnancy unit in southeast London, UK, in order to improve care. Methods Framework analysis was used to support an integrated analysis of data from six focus groups with 35 women and semi-structured interviews with 15 women, held in 2015. Participants were purposively sampled and were representative of the population being studied in terms of ethnicity, age, deprivation score and body mass index (BMI). Results We identified seven themes: the disrupted pregnancy, projected anxiety, reproductive asceticism, women as baby machines, perceived stigma, lack of shared understanding and postpartum abandonment. These themes highlight the often distressing experience of GDM. While most women were grateful for the intensive support they received during pregnancy, the costs to their personal autonomy were high. Women described feeling valued solely as a means to produce a healthy infant, and felt chastised if they failed to adhere to the behaviours required to achieve this. This sometimes had an enduring impact to the potential detriment of women’s long-term psychological and physical health. Conclusions This study reveals the experiences of a demographically diverse group of patients with GDM, reflecting findings from previous studies globally and extending analysis to the context of improving care. Healthcare delivery may need to be reoriented to improve the pregnancy experience and help ensure women are engaged and attentive to their own health, particularly after birth, without compromising clinical pregnancy outcomes. Areas for consideration in GDM healthcare include: improved management of emotional responses to GDM; a more motivational approach; rethinking the medicalisation of care; and improved postpartum care. Electronic supplementary material The online version of this article (10.1186/s12884-018-1657-9) contains supplementary material, which is available to authorized users.
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            Cultura, saúde e doença.

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              Resolução nº 466, de 12 de dezembro de 2012. Diretrizes e normas regulamentadoras sobre pesquisa envolvendo seres humanos

              (2012)
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                Author and article information

                Journal
                cadsc
                Cadernos Saúde Coletiva
                Cad. saúde colet.
                Instituto de Estudos em Saúde Coletiva da Universidade Federal do Rio de Janeiro (Rio de Janeiro, RJ, Brazil )
                1414-462X
                2358-291X
                December 2021
                : 29
                : 4
                : 595-603
                Affiliations
                [02] Rio de Janeiro Rio de Janeiro orgnameUniversidade Federal do Rio de Janeiro orgdiv1Instituto de Nutrição Josué de Castro orgdiv2Programa de Pós-Graduação em Nutrição Brazil
                [01] Rio de Janeiro Rio de Janeiro orgnameUniversidade Federal do Rio de Janeiro orgdiv1Serviço de Nutrição, Maternidade Escola Brazil
                Article
                S1414-462X2021000400595 S1414-462X(21)02900400595
                10.1590/1414-462x202129040329
                cc04bad7-d169-4da1-8b43-ac7dfd8ddcf8

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 10 August 2020
                : 06 August 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 22, Pages: 9
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                SciELO Brazil

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                Artigos Originais

                gravidez,diabetes mellitus,qualitative research,pregnancy,pesquisa qualitativa

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