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Abstract(s)
A autoeficácia da mulher durante o trabalho de parto influencia a forma como este é percebido e afeta a sua satisfação com a experiência de parto. No trabalho de parto, a utilização de estratégias de coping vai resultar da intencionalidade da mulher, que por sua vez depende dos julgamentos de autoeficácia, pois é em função desses juízos que o indivíduo tem incentivo para agir e imprimir uma determinada direção às suas ações. Vários estudos demonstraram ser, por isso, necessário que a preparação para o parto incorpore e reforce este conceito.
A presente investigação teve como finalidade desenvolver e avaliar um programa de intervenção em enfermagem que, tendo por base o reforço da autoeficácia, permita à mulher uma maior satisfação com a experiência de parto e, dessa forma, a promoção de uma melhor ligação mãe-filho. Incluiu quatro estudos, desenvolvidos em duas etapas. A primeira teve como finalidade elaborar um programa de intervenção em enfermagem promotor da autoeficácia para lidar com o trabalho de parto. Para a sua concretização realizou-se uma revisão da literatura e efetuaram-se dois estudos: um exploratório, de cariz qualitativo, com o objetivo geral de identificar um conjunto de intervenções de enfermagem adequadas à promoção da autoeficácia no trabalho de parto. Incluiu entrevistas a 25 mulheres no período pós-parto. O segundo, um estudo de consensos, de cariz quantitativo, com o objetivo de validar a relevância das intervenções identificadas. Compreendeu uma amostra de 42 peritos na área em estudo. A segunda etapa teve como finalidade implementar e avaliar a eficácia e o impacte, do programa de intervenção em enfermagem previamente elaborado, na perceção de autoeficácia das grávidas para lidar com o trabalho de parto e na satisfação com a experiência de parto. Englobou dois estudos: um exploratório, descritivo, de cariz misto, cuja amostra compreendeu 246 grávidas e que teve como objetivo conhecer as suas expetativas e preferências relativas ao trabalho de parto, à preparação para o parto e à sua confiança para lidarem com o trabalho de parto. Para a sua concretização foi utilizado um guião de entrevista semiestruturada, duas escalas e o questionário de autoeficácia no trabalho de parto (QAETP). E, ainda, um estudo quasi-experimental, com um desenho pré e pós-teste, incluindo uma amostra de 121 mulheres, 66 alocadas ao grupo experimental e 55 ao grupo controlo. Para a sua elaboração, usou-se o QAETP e o questionário de experiência e satisfação com o parto (QESP). As intervenções de enfermagem passíveis de promover a autoeficácia para lidar com o trabalho de parto identificadas, a teoria da autoeficácia de Bandura, o modelo de promoção de saúde de Nola Pender e a filosofia Lamaze, constituíram a base para a elaboração do programa “Construir a Confiança para o Parto”.
Os resultados obtidos permitiram concluir que o programa foi eficaz na promoção da autoeficácia da mulher para lidar com o trabalho de parto, promovendo um aumento significativo das expetativas de resultado e de autoeficácia; de sentimentos positivos durante o trabalho de parto; no uso das técnicas de relaxamento e respiratórias no trabalho de parto. Foi, igualmente eficaz, na concretização das expetativas das mulheres para o parto, na perceção de controlo e na redução do medo durante o trabalho de parto, e na experiência e satisfação com o parto.
The woman’s self-efficacy during labour influences the way it is understood and affects the satisfaction with the experience of childbirth. During labour, the use of coping strategies will result in woman’s intentionality, which in turn depend on the self-efficacy judgments, as it is according to this these judgements that the individual has the motivation to act and direct her actions. Several studies have therefore shown the need to include and reinforce this concept in childbirth education. The aim of this research was to develop and evaluate a nursing intervention programme. On the foundation of this program there was the self-efficacy strengthening, which allowed pregnant woman a greater satisfaction with the childbirth experience, resulting in the development of a better mother-child bonding. The research included four studies developed in two stages. During the first stage, a nursing intervention programme was created to promote self-efficacy to cope with labour. To develop this programme, a literature review was conducted as well as two studies: an exploratory study and a consensus study. The first one, of qualitative nature, aims to identify a set of suitable nursing interventions for promoting self-efficacy during labour. This study included interviews to 25 women on the post-natal period. The second one, of quantitative nature, aims to validate the relevance of the identified interventions. This study involved 42 specialists in this area. During the second stage, the goal was to implement and evaluate efficacy and impact of the nursing intervention programme previously defined. The efficacy of the evaluation was measured according to the pregnant women’s perception of self-efficacy to cope with labour and the overall satisfaction of the process. This stage included two studies as well: an exploratory descriptive study and a quasi-experimental study. The first one, of mixed nature, aims to know the expectations and preferences of 246 pregnant women regarding labour, childbirth education, and their own confidence to cope with labour. To accomplish this study, a semi-structured interview guide was used, as well as two scales and a childbirth self-efficacy questionnaire (CBSEI). The second study, had a pre and post-test design, and included a sample of 121 women, 66 of which were allocated to the experimental group and the remaining 55 to the control group. For this study, the CBSEI and the experience and satisfaction with childbirth questionnaire (QESP) were used. The identified nursing interventions to promote self-efficacy to cope with labour, the Bandura self-efficacy theory, the Nola Pender health promotion model and the Lamaze philosophy were the foundation for the elaboration of the programme “Building Trust to Childbirth”. The results achieved allowed to determine that the programme was effective in promoting woman’s self-efficacy to cope with labour, promoting a significant increase in: a) expectations of results and self-efficacy, b) positive feelings during labour and c) the use of relaxation and breathing technics during labour. Moreover, the programme was equally effective on the fulfilment of women’s childbirth expectations, on the perception of control and reduction of fear of childbirth, and on the satisfaction with the childbirth experience.
The woman’s self-efficacy during labour influences the way it is understood and affects the satisfaction with the experience of childbirth. During labour, the use of coping strategies will result in woman’s intentionality, which in turn depend on the self-efficacy judgments, as it is according to this these judgements that the individual has the motivation to act and direct her actions. Several studies have therefore shown the need to include and reinforce this concept in childbirth education. The aim of this research was to develop and evaluate a nursing intervention programme. On the foundation of this program there was the self-efficacy strengthening, which allowed pregnant woman a greater satisfaction with the childbirth experience, resulting in the development of a better mother-child bonding. The research included four studies developed in two stages. During the first stage, a nursing intervention programme was created to promote self-efficacy to cope with labour. To develop this programme, a literature review was conducted as well as two studies: an exploratory study and a consensus study. The first one, of qualitative nature, aims to identify a set of suitable nursing interventions for promoting self-efficacy during labour. This study included interviews to 25 women on the post-natal period. The second one, of quantitative nature, aims to validate the relevance of the identified interventions. This study involved 42 specialists in this area. During the second stage, the goal was to implement and evaluate efficacy and impact of the nursing intervention programme previously defined. The efficacy of the evaluation was measured according to the pregnant women’s perception of self-efficacy to cope with labour and the overall satisfaction of the process. This stage included two studies as well: an exploratory descriptive study and a quasi-experimental study. The first one, of mixed nature, aims to know the expectations and preferences of 246 pregnant women regarding labour, childbirth education, and their own confidence to cope with labour. To accomplish this study, a semi-structured interview guide was used, as well as two scales and a childbirth self-efficacy questionnaire (CBSEI). The second study, had a pre and post-test design, and included a sample of 121 women, 66 of which were allocated to the experimental group and the remaining 55 to the control group. For this study, the CBSEI and the experience and satisfaction with childbirth questionnaire (QESP) were used. The identified nursing interventions to promote self-efficacy to cope with labour, the Bandura self-efficacy theory, the Nola Pender health promotion model and the Lamaze philosophy were the foundation for the elaboration of the programme “Building Trust to Childbirth”. The results achieved allowed to determine that the programme was effective in promoting woman’s self-efficacy to cope with labour, promoting a significant increase in: a) expectations of results and self-efficacy, b) positive feelings during labour and c) the use of relaxation and breathing technics during labour. Moreover, the programme was equally effective on the fulfilment of women’s childbirth expectations, on the perception of control and reduction of fear of childbirth, and on the satisfaction with the childbirth experience.
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Keywords
Educação pré-natal Trabalho de parto Autoeficácia Cuidados de enfermagem Childbirth education Labour Self-efficacy Nursing care