Efetividade de um manual educativo na instrumentalização do acompanhante para a prestação de apoio à parturiente

Abstract

The objective of the study was to evaluate the effe ctiveness of an educational material about instrumentalization of the companion for the execut ion of actions to support the parturient. It is a Clinical Trial Randomized pilot study, which had compared two groups: control group (CG) and Intervention Group (IG) (it was used educationa l manual "Preparing the companion to vaginal delivery: What is important to know? "). Th e study happened in Fortaleza - CE, at the Natural Birth Center Ligia Barros Costa and the Cen ter for Integrated Education and Health Casimiro José de Lima Filho between April/2014 and June/2015. At the end, it was obtained a sample of 65 accompanying, 21 in GI and 44 in GC. T he study was developed in four phases: 1. Baseline; 2. Intervention; 3. Evaluation of the support provided by the companion in the delivery room; and 4. Evaluation of experience and satisfaction with labor and delivery. To collect data in Phase 1, it was used the companion characterization form; in Phase 3, it was used a form for the evaluation of the experience and sup port provided by the companion in the delivery room; and Phase 4, it was used the evaluat ion form of the experience and satisfaction of postpartum women with labor , which contains fou r sub-scales of the Labor Experience and Satisfaction Questionnaire (LESQ) (Sub-Scales: Posi tive experience, negative experience, Relaxation and Companion Support). Companions had, on average, thirty 39.3 (± 14.6) years and 8.4 (± 2.5) years of education, and most of the m were spouse/partner (36; 55.4%) or mother (15; 23.1%) of the parturient. At baseline, 44 (67. 7%) accompanying were aware of some kind of support actions, being the most prevalent the em otional support 22 (33.8%) and physical support 18 (27.7%), with no statistically significa nt differences between groups. In the evaluation of the support provided by the companion in the delivery room, it was found that GI's companions were more likely to use physical su pport actions (RR 1.85; 95% CI: 1.03 to 7.4), in particular, massage (RR 11.7, 95% CI: 1.6 to 81.8), walk (RR 4.27; 95% CI: 1.9 to 9.5), exercise ball (RR 3.75; 95% CI: 1.7 to 8.4) and bre athing exercises (RR 4.88; 95% CI: 2.2 to 10.8). GI companions had a higher number of support actions (7.2 vs 4.6; p: 0.001) and evaluated better the experience of accompanying the delivery (72.4 vs 64.2; p: 0.00). Mothers accompanied by GI participants were more likely to positively rate the self-control during labor (RR 6.58; 95% CI: 2.2 to 20.2) and delivery (RR 2.1 4; 95% CI: 1.2 -4.5), self-confidence (RR 2.65; 95% CI: 1.2 to 6.9), the use of breathing/rel axation methods (RR 2.43; 95% CI: 1.2 to 5.0 ), and the support provided by the companion (RR 3. 36; 95% CI: 1.03 to 7.4) during labor, reflecting a better experience and satisfaction wit h labor and delivery (119.6 vs 107.9; p: 0.000), according to LESQ Sub-scales analyzed here. The dat a showed that the educational manual was effective in the instrumentalization of the compani on for the realization of actions to support the parturient, by having the GI companions accompl ished a significantly higher number of supporting actions that GC companions. This reflect ed in a better evaluation of the companion and of the postpartum women with shared experience, demonstrating the synergy between the support provided by the companion and support perce ived and experienced by the woman in labor.