Gerar na pandemia: adaptação do pré-natal psicológico para gestantes diagnosticadas com Covid-19 durante o períodos gestacional

Abstract

This dissertation is the result of a quantitative and qualitative study, whose main objective was the systematization and adaptation of the psychological prenatal care (PNP) for pregnant women who had COVID-19 during the gestational period. This work was carried out with pregnant women from a prenatal clinic specialized in monitoring pregnant women who were exposed to the SARC-COV 2 virus, linked to the research project PROUDEST, from the Faculty of Medical Sciences of the University of Brasilia (UnB). The research method used was action research. There were 71 women in the first phase and 15 in the third phase (7 in the intervention group and 8 in the control group), in which the PNP was implemented and rated its effectiveness in mitigating maternal psychological distress in the puerperium and reducing the incidence of postpartum depression. Several instrumental resources were used for the construction of the data: forms for the evaluation of risk and protection factors for gestational and postpartum depression and other psychic suffering, interprofessional consultation, the group sessions of the PNP, the Beck Depression Scale (BDI) and the Edinburgh Postpartum Depression Scale (EPDS). The indicators developed through the analysis pointed out the existence of several issues related to maternity and the pandemic as generators of psychological distress for these women. The factor with the greatest impact on this group is related to the financial difficulties accentuated by the pandemic, with this statistically significant association with perinatal depression and protection to its development. Based on these data, the adaptation of the PNP was made regarding the psycho-education issues related to the pandemic and prevention of COVID-19, as well as to the social vulnerability associated and accentuated by this worldwide epidemic and the absence of effective public policies to support this population. The adaptation of the PNP proved to be efficient in terms of social, emotional, and instrumental support for this public, besides acting as a protection factor for postpartum depression and other psychological suffering related to the social place of maternity and the subjectivation of this place and identity in mothers. The use of the online modality was efficient for group intervention, providing a basis for it to be used as a tool in mental health prevention and promotion actions. At the end, this adaptation will be presented as the product developed from this study: a maternal mental health intervention model. It should also be noted that this dissertation has produced seven products, six of which are articles, and one is an intervention protocol.