Atitudes de Profissionais sobre o Uso de Drogas por Gestantes

Conteúdo do artigo principal

Júlia Magna da Silva Teixeira
Júlia de Souza Boden
Isabela Valverde Fonseca
Telmo Mota Ronzani
Fabiane Rossi dos Santos Grincenkov

Resumo

O uso de drogas é um dos fatores associados a gestações de alto risco, as crenças e atitudes dos profissionais configuram possíveis dificultadores dos cuidados em saúde. O presente estudo buscou verificar as atitudes profissionais em relação a gestantes usuárias de drogas. Realizou-se a busca bibliográfica de publicações entre 2000 a fevereiro de 2020, nas bases de dados Scielo, Lilacs, Pubmed, Scopus e PsycINFO. Ao final foram analisados 24 artigos, todos de língua inglesa.  Foram identificadas atitudes negativas em 37% dos artigos, na mesma medida que atitudes positivas; também foram encontradas atitudes ambivalentes (25%). Além disso, alguns dos estudos apontaram algumas barreiras quanto às intervenções. Atitudes negativas e moralizantes denotam um cunho individualizante, em relação às atitudes positivas essas podem ter um papel fundamental na atuação profissional e na saúde materna e do feto.

Downloads

Não há dados estatísticos.

Detalhes do artigo

Seção
Artigos

Referências

Abel, E. L., & Kruger, M. (2002). Physician attitudes concerning legal coercion of pregnant alcohol and drug abusers. American Journal of Obstetrics and Gynecology, 186(4), 768–772. https://doi.org/10.1067/mob.2002.122142

Acosta, L. M., Gonçalves, T. R., & Barcellos, N. T. (2016). Coinfecção HIV/sífilis na gestação e transmissão vertical do HIV: Um estudo a partir de dados da vigilância epidemiológica. Revista Panamericana de Salud Pública, 40(6), 435–442. https://www.scielosp.org/pdf/rpsp/2016.v40n6/435-442

Antunes, M. B., Demitto, M. O., Padovani, C, Elias, K. C. M., Miranda, A. C. M., & Pelloso, S. M. (2018). Desfecho perinatal em gestantes usuárias de drogas atendidas em um centro especializado. SMAD, Revista Electrónica em Salud Mental, Alcohol y Drogas, 14(4), 211–218. https://doi.org/10.11606/issn.1806-6976.smad.2018.000371

Bastos, F., Vasconcellos, M., De Boni, M., Reis, R., Coutinho, N., & Souza, C. (2017). III levantamento nacional sobre o uso de drogas pela população brasileira. Fiocruz. https://www.arca.fiocruz.br/handle/icict/34614

Benoit, C., Stengel, C., Marcellus, L., Hallgrimsdottir, H., Anderson, J., MacKinnon, K., Phillips, R., Zazueta, P., & Charbonneau, S. (2014). Providers’ constructions of pregnant and early parenting women who use substances. Sociology of Health & Illness, 36(2), 252–263. https://doi.org/10.1111/1467-9566.12106

Brown, S. D., Donelan, K., Martins, Y., Burmeister, K., Buchmiller, T., Sayeed, S., Mitchell, C., & Ecker, J. (2012). Differing attitudes toward fetal care by pediatric and maternal-fetal medicine specialists. Pediatrics, 130(6), 1534–1540. https://doi.org/10.1542/peds.2012-1352

Cavazza, N. (2008). Psicologia das atitudes e das opiniões. Loyola.

Chisolm, M. S., Brigham, E. P., Lookatch, S. J., Tuten, M., Strain, E. C., & Jones, H. E. (2010). Cigarette smoking knowledge, attitudes, and practices of patients and staff at a perinatal substance abuse treatment center. Journal of Substance Abuse Treatment, 39(3), 298–305. https://doi.org/10.1016 / j.jsat.2010.06.008

Condliffe, L., McEwen, A., & West, R. (2005). The attitude of maternity staff to, and smoking cessation interventions with, childbearing women in London. Midwifery, 21(3), 233–240. https://doi.org/10.1016/j.midw.2004.12.011

Courchesne, E. N. S., & Meyers, S. A. (2020). Women and pregnancy. In C. Marienfeld (Ed.), Absolute addiction psychiatric review (pp. 259–276). Springer.

Doi, L., Cheyne, H., & Jepson, R. (2014). Alcohol brief interventions in Scottish antenatal care: A qualitative study of midwives’ attitudes and practices. BMC Pregnancy and Childbirth, 14(170), 1–10. https://doi.org/10.1186/1471-2393-14-170

Fonti, S., Davis, D., & Ferguson, S. (2016). The attitudes of healthcare professionals towards women using illicit substances in pregnancy: A cross-sectional study. Women and Birth, 29(4), 330–335. https://doi.org/10.1016/j.wombi.2016.01.001

Geraghty, S., Doleman, G., & De Leo, A. (2019). Midwives’ attitudes towards pregnant women using substances: Informing a care pathway. Women and Birth, 32(4), e477-e482. https://doi.org/10.1016/j.wombi.2018.09.007

Gérardin, M., Victorri-Vigneau, C., Louvigné, C., Rivoal, M., & Jolliet, P. (2011). Management of cannabis use during pregnancy: An assessment of healthcare professionals’ practices. Pharmacoepidemiology and Drug Safety, 20(5), 464–473. https://doi.org/10.1002/pds.2095

Göransson, M., Faxelid, E., & Heilig, M. (2004). Beliefs and reality: detection and prevention of high alcohol consumption in Swedish antenatal clinics. Acta Obstetricia et Gynecologica Scandinavica, 83(9), 796–800. https://doi.org/10.1080/j.0001-6349.2004.00461.x

Guimarães, V. A., Fernandes, K. S., Lucchese, R., Vera, I., Martins, B. C. T., Amorim, T. A. D., & Guimarães, R. A. (2018). Prevalência e fatores associados ao uso de álcool durante a gestação em uma maternidade de Goiás, Brasil Central. Ciência & Saúde Coletiva, 23, 3413–3420. https://doi.org/10.1590/1413-812320182310.24582016

Herzig, K., Danley, D., Jackson, R., Petersen, R., Chamberlain, L., & Barbara G. (2006). Seizing the 9-month moment: Addressing behavioral risks in prenatal patients. Patient Education and Counseling, 61(2), 228–235. https://doi.org/10.1016/j.pec.2005.04.001

Holland, C., Nkumsah, M., Morrison, P., Tarr, J., Rubio, D., Rodriguez, K., Kraemer, K., Day, N., Arnold, R., & Chang, J. (2016). “Anything above marijuana takes priority”: Obstetric providers’ attitudes and counseling strategies regarding perinatal marijuana use. Patient Education and Counseling, 99(9), 1446–1451. https://doi.org/10.1016/j.pec.2016.06.003

Holland, C. L., Rubio, D., Rodriguez, K. L., Kraemer, K. L, Day, N., Arnold, R. M, & Chang, J. C. (2016). Obstetric health care providers’ counseling responses to pregnant patient disclosures of marijuana use. Obstetrics and Gynecology, 127(4), 681–687. https://doi.org/10.1097/AOG.0000000000001343

Hooks, C. (2015). Paranoid or persecuted? The stigmatisation of pregnant drug users: A literature review. Practising Midwife, 18(1), 14–18. https://pubmed.ncbi.nlm.nih.gov/26310087/

Kerker, B. D., Horwitz, S. M., & Leventhal, J. M. (2004). Patients’ characteristics and providers’ attitudes: Predictors of screening pregnant women for illicit substance use. Child Abuse & Neglect, 28(2), 209–223. https://doi.org/10.1016/j.chiabu.2003.07.004

Ketteres, F., Symons, L., Lambrechts, M., Mairiaux, P., Godderis, L., Peremans, L., Remmen, R., & Vanmeerbeek, M. (2014). What factors determine Belgian general practitioners’ approaches to detecting and managing substance abuse? A qualitative study based on the I-Change Model. BMC Family, 15(1), 1–19. https://doi.org/10.1186/1471-2296-15-119

Ko, J. Y., Tong, V. T., Haight, S. C., Terplan, M., Stark, L., Snead, C., & Schulkin, J. (2020) Obstetriciangynecologists’ practices and attitudes on substance use screening during pregnancy. Journal of Perinatology, 40(3), 422–432. https://doi.org/10.1038/s41372-019-0542-3

Maldonado, M. T. (2017). Psicologia da gravidez: Gestando pessoas para uma sociedade melhor (3a ed.). Ideias & Letras.

Malvezzi, C., & Nascimento, J. (2018). Cuidado aos usuários de álcool na atenção primária: Moralismo, criminalização e teorias da abstinência. Trabalho, Educação e Saúde, 16(3), 1095–1112. https://doi.org/10.1590/1981-7746-sol00153

Marcolino, T. Q., Joaquim, R. H. V. T., Wernet, M., Giovanetti, G., Kishi, R. G. B., Marchi, M., Fejes, M. A. N., Rodrigues, S. F., Passianatto, T. Y. S., & Caneira, É. G. (2018). Gestação e uso de substâncias psicoativas: Qual é o cuidado em saúde desejado pelas mulheres? Cadernos Saúde Coletiva, 26, 255–260. https://doi.org/10.1590/1414-462X201800030374

Mendez, D., Jacobson, P. D., Hassmiller, K. M., & Zellman, G. L. (2003). The effect of legal and hospital policies on physician response to prenatal substance exposure. Maternal and Child Health Journal, 7(3), 187–196. https://doi.org/10.1023/a:1025188405300

Miles, M., Chapman, Y., Francis, K., & Taylor, B. (2014). Midwives experiences of establishing partnerships: Working with pregnant women who use illicit drugs. Midwifery, 30(10), 1082–1087. https://doi.org/10.1016/j.midw.2013.06.020

Miles, M., Francis, K., & Chapman, Y. (2010). Challenges for midwives: Pregnant women and illicit drug use. Australian Journal of Advanced Nursing, 28(1), 83–90. https://doi.org/10.3316/ielapa.053248327279822

Miller-Thomas, T., Leoutsakos, J. M., Terplan, M., Brigham, E. P., & Chisolm, M. S. (2014). Comparison of cigarette smoking knowledge, attitudes, and practices among staff in perinatal and other substance abuse treatment settings. Journal of Addiction Medicine, 8(5), 377–383. https://doi.org/10.1097/ADM.0000000000000068

Ministério da Saúde (2012a). Gestação de alto risco: Manual técnico (5a ed.). http://bvsms.saude.gov.br/bvs/publicacoes/manual_tecnico_gestacao_alto_risco.pdf

Ministério da Saúde (2012b). Atenção ao pré-natal de baixo risco. http://bvsms.saude.gov.br/bvs/publicacoes/atencao_pre_natal_baixo_risco.pdf

Motta, K. M. C., & Linhares, M. B. M. (2016). Perfil das gestantes usuárias de álcool/drogas e os efeitos na saúde e desenvolvimento dos filhos. Interação em Psicologia, 19(1), 133–144. http://dx.doi.org/10.5380/psi.v19i1.35877

Neiva, E. R., & Mauro, T. G. (2011). Atitude e mudanças de atitude. In C. V. Torres & E. R. Neiva (Orgs.), Psicologia social: Principais temas e vertentes (pp. 171–203). Artmed.

Oni, H. T., Buultjens, M., Blandthorn, J., Davis, D., Abdel-Latif, M., & Islam, M.M (2020). Barriers and facilitators in antenatal settings to screening and referral of pregnant women who use alcohol or other drugs: A qualitative study of midwives’ experience. Midwifery, 81(102595), 1–32. https://doi.org/10.1016/j.midw.2019.102595

Ordean, A., Forte, M., Selby, P., & Grennell, E. (2020). Screening, brief intervention, and referral to treatment for prenatal alcohol use and cigarette smoking: A survey of academic and community health care providers. Journal of Addiction Medicine, 14(4), e76–e82. https://doi.org/10.1097/ADM.0000000000000588

Oser, C., Biebel, E., Harris, M., Klein, E., & Leukefeld, C. (2011). Gender differences in provider’s use of a standardized screening tool for prenatal substance use. Journal of Addiction Medicine, 5(1), 36–42. https://doi.org/10.1097/ADM.0b013e3181ccec2e

Petersen, P. W., Petersen, Z., Sorsdahl, K., Mathews, C., Everett-Murphy, K., & Parry, C. D. (2015). Screening and brief interventions for alcohol and other drug use among pregnant women attending midwife obstetric units in Cape Town, South Africa: A qualitative study of the views of health care professionals. Journal of Midwifery & Women’s Health, 60(4), 401–409. https://doi.org/10.1111/jmwh.12328

Rodrigues, A., Assmar, E. M. L., & Jablonski, B. (2014). Psicologia social (31a ed.). Vozes.

Romo-Avilés, N. (2018) Drugs and gender. In T. M. Ronzani (Ed.), Drugs and social context: Social perspectives on the use of alcohol and other drugs. Springer.

Röske, K., Hannöver, W., Thyrian, J. R., John, U., & Hannich, H. (2009). Smoking cessation counselling for pregnant and postpartum women among midwives, gynaecologists and paediatricians in germany. International Journal of Environmental Research and Public Health, 6(1), 96–107. https://doi.org/10.3390/ijerph6010096

Silva, F. T. R., Fernandes, C. A. M., Tamais, M. L. B., Costa, A. B, & Melo, S. C. C. S. D. (2021). Prevalência e fatores associados ao uso de drogas de abuso por gestantes. Revista Brasileira de Saúde Materno Infantil, 20(4), 1101–1107. https://doi.org/10.1590/1806-93042020000400010

St. Louis, J., Barreto, T., Taylor, M., Kane, C., Worringer, E., & Eden, A. R. (2022). Barriers to care for perinatal patients with opioid use disorder: Family physician perspectives. Family Practice, 39(2), 249–256. https://doi.org/10.1093/fampra/cmab154

Stone R. (2015). Pregnant women and substance use: Fear, stigma, and barriers to care. Health & Justice, 3(2), 1–15. https://doi.org/10.1186/s40352-015-0015-5

Tamashiro, E. M., Milanez, H. M., & Azevedo, R. C. S. (2020). “Por causa do bebê”: Redução do uso de drogas por gestantes. Revista Brasileira de Saúde Materno Infantil, 20(1), 313–317. https://doi.org/10.1590/1806-93042020000100017

Taylor, P., Zaichkin, J., Pilkey, D., Leconte, J., Johnson, B. K., & Peterson, A. C. (2007). Prenatal screening for substance use and violence: Findings from physician focus groups. Maternal and Child Health Journal, 11(3), 241–247. https://doi.org/10.1007/s10995-006-0169-9

Tuchman, E. (2010). Women and addiction: The importance of gender issues in substance abuse research. Journal of Addictive Diseases, 29(2), 127–138. https://doi.org/10.1080/10550881003684582

United Nations Office on Drugs and Crime (2016). World drug report. https://www.unodc.org/documents/scientific/WORLD_DRUG_REPORT_2016_web.pdf

Van der Wulp, N. Y., Hoving, C., & De Vries, H. (2013). A qualitative investigation of alcohol use advice during pregnancy: Experiences of Dutch midwives, pregnant women and their partners. Midwifery, 29(11), 89–98. https://doi.org/10.1016/j.midw.2012.11.014

Wangberg, S. C. (2015). Norwegian midwives’ use of screening for and brief interventions on alcohol use in pregnancy. Sexual & Reproductive Healthcare, 6(3), 186–190. https://doi.org/10.1016/j.srhc.2015.03.001

Wright, A., & Walker, J. (2007). Management of women who use drugs during pregnancy. Seminars in Fetal & Neonatal Medicine, 12(2), 114–118. https://doi.org/10.1016/j.siny.2007.01.001