Banca de QUALIFICAÇÃO: MICHELLY NOBREGA MONTEIRO

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
STUDENT : MICHELLY NOBREGA MONTEIRO
DATE: 21/09/2020
TIME: 15:00
LOCAL: DEFESA REMOTA - https://meet.google.com/fbd-ajkk-bju
TITLE:

EFFECT OF PHYSIOTHERAPY ON SEXUAL FUNCTION OF WOMEN IN THE POSSIBLE VAGINAL AND CESARIAN PARLIAMENT: RANDOMIZED CLINICAL TRIAL


KEY WORDS:

Sexual Behavior, Postpartum Period, Obstetric Childbirth, Physiotherapy, Sexuality, Urinary Incontinence


PAGES: 12
BIG AREA: Ciências da Saúde
AREA: Medicina
SUMMARY:

Pregnancy is an extremely important phase in a woman's life and her experience is influenced by some factors, including hormonal, physical and psychological changes. During this period, these transformations have a great impact on their own concept of what sexuality is, generally leading to problems in their life together.

Many uncertainties and anxieties permeate and sometimes impact the daily lives of women, and consequently their sexual partners, especially in relation to the period of pregnancy-puerperium. Some studies indicate that both pregnancy and the puerperium are an important phase for the appearance of sexual problems and / or urinary incontinence (UI), and some women may have decreased sexual interest in general, at this stage of life.

The presence of sexual dysfunction can be a factor resulting from a sum of factors, which promote total or partial barriers in the woman's sexual response related to desire, excitement and orgasm. The World Health Organization (WHO) considers sexual dysfunction to be an important public health problem and, due to the damage it has been proven to cause to quality of life, should be investigated.

This study is a randomized clinical trial conducted between July and December 2019, where data were collected on 56 women admitted to the Puerperio Wards of the Maternidade Escola Januário Cicco, which were divided into four groups: vaginal delivery without Intervention Physiotherapy - IF (n = 14), vaginal delivery with IF (n = 14), cesarean delivery without IF (n = 14) and cesarean delivery with IF (n = 14). The IF consisted of a physiotherapy training program in pelvic floor musculature, including pelvic floor exercises with manual awareness, pelvic floor exercise with dissociation of adductors, exercises with the sitting patient and standing exercises. In addition, the FSFI (Female Sexual Function Index) questionnaires were applied in order to assess the female sexual response in the postpartum period and the ICIQ-SF (International Consultation on Incontinence Questionnaire - Short Form), to assess the impact of Incontinence Urinary quality of life and qualifies urinary loss. The volunteers signed the Free and Informed Consent Form (ICF) and were evaluated during the 48 hours after delivery (still hospitalized), and in the second and third months postpartum, this monitoring was carried out at the Ambulatory of Puerperium of the referred maternity .

The data collection of the two groups not submitted to FI occurred in four stages: (1) Application of the evaluation form, questionnaires (sociodemographic, FSFI and ICIQ-SF) and physical examination of the parturient women with vaginal manometry; (2) Assistance during the immediate postpartum period, consisting of four Physiotherapy sessions in the first 48 hours after delivery; (3) Revaluation 2nd month: reevaluation of the puerperal woman between 40 and 60 days after the date of delivery; (4) Revaluation 3rd month: reevaluation of the puerperal woman 90 to 100 days after the date of delivery. Data collection from the other two groups submitted to FI also took place in four stages: (1) Application of the evaluation form, questionnaires and physical examination to parturients; (2) Assistance during the immediate puerperium period, consisting of four Physiotherapy sessions in the first 48 hours after delivery and delivery of a booklet with exercises for the Pelvic Floor and postpartum care; (3) Revaluation 2nd month: reevaluation of the puerperal woman between 40 and 60 days after the date of delivery, with delivery of a booklet with other exercises for the Pelvic Floor; (4) Revaluation 3rd month: reevaluation of the puerperal woman 90 to 100 days after the date of delivery.

A database was created in an Excel / Office 2000 software spreadsheet with all study variables. The cases were listed chronologically, attributing inherent variables to each one. The database was exported to EPI INFO, where initial data typing consistency was carried out through manual listing of the listing. Descriptive statistics were performed to present the socio-epidemiological characteristics of the research volunteers. Inferential statistics were used to establish the possible differences between the groups, and for the analysis of the primary outcome (sexual function) and the secondary outcomes (UI and vaginal manometry), the repeated measures anova tests and the 2x2 anova tests were used in order to to establish differences between groups, exceptionally, for vaginal manometry since only 2 evaluations were possible.

This research was approved by the Research Ethics Committee of Hospital Onofre Lopes (CEP-HUOL), linked to the Federal University of Rio Grande do Norte (UFRN), following the rules recommended by the “Declaration of Helsinki” and its modifications (DECLARATION OF HELSINKI, 2000) and Resolution 466/12 of the National Health Council (BRASIL, 2012).

In general, the observed result was that over time there was an improvement in all outcomes, but there was no time versus group interaction.

Improvement in sexual function was observed (p = 0.000), impact of urinary incontinence on quality of life (p = 0.000) and pressure of the muscles of the pelvic floor muscles (p = 0.000) over time (Figure 1). On the other hand, no time versus group interaction for sexual function was observed F (2, 52) = 0.13, p = 0.87, impact of urinary incontinence on quality of life F (2, 52) = 0.12, p = 0.88 and pressure of the pelvic floor muscles (p = 0.66).

The evaluation of the degree of sexual satisfaction of women is a current and constant problem, since numerous variables, such as social, human, biological, psychological, physiological, cultural taboos, which can influence the degree of final sexual satisfaction.

The sexual complaint is one of the most frequent problems in the daily practice of the tocogynecologist, and unfortunately it continues to be approached in a very simplistic way most of the time. Considering that sexual dysfunction may be associated with an increased risk of conflicts between the couple during pregnancy, the etiological diagnosis of this condition is important, so that appropriate treatment can be instituted when necessary, thus avoiding the many emotional problems, the non-acceptance of sexual relations during pregnancy, the fear of resuming this activity, among others, assessing the correlation of the mode of delivery with sexual dysfunction in the puerperium.

The motivation and benefit of this study was to investigate Physiotherapy as a facilitating agent in the puerperium, progressively improving sexual function. With the results of the study, it shows that the training of the pelvic floor muscles can emerge as an important alternative for the prevention and treatment of this type of woman's condition, reducing possible physical and emotional complications.


BANKING MEMBERS:
Presidente - 1199080 - ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
Externo ao Programa - 2328351 - GUSTAVO MAFALDO SOARES
Externo ao Programa - 2171955 - ROBINSON DIAS DE MEDEIROS
Notícia cadastrada em: 11/09/2020 22:48
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