THEMES

CONSTRUCTS OF THE FIRST ORDER

CONSTRUCTS OF THE SECOND ORDER

Interpersonal

relation

Way to treat—attentive/inattentive, polite/rude, patient/impatient, empathetic/impersonal, careful/careless, sincere professional [8] - [11] [13] [14] [21] ; supported by/abandoned by, safe/unsafe, respected/disrespected, revolted [9] - [12] [14] [15] [21] ; Availability to attend—took too long/attended quickly, had/lack of good will, attended without hurry/in a hurry [8] - [12] [14] [15] [21] ; felt at ease/embarrassed to consult [9] - [12] ; Factors that influenced the relation—overworking [8] - [11] [13] [15] [21] .

The careful centered technique is a hospital routine [10] [11] . Technical competence and ability to interact should co-exist [9] [10] [12] [14] . Women want to be treated as humans [9] [11] [12] . The overworking compromises the professional-user interaction [9] [13] . The interpersonal relation influences satisfaction with care [8] [9] . The interpersonal relation is influenced by professional ability and organization at work [8] .

Information

Information received—naval hygiene and general care for the baby [9] [13] [21] ; breastfeeding [8] - [11] [14] [21] , childcare [21] ; liked/lack of important issues [8] - [11] [14] [21] ; reliable/unreliable on the professional’s competence [8] [9] [11] [14] [15] ; sincere information [9] ; contradicted information [8] [10] [11] [14] [21] ; seemed in favor [8] [9] [13] [15] [21] ; liked the lectures [9] and the educational groups [21] ; Lack/insufficient information—general care, breastfeeding, baby illness, prevention on child illness [10] [12] [14] [15] ; ward routine [11] [15] ; woman prescription [12] ; postpartum surgical [15] [21] ; return to normal weigh [21] ; services referred to puerperium [10] [15] ; puerperal consultation and family planning [14] [21] ; Information by other sources—the use of television, video, posters, internet and invited speakers to inform [14] .

The women really appreciate the information about baby and breastfeeding [8] [12] [14] . The conflicting information causes lack of confidence on the conduct, increasing stress on women [8] [14] [21] . The women receive little information on postpartum recovery [15] . The lack of in-formation affects negatively on women [10] [14] [15] . The lack of information’s a barrier to access puerperal attention [21] .

Communication

Dialogic communication—professional talked/did not talk, listened/did not listen to woman [9] - [14] [21] ; Informative communication—informed slowly/quickly, clarified/limited to clarify, did not clarify doubts [12] [15] [8] -[10] [21] ; clarity of expression [9]; Feelings over communication—woman fee at ease /embarrassed to talk [9] -[13] [21] .

The dialog strengthens the professional-woman confidence [8] [9] . The dialog favors the identification of necessities [9] . Clarifying and giving comfort are decisive aspects for women’s well being [12] . The professional’s availability expresses through a verbal and non-verbal communication [9] . The lack of dialog restrains the rights of citizenship [12] . The professional’s listening ability development is a priority to the puerperal attention [9] [10] [12] [15] [21] .

Attending

the necessities

Specialized attention—only clinical attention [11] ; physical exam [12] [21] ; pain medication [9] [12] [15] ; lack of orientation/emotional support [10] [11] ; focusing on the baby [9] [11] [12] [14] [21] ; under estimated multiparous-complaints/feelings [11] [12] ; inattentive with the primiparous [11] [15] [9] [10] [12] ; general care for baby [9] [21] ; breastfeeding [9] [15] ; only got informed about breastfeeding [11] ; discontinued relationship [8] [11] ; Resting—time for woman [9] , ward routine restrained resting [11] [15] ; Public/private—greater quality in private hospital [9] [10] [12] [21] ; Primary attention—attention to the puerperal at the station [8] [10] [21] ; home assistance [8] [10] [13] -[15] ; inattentive with the primiparous [8] [10] [21] ; breastfeeding [8] [15] ; only got informed about breastfeeding [8] .

People’s necessities can differ from those identified by professionals [13] . The puerperal care is based on regulated necessities, the particular necessities should be redirected to mother/baby [8] -[11] [13] [14] . The puerperal woman-centered care is important to attend their necessities [8] [10] [14] [15] . To decrease morbimortality, it is necessary to identify the common complications earlier at puerperium [12] . The technical competence perception and the time availability are important for women to rely on nurses [8] . The care for the primiparous should be priorized [8] [10] [13] . Theattention at the primary level is a great problem for the puerperal [8] [10] . Facing the inequalities results in types of relation, social insertion and the primacy of the scientific knowledge is more difficult for the attended women at the public health service [12] .

Service

organization

Infrastructure—few professionals [9] [10] [12] ; insufficient clinic knowledge [12] [21] few hospital ladders; bed sheets and absorbent; clothing [1] ; Unit’s routine—child in nursery [11] , visit [11] [15] , lights on, noise, time for procedures [15] , nurse help [12] ; Room sharing—noise, without privacy [15] ; support from other mothers [10] [12] [14] ; Food—quality and quantity [12] [15] ; Leisure—lack of television [12] ; no space to stroll [12] [14] ; Environment—very warm ward [12] ; Staff’s overload—very weary, pressured, stressed professionals [8] [10] [11] [13] [15] [21] ; Obstacles to access—attending hours, long waiting periods, cost, misinformation, transport [10] [14] [21] .

A number of professionals relate to time spent in answering demands and attending time, referring to the quality in care [9] [10] . The primiparous does not have the courage to protest against the inhuman hospital system [11] . The inflexibility of the postpartum ward routine is the product of an organization which prioritizes the staff’s convenience, disregarding the woman as the center of attendance [15] .