Acessibilidade / Reportar erro

Educational technologies and practices for prevention of vertical HIV transmission

Tecnologías y prácticas educativas para la prevención de la transmisión vertical del SIDA

ABSTRACT

Objective:

to assess available evidence on educational technologies and practices for prevention of vertical HIV transmission.

Method:

LILACS, PubMed, Scopus, BDENF, between April and May 2016, with the descriptors: “Vertical Transmission of Infectious Disease”, “HIV”, “Health Education” and “Technology”.

Results:

there are 16 articles published between 2000 and 2014, mostly Brazilian and African, Cross-sectional and with low level of evidence. The studies covered the use of hard technologies, through video, radio and telephone, and soft, emphasizing, in particular, counseling.

Conclusion:

the studies recognize the importance of educational activities as a tool for health promotion in the context of vertical HIV transmission, despite reporting the need for constant training of professionals and urgency in the renewal of educational concepts and practices. Therefore, it is recommended to expand and consolidate health counseling and emphasize the role of nurses as an important actor in this setting.

Descriptors:
Vertical Transmission of Infectious Disease; HIV; Health Education; Technology; Nursing

RESUMEN

Objetivo:

evaluar las evidencias disponibles sobre las tecnologías y prácticas educativas para prevenir la transmisión vertical del SIDA.

Método:

la revisión integrativa, en las bases LILACS, PubMed, Scopus, BDENF, entre abril y mayo de 2016, con los descriptores: “Vertical Transmission of Infectious Disease”, “HIV”, “Health Education” e “Technology”.

Resultados:

se encuentran 16 artículos publicados entre 2000 y 2014, la mayoría brasileña y africana, transversal y con bajo nivel de evidencia. Los estudios abordaron la utilización de tecnologías duras, por medio de vídeo, radio y uso de teléfono, y ligeras, enfatizando, sobre todo el asesoramiento.

Conclusión:

los estudios reconocen la importancia de las actividades educativas como herramienta para promover la salud en el contexto de la transmisión vertical del SIDA, a pesar de relatar la necesidad de capacitación constante de los profesionales y urgencia en la renovación de los conceptos y prácticas educativas. De este modo, se recomienda la ampliación y consolidación del asesoramiento en salud y se destaca el papel del enfermero como importante actor de ese escenario.

Descriptores:
Transmisión Vertical de Enfermedad Infecciosa; SIDA; Educación en Salud; la Tecnología; Enfermería

RESUMO

Objetivo:

avaliar as evidências disponíveis sobre as tecnologias e práticas educativas para prevenção da transmissão vertical do HIV.

Método:

revisão integrativa, nas bases LILACS, PubMed, Scopus, BDENF, entre abril e maio de 2016, com os descritores: “Infectious Disease Transmission, Vertical”, “HIV”, “Health Education” e “Technology”.

Resultados:

encontram-se 16 artigos publicados entre 2000 e 2014, a maioria brasileiro e africano, transversal e com baixo nível de evidência. Os estudos abordaram a utilização de tecnologias duras, por meio de vídeo, rádio e uso de telefone, e leves, enfatizando, sobretudo o aconselhamento.

Conclusão:

Os estudos reconhecem a importância das atividades educativas como ferramenta para promoção da saúde no contexto da transmissão vertical do HIV, apesar de relatar a necessidade de capacitação constante dos profissionais e urgência na renovação dos conceitos e práticas educativas. Destarte, recomenda-se a ampliação e consolidação do aconselhamento em saúde e destaca-se o papel do enfermeiro como importante ator desse cenário.

Descritores:
Transmissão Vertical de Doença Infecciosa; HIV; Educação em Saúde; Tecnologia; Enfermagem

INTRODUCTION

In recent years, there has been great progress in the context of vertical transmission (VT) of HIV. It is now possible to reduce maternal and child transmission rates by 25% to between 1% and 2% with appropriate use of recommended prophylactic measures(11 Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Recomendações para profilaxia da transmissão vertical do HIV e terapia antirretroviral em gestantes[Internet]. Brasília, DF: MS; 2010. [cited 2016 Apr 01]. Available From: http://www.aids.gov.br/sites/default/files/consenso_gestantes_2010_vf.pdf
http://www.aids.gov.br/sites/default/fil...
). In view of the possibility of this reduction as early as possible, it is recommended that health professionals work with educational activities, informing HIV-infected pregnant women and women about the risks and means of preventing transmission from pregnancy to the puerperium, as well as the monitoring of the child until the definition of their serological situation.

Among the factors indicated for non-adherence to prophylaxis of vertical HIV transmission is lack of access to information. Lack of access to information on the infection may create erroneous expectations regarding the prevention of virus transmission, clinical evolution and treatment of the disease. Consequently, it may increase the possibility of illness, since it makes it difficult to understand the damage to their health and to make changes in behavior(22 Padoin SMM, Paula CC, Ribeiro TP, Romanini R.M., Ribeiro AM. Vulnerabilidade materno-infantil: Fatores de (não) adesão à profilaxia da transmissão vertical do HIV. Rev Min Enferm[Internet] 2011 [cited 2016 Apr 01];15(3):443-52. Available from: http://www.reme.org.br/artigo/detalhes/57
http://www.reme.org.br/artigo/detalhes/5...
).

Studies(33 Arruda SFA, Henriques AHB, Trigueiro JVS, Pontes MGA, Lima EAR, Torquato IMB. Desvelando o conhecimento de gestantes soropositivas acerca da transmissão vertical do HIV. Rev Enferm UFPE[Internet]. 2016[cited 2017 Apr 15];10(Supl-3):1441-9. Available from: https://periodicos.ufpe.br/revistas/revistaenfermagem/article/view/11085
https://periodicos.ufpe.br/revistas/revi...
-44 Jordão BA, Espolador GM, Sabino AMNF, Tavares BB. Conhecimento da gestante sobre o HIV e a transmissão vertical em São José do Rio Preto, São Paulo. Rev Bras Pesq Saúde[Internet]. 2016[cited 2017 Apr 15];18(2):26-34. Available from: http://periodicos.ufes.br/RBPS/article/view/15081
http://periodicos.ufes.br/RBPS/article/v...
) show a lack of knowledge regarding the vertical transmission of HIV by seropositive pregnant women. This lack of knowledge may lead to weaknesses in the adoption of VT prophylactic measures, as well as the fact that this population is still under-assisted in its biopsychosocial aspects, requiring multiprofessional attention in aspects that go beyond a normal gestation period and obstetric procedures.

It is essential that the individuality of humanized care be implemented for seropositive mothers, in order to provide support for coping with the main difficulties experienced by them, and it is essential that the professionals approach the reality of these women, listening to them and allowing them to express all the your doubts. Health education is, therefore, the best way to overcome these knowledge deficiencies of HIV positive pregnant women(33 Arruda SFA, Henriques AHB, Trigueiro JVS, Pontes MGA, Lima EAR, Torquato IMB. Desvelando o conhecimento de gestantes soropositivas acerca da transmissão vertical do HIV. Rev Enferm UFPE[Internet]. 2016[cited 2017 Apr 15];10(Supl-3):1441-9. Available from: https://periodicos.ufpe.br/revistas/revistaenfermagem/article/view/11085
https://periodicos.ufpe.br/revistas/revi...
-44 Jordão BA, Espolador GM, Sabino AMNF, Tavares BB. Conhecimento da gestante sobre o HIV e a transmissão vertical em São José do Rio Preto, São Paulo. Rev Bras Pesq Saúde[Internet]. 2016[cited 2017 Apr 15];18(2):26-34. Available from: http://periodicos.ufes.br/RBPS/article/view/15081
http://periodicos.ufes.br/RBPS/article/v...
).

Thus, it is up to health professionals to be able to reduce this gap regarding the lack of access to information by women living with HIV and their lack of knowledge about HIV VT. Thus, the role of the nurse, who has, within its formative pillar, health education, can overcome the classic process of information transfer, leading the individual to reflect and decide in search of the adoption of healthy behaviors. In order to achieve this objective, it is imperative to use technologies that facilitate this teaching process.

In the practice of health education, technology should be used in a way that favors the participation of the subjects in the educational process, contributing to the construction of citizenship and the increase of the autonomy of those involved. In both education and health, educators must understand technologies as facilitators of knowledge-building processes in a creative, transformative and critical perspective(55 Martins AKL, Nunes JM, Nóbrega MFB, Pinheiro PNC, Souza AMA, Vieira NFC, et al. Literatura de cordel: tecnologia de educação para saúde e enfermagem. Rev Enferm UERJ [Internet]. 2011[cited 2017 Apr 01];19(2): 324-9. Available from: http://www.facenf.uerj.br/v19n2/v19n2a25.pdf
http://www.facenf.uerj.br/v19n2/v19n2a25...
).

The types of technology that professionals can rely on are: hard technology, when using tools, standards and technological equipment; soft-hard technology, when it comes to structured knowledge (theories, care models, nursing process); and soft technologies, in which it is clearly seen that the implementation of care requires the establishment of relationships (bonding, service management and care)(66 Merhy EE. Em busca de ferramentas analisadoras das Tecnologias em Saúde: a informação e o dia a dia de um serviço, interrogando e gerindo trabalho em saúde. In: Merhy EE, Onoko R, (Orgs.). Agir em saúde: um desafio para o público. 2ª ed. São Paulo: Hucitec; 2002. p. 113-50.).

Among the options of educational technologies, whether they are hard, soft-hard or soft, have printed educational materials (leaflets, pamphlets, booklets, serials and albums), which use audiovisual resources (such as videos, radio and telephone use) or those who use personal relationships through counseling, reception and dialogue. In one way or another, they all provide information on health promotion, disease prevention, treatment modalities and self-care(77 Bernier MJ. Establishing the psychometric properties of a scale for evaluating quality in printed education materials. Patient Educ Couns[Internet]. 1996[cited 2017 Apr 01];29(3):283-99. Available from: http://www.pec-journal.com/article/S0738-3991(96)00927-5/pdf
http://www.pec-journal.com/article/S0738...
).

With this, the need and relevance of the development of technologies and educational activities in the context of the vertical transmission of HIV is realized. Thus, the following guiding question emerged: what has been produced in the national and international literature on educational technologies and practices for prevention of vertical transmission of HIV?

OBJECTIVE

To assess the available evidence on educational technologies and practices to prevent vertical transmission of HIV. It is believed that the results obtained can cooperate for the improvement of women’s care in this condition.

METHOD

It is a study of the type integrative review of the literature, whose purpose is to gather and synthesize research results on a given topic or issue, in a systematic and orderly manner, contributing to the deepening of the knowledge of the subject investigated(88 Mendes KDS, Silveira RCCP, Galvão CM. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto Contexto Enferm[Internet]. 2008[cited 2017 Apr 01];17(4):758-64. Available from: http://www.scielo.br/pdf/tce/v17n4/18.pdf
http://www.scielo.br/pdf/tce/v17n4/18.pd...
).

To carry out this integrative review, initially, the research question was identified, allied to the selection of the descriptors, and then the criteria for inclusion and exclusion of articles were established. From this, the following steps were taken during the elaboration of this study: the selection of the sample through the search in the databases, the summarization of the information extracted from the selected articles, the evaluation of the studies the interpretation and discussion of the results and, finally, the presentation of the revision and synthesis of knowledge(88 Mendes KDS, Silveira RCCP, Galvão CM. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto Contexto Enferm[Internet]. 2008[cited 2017 Apr 01];17(4):758-64. Available from: http://www.scielo.br/pdf/tce/v17n4/18.pdf
http://www.scielo.br/pdf/tce/v17n4/18.pd...
).

The guiding question for this study was: “What educational technologies and practices are used to prevent vertical transmission of HIV?” The construction of the question involved the acronym PICO(99 Brasil. Ministério da Saúde. Diretrizes metodológicas: elaboração de revisão sistemática e metanálise de ensaios clínicos randomizados[Internet]. Brasília, DF: MS; 2012 [cited 2017 Dec 16]. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/diretrizes_metodologicas_elaboracao_sistematica.pdf
http://bvsms.saude.gov.br/bvs/publicacoe...
), being: P for population (pregnant and postpartum women with HIV); I for intervention (technologies and educational practices used to prevent the vertical transmission of HIV); C for control (no terms were used for comparison); O for outcomes (educational technologies used).

Four databases were analyzed: LILACS (Latin American and Caribbean Literature in Health Sciences), PubMed (Public/Publish Medline), Scopus and Nursing Database (BDENF). The inclusion criteria of the articles in the review were: original research article, complete and published in Portuguese, English or Spanish; address the use of educational technologies, health education, health counseling or some kind of educational practice related to the prevention of vertical transmission of HIV. Studies that did not fit the mentioned characteristics were excluded from this review. There were no limitations on the year of publication of the articles during searches.

The controlled descriptors (DECS descriptors) were used: “Infectious Disease Transmission Vertical”, “HIV”, “Health education” and “Technology”. The choice of the descriptors “Health education” and “Technology” is justified by the fact that the objective of this study is to seek both evidence that addresses educational technologies and educational practices to prevent vertical transmission of HIV. In addition, the descriptor “Technology” was restricted in the results of the searches in certain databases when compared to “Health education”, which during the search extended the number of studies found.

A combination of the descriptors with the boolean operator “AND” was used for each of the selected databases, due to its specific characteristics, having as its guiding axis the question and inclusion criteria established, without the use of filters. The search was performed by online access, in the month of April and May 2016.

For the selection of studies, the recommendations of PRISMA(99 Brasil. Ministério da Saúde. Diretrizes metodológicas: elaboração de revisão sistemática e metanálise de ensaios clínicos randomizados[Internet]. Brasília, DF: MS; 2012 [cited 2017 Dec 16]. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/diretrizes_metodologicas_elaboracao_sistematica.pdf
http://bvsms.saude.gov.br/bvs/publicacoe...
) were followed, as shown in Figure 1, with 16 articles included in this review.

Figure 1
Flowchart of the process of identification, selection and inclusion of the studies, based on the PRISMA recommendation, Brazil, 2016

For the data collection, an adapted tool(1010 Bianchini SM, Galvão CM, Arcuri EAM. Cuidado de enfermagem ao paciente com acidente vascular encefálico: revisão integrativa. O Braz J Nurs[Internet]. 2010[cited 2017 Apr 01];9(2). Available from: http://www.objnursing.uff.br/index.php/nursing/article/view/j.1676-4285.2010.3112/695
http://www.objnursing.uff.br/index.php/n...
) was used to highlight the characteristics of the research, such as: identification (article title, journal title, authors, country, language and year of publication), level of evidence , type of study, objective, methodology, topic categorization, results, conclusions and databases.

The evidence found in the literature was categorized according to the type of educational approach: “use of soft technologies and educational practices to prevent vertical transmission of HIV” and “use of hard educational technologies to prevent vertical transmission of HIV.” In the topic “Use of soft technologies and educational practices for prevention of vertical transmission of HIV” are articles that address educational practices in general, assessing their use or only verifying the importance of counseling, guidance, dialogue and delivery of education in health care providers and women with HIV in the context of vertical transmission of HIV. In the topic “use of hard educational technologies to prevent vertical transmission of HIV” is used in the studies technological equipment, such as video, radio and telephone, which are classified as hard technologies.

The articles were classified as level of evidence at: 1, when evidence was from a systematic review or meta-analysis of all randomized controlled trials, relevant or from clinical guidelines based on systematic reviews of randomized controlled trials; 2, if the evidence was derived from at least one well-delineated randomized controlled trial; 3, when the evidence was obtained from well-delineated clinical trials without randomization; 4, evidence from well-delineated cohort and case control studies; 5, evidence from a systematic review of descriptive and qualitative studies; 6, evidence derived from a single descriptive or qualitative study; 7, evidence originating from the opinion of authorities and/or report of expert committees(1111 Melnyk BM, Fineout-Overholt E. Evidence-based practice in nursing & healthcare: a guide to best practice. Philadelphia: Lippincott Williams & Wilkins; 2005.).

The results were described by means of frequencies, presented in the form of a table and discussed according to the pertinent literature, allowing the reader to evaluate the applicability of the elaborated integrative review, in order to reach the objective of this method.

RESULTS

Chart 1 presents a summary of the characteristics, the categorization of the study, the level of evidence, the objectives, the results and the conclusions of the productions found.

Chart 1
Presentation of the synthesis of articles included in the integrative review, 2016

According to Chart 1, the 16 articles found were published between 2000 and 2014. Of the articles included for analysis, 7 were produced in Brazil and 7 in Africa (2 in Kenya, 1 in Ghana, 1 in Uganda, 1 in Botswana, 1 in Sudan and 1 in South Africa), 1 in Jamaica (Central America) and 1 in place was not reported in the article.

Regarding the type of methodology, most of the articles were cross-sectional with a descriptive and exploratory design, 4 presented a qualitative approach and 1 study was of the cohort type. There was a low level of evidence from the studies, 15 of them presented level of evidence 6 and only 1 presented level 4.

Of the 16 studies analyzed, 4 addressed the use of hard-type educational technologies in order to promote health education for the population through video, radio and telephone, and fall under the topic “use of hard educational technologies for vertical prevention transmission of HIV”, and 12 addressed general educational practices, mainly based on counseling and dialogue between health professional and user of the service, and belong to the topic “Use of soft technologies and educational practices to prevent vertical transmission of HIV.”

In soft technologies, it is seen that the implementation of care requires the establishment of relationships, such as bonding and welcoming(66 Merhy EE. Em busca de ferramentas analisadoras das Tecnologias em Saúde: a informação e o dia a dia de um serviço, interrogando e gerindo trabalho em saúde. In: Merhy EE, Onoko R, (Orgs.). Agir em saúde: um desafio para o público. 2ª ed. São Paulo: Hucitec; 2002. p. 113-50.), as mentioned in some articles on the topic “use of soft technologies and educational practices to prevent vertical transmission of HIV” the use of counseling, guidance and dialogue between the health professional and the service user, it can be said that some of these studies have used soft technologies.

It is emphasized that in none of the review articles was the use of soft-hard technologies and hard-technology technologies found no study addressing the use of printed educational materials such as booklets, booklets, booklets and manuals or software use and scales.

DISCUSSION

The technology is present in all stages of Nursing care, being considered at the same time, process and product. Moreover, it is present in the way in which the relationships between the agents are established and in the way health care is given, which is understood as living work in act(2828 Rocha PK, Prado ML, Wal ML, Carraro TE. Cuidado e tecnologia: aproximações através do Modelo do Cuidado. Rev Bras Enferm[Internet]. 2008[cited 2017 Apr 01];61(1):113-6. Available from: http://www.scielo.br/pdf/reben/v61n1/18.pdf
http://www.scielo.br/pdf/reben/v61n1/18....
).

Nurses, as health education professionals, have been using technologies to mediate the care provided to the assisted individual, and two types of technologies have been identified in the studies analyzed regarding educational practices to prevent vertical transmission of HIV: soft and hard, which will be better discussed in the following topics.

Use of soft technologies and educational practices to prevent vertical transmission of HIV

Most of the evidence in the review is in this category, totaling twelve articles. Of these, seven(1616 Omwega AM, Oguta TJ, Sehmi JK. Maternal knowledge on mother-to-child transmission of HIV and breastmilk alternatives for HIV positive mothers in Homa Bay District Hospital, Kenya. East Afr Med J [Internet]. 2006[cited 2017 Apr 01];83(11):610-8. Available from: https://www.ncbi.nlm.nih.gov/labs/articles/17455450/
https://www.ncbi.nlm.nih.gov/labs/articl...
-1717 Mahmoud MM, Nasr AM, Gassmelseed DE, Abdalelhafiz MA, Elsheikh MA, Adam I. Knowledge and attitude toward HIV voluntary counseling and testing services among pregnant women attending an antenatal clinic in Sudan. J Med Virol[Internet]. 2007[cited 2017 Apr 01];79(5):469-73. Available from: http://onlinelibrary.wiley.com/doi/10.1002/jmv.20850/abstract
http://onlinelibrary.wiley.com/doi/10.10...
,1919 Moore J, Palmer P, Anderson-allen M, Billings C, Mcdonald-kerr C. Challenges and successes of HIV voluntary counselling and testing programme in antenatal clinics in Greater Kingston, Jamaica. West Indian Med J[Internet]. 2008[cited 2017 Apr 01];57(3):269-73. Available from: http://caribbean.scielo.org/pdf/wimj/v57n3/a18v57n3.pdf
http://caribbean.scielo.org/pdf/wimj/v57...
,2222 Silva MR, Alvarenga WA, Dupas G. Caregiver experience in preventive treatment for children exposed to Human. Rev RENE[Internet]. 2014[cited 2017 Apr 01];15(5):743-52. Available from: http://www.revistarene.ufc.br/revista/index.php/revista/article/viewFile/1695/pdf_1
http://www.revistarene.ufc.br/revista/in...
,2424 Feitosa JA, Coriolano MWL, Alencar EM, Lima LS. Aconselhamento do pré-teste anti-HIV no pré-natal: percepções da gestante. Rev Enferm UERJ [Internet]. 2010 [cited 2017 Apr 01];18(4):559-64. Available from: http://www.facenf.uerj.br/v18n4/v18n4a10.pdf
http://www.facenf.uerj.br/v18n4/v18n4a10...
-2525 Praça NS, Barrancos JTG. Teste anti-HIV e aconselhamento no pré-natal: percepção de puérperas. Rev. Gaúcha Enferm[Internet] 2007. [cited 2017 Apr 01];28(1):106-16. Available from: http://www.seer.ufrgs.br/RevistaGauchadeEnfermagem/article/view/4706
http://www.seer.ufrgs.br/RevistaGauchade...
,2727 Byamugisha R, Tumwine JK, Ndeezi G, Karamagi CAS, Tylleskär T. Attitudes to routine HIV counselling and testing, and knowledge about prevention of mother to child transmission of HIV in eastern Uganda: A cross-sectional survey among antenatal attendees. J Int AIDS Soc[Internet]. 2010[cited 2017 Apr 01];13(52). Available from: http://www.biomedcentral.com/1758-2652/13/52
http://www.biomedcentral.com/1758-2652/1...
) evaluated the counseling or reported the use and importance of this practice for the implementation of preventive actions regarding mother-to-child transmission of HIV, showing that type has been the most preponderant among those used in this context.

The establishment of human relations is essential when it comes to the issue of vertical transmission of HIV, since supporting a seropositive woman does not only involve a set of techniques. Technology should not be seen only as something concrete, as a palpable product, but may be the result of a work involving a set of abstract actions that have a specific purpose, in this case the prevention of vertical transmission of HIV(2929 Joventino ES, Dodt RCM, Araujo TL, Cardoso MVLML, Silva VM, Ximenes LB. Tecnologias de enfermagem para promoção do aleitamento materno: revisão integrativa da literatura. Rev Gaúcha Enferm. [Internet] 2011[cited 2017 Apr 01];32(1):176-84. Available from: http://www.scielo.br/pdf/rgenf/v32n1/a23v32n1.pdf
http://www.scielo.br/pdf/rgenf/v32n1/a23...
).

It was also verified among the analyzed publications that the educational practices related to the prophylaxis for the VT of HIV are very focused for the pre- and post-test HIV diagnosis counseling. During counseling, especially if the test result is positive, all phases susceptible to vertical transmission should be reinforced, from the preconceptional to the postpartum period, in order for pregnant women and puerperal women to become aware of the specific care of each phase.

Nurses must understand the practices related to the reduction of vertical transmission of HIV integrally(3030 Silva O, Tavares LHL, Paz LC. As atuações do enfermeiro relacionadas ao teste rápido anti-HIV diagnóstico: uma reflexão de interesse da enfermagem e da saúde pública. Enferm Foco[Internet]. 2011 [cited 2017 Apr 01];2(supl):58-62. Available from: http://revista.portalcofen.gov.br/index.php/enfermagem/article/view/83/69
http://revista.portalcofen.gov.br/index....
). Health professionals should be available for dialogue and linked to issues of gender, sexuality and reproductive health, without losing sight of the ethical, social and cultural dimensions that normalize the lives of HIV positive women. The decisions and desires of women should therefore be discussed in order to provide women with adequate information on the safest recommendations for family planning, as well as on the care needed during pregnancy, delivery and puerperium, and respect for their rights as citizens(2323 Teixeira SVB, Silva GS, Silva CS, Moura MAV. Women living with HIV: the decision to become pregnant. Rev Pesq Cuid Fundam [Internet]. 2013[cited 2017 Apr 01];5(1):3159-67. Available from: https://www.ssoar.info/ssoar/handle/document/32868
https://www.ssoar.info/ssoar/handle/docu...
).

Some review studies have reported that educational interventions are necessary to develop positive behaviors and increase adherence to HIV vertical transmission prophylaxis(1818 Boateng D, Kwapong GD, Agyei-Baffour P. Knowledge, perception about antiretroviral therapy (ART) and prevention of mother-to-child-transmission (PMTCT) and adherence to ART among HIV positive women in the Ashanti Region, Ghana: a cross-sectional study. BMC Womens Health [Internet]. 2013 [cited 2017 Jun 25];13:2. Available from: https://www.ncbi.nlm.nih.gov/pubmed/23336813
https://www.ncbi.nlm.nih.gov/pubmed/2333...
,2121 Nogueira SA. Successful prevention of HIV transmission from mother to infant in Brazil using a multidisciplinary team approach. Braz J Infect Dis[Internet]. 2001[cited 2017 Apr 01];5(2):78-86. Available from: http://www.scielo.br/pdf/bjid/v5n2/a06v05n2.pdf
http://www.scielo.br/pdf/bjid/v5n2/a06v0...
,2626 Moura EL, Praça NS. Perinatal transmission: expectations and actions of hiv-positive pregnant women. Rev Latino-Am Enferm[Internet]. 2006[cited 2017 Apr 01];14(3):405-13. Available from: http://www.scielo.br/pdf/rlae/v14n3/v14n3a15.pdf
http://www.scielo.br/pdf/rlae/v14n3/v14n...
), as well as the need for greater professional involvement with health education and clientele(2525 Praça NS, Barrancos JTG. Teste anti-HIV e aconselhamento no pré-natal: percepção de puérperas. Rev. Gaúcha Enferm[Internet] 2007. [cited 2017 Apr 01];28(1):106-16. Available from: http://www.seer.ufrgs.br/RevistaGauchadeEnfermagem/article/view/4706
http://www.seer.ufrgs.br/RevistaGauchade...
). An article also showed that one of the most important actions to be developed by the nurse in the context of vertical transmission of HIV is health counseling, since it has allowed the improvement of HIV sensitization, prevention and control in pregnant women in Jamaica, besides the increase acceptance and empowerment to care for themselves and their children(1919 Moore J, Palmer P, Anderson-allen M, Billings C, Mcdonald-kerr C. Challenges and successes of HIV voluntary counselling and testing programme in antenatal clinics in Greater Kingston, Jamaica. West Indian Med J[Internet]. 2008[cited 2017 Apr 01];57(3):269-73. Available from: http://caribbean.scielo.org/pdf/wimj/v57n3/a18v57n3.pdf
http://caribbean.scielo.org/pdf/wimj/v57...
).

These data are corroborated by studies that emphasize the relevance of education in the continued health of HIV positive pregnant women, orchestrated to the level of understanding them, making them aware of their right to choose care with their body and advising on the importance and adverse effects of treatment, and that such effects are only phases that are necessary to be addressed as part of stages of coping with the disease(44 Jordão BA, Espolador GM, Sabino AMNF, Tavares BB. Conhecimento da gestante sobre o HIV e a transmissão vertical em São José do Rio Preto, São Paulo. Rev Bras Pesq Saúde[Internet]. 2016[cited 2017 Apr 15];18(2):26-34. Available from: http://periodicos.ufes.br/RBPS/article/view/15081
http://periodicos.ufes.br/RBPS/article/v...
,3131 Silva JVF, Nascimento Jr FJM, Rodrigues APRA. Fatores de não adesão ao tratamento antirretroviral: desafio de saúde pública. Cad Grad-Ciênc Biol Saúde-FITS [Internet]. 2014 [cited 2017 Apr 15];2(1):165-75. Available from: https://periodicos.set.edu.br/index.php/fitsbiosaude/article/view/1193/772
https://periodicos.set.edu.br/index.php/...
).

In a study carried out in the city of Campina Grande, Paraíba State, it was verified that the health education was shown as the best way to fill the knowledge deficiencies of the seropositive pregnant women, being pointed out the Groups of Pregnant women as an important tool for the exchange of information between professionals and patients, as well as among the participants themselves(3232 Lima ICV, Galvão MTG, Paiva SS, Brito DMS. Ações de promoção da saúde em serviço de assistência ambulatorial especializada em HIV/Aids. Ciênc Cuid Saúde[Internet]. 2011[cited 2017 Apr 15];10(3):556-63. Available from: http://periodicos.uem.br/ojs/index.php/CiencCuidSaude/article/view/13193
http://periodicos.uem.br/ojs/index.php/C...
).

Despite this, it was verified that the educational work is focused on providing information during the consultation(2020 Feliciano KVO, Kovacs MH. As necessidades comunicacionais das práticas educativas na prevenção da transmissão materno-fetal do HIV. Rev Bras Saúde Matern Infant[Internet]. 2003 [cited 2017 Apr 01];3(4):393-400. Available from: http://www.scielo.br/pdf/rbsmi/v3n4/18884.pdf
http://www.scielo.br/pdf/rbsmi/v3n4/1888...
). The small supply of prenatal educational activities and the “technocratic monologue” that prevails in the relations between the users and the health services have negative repercussions on the vulnerability of the female population and their children(1717 Mahmoud MM, Nasr AM, Gassmelseed DE, Abdalelhafiz MA, Elsheikh MA, Adam I. Knowledge and attitude toward HIV voluntary counseling and testing services among pregnant women attending an antenatal clinic in Sudan. J Med Virol[Internet]. 2007[cited 2017 Apr 01];79(5):469-73. Available from: http://onlinelibrary.wiley.com/doi/10.1002/jmv.20850/abstract
http://onlinelibrary.wiley.com/doi/10.10...
). Another study also showed this difficulty, reporting that improvements in the quality of health counseling are needed(2222 Silva MR, Alvarenga WA, Dupas G. Caregiver experience in preventive treatment for children exposed to Human. Rev RENE[Internet]. 2014[cited 2017 Apr 01];15(5):743-52. Available from: http://www.revistarene.ufc.br/revista/index.php/revista/article/viewFile/1695/pdf_1
http://www.revistarene.ufc.br/revista/in...
).

Ratifying these results, in a study that sought to identify the conceptions and practice of promoting the health of the multidisciplinary team in specialized HIV/AIDS care service, among the actions carried out, there was emphasis on traditional health education, based on the acquisition of knowledge related to disease to change lifestyles considered unhealthy. However, current health demands require changes in these paradigms, both in the services and in the education and teaching of the professionals who will work in these services(3232 Lima ICV, Galvão MTG, Paiva SS, Brito DMS. Ações de promoção da saúde em serviço de assistência ambulatorial especializada em HIV/Aids. Ciênc Cuid Saúde[Internet]. 2011[cited 2017 Apr 15];10(3):556-63. Available from: http://periodicos.uem.br/ojs/index.php/CiencCuidSaude/article/view/13193
http://periodicos.uem.br/ojs/index.php/C...
).

It is also highlighted the barriers faced by health professionals for the realization of educational practices. Among them, the challenges related to the workload, the resources, the scientific update, as well as the need to adjust to the frequent changes in the recommendations are highlighted(2424 Feitosa JA, Coriolano MWL, Alencar EM, Lima LS. Aconselhamento do pré-teste anti-HIV no pré-natal: percepções da gestante. Rev Enferm UERJ [Internet]. 2010 [cited 2017 Apr 01];18(4):559-64. Available from: http://www.facenf.uerj.br/v18n4/v18n4a10.pdf
http://www.facenf.uerj.br/v18n4/v18n4a10...
,3333 Fadnes LT. Infant feeding counseling in Uganda in a changing environment with focus on the general population and HIV-positive mothers: a mixed method approach. BMC Health Serv Res[Internet]. 2010[cited 2017 Apr 01];10(260). Available from: http://www.biomedcentral.com/1472-6963/10/260
http://www.biomedcentral.com/1472-6963/1...
). However, nurses who are adequately trained and trained in health education in the context of vertical transmission of HIV can play a key role in delivering successful services(1919 Moore J, Palmer P, Anderson-allen M, Billings C, Mcdonald-kerr C. Challenges and successes of HIV voluntary counselling and testing programme in antenatal clinics in Greater Kingston, Jamaica. West Indian Med J[Internet]. 2008[cited 2017 Apr 01];57(3):269-73. Available from: http://caribbean.scielo.org/pdf/wimj/v57n3/a18v57n3.pdf
http://caribbean.scielo.org/pdf/wimj/v57...
).

Many factors culminate in the fragility of consistent proposals for the reorganization of healthcare practices in the field of health promotion, such as difficulties in working with the collective body through the implementation of self-help groups, as well as the lack of infrastructure and human resources for services. In addition to the difficulties related to the motivation of the HIV infected client as responsible for their health, due to their difficulty in accepting the disease, the chronic nature and the repercussions of stigma and prejudice still strongly linked to infection. Issues of vulnerability, especially impoverishment, low level of schooling and difficulty in accessing health services were also mentioned. It is necessary to advance the proposals of the health system that express an expanded vision of health, so that the care is not only focused on aspects of cure and prevention of diseases, but also goes in the field of health promotion. Therefore, it is pertinent to change the attitude of the professionals through processes of continuing education, training and new organizational processes of work(3232 Lima ICV, Galvão MTG, Paiva SS, Brito DMS. Ações de promoção da saúde em serviço de assistência ambulatorial especializada em HIV/Aids. Ciênc Cuid Saúde[Internet]. 2011[cited 2017 Apr 15];10(3):556-63. Available from: http://periodicos.uem.br/ojs/index.php/CiencCuidSaude/article/view/13193
http://periodicos.uem.br/ojs/index.php/C...
).

Four studies(1616 Omwega AM, Oguta TJ, Sehmi JK. Maternal knowledge on mother-to-child transmission of HIV and breastmilk alternatives for HIV positive mothers in Homa Bay District Hospital, Kenya. East Afr Med J [Internet]. 2006[cited 2017 Apr 01];83(11):610-8. Available from: https://www.ncbi.nlm.nih.gov/labs/articles/17455450/
https://www.ncbi.nlm.nih.gov/labs/articl...

17 Mahmoud MM, Nasr AM, Gassmelseed DE, Abdalelhafiz MA, Elsheikh MA, Adam I. Knowledge and attitude toward HIV voluntary counseling and testing services among pregnant women attending an antenatal clinic in Sudan. J Med Virol[Internet]. 2007[cited 2017 Apr 01];79(5):469-73. Available from: http://onlinelibrary.wiley.com/doi/10.1002/jmv.20850/abstract
http://onlinelibrary.wiley.com/doi/10.10...
-1818 Boateng D, Kwapong GD, Agyei-Baffour P. Knowledge, perception about antiretroviral therapy (ART) and prevention of mother-to-child-transmission (PMTCT) and adherence to ART among HIV positive women in the Ashanti Region, Ghana: a cross-sectional study. BMC Womens Health [Internet]. 2013 [cited 2017 Jun 25];13:2. Available from: https://www.ncbi.nlm.nih.gov/pubmed/23336813
https://www.ncbi.nlm.nih.gov/pubmed/2333...
,2727 Byamugisha R, Tumwine JK, Ndeezi G, Karamagi CAS, Tylleskär T. Attitudes to routine HIV counselling and testing, and knowledge about prevention of mother to child transmission of HIV in eastern Uganda: A cross-sectional survey among antenatal attendees. J Int AIDS Soc[Internet]. 2010[cited 2017 Apr 01];13(52). Available from: http://www.biomedcentral.com/1758-2652/13/52
http://www.biomedcentral.com/1758-2652/1...
) also had among their objectives assess maternal knowledge about the vertical transmission of HIV. Two of them showed that women’s knowledge is still low, while the other two studies revealed adequate knowledge of mothers, but could be increased. Nevertheless, all studies reinforced the importance of educational interventions to improve knowledge about vertical transmission and adherence to vertical transmission prophylaxis.

In contrast to studies that found adequate knowledge of women, two recent researches that aimed to analyze the knowledge of seropositive pregnant women about the vertical transmission of HIV showed that mothers have a lack of knowledge regarding VT. However, both corroborate with the four studies of this review that health education should be an important tool in order to improve this knowledge(33 Arruda SFA, Henriques AHB, Trigueiro JVS, Pontes MGA, Lima EAR, Torquato IMB. Desvelando o conhecimento de gestantes soropositivas acerca da transmissão vertical do HIV. Rev Enferm UFPE[Internet]. 2016[cited 2017 Apr 15];10(Supl-3):1441-9. Available from: https://periodicos.ufpe.br/revistas/revistaenfermagem/article/view/11085
https://periodicos.ufpe.br/revistas/revi...
-44 Jordão BA, Espolador GM, Sabino AMNF, Tavares BB. Conhecimento da gestante sobre o HIV e a transmissão vertical em São José do Rio Preto, São Paulo. Rev Bras Pesq Saúde[Internet]. 2016[cited 2017 Apr 15];18(2):26-34. Available from: http://periodicos.ufes.br/RBPS/article/view/15081
http://periodicos.ufes.br/RBPS/article/v...
).

In view of these results, the development of educational and health actions imbricated in an acknowledged effective public policy(22 Padoin SMM, Paula CC, Ribeiro TP, Romanini R.M., Ribeiro AM. Vulnerabilidade materno-infantil: Fatores de (não) adesão à profilaxia da transmissão vertical do HIV. Rev Min Enferm[Internet] 2011 [cited 2016 Apr 01];15(3):443-52. Available from: http://www.reme.org.br/artigo/detalhes/57
http://www.reme.org.br/artigo/detalhes/5...
), in order to potentiate educational practices within the perspective of the vertical transmission of HIV with a view to promoting the health of the binomial mother-son.

Use of hard educational technologies to prevent vertical transmission of HIV

In relation to the four studies that used hard technology as a tool for health education for prophylaxis of vertical transmission of HIV, video(1212 Kuhlmann AKS, Kraft JM, Galavotti C, Creek TL, Mooki M, Ntumy R. Radio role models for the prevention of mother-to-child transmission of HIV and HIV testing among pregnant women in Botswana. Health Promot Int[Internet]. 2008[cited 2017 Apr 01];23(3):260-8. Available from: http://heapro.oxfordjournals.org/content/23/3/260.long
http://heapro.oxfordjournals.org/content...
), the use of a radio series(1313 Murdaugh C, Russell RB, Sowell R. Using focus groups to develop a culturally sensitive videotape intervention for HIV-positive women. J Adv Nurs[Internet]. 2000 [cited 2017 Apr 01];32(6):1507-13. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2648.2000.01610.x
https://onlinelibrary.wiley.com/doi/abs/...
), the telephone(1414 Jennings L, Ong’ech J, Simiyu R, Sirengo M, Kassaye S. Exploring the use of mobile phone technology for the enhancement of the prevention of mother-to-child transmission of HIV program in Nyanza, Kenya: a qualitative study. BMC Public Health [Internet]. 2013 [cited 2017 Jun 25];13. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4234194/
https://www.ncbi.nlm.nih.gov/pmc/article...
) and the use of SMS(1515 Dean AL, Makin JD, Kydd AS, Biriotti M, Forsyth BW. A pilot study using interactive SMS support groups to prevent mother-to-child HIV transmission in South Africa. J Telemed Telecare [Internet]. 2012 [cited 2017 Jun 25];18(7):399-403. Available from: https://www.ncbi.nlm.nih.gov/pubmed/23034933
https://www.ncbi.nlm.nih.gov/pubmed/2303...
) were reported. However, other types of hard technology such as printed educational materials, software or use of scales were not mentioned in any of the studies found in the review.

One of the studies in this category(1212 Kuhlmann AKS, Kraft JM, Galavotti C, Creek TL, Mooki M, Ntumy R. Radio role models for the prevention of mother-to-child transmission of HIV and HIV testing among pregnant women in Botswana. Health Promot Int[Internet]. 2008[cited 2017 Apr 01];23(3):260-8. Available from: http://heapro.oxfordjournals.org/content/23/3/260.long
http://heapro.oxfordjournals.org/content...
) aimed to develop an educational video of guidelines for HIV positive women on care in pregnancy and antiretroviral use, using the focal group methodology for this. The study revealed that the information obtained from the focus groups was successfully used to develop a video to be used in a multicenter intervention study.

Educational video deserves to be highlighted as a hard technology that can be used in primary, secondary and tertiary care. It is a playful teaching-learning method that, besides allowing the rapid dissemination of information, can be easily made available to reach any person, regardless of social class or educational level. In addition, this tool enables the stimulation of critical thinking and the development of skills and abilities in the individuals reached by it(3434 Nascimento LA, Joventino ES, Andrade LCO, Gomes ALA, Ximenes LB. Evaluation of educational videos produced in Brazil about infant diarrhea: a documental study. O Braz J Nurs [Internet]. 2014[cited 2017 Apr 01];13(3):311-20. Available from: http://www.objnursing.uff.br/index.php/nursing/article/view/4702
http://www.objnursing.uff.br/index.php/n...
).

A review study on the types of technologies that nurses have developed for the promotion of breastfeeding found that among the types of hard technologies developed, the most prominent was the use of video(2929 Joventino ES, Dodt RCM, Araujo TL, Cardoso MVLML, Silva VM, Ximenes LB. Tecnologias de enfermagem para promoção do aleitamento materno: revisão integrativa da literatura. Rev Gaúcha Enferm. [Internet] 2011[cited 2017 Apr 01];32(1):176-84. Available from: http://www.scielo.br/pdf/rgenf/v32n1/a23v32n1.pdf
http://www.scielo.br/pdf/rgenf/v32n1/a23...
), revealing that this type technology is well used within educational practices.

In a randomized controlled clinical trial that sought the effects of an educational video on maternal self-efficacy in preventing childhood diarrhea, it was shown that video had a significant effect on maternal self-efficacy, demonstrating the efficacy of using this type of technology(3535 Joventino ES, Ximenes LB, Penha JC, Andrade LCO, Almeida PC. The use of educational video to promote maternal self-efficacy in preventing early childhood diarrhoea. Int J Nurs Practice [Internet]. 2017[cited 2017 Apr 15];23:12524-1-7. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/ijn.12524
https://onlinelibrary.wiley.com/doi/full...
).

The second study in this category(1313 Murdaugh C, Russell RB, Sowell R. Using focus groups to develop a culturally sensitive videotape intervention for HIV-positive women. J Adv Nurs[Internet]. 2000 [cited 2017 Apr 01];32(6):1507-13. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2648.2000.01610.x
https://onlinelibrary.wiley.com/doi/abs/...
) evaluated the association between exposure to a long-term radio drama series that encourages use of the HIV vertical transmission prevention program and HIV testing during pregnancy. It was evidenced in the study that along with other supporting elements, radio serial dramas can contribute to HIV prevention, treatment and early care of the infection.

The last two researches of this category sought to investigate the viability of the use of the cellular as a means of promoting the prevention of HIV VT, both being the results of the research favorable to the use of this technology medium.

A systematic review(3636 Delphino TM, Souza PA, Santana RF. Telemonitoramento como intervenção no pós-operatório de facectomia: revisão sistemática da literatura. Rev Min Enferm[Internet]. 2016[cited 2017 Jun 25];20:e937. Available from: http://www.reme.org.br/artigo/detalhes/1071
http://www.reme.org.br/artigo/detalhes/1...
) about “telephone follow-up” as a post-operative nursing intervention of patients undergoing facectomy surgery evidenced the need to increase the production of research on the subject in the Nursing area and in our sociocultural context. In addition, he observed that the use of telemonitoring can be considered a viable and low cost alternative for the continuity of postoperative care in their homes.

It is important to highlight that new technologies are reaching the health sector and impart changes in the attributions of the various professional categories. In this context, Nursing needs to update the knowledge and incorporate such advances in its practice. Among the nurses’ multiple actions, health promotion actions can be highlighted, aiming at the quality of life of HIV patients(2828 Rocha PK, Prado ML, Wal ML, Carraro TE. Cuidado e tecnologia: aproximações através do Modelo do Cuidado. Rev Bras Enferm[Internet]. 2008[cited 2017 Apr 01];61(1):113-6. Available from: http://www.scielo.br/pdf/reben/v61n1/18.pdf
http://www.scielo.br/pdf/reben/v61n1/18....
). Thus, it is imperative that nurses seek the development of new technologies to improve their practice in the context of vertical transmission of HIV, especially with regard to guaranteeing the autonomy of HIV-positive women.

Study limitations

It can be said that the small diversity of educational technologies found, coupled with the presence of methodologically limited studies and with a low level of evidence, made it difficult to evaluate the effectiveness of the interventions used. In addition, there was a sample of very different studies to allow comparisons, making it difficult to categorize and a small number of researches on educational technologies within the theme limited the discussion with similar articles. One can also mention as a limitation, the inclusion of articles available only in English, Portuguese and Spanish.

Contributions of the study

Recognizing what has been produced at national and international level about educational practices and technologies to prevent vertical transmission of HIV, it is possible to identify in which aspect there is a greater lack of nurse’s actions, what kind of technology has been developed and what their failures are and reported successes, as well as new perspectives from these results begin to emerge. With this study, it is possible to verify what has been suggested in the literature for improvement of educational practices, allowing a better direction of new studies and offering more scientific basis for a safer methodological path.

This integrative literature review allows the incorporation of evidence into clinical practice in a clear and summarized way, based on the synthesis of the results of the research found, contributing to the deepening of the knowledge and to the improvement of the educational practices about the vertical transmission of the HIV.

CONCLUSION

From this review, it was possible to verify that almost all the studies found were carried out in Brazil and in Africa between 2000 and 2014, with low level of evidence and Cross-sectional methodology.

It was evidenced that the published studies on educational practices in the context of vertical transmission of HIV addressed the use of hard technologies, through video, radio and telephone, and light, emphasizing, above all, counseling, besides recognizing the importance of educational activities as a tool to promote health. However, no light-hard educational technology was produced in this context, as well as, among hard technologies, no study was found that addressed the use of printed educational materials, for example.

In addition, it was evident the need for constant training of professionals who attend HIV positive women, pregnant women and postpartum women, and that it is urgent to renew educational concepts and practices, which are still carried out vertically and without prioritizing the dialogue and empowerment of clients attended. Thus, the studies recommend the expansion and consolidation of health counseling within practices for prophylaxis of vertical transmission of HIV and highlight the role of nurses as an important actor in this setting.

With this study, we hope to encourage further research in this area, as well as to encourage the development of new educational technologies and to test the effectiveness of those that have been developed in order to implement them in clinical practice. Finally, it is recommended the development of studies with methodological designs with a higher level of evidence, thus contributing to consolidated and evidence-based health practice.

REFERENCES

  • 1
    Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Recomendações para profilaxia da transmissão vertical do HIV e terapia antirretroviral em gestantes[Internet]. Brasília, DF: MS; 2010. [cited 2016 Apr 01]. Available From: http://www.aids.gov.br/sites/default/files/consenso_gestantes_2010_vf.pdf
    » http://www.aids.gov.br/sites/default/files/consenso_gestantes_2010_vf.pdf
  • 2
    Padoin SMM, Paula CC, Ribeiro TP, Romanini R.M., Ribeiro AM. Vulnerabilidade materno-infantil: Fatores de (não) adesão à profilaxia da transmissão vertical do HIV. Rev Min Enferm[Internet] 2011 [cited 2016 Apr 01];15(3):443-52. Available from: http://www.reme.org.br/artigo/detalhes/57
    » http://www.reme.org.br/artigo/detalhes/57
  • 3
    Arruda SFA, Henriques AHB, Trigueiro JVS, Pontes MGA, Lima EAR, Torquato IMB. Desvelando o conhecimento de gestantes soropositivas acerca da transmissão vertical do HIV. Rev Enferm UFPE[Internet]. 2016[cited 2017 Apr 15];10(Supl-3):1441-9. Available from: https://periodicos.ufpe.br/revistas/revistaenfermagem/article/view/11085
    » https://periodicos.ufpe.br/revistas/revistaenfermagem/article/view/11085
  • 4
    Jordão BA, Espolador GM, Sabino AMNF, Tavares BB. Conhecimento da gestante sobre o HIV e a transmissão vertical em São José do Rio Preto, São Paulo. Rev Bras Pesq Saúde[Internet]. 2016[cited 2017 Apr 15];18(2):26-34. Available from: http://periodicos.ufes.br/RBPS/article/view/15081
    » http://periodicos.ufes.br/RBPS/article/view/15081
  • 5
    Martins AKL, Nunes JM, Nóbrega MFB, Pinheiro PNC, Souza AMA, Vieira NFC, et al. Literatura de cordel: tecnologia de educação para saúde e enfermagem. Rev Enferm UERJ [Internet]. 2011[cited 2017 Apr 01];19(2): 324-9. Available from: http://www.facenf.uerj.br/v19n2/v19n2a25.pdf
    » http://www.facenf.uerj.br/v19n2/v19n2a25.pdf
  • 6
    Merhy EE. Em busca de ferramentas analisadoras das Tecnologias em Saúde: a informação e o dia a dia de um serviço, interrogando e gerindo trabalho em saúde. In: Merhy EE, Onoko R, (Orgs.). Agir em saúde: um desafio para o público. 2ª ed. São Paulo: Hucitec; 2002. p. 113-50.
  • 7
    Bernier MJ. Establishing the psychometric properties of a scale for evaluating quality in printed education materials. Patient Educ Couns[Internet]. 1996[cited 2017 Apr 01];29(3):283-99. Available from: http://www.pec-journal.com/article/S0738-3991(96)00927-5/pdf
    » http://www.pec-journal.com/article/S0738-3991(96)00927-5/pdf
  • 8
    Mendes KDS, Silveira RCCP, Galvão CM. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto Contexto Enferm[Internet]. 2008[cited 2017 Apr 01];17(4):758-64. Available from: http://www.scielo.br/pdf/tce/v17n4/18.pdf
    » http://www.scielo.br/pdf/tce/v17n4/18.pdf
  • 9
    Brasil. Ministério da Saúde. Diretrizes metodológicas: elaboração de revisão sistemática e metanálise de ensaios clínicos randomizados[Internet]. Brasília, DF: MS; 2012 [cited 2017 Dec 16]. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/diretrizes_metodologicas_elaboracao_sistematica.pdf
    » http://bvsms.saude.gov.br/bvs/publicacoes/diretrizes_metodologicas_elaboracao_sistematica.pdf
  • 10
    Bianchini SM, Galvão CM, Arcuri EAM. Cuidado de enfermagem ao paciente com acidente vascular encefálico: revisão integrativa. O Braz J Nurs[Internet]. 2010[cited 2017 Apr 01];9(2). Available from: http://www.objnursing.uff.br/index.php/nursing/article/view/j.1676-4285.2010.3112/695
    » http://www.objnursing.uff.br/index.php/nursing/article/view/j.1676-4285.2010.3112/695
  • 11
    Melnyk BM, Fineout-Overholt E. Evidence-based practice in nursing & healthcare: a guide to best practice. Philadelphia: Lippincott Williams & Wilkins; 2005.
  • 12
    Kuhlmann AKS, Kraft JM, Galavotti C, Creek TL, Mooki M, Ntumy R. Radio role models for the prevention of mother-to-child transmission of HIV and HIV testing among pregnant women in Botswana. Health Promot Int[Internet]. 2008[cited 2017 Apr 01];23(3):260-8. Available from: http://heapro.oxfordjournals.org/content/23/3/260.long
    » http://heapro.oxfordjournals.org/content/23/3/260.long
  • 13
    Murdaugh C, Russell RB, Sowell R. Using focus groups to develop a culturally sensitive videotape intervention for HIV-positive women. J Adv Nurs[Internet]. 2000 [cited 2017 Apr 01];32(6):1507-13. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2648.2000.01610.x
    » https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2648.2000.01610.x
  • 14
    Jennings L, Ong’ech J, Simiyu R, Sirengo M, Kassaye S. Exploring the use of mobile phone technology for the enhancement of the prevention of mother-to-child transmission of HIV program in Nyanza, Kenya: a qualitative study. BMC Public Health [Internet]. 2013 [cited 2017 Jun 25];13. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4234194/
    » https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4234194/
  • 15
    Dean AL, Makin JD, Kydd AS, Biriotti M, Forsyth BW. A pilot study using interactive SMS support groups to prevent mother-to-child HIV transmission in South Africa. J Telemed Telecare [Internet]. 2012 [cited 2017 Jun 25];18(7):399-403. Available from: https://www.ncbi.nlm.nih.gov/pubmed/23034933
    » https://www.ncbi.nlm.nih.gov/pubmed/23034933
  • 16
    Omwega AM, Oguta TJ, Sehmi JK. Maternal knowledge on mother-to-child transmission of HIV and breastmilk alternatives for HIV positive mothers in Homa Bay District Hospital, Kenya. East Afr Med J [Internet]. 2006[cited 2017 Apr 01];83(11):610-8. Available from: https://www.ncbi.nlm.nih.gov/labs/articles/17455450/
    » https://www.ncbi.nlm.nih.gov/labs/articles/17455450/
  • 17
    Mahmoud MM, Nasr AM, Gassmelseed DE, Abdalelhafiz MA, Elsheikh MA, Adam I. Knowledge and attitude toward HIV voluntary counseling and testing services among pregnant women attending an antenatal clinic in Sudan. J Med Virol[Internet]. 2007[cited 2017 Apr 01];79(5):469-73. Available from: http://onlinelibrary.wiley.com/doi/10.1002/jmv.20850/abstract
    » http://onlinelibrary.wiley.com/doi/10.1002/jmv.20850/abstract
  • 18
    Boateng D, Kwapong GD, Agyei-Baffour P. Knowledge, perception about antiretroviral therapy (ART) and prevention of mother-to-child-transmission (PMTCT) and adherence to ART among HIV positive women in the Ashanti Region, Ghana: a cross-sectional study. BMC Womens Health [Internet]. 2013 [cited 2017 Jun 25];13:2. Available from: https://www.ncbi.nlm.nih.gov/pubmed/23336813
    » https://www.ncbi.nlm.nih.gov/pubmed/23336813
  • 19
    Moore J, Palmer P, Anderson-allen M, Billings C, Mcdonald-kerr C. Challenges and successes of HIV voluntary counselling and testing programme in antenatal clinics in Greater Kingston, Jamaica. West Indian Med J[Internet]. 2008[cited 2017 Apr 01];57(3):269-73. Available from: http://caribbean.scielo.org/pdf/wimj/v57n3/a18v57n3.pdf
    » http://caribbean.scielo.org/pdf/wimj/v57n3/a18v57n3.pdf
  • 20
    Feliciano KVO, Kovacs MH. As necessidades comunicacionais das práticas educativas na prevenção da transmissão materno-fetal do HIV. Rev Bras Saúde Matern Infant[Internet]. 2003 [cited 2017 Apr 01];3(4):393-400. Available from: http://www.scielo.br/pdf/rbsmi/v3n4/18884.pdf
    » http://www.scielo.br/pdf/rbsmi/v3n4/18884.pdf
  • 21
    Nogueira SA. Successful prevention of HIV transmission from mother to infant in Brazil using a multidisciplinary team approach. Braz J Infect Dis[Internet]. 2001[cited 2017 Apr 01];5(2):78-86. Available from: http://www.scielo.br/pdf/bjid/v5n2/a06v05n2.pdf
    » http://www.scielo.br/pdf/bjid/v5n2/a06v05n2.pdf
  • 22
    Silva MR, Alvarenga WA, Dupas G. Caregiver experience in preventive treatment for children exposed to Human. Rev RENE[Internet]. 2014[cited 2017 Apr 01];15(5):743-52. Available from: http://www.revistarene.ufc.br/revista/index.php/revista/article/viewFile/1695/pdf_1
    » http://www.revistarene.ufc.br/revista/index.php/revista/article/viewFile/1695/pdf_1
  • 23
    Teixeira SVB, Silva GS, Silva CS, Moura MAV. Women living with HIV: the decision to become pregnant. Rev Pesq Cuid Fundam [Internet]. 2013[cited 2017 Apr 01];5(1):3159-67. Available from: https://www.ssoar.info/ssoar/handle/document/32868
    » https://www.ssoar.info/ssoar/handle/document/32868
  • 24
    Feitosa JA, Coriolano MWL, Alencar EM, Lima LS. Aconselhamento do pré-teste anti-HIV no pré-natal: percepções da gestante. Rev Enferm UERJ [Internet]. 2010 [cited 2017 Apr 01];18(4):559-64. Available from: http://www.facenf.uerj.br/v18n4/v18n4a10.pdf
    » http://www.facenf.uerj.br/v18n4/v18n4a10.pdf
  • 25
    Praça NS, Barrancos JTG. Teste anti-HIV e aconselhamento no pré-natal: percepção de puérperas. Rev. Gaúcha Enferm[Internet] 2007. [cited 2017 Apr 01];28(1):106-16. Available from: http://www.seer.ufrgs.br/RevistaGauchadeEnfermagem/article/view/4706
    » http://www.seer.ufrgs.br/RevistaGauchadeEnfermagem/article/view/4706
  • 26
    Moura EL, Praça NS. Perinatal transmission: expectations and actions of hiv-positive pregnant women. Rev Latino-Am Enferm[Internet]. 2006[cited 2017 Apr 01];14(3):405-13. Available from: http://www.scielo.br/pdf/rlae/v14n3/v14n3a15.pdf
    » http://www.scielo.br/pdf/rlae/v14n3/v14n3a15.pdf
  • 27
    Byamugisha R, Tumwine JK, Ndeezi G, Karamagi CAS, Tylleskär T. Attitudes to routine HIV counselling and testing, and knowledge about prevention of mother to child transmission of HIV in eastern Uganda: A cross-sectional survey among antenatal attendees. J Int AIDS Soc[Internet]. 2010[cited 2017 Apr 01];13(52). Available from: http://www.biomedcentral.com/1758-2652/13/52
    » http://www.biomedcentral.com/1758-2652/13/52
  • 28
    Rocha PK, Prado ML, Wal ML, Carraro TE. Cuidado e tecnologia: aproximações através do Modelo do Cuidado. Rev Bras Enferm[Internet]. 2008[cited 2017 Apr 01];61(1):113-6. Available from: http://www.scielo.br/pdf/reben/v61n1/18.pdf
    » http://www.scielo.br/pdf/reben/v61n1/18.pdf
  • 29
    Joventino ES, Dodt RCM, Araujo TL, Cardoso MVLML, Silva VM, Ximenes LB. Tecnologias de enfermagem para promoção do aleitamento materno: revisão integrativa da literatura. Rev Gaúcha Enferm. [Internet] 2011[cited 2017 Apr 01];32(1):176-84. Available from: http://www.scielo.br/pdf/rgenf/v32n1/a23v32n1.pdf
    » http://www.scielo.br/pdf/rgenf/v32n1/a23v32n1.pdf
  • 30
    Silva O, Tavares LHL, Paz LC. As atuações do enfermeiro relacionadas ao teste rápido anti-HIV diagnóstico: uma reflexão de interesse da enfermagem e da saúde pública. Enferm Foco[Internet]. 2011 [cited 2017 Apr 01];2(supl):58-62. Available from: http://revista.portalcofen.gov.br/index.php/enfermagem/article/view/83/69
    » http://revista.portalcofen.gov.br/index.php/enfermagem/article/view/83/69
  • 31
    Silva JVF, Nascimento Jr FJM, Rodrigues APRA. Fatores de não adesão ao tratamento antirretroviral: desafio de saúde pública. Cad Grad-Ciênc Biol Saúde-FITS [Internet]. 2014 [cited 2017 Apr 15];2(1):165-75. Available from: https://periodicos.set.edu.br/index.php/fitsbiosaude/article/view/1193/772
    » https://periodicos.set.edu.br/index.php/fitsbiosaude/article/view/1193/772
  • 32
    Lima ICV, Galvão MTG, Paiva SS, Brito DMS. Ações de promoção da saúde em serviço de assistência ambulatorial especializada em HIV/Aids. Ciênc Cuid Saúde[Internet]. 2011[cited 2017 Apr 15];10(3):556-63. Available from: http://periodicos.uem.br/ojs/index.php/CiencCuidSaude/article/view/13193
    » http://periodicos.uem.br/ojs/index.php/CiencCuidSaude/article/view/13193
  • 33
    Fadnes LT. Infant feeding counseling in Uganda in a changing environment with focus on the general population and HIV-positive mothers: a mixed method approach. BMC Health Serv Res[Internet]. 2010[cited 2017 Apr 01];10(260). Available from: http://www.biomedcentral.com/1472-6963/10/260
    » http://www.biomedcentral.com/1472-6963/10/260
  • 34
    Nascimento LA, Joventino ES, Andrade LCO, Gomes ALA, Ximenes LB. Evaluation of educational videos produced in Brazil about infant diarrhea: a documental study. O Braz J Nurs [Internet]. 2014[cited 2017 Apr 01];13(3):311-20. Available from: http://www.objnursing.uff.br/index.php/nursing/article/view/4702
    » http://www.objnursing.uff.br/index.php/nursing/article/view/4702
  • 35
    Joventino ES, Ximenes LB, Penha JC, Andrade LCO, Almeida PC. The use of educational video to promote maternal self-efficacy in preventing early childhood diarrhoea. Int J Nurs Practice [Internet]. 2017[cited 2017 Apr 15];23:12524-1-7. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/ijn.12524
    » https://onlinelibrary.wiley.com/doi/full/10.1111/ijn.12524
  • 36
    Delphino TM, Souza PA, Santana RF. Telemonitoramento como intervenção no pós-operatório de facectomia: revisão sistemática da literatura. Rev Min Enferm[Internet]. 2016[cited 2017 Jun 25];20:e937. Available from: http://www.reme.org.br/artigo/detalhes/1071
    » http://www.reme.org.br/artigo/detalhes/1071

Publication Dates

  • Publication in this collection
    2018

History

  • Received
    04 Nov 2016
  • Accepted
    27 Jan 2018
Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br