Designing a resilience-based intervention program for children with cancer and their families: a study protocol.

Background: Advances in pediatric oncology have significantly increased survival rates, yet have introduced challenges in managing long-term treatment side effects. This study process introduces an interdisciplinary clinical intervention program rooted in the family resilience framework, aimed at improving well-being across the cancer trajectory for children and their families, especially those in Canadian communities far from specialized oncology centers with limited access to resources. Methods: Employing an intervention mapping approach, this program collaboratively involves patients, families, professionals, and researchers. It aims to identify vulnerability factors, establish a logic model of change, and devise comprehensive strategies that include professional interventions alongside self-management tools. These strategies, tailored to address biopsychosocial and spiritual challenges, are adapted to the unique contexts of communities distant from specialized cancer treatment centers. A mixed-methods approach will evaluate program effectiveness. Expected results: Anticipated outcomes include the empowerment of families with self-management tools and professional support, designed to mitigate biopsychosocial and spiritual complications. By addressing the specific needs and limitations of these communities, the program strives to improve the overall health and well-being of both undergoing treatment and survivorship phases. Discussion: By focusing on comprehensive care that includes both professional interventions and self-management, this initiative marks a significant shift toward a holistic, family-centered approach in pediatric oncology care for remote communities. It underlines the necessity of accessible interventions that confront immediate and long-term challenges, aiming to elevate the standard of care by emphasizing resilience, professional support, and family empowerment in underserved areas.

Adoptees' experiences of using direct-to-consumer genetic testing and determinants of this use: A mixed study in Quebec.

Adoptees' use of direct-to-consumer genetic testing (DTC-GT) is known to raise both ethical and emotional issues, and it can also challenge their identity. The objective of the present study was to describe the experiences of DTC-GT use among adoptees living in Quebec and to better understand the benefits and disadvantages of use. We adopted a mixed method approach whereby a questionnaire comprising standardized scales was administered to 143 adoptees who had used genetic testing and 40 adoptees who had not. Semi-structured interviews were performed with five respondents from the DTC-GT use group. The quantitative and qualitative data were analyzed and integrated together using the Pillar Integration Process. The results highlighted familial reunion as the primary motivation for the use of DTC-GT among responding adoptees. Reported challenges included needing help with results interpretation, as well as the need for autonomy in the ownership of the results. Participants describe not being particularly concerned by potential ethical issues, describing the benefits of the tests as more important than possible disadvantages. Overall, participants had a good experience of using DTC-GT, and users were less anxious. Various factors associated with the use and experience of use were highlighted (age, psychological distress, community membership, etc.). The results from this study provide much-needed information about adoptees' needs regarding DTC-GT, highlight key risk factors, and introduces best practice recommendations so that adoptees are properly informed and supported when pursuing DTC-GT.

Evaluating facilitators' challenges administering a program building on existing strengths in families facing difficulties.

The primary objective of this study was to understand the challenges faced by 12 facilitators (9 women and 3 men) of the Strengthening Families Program (SFP) implemented in the Adélard-Dugré and Jean-Nicolet neighbourhoods of Trois-Rivières, Quebec. This objective was operationalized as the following question: How did facilitators manage to buy in to, and align themselves with, program principles while avoiding an expert stance and remaining focused on participating families' strengths? This question has not been investigated before in connection with the SFP program. This study was conducted between 2011 and 2014, and relied on semi-annual group interviews. The results indicate that facilitators' first step was to acknowledge their expectations. Once they had accomplished this, they were able to let go and distance themselves from an expert stance. This allowed them to recognize the benefits flowing from application of the program's principles, and understand how they could repurpose their expertise for intervention with program participants. Facilitators also came to realize that they had developed strong relationships with the families and better understood the latter's realities. Finally, this article explores the implications of the results, both for practice (in terms of program compliance) and research (in terms of program evaluation).

La perspective des parents sur le contexte de soin et sur l'adaptation sociale de leur enfant après un séjour hospitalier : une étude par méthodes mixtes.

Introduction : A child's hospitalization can be a difficult experience for many parents and can disrupt parenting. However, parenthood in relation to this care context is little studied.Objectives : The purpose of this study is to describe the experience of parents in their relationship to the care setting and the social adjustment of children.Method : A sequential mixed-methods survey was conducted, involving 94 parents with children aged between 17 and 48 months after a hospital stay in three regions of Quebec. After completing the questionnaire, 16 participated in semi-structured interviews.Results : 1) The mothers' perceived stressors, related to care as well as the child's behavior, are associated with maternal cognitions and behaviors two months after a hospital stay.2) The parents' relationship to the care setting and the child's adaptation highlights four relational processes : continuous, difficult, ambivalent, and complex.Discussion : The care context influences the parent's ability to assume their role two months after a hospital stay.Conclusion : It is important to offer nursing to parents that takes into account the psychological dimension of parenthood and the social adaptation of children to the care context.

Evaluation of the Acceptability of a Prenatal Program for Women With Histories of Childhood Trauma: The Program STEP.

Background: Childhood trauma would negatively affect pregnant women's mental health and would have intergenerational repercussions. However, there is a paucity of prenatal interventions specifically designed for women exposed to childhood trauma. The study aims to evaluate the acceptability of STEP, a manualized group intervention designed for pregnant women having experienced early life adversity. Methods: The acceptability of STEP was assessed in four phases. In Phase 1, six experts evaluated whether the program activities were pertinent and trauma sensitive. In Phase 2, three parents read the intervention manuals and evaluated whether they considered each session relevant, interesting, and clear. In Phase 3, the program was briefly presented by phone to 309 pregnant women from the community. Women were inquired about their interest in the program, and the reasons for their lack of interest were assessed. In Phase 4, 30 pregnant women exposed to childhood trauma participated in the program and completed anonymous satisfaction questionnaires after each session. Psychological distress was also measured before and after the program. Results: All activities were rated by independent experts as highly pertinent, adequate, and sufficiently safe to be offered to pregnant women. Parents who read through the intervention manuals also considered that the sessions were relevant, clear, and interesting. About half of the pregnant women from the community showed interest in the program. Participants reported very high levels of satisfaction and a significant decrease in psychological distress during the program. Conclusions: Our findings show a high level of convergence among various indicators of program acceptability.

Beyond new public management: Empowering community-based organisations.

AIMS: To describe how new public management practices, a global public service management trend, and a provincial community of practice, a group of people who learn from each other by interacting on an ongoing basis, affected a group of 240 community-based organisations. METHODS: We conducted a holistic single case study of 240 grassroots, community-based organisations called Family Resource Centres in the province of Québec, Canada. Data was collected from 36 research interviews, 6 years of participant observation, institutional documents and a research journal, and analysed qualitatively. RESULTS: New public management practices foster social injustice and endanger the integrity of the community-based organisations, whereas the provincial community of practice empowered them to fight back deleterious new public management practices and reclaim their identity. CONCLUSION: A provincial community of practice allowed 240 independent community-based organisations in Québec, Canada to become empowered on a macro level while remaining faithful to their small scale community orientation. We hope this model can serve as an example of alternatives to current (new public) management practices.

Parental Cannabis Use: Contradictory Discourses in the Media, Government Publications, and the Scientific Literature.

Approximately 7% of Americans and 13% of Canadians older than 25 years old use cannabis,1,2 suggesting that millions of parents across North America are users. We hypothesize that parental cannabis use may affect children in two ways: by increasing personal exposure to the substance (eg, in utero exposure) and through its impact on parenting (Figure 1). Regarding direct exposure, scientific evidence suggests that using cannabis during pregnancy is unsafe and may lead to complications at birth, such as preterm delivery, lower birth weight, lower Apgar scores, and decreased fetal growth.3 In addition, in one study, offspring of parents consuming cannabis were more likely to use cannabis themselves in adolescence,4 which was found, in a systematic review, to be associated with higher odds of depression, suicidal behavior, and psychotic illness.5 Paradoxically, we believe that our field is not well informed by scientific research about the effects of parental cannabis use on parenting and offspring development at early developmental periods when the child is highly sensitive to the types of parental behaviors identified at the bottom of Figure 1. Such a gap in our knowledge is of definite concern for public health and child psychiatry, particularly considering that parents and professionals have access to very conflictual information on this issue. To support our standpoint that the important gaps in our knowledge about the issue of parental cannabis use open the door for highly diverse opinions regarding the harmfulness of parental cannabis use, we reviewed the portrayal of parental cannabis use provided by three sources: the scientific literature, media (online media, print news, and print media), and publications of government and other public agencies (more information on the search strategy is provided in Supplement 1, available online).

The protective role of mentalizing: Reflective functioning as a mediator between child maltreatment, psychopathology and parental attitude in expecting parents.

BACKGROUND: Childhood maltreatment impacts parenting and has intergenerational consequences. It is therefore crucial to identify clinically responsive resilience-promoting factors in pregnant women and expecting men with history of childhood maltreatment. Mentalization, or reflective functioning, appears as a promising concept to understand risk and resilience in the face of childhood maltreatment. OBJECTIVE: This study evaluated the multivariate relationship between exposure to childhood maltreatment, reflective functioning, psychological symptoms and parental attitude in expecting parents. METHODS: Two hundred and thirty-five pregnant women and 66 expecting fathers completed self-report assessment measures of childhood trauma, reflective functioning, depression, post-traumatic stress disorder, parental sense of competence and antenatal attachment. Twenty-eight percent (n = 85) of the community sample reported personal histories of childhood maltreatment. RESULTS: Structural equation modeling indicated that reflective functioning (a) partially mediated the association between childhood maltreatment and psychological symptoms during pregnancy and (b) independently predicted participants' perception of parental competence and psychological investment toward the unborn child. CONCLUSION: Overall, this study provides empirical evidence of the protective role of reflective functioning during the prenatal period in parents with histories of childhood maltreatment.

Development of a prenatal program for adults with personal histories of childhood abuse or neglect: a Delphi consensus consultation study. / Développement d'un programme d'accompagnement prénatal pour les adultes ayant été victimes d'abus ou de négligence au cours de leur enfance : étude de consensus par la méthode Delphi.

INTRODUCTION: Pregnancy and the birth of a child present particular challenges for adults with personal histories of childhood abuse or neglect. However, few prenatal interventions address the specific needs of this population. This research aims to determine a list of actions that should be achieved during group interventions designed for expectant parents who experienced childhood trauma. METHODS: Fifteen stakeholders representing nine different Quebec health care and community organizations that work with families and/or trauma survivors participated in a Delphi process in two rounds. In round 1, three project leaders identified, from clinical and empirical literature, a set of 36 actions relevant for expectant parents who experienced childhood trauma. Using an anonymized online survey, stakeholders coded how important they considered each action and whether they were already conducting similar interventions in their clinical setting. Stakeholders subsequently participated in a one-day in-person meeting during which they discussed the pertinence of each action, proposed new ones and refined them. This was followed by a second anonymized online survey (round 2). A consensus was reached among the stakeholders regarding a final list of 22 actions. RESULTS: Two central clusters of actions emerged from the consultation process: actions aiming to support mentalization about self and parenthood, and actions aiming to support mentalization of trauma. CONCLUSION: The Delphi process helped to identify what should be the core of a prenatal intervention targeting adults who experienced childhood trauma, from the viewpoint of professionals who will ultimately deliver such a program.

INTRODUCTION: La grossesse et la naissance d'un enfant posent des défis particuliers aux adultes ayant été victimes d'abus ou de négligence durant leur enfance. Il existe cependant peu d'interventions prénatales adaptées aux besoins spécifiques de ces personnes. Cette recherche vise à identifier une liste d'actions à mettre en oeuvre dans le cadre d'interventions de groupe destinées aux futurs parents ayant subi des traumatismes relationnels durant leur enfance. MÉTHODOLOGIE: Quinze intervenants représentant neuf organismes communautaires et de soins de santé du Québec travaillant auprès des familles ou des victimes de traumatismes ont participé à un processus de consultation Delphi à deux volets. Dans le premier volet, les trois chercheurs responsables du projet ont élaboré, en se fondant sur la littérature clinique et empirique, 36 actions pertinentes pour les futurs parents ayant subi des traumatismes durant leur enfance. Des intervenants ont ensuite participé à un sondage en ligne anonyme au cours duquel ils avaient à coder l'importance qu'ils accordaient à ces actions ainsi que la similitude entre ces dernières et les interventions pratiquées dans leur milieu clinique. Les intervenants ont ensuite pris part à une journée de consultation en personne, au cours de laquelle ils ont discuté de la pertinence des actions présentées, proposé de nouvelles actions et revu toutes les actions. Un second sondage anonyme a ensuite permis d'en arriver à un consensus sur une liste finale de 22 actions classées en fonction de leur pertinence. RÉSULTATS: Le processus de consultation a abouti à deux séries d'actions : une série visant à favoriser la mentalisation à propos de soi et de son rôle de parent et une série visant à favoriser la mentalisation à propos des traumas. CONCLUSION: Le processus de consultation a abouti à deux séries d'actions : une série visant à favoriser la mentalisation à propos de soi et de son rôle de parent et une série visant à favoriser la mentalisation à propos des traumas.

Transformando um mundo selvagem: ajudando crianças e famílias ante a negligência na província de Quebec, Canadá / Reshaping a wild world: helping children and families facing negligence in the province of Quebec, Canada / Transformando un mundo salvaje: ayudando niños y familias ante la negligencia en la provincia de Quebec, Canadá

A negligência é um problema social complexo, com graves consequências para o cumprimento das necessidades de uma criança, pelos adultos que compõem a família da criança e da rede social; não somente pais, mas outros adultos que entram em contato com a criança (incluindo profissionais). Pela complexidade das relações sociais envolvidas, os sistemas de proteção da criança têm dificuldade de identificar e criar programas de atendimento. Na verdade, eles apresentam uma tendência a concentrar-se sobre as deficiências dos pais em relação à sua responsabilidade para com os seus filhos. Este artigo descreve a fundamentação teórica de um modelo ecossistêmico e de desenvolvimento que tem como base os serviços integrados de negligência infantil em Québec, no Canadá. Também descreve os componentes e atividades que visam a operacionalizar esse modelo ecossistêmico e o modelo de desenvolvimento de negligência infantil.

Child neglect is a complex social problem with serious consequences to the fulfillment of a child's needs, provided by adults who are the members of the child's family, and the social network; not only parents, but other adults who interrelate with the child (including professionals). Due to the complexity of the social relations involved, it is hard for child protection systems to design and develop assistance programs. In fact, they have a tendency to concentrate on parents' deficiencies concerning their responsibility for their children. This article describes the theoretical foundation of an ecosystemic and developmental model which is based on the integrated services dealing with child neglect in Quebec, Canada. It also describes the components and activities that aim to operationalize this ecosystemic and developmental model approaching child neglect.

La negligencia es un problema social complejo con graves consecuencias para el cumplimiento de las necesidades de un niño por parte de los adultos en la familia inmediata del niño y de la red social - no sólo padres, sino también otros adultos que están en contacto con el niño (incluyendo los profesionales). Por la complejidad de las relaciones sociales implicadas, los sistemas de protección de los niños tienen dificultades para identificar y crear programas de atención. De hecho, tienen una tendencia a concentrarse en las deficiencias de los padres con respecto a su responsabilidad con sus hijos. En este artículo se describe el fundamento teórico de un modelo ecosistémico y de desarrollo que constituye la base de los servicios integrados de negligencia infantil en Quebec, Canadá. También se describen los componentes y actividades que tienen como objetivo poner en práctica este modelo ecosistémico y el modelo de desarrollo de negligencia infantil.

Práticas profissionais que silenciam a violência intrafamiliar contra crianças e adolescentes / Prácticas profesionales que silencian la violencia intrafamiliar contra niños y adolescentes / Professional practices that silence domestic violence against children and adolescents

RESUMO Objetivo: identificar, a partir do discurso dos profissionais que trabalham em serviços de proteção a crianças e adolescentes, práticas que silenciam a violência intrafamiliar. Método: estudo qualitativo, realizado com 15 profissionais, sendo seis enfermeiros, dois psicólogos, dois médicos, dois agentes comunitários de saúde, dois conselheiros tutelares e um assistente social. Os dados foram coletados entre novembro de 2013 e março de 2015, utilizando entrevistas semiestruturadas. Para o processo de organização, análise e interpretação dos dados foi utilizada uma matriz teórica construída a partir da Etnografia Institucional e a técnica de análise foi a textual discursiva. Resultados: foram identificadas três categorias: O agir reducionista frente à violência intrafamiliar contra criança e adolescentes; Os encaminhamentos como transferência da responsabilidade de proteger; A exclusão do agressor do processo de intervenção. Conclusão: as práticas desenvolvidas pelos profissionais deste estudo podem contribuir para a reincidência da violência intrafamiliar contra crianças e adolescentes, colocando em evidência as fragilidades dos serviços que compõem a rede de proteção infanto-juvenil. Diante disso, este estudo propõe refletir sobre novas formas de agir frente à violência intrafamiliar, com vistas a assegurar que crianças e adolescentes tenham seus direitos garantidos.

RESUMEN Objetivo: identificar, a partir del discurso de los profesionales que trabajan en servicios de protección a niños y adolescentes, prácticas que silencian la violencia intrafamiliar. Método: estudio cualitativo, realizado con 15 profesionales, siendo seis enfermeros, dos psicólogos, dos médicos, dos agentes comunitarios de salud, dos consejeros tutelares y un asistente social. Los datos fueron recolectados entre noviembre de 2013 y marzo de 2015, utilizando entrevistas semi-estructuradas. Para el proceso de organización, análisis e interpretación de los datos se utilizó una matriz teórica construida a partir de la Etnografía Institucional y la técnica de análisis fue la textual discursiva. Resultados: se identificaron tres categorías: el actuar reduccionista frente a la violencia intrafamiliar contra niños y adolescentes; las referencias como transferencia de la responsabilidad de proteger; la exclusión del agresor del proceso de intervención. Conclusión: las prácticas desarrolladas por los profesionales de este estudio pueden contribuir a la reincidencia de la violencia intrafamiliar contra niños y adolescentes, resaltando las fragilidades de los servicios que componen la red de protección infanto-juvenil. Este estudio propone reflexionar sobre nuevas formas de actuar frente a la violencia intrafamiliar, con miras a asegurar que niños y adolescentes tengan sus derechos garantizados.

ABSTRACT Objective: The objective of this study is to identify practices that silence domestic violence from the discourse of professionals who work in children and adolescent protection services. Method: This is a qualitative study, carried out with fifteen professionals, being six nurses, two psychologists, two physicians, two community health agents, two child protective council workers, and one social worker. The data were collected between November 2013 and March 2015, using semi-structured interviews. For the process of organization, analysis, and interpretation of the data, we used a theoretical matrix built from Institutional Ethnography, and the technique of analysis used was the textual discourse. Results: We have identified three categories: the reductionist action in relation to the domestic violence against children and adolescents; referrals as the transfer of the responsibility to protect; and, the exclusion of the aggressor from the intervention process. Conclusion: The practices developed by the professionals of this study can contribute to the recurrence of domestic violence against children and adolescents, highlighting the weaknesses of the services that make up the child and youth protection network. Therefore, this study proposes to reflect on new ways of acting against domestic violence, in order to ensure that children and adolescents have their rights guaranteed.

Organization of professional practices against intrafamily violence against children and adolescents in the institutional context.

Objective: to analyze based on the practitioners' discourse, the way they organize their practices confronting situations of intra-family violence against children and adolescents. Method: qualitative research carried out with 15 professionals who work in social and health services located in the southernmost of Brazil. Data were collected through semi-structured interviews, performed at the participants' workplace. We used a theoretical matrix to analyze the data, based on Institutional Ethnography and the technique of discursive textual analysis. Results: the practitioners' practices developed in situations of intra-family violence against children and adolescents are organized on the basis of: power relations that take place in services that respond to violence situations; routines instituted to meet the demands of care in services; and the interplay between the conception of violence as a public health problem and the conception of violence as a social problem. Conclusion: the way these practices are organized is reflected in actions that are not protective against situations of intra-family violence against children and adolescents.

Protocol for evaluation of the continuum of primary care in the case of a miscarriage in the emergency room: a mixed-method study.

BACKGROUND: In Quebec (Canada), nearly 20,000 pregnancies end in miscarriage, and the majority of the miscarriages are dealt with in an emergency unit. Although there are studies documenting the effects of this type of grief on mental health, men's experiences are much less discussed than those of women. Similarly, no study has evaluated best practices in terms of service continuity, from emergency care to community resources. The aim of this study is to better understand the relationships that exist between the organization of emergency room and primary care health services for women presenting with miscarriage, on the one hand, and the positions and experiences of women and men within these services, on the other. METHODS: The general objective of this mixed-method study can be broken down into three methodological sections. Focus 1. Institutional discourses and practices. This section is structured as a multiple case study of the mandates of five participant institutions. The study will involve (a) a documentary analysis; (b) a quantitative survey (N: 200) and (c) group interviews (N: 75) with caregivers and emergency unit managers. Focus 2. Women's and men's experiences of miscarriages and the institutional response. This section includes (a) a survey (N: 232) and (b) individual interviews (N: 80) designed to identify best practices in emergency involving women and their partners in each area. Focus 3. This section will integrate the information furnished by the first two sections in order to create an ethnographic overview of the situation. DISCUSSION: This innovative project will provide answers to critical questions on how to improve the effectiveness and quality of interdisciplinary and multisectoral interventions to promote the mental health and psychosocial well-being of couples having experienced a miscarriage. It will have a material effect on the organization of emergency services and of the primary care pathway for women experiencing a miscarriage and for their partners. TRIAL REGISTRATION: Not applicable. This study involves a retrospective view of usual health care interventions. This study is not a clinical trial that prospectively assigns human participants or groups of humans to one or more health-related interventions to evaluate the effects on health outcomes.

Organization of professional practices against intrafamily violence against children and adolescents in the institutional context / Organização das práticas profissionais frente à violência intrafamiliar contra crianças e adolescentes no contexto institucional / Organización de las prácticas profesionales frente a la violencia familiar contra los niños y adolescentes en el contexto institucional

ABSTRACT Objective: to analyze based on the practitioners' discourse, the way they organize their practices confronting situations of intra-family violence against children and adolescents. Method: qualitative research carried out with 15 professionals who work in social and health services located in the southernmost of Brazil. Data were collected through semi-structured interviews, performed at the participants' workplace. We used a theoretical matrix to analyze the data, based on Institutional Ethnography and the technique of discursive textual analysis. Results: the practitioners' practices developed in situations of intra-family violence against children and adolescents are organized on the basis of: power relations that take place in services that respond to violence situations; routines instituted to meet the demands of care in services; and the interplay between the conception of violence as a public health problem and the conception of violence as a social problem. Conclusion: the way these practices are organized is reflected in actions that are not protective against situations of intra-family violence against children and adolescents.

RESUMO Objetivo: analisar, com base no discurso dos profissionais, como ocorre a organização de suas práticas frente às situações de violência intrafamiliar contra crianças e adolescentes. Método: pesquisa qualitativa, realizada com 15 profissionais que atuam em serviços sociais e de saúde localizados no extremo sul do Brasil. Os dados foram coletados por meio de entrevistas semiestruturadas, realizadas no próprio local de trabalho dos participantes. Para a análise dos dados foi construída uma matriz teórica com base na Etnografia Institucional e utilizada a técnica de análise textual discursiva. Resultados: as práticas profissionais desenvolvidas nas situações de violência intrafamiliar contra crianças e adolescentes se organizam a partir de: relações de poder que se desenrolam nos serviços que atendem às situações de violência; rotinas instituídas para suprir as demandas de atendimento nos serviços e o inter-jogo entre a concepção de violência como um problema de saúde pública e a de violência como um problema social. Conclusão: a maneira como essas práticas estão organizadas se reflete em ações pouco protetivas frente às situações de violência intrafamiliar contra crianças e adolescentes.

RESUMEN Objetivo: analizar, basado en el discurso profesional, como ocurre la organización de sus prácticas frente a las situaciones de violencia doméstica intrafamiliar contra niños y adolescentes. Método: investigación cualitativa realizada con 15 profesionales que trabajan en salud y servicios sociales en el sur de Brasil. Los datos fueron recolectados a través de entrevistas semiestructuradas realizadas en el lugar de trabajo de los participantes. Para el análisis de los datos se construyó una matriz teórica basada en la Etnografia Institucional y utilizada la técnica de análisis textual del discurso. Resultados: las prácticas profesionales desarrolladas en situaciones de violencia intrafamiliar contra los niños y adolescentes se organizan a partir de: las relaciones de poder que tienen lugar en los servicios que responden a las situaciones de violencia; las rutinas puestas en practica para satisfacer las demandas de servicios de atención y el inter-juego entre la concepción de la violencia como un problema de salud pública y la violencia como un problema social. Conclusión: la forma en que estas prácticas se organizan se refleja en acciones de poca protección en el enfrentamiento de las situaciones de violencia intrafamiliar contra niños y adolescentes.

Professionals and interfamily violence against children and adolescents: in between legal and conceptual precepts.

OBJECTIVE: To identify the conceptions of professionals regarding interfamily violence against children and adolescents. METHOD: A qualitative study conducted with 15 professionals who had taken children and adolescents under their care as a result of interfamily violence. Data were collected between November, 2013, and March, 2015, through semi-structured interviews. Data were organized and analyzed using the Textual Discourse Analysis technique. RESULTS: The professional discourse highlighted that some legal aspects regarding the handling of interfamily violence against children and adolescents are neglected; an omission supported by the justification of professionals to preserve the family. We highlight the confrontation between the concept of family as a caregiver and the family that commits violence against children, in addition to the positioning of professionals, which does not include the family or the aggressor in the intervention process in facing situations of interfamily violence attended to by the services. CONCLUSION: Acting against interfamily violence requires professionals to do away with some pre-established concepts in ordee to put the actual needs of victims and families into evidence. OBJETIVO: Identificar, com base no discurso dos profissionais, suas concepções a respeito da violência intrafamiliar contra crianças e adolescentes. MÉTODO: Estudo qualitativo, realizado com 15 profissionais, que tiveram sob seus cuidados crianças e adolescentes atendidas em decorrência da violência intrafamiliar. Os dados foram coletados entre novembro de 2013 e março de 2015, por meio de entrevistas semiestruturadas. Os dados foram organizados e analisados utilizando a técnica de Análise Textual Discursiva. RESULTADOS: O discurso dos profissionais colocou em evidência que alguns aspectos legais em relação ao manejo da violência intrafamiliar contra crianças e adolescentes são negligenciados, omissão respaldada pela justificativa dos profissionais de preservar a família. Destaca-se o confronto entre a concepção de família como cuidadora e a família que violenta os filhos, além do posicionamento dos profissionais, os quais não incluem a família e o agressor nos processos de intervenção frente às situações de violência intrafamiliar atendidas nos serviços. CONCLUSÃO: Atuar frente à violência intrafamiliar requer do profissional romper com algumas concepções preestabelecidas para colocar em evidência as reais necessidades de vítimas e famílias.

Professionals and interfamily violence against children and adolescents: in between legal and conceptual precepts / Los profesionales y la violencia intrafamiliar contra niños y adolescentes: entre los preceptos legales y conceptuales / Os profissionais e a violência intrafamiliar contra crianças e adolescentes: entre os preceitos legais e conceptuais

Abstract OBJECTIVE To identify the conceptions of professionals regarding interfamily violence against children and adolescents. METHOD A qualitative study conducted with 15 professionals who had taken children and adolescents under their care as a result of interfamily violence. Data were collected between November, 2013, and March, 2015, through semi-structured interviews. Data were organized and analyzed using the Textual Discourse Analysis technique. RESULTS The professional discourse highlighted that some legal aspects regarding the handling of interfamily violence against children and adolescents are neglected; an omission supported by the justification of professionals to preserve the family. We highlight the confrontation between the concept of family as a caregiver and the family that commits violence against children, in addition to the positioning of professionals, which does not include the family or the aggressor in the intervention process in facing situations of interfamily violence attended to by the services. CONCLUSION Acting against interfamily violence requires professionals to do away with some pre-established concepts in ordee to put the actual needs of victims and families into evidence.

Resumen OBJETIVO Identificar, con base en el discurso de los profesionales, sus concepciones con respecto a la violencia intrafamiliar contra niños y adolescentes. MÉTODO Estudio cualitativo, realizado con 15 profesionales que tuvieron bajo sus cuidados a niños y adolescentes atendidos en consecuencia de la violencia intrafamiliar. Se recogieron los datos entre noviembre de 2013 y marzo de 2015, mediante entrevistas semiestructuradas. Los datos fueron organizados y analizados empleando la técnica de Análisis Textual Discursivo. RESULTADOS El discurso de los profesionales puso en evidencia que se descuidan algunos aspectos legales con respecto al manejo de la violencia intrafamiliar contra niños y adolescentes, omisión esa respaldada por la justificación de los profesionales de preservar a la familia. Se destaca el confronto entre la concepción de familia como cuidadora y la familia que violenta a los hijos, además de la postura de los profesionales, quienes no incluyen a la familia y al agresor en los procesos de intervención frente a las situaciones de violencia intrafamiliar atendidas en los servicios. CONCLUSIÓN Actuar ante la violencia intrafamiliar requiere que el profesional rompa algunas concepciones prestablecidas para poner en evidencia las reales necesidades de víctimas y familias.

Resumo OBJETIVO Identificar, com base no discurso dos profissionais, suas concepções a respeito da violência intrafamiliar contra crianças e adolescentes. MÉTODO Estudo qualitativo, realizado com 15 profissionais, que tiveram sob seus cuidados crianças e adolescentes atendidas em decorrência da violência intrafamiliar. Os dados foram coletados entre novembro de 2013 e março de 2015, por meio de entrevistas semiestruturadas. Os dados foram organizados e analisados utilizando a técnica de Análise Textual Discursiva. RESULTADOS O discurso dos profissionais colocou em evidência que alguns aspectos legais em relação ao manejo da violência intrafamiliar contra crianças e adolescentes são negligenciados, omissão respaldada pela justificativa dos profissionais de preservar a família. Destaca-se o confronto entre a concepção de família como cuidadora e a família que violenta os filhos, além do posicionamento dos profissionais, os quais não incluem a família e o agressor nos processos de intervenção frente às situações de violência intrafamiliar atendidas nos serviços. CONCLUSÃO Atuar frente à violência intrafamiliar requer do profissional romper com algumas concepções preestabelecidas para colocar em evidência as reais necessidades de vítimas e famílias.

The Father Friendly Initiative within Families: Using a logic model to develop program theory for a father support program.

The transition to fatherhood, with its numerous challenges, has been well documented. Likewise, fathers' relationships with health and social services have also begun to be explored. Yet despite the problems fathers experience in interactions with healthcare services, few programs have been developed for them. To explain this, some authors point to the difficulty practitioners encounter in developing and structuring the theory of programs they are trying to create to promote and support father involvement (Savaya, R., & Waysman, M. (2005). Administration in Social Work, 29(2), 85), even when such theory is key to a program's effectiveness (Chen, H.-T. (2005). Practical program evaluation. Thousand Oaks, CA: Sage Publications). The objective of the present paper is to present a tool, the logic model, to bridge this gap and to equip practitioners for structuring program theory. This paper addresses two questions: (1) What would be a useful instrument for structuring the development of program theory in interventions for fathers? (2) How would the concepts of a father involvement program best be organized? The case of the Father Friendly Initiative within Families (FFIF) program is used to present and illustrate six simple steps for developing a logic model that are based on program theory and demonstrate its relevance.

Negligência infantil a partir do Child Neglect Index aplicado no Brasil / Child neglect based on the use of the Child Neglect Index applied in Brazil

Este estudo objetivou descrever a utilização do Child Neglect Index para identificar casos de crianças negligenciadas por seus pais/cuidadores no contexto brasileiro. Após adaptação inicial à realidade sociocultural brasileira, o instrumento foi aplicado em três grupos de indivíduos, cada qual com 30 díades de crianças/pais, totalizando 90 díades (n=180), assim compostos: G1 (primeiro grupo) = casos oficialmente notificados por negligência infantil; G2 (segundo grupo) = casos suspeitos de negligência não notificados; G3 (terceiro grupo) = casos sem suspeita de negligência ou outra forma de maus-tratos (grupo de comparação); além de um quarto grupo de professoras dessas crianças (n=11). Os resultados apontaram altos escores no índice de negligência em G1 e G2, e baixos escores em G3, sugerindo presença de indicadores de falta de supervisão parental referentes a cuidados com alimentação, vestimenta, higiene, saúde física, saúde mental e educação nos dois primeiros grupos avaliados, comparativamente às crianças sem suspeita de maus-tratos. Os atuais achados empíricos, embora preliminares em termos de adaptação do Child Neglect Index ao contexto do Brasil, foram promissores ao sinalizar potencial do instrumento como recurso para detecção/confirmação da negligência infantil, estimulando novas investigações e aprimoramento desse recurso técnico para favorecer adequada identificação e intervenção nesses casos.(AU)

This study describes the use of Child Neglect Index to identify cases of children neglected by their parents/caregivers in the Brazilian context. After initial adaptation to the Brazilian sociocultural reality, the instrument was applied in three different groups. Each group is composed of 30 dyads of children/parents, totaling 90 dyads of participants (n=180). They are: G1 (first group) = officially reported cases of child neglect; G2 (second group) = suspected cases of neglect, but not notified; G3 (third group) = unsuspected cases of neglect or otherwise abuse (comparison group). There is also a fourth group composed of the children's teachers (n=11). The results showed high scores on the index of neglect in G1 and G2, but low scores in G3, suggesting the presence of indicators of lack of parental supervision regarding the care of food, clothing, hygiene, physical health, mental health and education in the first two groups evaluated when compared to no suspicion of child maltreatment. The current empirical findings, although preliminary in terms of adaptation of Child Neglect Index to the Brazilian context, were promising to signal the potential of the instrument as a resource for detection/confirmation of child neglect. It stimulates further research and improvements in this technical resource to facilitate proper identification and intervention in these cases.(AU)

Negligência infantil a partir do Child Neglect Index aplicado no Brasil / Child neglect based on the use of the Child Neglect Index applied in Brazil

Este estudo objetivou descrever a utilização do Child Neglect Index para identificar casos de crianças negligenciadas por seus pais/cuidadores no contexto brasileiro. Após adaptação inicial à realidade sociocultural brasileira, o instrumento foi aplicado em três grupos de indivíduos, cada qual com 30 díades de crianças/pais, totalizando 90 díades (n=180), assim compostos: G1 (primeiro grupo) = casos oficialmente notificados por negligência infantil; G2 (segundo grupo) = casos suspeitos de negligência não notificados; G3 (terceiro grupo) = casos sem suspeita de negligência ou outra forma de maus-tratos (grupo de comparação); além de um quarto grupo de professoras dessas crianças (n=11). Os resultados apontaram altos escores no índice de negligência em G1 e G2, e baixos escores em G3, sugerindo presença de indicadores de falta de supervisão parental referentes a cuidados com alimentação, vestimenta, higiene, saúde física, saúde mental e educação nos dois primeiros grupos avaliados, comparativamente às crianças sem suspeita de maus-tratos. Os atuais achados empíricos, embora preliminares em termos de adaptação do Child Neglect Index ao contexto do Brasil, foram promissores ao sinalizar potencial do instrumento como recurso para detecção/confirmação da negligência infantil, estimulando novas investigações e aprimoramento desse recurso técnico para favorecer adequada identificação e intervenção nesses casos.

This study describes the use of Child Neglect Index to identify cases of children neglected by their parents/caregivers in the Brazilian context. After initial adaptation to the Brazilian sociocultural reality, the instrument was applied in three different groups. Each group is composed of 30 dyads of children/parents, totaling 90 dyads of participants (n=180). They are: G1 (first group) = officially reported cases of child neglect; G2 (second group) = suspected cases of neglect, but not notified; G3 (third group) = unsuspected cases of neglect or otherwise abuse (comparison group). There is also a fourth group composed of the children's teachers (n=11). The results showed high scores on the index of neglect in G1 and G2, but low scores in G3, suggesting the presence of indicators of lack of parental supervision regarding the care of food, clothing, hygiene, physical health, mental health and education in the first two groups evaluated when compared to no suspicion of child maltreatment. The current empirical findings, although preliminary in terms of adaptation of Child Neglect Index to the Brazilian context, were promising to signal the potential of the instrument as a resource for detection/confirmation of child neglect. It stimulates further research and improvements in this technical resource to facilitate proper identification and intervention in these cases.

Marital satisfaction and quality of father-child interactions: the moderating role of child gender.

The authors aimed to investigate the prospective links between normative variation in fathers' marital satisfaction and the observed quality of father-toddler interactions, as well as the moderating role of child gender in these associations. Sixty-three fathers reported on their marital satisfaction when their children were 15 months of age, and were observed interacting with their child at 18 months. The results suggested that marital satisfaction was positively associated with the quality of father-son interactions, while no relations emerged among fathers of girls. These findings reiterate the importance of marital relationships for the quality of fathers' parenting, while reaffirming previous suggestions that the role of child gender in the marriage-parenting connections requires further investigation.