First aid intervention with mothers/caregivers of children affected by the Zika virus in Brazil.

BACKGROUND: Children with microcephaly associated with the Zika virus are more likely to develop choking and apnea, so it is necessary that mothers of this population receive first aid training to cope with emergency situations that their children may experience. OBJECTIVE: To understand how an educational first aid intervention with mothers/caregivers of Brazilian children with congenital Zika virus syndrome impacts their management of seizures and choking. METHOD: A qualitative study conducted in a philanthropic institution with ten mothers/caregivers of children with congenital Zika virus syndrome. Data were collected between August and November 2018 through four focus groups with two meetings for intervention/educational workshops in first aid on situations of choking and seizure. After one month, two more meetings were held to evaluate the effectiveness of this action performed at home. The empirical material was submitted to Content Analysis, and discussed in the light of Paulo Freire's Pedagogy of Autonomy. RESULTS: The mothers/caregivers performed ineffective and harmful behaviors to the children in situations of choking and seizure before the intervention. Thus, the intervention empowered these caregivers through an exchange of experiences which began to present discernment, autonomy, resolving capacity and confidence to act in these experienced situations. They also became knowledge disseminators for family members and neighbors. CONCLUSION: The educational intervention can have satisfactory results in training mothers/caregivers in first aid, highlighting the importance of this initiative to reduce the morbidity and mortality of children who experience choking and seizures.

Challenges in Primary Care Regarding Children and Adolescents With Chronic Conditions in Brazil.

The coordination of primary care is pivotal to the management of chronic conditions. However, current systems may not be as efficient or effective as one would hope. This article addresses to the managers and health teams in the primary care setting and their challenges regarding children and adolescents with chronic conditions in Brazil. A qualitative study was conducted with 26 primary care professionals and managers using thematic content analysis. The results showed a scarcity of specialists for referrals and a lack of professional training for dealing with this specific group of patients. It is necessary to improve health information systems to ensure the continuity of care. Current health care of children and adolescents with chronic conditions is neither efficient nor effective. For this type of care to be comprehensive, the health needs of this population must be addressed and the operational structure of the health care network must be strengthened.

Paternal care to children and adolescent with chronic disease: maternal perception. / Cuidado paterno à criança e ao adolescente com doença crônica: percepção materna.

OBJECTIVE: To analyze the maternal perception about the paternal care and to understand how this care Is made effective In practical actions in the care of the child/adolescent with chronic disease in the family routine. METHODS: Exploratory-descriptive, qualitative study, carried out at the pediatric outpatient clinic of a public hospital in the state of Paraíba, between November/2013 and April/2014, with 10 mothers whose children had more than six months of diagnosis. Semi-structured interview subsidized the data collection, which was submitted to thematic analysis. RESULTS: Parents participated in activities such as routine care of the child, medication management, leisure, binomial support and household chores. They took on different roles in the care depending on the availability of time and the maternal freedom given for their participation. Among the separated couples, the distance between parents in the care reflected on the child's health. CONCLUSION: It is important to involve fathers in the care of the child with chronic diseases. However, there is a need for a greater involvement of fathers in the performance of this care.

First week of integral health for the newborn: nursing actions of the Family Health Strategy. / Primeira semana saúde integral do recém-nascido: ações de enfermeiros da Estratégia Saúde da Família.

OBJECTIVE: To describe the nurses' actions of the Family Health Strategy about the First Week for Integral Health regarding the care devoted to the newborn. METHOD: It is a descriptive, exploratory research with qualitative approach carried out from October 2014 to February 2015, through a semi-structured interview, with nine nurses from the Family Health Strategy of João Pessoa-PB. Data were submitted to thematic analysis. RESULTS: The actions identified at the first visit to the newborn child are based on maternal guidance on basic newborn care, breastfeeding, neonatal screening, immunization and childcare, as well as evaluation of the puerperal, but it was sometimes performed outside the period recommended and with incomplete and outdated guidelines. CONCLUSION: Although there are potentialities in nurses' actions to this population, the fragilities compromise the care of the newborn and the puerperium, and it is necessary to sensitize these professionals about the importance and effectiveness of First Week for Integral Health.

Chronic disease in children and adolescents: professional-family bond for the promotion of social support. / Doença crônica infantojuvenil: vínculo profissional-família para a promoção do apoio social.

OBJECTIVE: To analyze the bond in social support delivery by a multidisciplinary team to families during the hospital stay of children/adolescents with chronic disease. METHOD: Qualitative research, conducted in the pediatric unit of a public hospital in Paraíba State, Brazil, from November 2012 to July 2013, involving fourteen health professionals, by means of a semi-structured interview. The data were subjected to thematic analysis. RESULTS: The bond between the team and the family is promoted by dialogue and listening, which are recognized sources of social support. The encountered difficulties that interfered with the delivery of social support were weakness in team-family communication and interaction, gaps in the organization of the work process and lack of hospital infrastructure. Possible approaches to overcome these obstacles were follow-up beyond hospital discharge and a stronger team-family bond. CONCLUSION: Satisfying social support has an influence on coping with chronic disease in children and adolescents, and its proper delivery relies upon bonding and embracement.

Self-care support for the management of type 1 diabetes during the transition from childhood to adolescence.

OBJECTIVE: To analyze the needs of pre-adolescents with type 1 diabetes regarding self-care support for disease management. METHOD: Qualitative study conducted between October and December 2016 with pre-adolescents seen at a hospital outpatient clinic and at Family Health Units; semi-structured interviews were used. Data were analyzed using a thematic analysis based on the theoretical basis of self-care support. RESULTS: Nine pre-adolescents participated in the study. It was identified that in order to build self-efficacy, pre-adolescents need to overcome the disease denial phase, know how to handle feelings triggered by the need for lifestyle changes, receive support from their families and social networks, and have the self-awareness and self-perception needed to feel secure in managing their diabetes. CONCLUSION: The intrinsic challenges of adolescence and the way pre-adolescents with diabetes handle the disease have an influence on diabetes management and create needs that must be appreciated by health care professionals in order to provide self-care support.

Chronic disease in childhood and adolescence: continuity of care in the Health Care Network.

OBJECTIVE: To evaluate the continuity of care for children and adolescents with chronic diseases in the health care network. METHODS: This qualitative study was conducted between February and October 2013 with 12 families, six health managers, and 14 health professionals from different health care services in a municipality of the state of Paraíba, Brazil, using focal groups, semi-structured interviews, and medical record consultation. The data were analyzed by triangulation and thematic analysis. RESULTS: Two categories were created: "health care management" and "(dis)continuity of care." We found gaps in the system, including poor data recording aimed to facilitate follow-up and guide the planning actions as well as sporadic and discoordinate services with a limited flow of information, which hinders follow-up over time. CONCLUSION: Continuity of care in the health care network is limited and creates the need to develop strategies to improve these services. OBJETIVO: Analisar a continuidade do cuidado à criança/adolescente com doença crônica na rede de atenção à saúde. MÉTODO: Pesquisa qualitativa realizada entre fevereiro e outubro de 2013 com 12 familiares, seis gestores e 14 profissionais de saúde de diferentes serviços da rede de saúde de um município da Paraíba através das técnicas de grupo focal, entrevista semiestruturada e consulta a prontuários. A triangulação dos dados e a análise temática subsidiaram a interpretação dos dados. RESULTADOS: Foram construídas duas categorias: "Gestão da atenção à saúde" e "(Des)continuidade do cuidado". Constataram-se lacunas como a ausência de cadastro para favorecer o acompanhamento e nortear o planejamento de ações; atendimento pontual e desarticulado entre os serviços com fragilidade no fluxo de informações, que obstaculizam o seguimento ao longo do tempo. CONCLUSÃO: A continuidade do cuidado na rede de atenção à saúde está fragilizada e há necessidade do desenvolvimento de estratégias que a favoreçam.

Evaluating comprehensiveness in children's healthcare. / Avaliação do atributo integralidade na atenção à saúde da criança.

OBJECTIVE: To evaluate the presence and extent of comprehensiveness in children's healthcare in the context of the Family Health Strategy. METHOD: Evaluative, quantitative, cross-sectional study conducted with 344 family members of children at the Family Health Units of João Pessoa, PB, Brazil. Data were collected using the PCATool Brazil - child version and analysed according to descriptive and exploratory statistics. RESULTS: The attribute of comprehensiveness did not obtain satisfactory scores in the two evaluated dimensions, namely "available services" and "provided services". The low scores reveal that the attribute comprehensiveness is not employed as expected in a primary care unit and points to the issues that must be altered. CONCLUSION: It was concluded that the services should be restructured to ensure cross-sector performance in the provision of child care. It is also important to improve the relations between professionals and users to promote comprehensive and effective care.

Infantile autism: impact of diagnosis and repercussions in family relationships. / Autismo infantil: impacto do diagnóstico e repercussões nas relações familiares.

OBJECTIVE: To analyse the context in which the diagnosis of autism is revealed and the impact of this revelation on family relationships. METHODS: This is a qualitative study with 10 families of autistic children assisted at the Psychosocial Care Centre for Children and Youths in a municipality of Paraíba. Data were collected between July and August 2013 through semi-structured interviews and interpreted using thematic content analysis. RESULTS: The identified Main Unit of Analysis and the respective categories were: the impact of disclosing the diagnosis of autism to the family; characteristics of diagnosis disclosure: the place, time, and the dialogic relationship between the professional and the family; changes in family relationships and the mother's burden when caring for the autistic child. CONCLUSIONS: The health professionals who report autism should better prepare the family to cope with the difficulties of this syndrome and autonomously care for the autistic child.

[Longitudinality in childcare provided through Family Health Strategy]. / Longitudinalidade do cuidado à criança na Estratégia Saúde da Família.

OBJECTIVE: To evaluate the longitudinality attribute in childcare provided through the Family Health Strategy. METHOD: Quantitative survey performed with 344 caregivers of children below 10 years old, registered in the family health strategy of Distrito Sanitario III in João Pessoa, Paraiba. Data were collected from July to December, 2012, from the Brazil PCATool child version form and analyzed using descriptive statistics. RESULTS: Among the aspects evaluated, it is highlighted that 89.5% of caregivers said they were consulted by the same professionals, and 81.9% felt good talking to the professional. The average score for the longitudinality component was satisfactory, with a 6.6 value. CONCLUSION: The health facilities assessed are guided towards the longitudinality attribute, however, the target mean score was exactly the cutoff value, implying the need for a thoughtful look at the improvement of the attribute in the care of children under ten years.

[Playful intervention with chronically-ill children: promoting coping]. / Intervenção iúdica a crianças com doença crônica: promovendo o enfrentamento.

Chronic diseases can adversely affect the development process of children. This qualitative, action-research study had the aim to analyze the effects of activities in the manual "Como H6spede no Hospital" (As a patient in the hospital) on the coping process of children with chronic diseases. Study participants included six children and adolescents aged seven to 13 years, who suffered from a chronic disease. Data were collected in the pediatric clinic of a public hospital in the Brazilian state of Paraíba, through participant observation and individual sessions with activities from the manual. Data interpretation followed the principles of thematic analysis. The activities from the manual encouraged participants' search for information about their disease and treatment, and increased their interest and participation in their health care process, thereby contributing to better coping. The study points to the need for comprehensive care for children with chronic diseases.

Clinical and sociodemographic factors associated with the quality of life of children and adolescents with type 1 diabetes.

OBJECTIVE: To analyze clinical and sociodemographic factors associated with the health-related quality of life of children and adolescents with type 1 Diabetes Mellitus. METHOD: A quantitative, cross-sectional and analytical study, developed in a municipality in northeastern Brazil, between March and September 2021, with 81 children/adolescents with type 1 Diabetes Mellitus and their guardians/caregivers. A questionnaire containing sociodemographic and clinical variables and two quality of life instruments were used. Descriptive and inferential analysis was carried out. RESULTS: Adolescents whose parents had a family income greater than a minimum wage had a lower prevalence of impaired quality of life when compared to those with a lower income. Adolescents with time since diagnosis of less than four years had a satisfactory quality of life, and children aged 8 to 12 years who self-administered insulin had a lower prevalence of high quality of life compared to those who did not. CONCLUSION: Adolescents with a family income of less than a minimum wage, diagnosis time of more than four years and children aged 8-12 who self-administer insulin need greater professional support to have a better quality of life.

Educational action to monitor children's growth and development based on the theory of meaningful learning.

OBJECTIVE: Evaluating the effect of an educational program on the knowledge of Primary Health Care nurses regarding the surveillance of growth and development during childcare appointments. METHOD: A before-after intervention study with 30 nurses. The nurses' knowledge and practice assessment were done using a tool that had been developed and validated. The educational activity was carried out, linking child growth and development indicators with public policies for early childhood and nurses' practices. David Ausubel's Significant Learning Theory was used as a teaching-learning strategy. The same instrument was reapplied after one month. Descriptive statistics were used in the analysis and the proportion test, Wilcoxon test and Item Response Theory with the Rasch model were applied. RESULTS: The nurses checked more items right in the instrument after the intervention; there was an increase in the scores of correct answers and a decrease in the item response difficulty index in the knowledge and practice section, post-intervention. CONCLUSION: The educational activity had a positive effect, affecting changes in nurses' knowledge and practice, which enabled childcare consultations to become more qualified.

Meanings attributed to health-related quality of life by caregivers of adolescents with diabetes.

OBJECTIVE: to interpret the meanings attributed to the health-related quality of life by caregivers of adolescents with type 1 diabetes mellitus. METHODS: qualitative, descriptive-exploratory study of 14 caregivers of adolescents with diabetes developed at the reference outpatient clinic for endocrine diseases in a city in the state of Paraíba. Interviews were performed between May and September 2021. Inductive thematic analysis of the empirical material, and its interpretation in light of the concepts of health-related quality of life and family functioning were performed. RESULTS: the meanings attributed by caregivers to the health-related quality of life of adolescents converged on the feeling of being healthy, healthy eating, satisfactory family income, family involvement in care and effective access to the care network. FINAL CONSIDERATIONS: knowledge of these meanings enables health professionals to develop strategies that meet the unique demands of caregivers experiencing this diagnosis.

Hospital discharge intervention developed in a dialogical way with families to prepare them to care for children with chronic diseases at home: Mixed methods study.

A convergent parallel mixed methods design with qualitative data collection embedded in a quasi-experimental study was developed to examine the potential of three modalities of preparation for hospital discharge of the families of children with chronic diseases in terms of uncertainty levels and management of the disease at home. Caregivers of these children were divided into three groups: two experimental groups and one control group. Two scales were applied: one measured family management, and the other evaluated uncertainties in relation to the disease. In addition, an in-depth interview was conducted. Wilcoxon's test and the integrated response index were used in data analysis to compare performance between the groups. Inductive thematic analysis was employed for the qualitative data. The data were integrated, comparing the groups before and after preparation for hospital discharge. Twenty-five family caregivers completed this study. Data integration showed that the intervention group, in which the families developed planning to prepare for discharge in a dialogical way with professionals, presented better perceptions regarding care management when compared to structured guide and usual care groups. Participation of families in planning for hospital discharge showed a reduction in uncertainties regarding the disease and better care management of children at home.

Impact of the Covid-19 pandemic on the use of screens in early childhood.

OBJECTIVE: To identify the impact of the Covid-19 pandemic on the use of digital screens in early childhood, from the perspective of mothers and education professionals. METHOD: Qualitative study, based on Bronfenbrenner's Bioecological Theory. Nine mothers of children under three years of age, enrolled in daycare centers in a municipality in the state of Paraíba, Brazil, and six education professionals who worked in these daycare centers participated. The data were collected between July and October 2021 via virtual interviews and analyzed according to inductive thematic analysis. RESULTS: The restrictions imposed by the pandemic made screens the only available resource for children's educational activities, interaction, leisure, and distraction, causing an exponential increase in the time they spent in front of screens. CONCLUSION: The pandemic had a direct impact on the use of digital screens in early childhood, increasing the child's exposure time, according to parents and education professionals.

[Family's abilities and diffculties in caring for children with cerebral palsy]. / Facilidades e dificuldades da familia no cuidado à criança com paralisia cerebral.

This is a qualitative research and exploratory-descriptive study aimed at finding out the family's abilities and difficulties in caring for children with cerebral palsy. Data was collected from seven families, between March and April 2009, through semi-structured interviews. The analysis followed the principles of thematic interpretation. The diffculties are more evident than the abilities and bring repercussions to daily life activities. Dealing with difficulties to control seizures, spasticity, changes in postural tone, occurrence of primitive reflexes, result in the complexity to perform simple tasks like feeding, bathing, locomotion, because children become increasingly dependent on caregivers. Over time, the difficulties give way to the routine and adaptation to the child's daily life. Strengthening relationships with families by improving their bonds and developing quality and comprehensive actions, promotes the welfare of the family/child with cerebral palsy.

[Caring for tuberculosis patients in the Family Health Strategy: the nurses' perceptions]. / Cuidado ao doente de tuberculose na Estratégia Saúde da Família: percepções de enfermeiras.

The objective of this study was to analyze the nurses' perceptions regarding tuberculosis control, according to the theoretical axis of comprehensive healthcare and the concepts of attachment and teamwork. This qualitative study involved 13 nurses from the Family Health Strategy of a priority city in the metropolitan region of João Pessoa, Paraíba, Brazil. Data were collected in focal groups and subjected to thematic content analysis. Factors that strengthen tuberculosis control were: supervised treatment, free medication and the provision of supplies. Weakening factors were: worker's turnover, the lack of encouragement for patients and incipient educational actions. The factors that, according to the nurses, weaken tuberculosis patient care should be reviewed by administrators, workers, users and educators with a view to redefining healthcare activities that strengthen attachment, comprehensive healthcare and teamwork.

[Burn injuries in children and adolescents: clinical and epidemiological characterization]. / Queimaduras em crianças e adolescentes: caracterização clínica e epidemiológica.

Burns are important causes of morbidity and mortality in children and adolescents whose effects are reflected in significant functional limitations. This is a descriptive, quantitative study aimed to characterize the clinical and epidemiological profile of children and adolescents victims of burns admitted to a referral Hospital of Joao Pessoa, Brazil from January 2007 to December 2009. The majority of victims were infants (87%), preschoolers (88.2%) and boys (54%). The incident mostly occurred at home (85.5%) by accident (90%) and scalding (69.6%). Second-degree burns were predominant in 62.6% of cases and about 24.2% of the sample developed complications and secondary infection was the most common (1.1%). Balneotherapy is one of the most common procedures. We conclude that education programs at schools, community centers and in the media need to be strengthen since most injuries occur in the home environment and could be prevented.

The family of the child with special health care needs and their social relationships.

OBJECTIVES: to identify aspects that can influence the types of bonds developed in the social support network of family members of children with special health care needs. METHODS: qualitative research conducted through interviews with 15 family members/guardians in the city of Rio de Janeiro, from January to February 2020. Sanicola's theoretical-methodological framework and Bardin's thematic analysis technique were used. RESULTS: social distancing, lack of responsibility for coordinating care, lack of supplies and lack of individualized care were weaknesses found in the families' social relationships. However, the bonds were strengthened by the relationship of familiarity and availability of professionals in the care of children with special health needs. FINAL CONSIDERATIONS: understanding the configuration of primary and secondary social networks and the types of support offered can improve the care of children and strengthen bonds that provide security for families.