Experience of mothers of premature babies from birth to discharge: notes of field journals. / Vivência de mães de bebês prematuros do nascimento a alta: notas de diários de campo.

OBJECTIVE: To describe the maternal care process mediated by nurses during the period of hospitalisation and discharge of premature babies. METHOD: This is a descriptive, exploratory, and qualitative study, using the methodological framework of convergent care research, with seven mothers of premature babies admitted to a hospital in southern Brazil, from October to December 2011. Data from the mother's daily journals were submitted to content analysis. RESULTS: Analysis resulted in three categories portraying the path and the adaptation process of the mothers to the care of their premature babies, from preparation for discharge to overcoming her fears and insecurities concerning home care. CONCLUSION: It is important for mothers in this initial and critical stage of hospitalisation of preterm infants to receive assistance, especially in terms of receptiveness and ongoing care, as a strategy to promote maternal autonomy and home adaptation.

(Un)receptiveness in interactions with professionals: experiences of parents of children with retinopathy of prematurity.

OBJECTIVE: To analyze the influence of health professionals' receptiveness on parental care of children with retinopathy of prematurity (ROP). METHOD: A qualitative study developed under the theoretical framework of Symbolic Interactionism and using a narrative research methodology. Six women and three men, being parents of children with retinopathy of prematurity were individually interviewed in depth. RESULTS: From the scope of information, emotions and their rights, the parents experienced receptiveness from some professionals and unreceptiveness from others. The predominance of unreceptive attitudes in the parental narratives originated the following analysis themes: Informational (un)receptiveness, Emotional (un)receptiveness, and (Un)receptiveness of rights. CONCLUSION: The study supports human and comprehensive healthcare in the context of retinopathy of prematurity by pointing out the interactive process with health professionals as a potential stressor of parental care. The results signal a nuclear of attitudinal changes and reinforce challenges to the child and family-centered approach. OBJETIVO: Analisar a influência do acolhimento do profissional de saúde no cuidado parental junto ao filho com retinopatia da prematuridade. MÉTODO: Estudo qualitativo desenvolvido sob o referencial teórico do Interacionismo Simbólico e metodológico da pesquisa de narrativas. Foram entrevistados em profundidade e individualmente seis mulheres e três homens, pais de crianças com retinopatia da prematuridade. RESULTADOS: Os pais vivenciam, nos âmbitos informacional, emocional e de direitos, acolhimento com alguns profissionais e destrato com outros. A predominância da postura de desacolhimento nas narrativas parentais deu origem aos temas de análise: (Des)acolhimento informacional, (Des)acolhimento emocional, e (Des)acolhimento de direitos. CONCLUSÃO: O estudo oferece subsídios ao cuidado humano e integral em saúde no contexto da retinopatia da prematuridade ao apontar o processo interativo com os profissionais de saúde enquanto potencial estressor do cuidado parental. Os resultados sinalizam núcleos de mudanças atitudinais e reforçam desafios à abordagem centrada na criança e família.

[Perceptions of the family members of children regarding well-child check-ups in the family healthcare strategy]. / Percepções dos familiares de crianças sobre a consulta de puericultura na estratégia saúde da família.

A qualitative descriptive study aimed at understanding the perceptions of the family members of children regarding well-child check-ups in the context of attention to child healthcare. Data collection was done using semi-structured interviews of 19 families, in the city of Maringá, in the state of Paraná, Brazil, from December 2012 to February 2013. The data was analyzed using content analysis, a thematic modality, which resulted in the thematic category "Revealing well-child check-ups from the family's point of view" and two secondary categories. The results showed the interviewees' insipient knowledge of well-child check-ups, reflecting the lack of adequate guidance about this type of care. The family members showed a preference for care of children by a pediatrician. Although secondary, the family noted the participation of the nurse in this activity. It is considered extremely important that well-child check-ups are valued by family members in order to promote effective multi-professional participation in this modality of attention.

[Evaluation of digital educational student-technology interaction in neonatal nursing]. / Avaliação da interação estudante-tecnologia educacional digital em enfermagem neonatal.

OBJECTIVE: To assess the digital educational technology interface Caring for the sensory environment in the neonatal unit: noise, lighting and handling based on ergonomic criteria. METHODS: Descriptive study, in which we used the guidelines and ergonomic criteria established by ISO 9241-11 and an online Likert scale instrument to identify problems and interface qualities. The instrument was built based on Ergolist, which follows the criteria of ISO 9141-11. There were 58 undergraduate study participants from the School of Nursing of Ribeirao Preto, University of Sao Paulo, who attended the classes about neonatal nursing content. RESULTS: All items were positively evaluated by more than 70% of the sample. CONCLUSION: Educational technology is appropriate according to the ergonomic criteria and can be made available for teaching nursing students.

Absenteeism in child health services: a systematic review.

OBJECTIVES: to analyze data from qualitative studies related to the phenomenon of health follow-up dropout of newborns, infants and preschoolers in child health services. METHODS: systematic review, carried out in 19 information bases. Studies were included that portray the reasons for dropping out health follow-up of children up to five years old. The JBI methodology was used for systematic reviews of qualitative evidence. RESULTS: we identified 20,199 studies. After applying the eligibility criteria, 81 were selected. Seven were excluded due to duplicity, resulting in 74 articles that were read in full. After this phase, three articles were selected for the final sample and later after reading their references, one more was included, totaling four articles for critical analysis. CONCLUSIONS: the synthesized findings highlight that health follow-up dropout is based on personal knowledge and beliefs, the family routine dynamics and access to services.

Factors associated with loss to follow-up in tuberculosis treatment in Brazil: a retrospective cohort study.

OBJECTIVE: To analyze the factors associated with loss to follow-up in tuberculosis cases among adults in Brazil in 2020 and 2021. METHOD: Retrospective cohort with secondary data from the Brazilian Notifiable Diseases Information System. A total of 24,344 people diagnosed with tuberculosis whose information was complete in the database were included. Adjusted odds ratios and confidence intervals were estimated by binary logistic regression. RESULTS: Higher odds of loss to follow-up were observed for males, non-white ethnicity/color, with lower education level, homeless or deprived of liberty, who used drugs, alcohol and/or tobacco, with admission due to recurrence or re-entry after abandonment, and with unknown or positive serology for HIV. On the other hand, older age, extrapulmonary tuberculosis, deprivation of libertyand supervised treatment were associated with lower odds of loss to follow-up. CONCLUSION: Demographic, socioeconomic and clinical-epidemiological factors were associated with the loss to follow-up in tuberculosis cases, which reiterates the various vulnerabilities intertwined with the illness and treatment of this disease. Therefore, there is a need to promote strategies aimed at adherence and linkage to the care for groups most vulnerable to loss to follow-up in tuberculosis treatment in Brazil.

Workshop on pediatric trauma care: low-cost simulation.

OBJECTIVE: to assess nursing students' and nurses' knowledge, satisfaction and self-confidence after a theoretical workshop on emergency care for traumatized children and clinical simulation. METHODS: a quasi-experimental study, carried out with nursing students and nurses residing at a public university in southern Brazil. A workshop on pediatric trauma care was created and a mannequin was created for simulations. A knowledge pre-test and post-test and the Student Satisfaction and Self-Confidence in Learning instrument were applied to measure satisfaction and self-confidence in learning. For analysis, descriptive statistics and the Wilcoxon test were used to compare means before and after intervention. RESULTS: the difference between misses and hits was statistically significant (p<0.005), demonstrating an increase in participants' knowledge after the workshop. Satisfaction and self-confidence were demonstrated in the instrument's high scores. CONCLUSIONS: the effectiveness of the workshop in teaching-learning emergency care for pediatric trauma was demonstrated.

Adolescent health in the Covid-19 pandemic: a construction through Nola Pender's model.

OBJECTIVE: To construct perspectives of adolescent health in the face of the Covid-19 pandemic, through emancipatory dialogues guided by Nola Pender's Model. METHOD: This is a participatory research based on the methodology of Psychodramatic Pedagogy of María Alicia Romaña. The action was carried out with 17 school-aged adolescents from a city in the Center-West Region of Brazil. The theoretical-analytical framework used was Nola Pender's Health Promotion Model, and the data collected were discussed based on Paulo Freire's dialogical framework. RESULTS: The workshop allowed the sharing of individual characteristics and experiences of adolescents regarding the reality experienced in the pandemic, highlighting mental health as a main theme for health promotion. FINAL CONSIDERATIONS: It was construct, along with the adolescents, important knowledge about health in the pandemic, supporting the thematic reflection and the elaboration of timely health promotion interventions.

Monitoring of high-risk children in health services: A geospatial mixed-methods study.

OBJECTIVE: to analyze adherence, non-adherence and abandonment of the monitoring of children referred to the high-risk reference centers of Rede Mãe Paranaense. METHOD: a parallel and convergent mixed-methods study, in which both approaches have the same weight. The study loci were two high-risk outpatient services from the South of the country. In the quantitative part, 3,107 medical charts of high-risk children were analyzed and the spatial distribution was performed. In the qualitative part, interviews were conducted with 29 health professionals, in addition to 34 family members, and content analysis was performed. Two databases were produced, which were analyzed separately and eventually integrated. RESULTS: the rates regarding adherence to monitoring are decreasing, mainly in the municipalities that are far away from the high-risk outpatient services, and the non-adherence and abandonment rates are increasing. In the reports by the representatives and the manager, a failure was observed between the transportation offer and the active search flow of the absent patients, which contributes to the increase in the non-adherence and abandonment rates and to the consequent decrease in adherence. CONCLUSION: in high-risk children, adherence is decreasing and the non-adherence and abandonment rates increased.

Rede Cegonha: maternal characteristics and perinatal outcomes related to prenatal consultations at intermediate risk.

OBJECTIVE: to analyze the correlation between maternal characteristics and perinatal outcomes, with the number of prenatal consultations performed. METHOD: a cross-sectional study, carried out with 1,219 mothers and newborns stratified as intermediate risk according to the Programa Rede Mãe Paranaense, adaptation of the Rede Cegonha at the state level. Data were collected from the Birth Certificates. Spearman, Wilcoxon and Kruskal-Wallis tests were used to analyze the correlation between the variables of interest. RESULTS: married women, with higher education, white and aged 30 years or older were the ones who most attended prenatal consultations. With regard to perinatal outcomes, children whose mothers had more frequent prenatal consultations had better Apgar and birth weight scores. High rates of cesarean delivery were identified before the onset of labor. CONCLUSION: maternal characteristics influence the process of adherence to prenatal care, impacting perinatal outcomes, indicating the relevance of these risk factors and the need to improve actions aimed at greater compliance with risk stratification and qualified and resolute care for pregnant women at intermediate risk.

Family and community guidance in adolescence: assessment in the family health strategy.

OBJECTIVE: to evaluate family and community guidance in adolescence, within the scope of Primary Health Care. METHOD: an evaluative and descriptive study with a quantitative approach, developed through the application of the Primary Care Assessment Instrument (PCATool), with 70 professionals from the Family Health Strategy and 140 adolescents from the widerange areas. Data collection took place in Basic Health Units and in the adolescents' homes in a municipality of southern Brazil, from May to September 2019. The data were analyzed using descriptive and inferential statistics using ANOVA and Tukey's test, performed using the R Studio software. RESULTS: there was divergence in the assessment of the attributes of family and community guidance between users and responsible professionals, showing weaknesses in the communication process and in the formation of the care bond in this reality, with impacts on quality of care. CONCLUSION: there was a need for continued assessment of the care practice in primary health care, as well as for permanent education with a focus on increasing qualification of care for adolescents.

Ergonomics of anatomical bra models for breastfeeding: a contribution of nursing.

OBJECTIVES: to analyze the ergonomics of two models of breastfeeding bras. METHODS: descriptive study carried out with 152 infants in a Brazilian university hospital. The prototypes were separated into two groups (A and B). To compare the two bra models, the Odds Ratio (OR) was used as a measure of the strength of the association. In subjective perceptions, the Modified Borg Scale, and the chi-square test of independence (χ2) were used. To compare the two prototypes, the Z test and logistic regression analysis were performed. A significance level of 5% was considered. RESULTS: the bra in group B was more suitable for ergonomics of physical and psycho-aesthetic comfort than the bra in group A (p < 0.0001), according to the logistic regression tests. CONCLUSIONS: modeling B was ergonomically adequate, with usability and evaluation criteria centered on breastfeeding women.

[Increase in physical violence against women perpetrated by the intimate partner: a trend analysis]. / Aumento da violência física contra a mulher perpetrada pelo parceiro íntimo: uma análise de tendência.

The scope of this article is to analyze the temporal trend by conducting a time series study of physical violence against women by an intimate partner in the State of Paraná between 2009 and 2016. Records of violence were obtained from the Notifiable Diseases and Violent Events Information System-SINAN. Levels of physical violence against women were calculated according to sociodemographic characteristics and means of aggression. For the trend analysis, polynomial regression was used. The notifications increased from 11.1 cases/100,000 women in 2009 to 91.2 in 2016, with an average annual increase of 14.84. There was an increase in rates of physical violence against women in all the Health Macroregional units, especially in the West with the highest average rate and in the North with the highest average annual increase. The spouse was the main aggressor. However, there was an increase in aggression by ex-spouses and boyfriends. There was also an increase in notifications among women aged 20-29 and 50-59 years, with eight years or more of study, and black/brown, yellow and indigenous race/color. The results reveal an increase in notifications of physical violence against women by an intimate partner, with changes in the sociodemographic profile of the victims.

O objetivo deste artigo é analisar a tendência temporal da violência física contra a mulher perpetrada pelo parceiro íntimo no Paraná. Trata-se de um estudo de séries temporais (2009 a 2016) dos registros de violência física contra a mulher por parceiro íntimo no Paraná. Os dados foram obtidos no Sistema de Informação de Agravos de Notificação-SINAN. Foram calculadas taxas de violência física contra a mulher por parceiro íntimo, segundo características sociodemográficas e meio de agressão. Para a análise de tendência, utilizou-se a regressão polinomial. As notificações aumentaram de 11,1 casos/100.000 mulheres em 2009 para 91,2 em 2016, com aumento anual médio de 14,84. Houve elevação nas taxas de violência física contra a mulher em todas as macrorregionais de saúde, destacando-se a Oeste, com a maior taxa média, e a Norte, com maior crescimento anual médio. O cônjuge foi o principal agressor. Entretanto, registrou-se crescimento das agressões por ex-cônjuges e namorados(as). Também houve aumento de notificações entre mulheres de 20-29 e 50-59 anos, com oito anos ou mais de estudo, e raça/cor preta/parda, amarela e indígena. Os resultados mostram aumento das notificações de violência física contra a mulher por parceiro íntimo, com mudanças no perfil sociodemográfico das vítimas.

[Support netwrok to the families of children admitted in a pediatric intensive care unit]. / Rede social de apoio à família de crianças internadas em uma unidade de terapia intensiva pediátrica.

With the intention of understanding how the support network of the families of children admitted in a hospital Pediatric Intensive Care Unit (PICU) is established, and its importance in the life of their relatives, a descriptive study with qualitative approach was carried out with 21 parents of children admitted in a PICU of a University Hospital located in the northwest area of Paraná State. It was observed that, the support network to the families was made of a mixed of affectivity, faith and solidarity as the fundamental components to relieve the suffering and out-of-hospital support. The study also showed, that the work with families should be permeated by the special attention to the peculiarities that surround each family context and its relationships, what ratifies the importance of a more comprehensive performance of nursing, better understanding the multiple influences of the different configurations of the family and social support network on the quality and effectiveness of the implemented interventions.

Temporal trend and factors associated to teenage pregnancy. / Tendência temporal e fatores associados à gravidez na adolescência.

OBJECTIVE: To analyze the trend and factors associated to teenage pregnancy in a municipality in Paraná state. METHOD: Ecological study conducted with registers of babies born to teenage mothers between 2000 and 2015 from the Birth Information System (Sistema de Informação sobre Nascimento). Proportions were calculated year by year for a trend analysis of teenage pregnancy. Two series of three-year periods were collected for an odds ratio analysis of associated factors. RESULTS: The following variables were associated to teenage pregnancy: not having a partner; less than eight years of schooling; primiparity; gestational age shorter than thirty-seven weeks; caesarean section; less than seven appointments; and Apgar below seven in the first minute. A decline trend was observed among pregnant teenagers who had partners; growing trend for teenage expectant mothers who had more than eight years of schooling and premature birth; decline/growing for normal birth; growing for number of prenatal appointments; decline for first and fifth minute Apgar score; growing for congenital anomalies. CONCLUSION: The analysis provided information that can be used to promote pregnancy prevention strategies and assistance to adolescent mothers.

Neonatal near miss in the intensive care unit.

OBJECTIVE: To analyze near miss cases among newborns hospitalized in the Intensive Care Unit. METHODS: An observational, cross-sectional, retrospective study using the STROBE guideline. Data were collected from 1,101 records of live births (newborns). Statistical analysis used the Epi-Info program 3.3.2 and Chi-square and Fisher's exact tests. RESULTS: A total of 162 newborns were hospitalized, of which 63 had at least one criterion of near miss. The variables that remained associated with neonatal near miss were weight <1.750 g, gestational age <33 weeks and Apgar at 5 minutes <7, pragmatic criteria to identify cases of neonatal near miss morbidity. CONCLUSION: Prematurity and low birth weight were the factors that contributed most to the near miss outcome among newborns hospitalized in intensive care, a rate two and a half times higher than the number of deaths, according to scientific evidence.

[Family changes due to the hospitalization of a child in a pediatric intensive care unit]. / Alterações familiares decorrentes da internação de um filho em uma unidade de terapia intensiva pediátrica.

The study aimed at understanding the changes that occurs in a family after the hospitalization of a child in a Pediatric Intensive Care Unit (PICU). It was a descriptive study, with a qualitative approach. Data were collected in the period of March to June 2007, through semi-structured interviews carried out with 21 parents of children admitted in a PICU of a University Hospital located in the northwest area of Paraná State, Brazil. The results showed the family, even when facing the hospitalization and the risk of death of a family member, as well as the separation of other family members from the mother who is keeping company to the sick child, tries to establish means to maintain united and to follow its routine. The study revealed the importance of the support to the relatives of a hospitalized child, as an essential part of the caring process, thus contributing to turn it indubitably humanized.

Case management as a high-risk prenatal care strategy.

OBJECTIVE: to discuss the benefits of using high-risk prenatal case management. METHOD: a qualitative, convergent care study with six high-risk pregnant women, performed in a municipality in the south of Brazil. Data were produced by case management from April to August of 2017 through observation-participant. Analysis followed the processes of Convergent Care Research: apprehension, synthesis, theorization and transfer. RESULTS: case management identified important elements in the care of pregnant women, which denoted a greater complexity to the cases; was shown as a relevant space for nurses to act, because it is an intervention that requires knowledge and specific skills. FINAL CONSIDERATIONS: case management provides differentiated management in complex cases, facilitates the flow between health services, concretizing the comprehensiveness and equity of the care. It was found, in the convergence between research and care, that participants were benefited by case management.

O uso do Facebook com pais de recém-nascidos: uma revisão integrativa / The use of Facebook with parents of newborns: an integrative review / El uso de Facebook con padres de recién nacidos: una revisión integradora

Investigar e analisar as evidências disponíveis na literatura sobre o uso do Facebook com os pais de recém--nascidos. Trata-se de uma revisão integrativa, realizada no segundo semestre de 2020, nas bases de dados Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde), SciELO (Scientific Electronic Li-brary Online) e Medline (Medical Literature Analysis and Retrieval System Online). Amostra composta por 11 artigos, divididos em duas categorias. Foi evidenciado o uso do Facebook como forma de recrutamento de participantes e como suporte de apoio e compartilhamento de informações entre os pais dos recém--nascidos. No recrutamento, a utilização do Facebook foi eficaz, podendo ser um método viável de contatar usuários. Como suporte de apoio e compartilhamento de informações, a rede social também foi efetiva, devido à troca de experiência, apoio mútuo entre os usuários, disseminação de informações, facilidade ao usar a plataforma e alto engajamento dos participantes.

To investigate and analyze the evidence available in the literature on the use of Facebook with parents of newborns. This is an integrative review, carried out in the second half of 2020, in the Lilacs databases (Literatura Latino-Americana e do Caribe em Health Sciences), SciELO (Scientific Electronic Library Online) and Medline (Medical Literature Analysis and Retrieval System Online). Sample composed of eleven articles, divided into two categories. The use of Facebook was evidenced as a way of recruiting participants and as support and information sharing between parents of newborns. In recruitment, the use of Facebook was effective and may be a viable method of contacting users. As support and information sharing, the social network was also effective, due to the exchange of experience, mutual support among users, dissemination of information, ease of use of the platform and the high engagement of participants.

Investigar y analizar la evidencia disponible en la literatura sobre el uso de Facebook con padres de recién nacidos, se trata de una revisión integradora, realizada en el segundo semestre de 2020, en las bases de datos Lilacs (Literatura Latino-Americana e do Caribe em Health Sciences ), SciELO (Biblioteca científica electrónica en línea) y Medline (Sistema de recuperación y análisis de literatura médica en línea). Muestra compuesta por once artículos, divididos en dos categorías. Se evidenció el uso de Facebook como forma de captación de participantes y como apoyo e intercambio de información entre padres de recién nacidos. En la contratación, el uso de Facebook fue efectivo y puede ser un método viable para contactar a los usuarios. Como apoyo e intercambio de información, la red social también resultó eficaz, debido al intercambio de experiencias, el apoyo mutuo entre los usuarios, la difusión de información, la facilidad de uso de la plata-forma y el alto compromiso de los participantes.

"Eu não sei como eu tenho força pra vir na escola": manifestações e implicações do bullying entre adolescentes escolares / "I don't know how I have the strength to come to school: " manifestations and implications of bullying between school adolescents

Resumo Este artigo tem como objetivo compreender, pelo uso do Photovoice, as representações de bullying presentes entre adolescentes escolares do ensino médio. Trata-se de um estudo qualitativo, realizado com 54 adolescentes da rede pública de ensino do estado do Paraná, organizados em seis grupos focais. Os dados foram coletados mediante a técnica participativa Photovoice e submetidos à análise de conteúdo proposta por Bardin. Da análise dos dados emergiram três categorias: "Bullying estético, homofóbico e de gênero: estratégias subversivas", "Os efeitos danosos do bullying" e "O diálogo interdisciplinar como estratégia de prevenção e combate ao bullying". Com os resultados, foi possível evidenciar que a prática do bullying acontece a partir das dissonâncias entre agressores e vítimas, com insultos à condição de conformação corporal, orientação sexual, identidade de gênero, entre outros. Por essa razão, é preciso viabilizar ações articuladas entre educação e saúde para o diálogo e escuta a respeito do bullying na comunidade escolar, com vistas a seu enfrentamento, prevenção e proteção, almejando, sobretudo, o respeito e valorização das diferenças.

Abstract This article aims to understand, by using Photovoice, the representations of bulling among high school adolescents. This is a qualitative study, conducted with 54 adolescents from the public school system of the state of Paraná, organized into six focus groups. The data were collected using the Photovoice participatory technique and submitted to content analysis proposed by Bardin. Three categories emerged from the data analysis: "Esthetic, homophobic, and gender bullying: subversive strategies", "The harmful effects of bullying", and "Interdisciplinary dialogue as a strategy to prevent and combat bullying." With the results, it was possible to evidence that the practice of bullying happens from dissonances between aggressors and victims, with insults to the condition of body conformation, sexual orientation, gender identity, among others. For this reason, it is necessary to enable articulated actions between education and health for dialogue and listening about bullying in the school community, with a view to coping with it, prevent it, and protect against it, seeking above all the respect and appreciation of differences.