Resources for health literacy among caregivers of prematurely born children: a scoping review.

OBJECTIVES: to map the available evidence on resources used to promote health literacy among caregivers of prematurely born children during outpatient follow-up. METHODS: the Joanna Briggs Institute's scope review protocol was utilized. The search encompassed six databases, incorporating studies from 2012 to 2022. RESULTS: the three included publications revealed that the resources employed are: mobile applications, phone calls, individual counseling, videos, educational pamphlets, and group discussions. Implementing an education protocol during the transition home enhances scientifically grounded health promotion rates. CONCLUSIONS: there is limited literature addressing the health literacy of these caregivers. The nursing team plays a crucial role in health education and in developing resources applicable to these families.

Utilization of local pressure devices in pain management during injections: scoping review.

OBJECTIVE: to map scientific evidence regarding the use of local pressure devices in pain relief during injection procedures in patients. METHODS: scoping review, following the recommendations of the JBI Manual for Evidence Synthesis and PRISMA-ScR, with searches conducted in the PubMed, EMBASE, CINAHL, LILACS, and PsycINFO databases, without temporal restrictions and with a cutoff date of March 2023. RESULTS: a total of 1,514 studies were identified, with 20 articles included in the final sample. The ShotBlocker® device was utilized during subcutaneous and intramuscular injections in children and adults, proving beneficial in reducing pain, anxiety, and fear associated with the procedure. FINAL CONSIDERATIONS: the ShotBlocker® is a low-cost, easy-to-use device that can enhance nursing clinical practice during painful procedures. However, studies involving the Brazilian Pikluc® device are scarce. Further research involving both local pressure devices is recommended.

Operational Definition of the Concept of Success in Peripheral Intravenous Catheterization in Hospitalized Children.

The objective of this study was to operationally define the concept of success in peripheral intravenous catheterization in children considering the Walker and Avant model. This is a methodological study, carried out through the following steps: concept selection, the definition of the analysis objective, identification of possible uses of the concept, determination of critical or essential attributes, construction of a model and opposite case, and identification of antecedents and consequences. The study was carried out based on a search in international databases from January to March 2021. The sample consisted of 47 studies conducted in 17 countries between 2008 and 2021. Five attributes, 20 antecedents, 10 consequences, and an empirical reference of the studied concept were identified. Also, 2 cases, model and opposite, were elaborated, and an operational definition of the concept was developed. The Walker and Avant method enabled the operationalization of the concept of success of peripheral intravenous catheterization in children based on attributes, antecedents and consequents, and model and opposite cases.

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.

Fear of COVID-19 when experiencing pregnancy or childbirth in the pandemic: what are the associated factors?

OBJECTIVE: to identify factors associated with fear of COVID-19 among women who experienced pregnancy or childbirth during the pandemic. METHODS: a cross-sectional study, nested within a prospective cohort, using an online survey, from August 2021 to February 2022, based on descriptive data analysis. RESULTS: of the 431 participants, 52.8% were postpartum women and 20.1% were pregnant women. With regard to fear of COVID-19, a mean score of 20.46 was obtained (moderate fear). The highest fear scores were present in women whose newborns were admitted to hospital in neonatal critical units (p=0.032), and the lowest among those covered by supplementary health (insurance) (p=0.016). CONCLUSION: among pregnant and postpartum women, high fear of COVID-19 translated into the possibility of having newborns admitted to hospital in a critical unit. The importance of supporting actions to support pregnant/postpartum women's mental health in relation to COVID-19 or other threats that may influence the neonatal outcome stands out.

Compliance with central venous catheter infection prevention practices after intervention with simulation.

OBJECTIVES: to assess the effect of an educational intervention based on clinical simulation on nursing professionals' compliance with practices to prevent peripherally inserted central venous catheter-associated primary bloodstream infections in a Neonatal Intensive Care Unit. METHODS: a quasi-experimental study, with preand post-intervention assessment with a single group. The population consisted of 41 nursing professionals, with 31 observations being made before and after the intervention. Analyzes were performed using descriptive statistics and the McNemar non-parametric test. A significance level of 5% was adopted. RESULTS: after the intervention, there was an increase in compliance with prevention practices of surgical antisepsis and professional hand hygiene, skin antisepsis with chlorhexidine, waiting for the time of the effect of alcoholic chlorhexidine and compliance with the sterile technique. CONCLUSIONS: the educational intervention showed an effect on increasing compliance with catheter-associated infection prevention practices.

Transitions experienced by mothers of children/adolescents with sickle cell disease in the context of the COVID-19 pandemic.

OBJECTIVE: To analyze the transitions experienced by mothers and children/adolescents with sickle cell disease after the emergence of the COVID-19 pandemic. METHOD: A qualitative study involving 19 mothers of children and adolescents with sickle cell disease. Data were obtained through semi-structured interviews via WhatsApp, followed by Thematic Analysis and Descending Hierarchical Classification with the help of Interface de R pour les Analyses Multidimensionnelles de Texteset de Questionnaires and interpreted in the light of Afaf Meleis' Transition Theory. RESULTS: Support from family members for displacement; mothers' adherence to the routine of daily stimuli and physical exercises favored healthy transitions; lack of remote health care; low socioeconomic resources; interruption of the physiotherapy service; and maternal overload favor unhealthy transitions. FINAL CONSIDERATIONS: Efforts/movements by mothers ensure the healthy transition of children/adolescents with sickle disease during the pandemic, while supporting their unhealthy transition.

Risk factors for infiltration in children and adolescents with peripheral intravenous catheters.

OBJECTIVES: to estimate the incidence of infiltration and the factors associated with its occurrence in children and adolescents in the operative period and with peripheral intravenous catheters. METHODS: a longitudinal and prospective study with children and adolescents using peripheral intravenous catheters, conducted at the surgical clinic unit of a pediatric hospital in Feira de Santana, State of Bahia, from April 2015 to December 2016. The study used Pearson's chi-square and Fisher's exact test for the analysis. It also applied multiple analyses using Poisson regression with robust variance. RESULTS: the incidence of infiltration was 31.2% and was associated with female sex (RR=0.53; CI=[0.30-0.96]), non-eutrophic children (RR=2.27; CI=[1.25-4.20]), who used non-irritating and non-vesicant drugs (RR=1.72; CI=[1.03-2.87]), vesicant drugs (RR=1.84; CI=[1.05-3.22]) and irritating/vesicant electrolytes (RR=2.35; CI=[1.38-3.97]). CONCLUSIONS: the study suggests the development of strategies that will help in the prevention of this adverse event through the knowledge of the associated factors.

Care related to peripheral intravenous catheterism in pediatrics performed by nursing technicians.

OBJECTIVES: to evaluate the care practice adopted by nursing technicians before, during and after peripheral intravenous catheterization performed in hospitalized children. METHODS: cross-sectional and descriptive research, carried out in a pediatric hospital in Bahia through non-participatory observation of peripheral intravenous catheterizations performed in children by nursing technicians. Data was collected through an instrument containing care related to the moments before, during and after insertion of the catheter, calculating absolute and relative frequencies, measures of central tendency and dispersion. RESULTS: there were 31 nursing technicians, who performed care mainly before intravenous catheterization. Nonconformities were identified regarding hand hygiene, use of a disposable mask, selection of the catheter insertion site, antisepsis, stabilization and catheter coverage. CONCLUSIONS: most of the precautions observed regarding peripheral intravenous catheterization are not in accordance with the standards of practice recommended by the national and international literature.

Methods for measuring venous peripherally inserted central catheters in newborns.

OBJECTIVE: to analyze the results of insertion procedures of Peripherally Inserted Central Catheters in newborns using two measurement methods. METHODS: this is a randomized clinical trial, presenting descriptive and exploratory results of variables. It was held at a Neonatal Intensive Care Unit. Data were collected between September 2018 and 2019. The sample analyzed was 88 catheter insertion procedures, distributed in two groups. Study approved by an Institutional Review Board and obtained registration in the country and abroad. Descriptive analysis and logistic regression of data. RESULTS: modified measurement obtained a significant difference for the central catheter tip location. Elective removals and adverse events were not significant between groups; however, poor positioning was related to adverse events. CONCLUSIONS: between the two methods analyzed, the modified measurement obtained better results in the proper catheter tip positioning and, consequently, less risk to patients.

Construction and validation of a family guidance manual on complications of intravenous therapy in children.

OBJECTIVES: to build and validate the content of an educational manual for the inclusion of family members of hospitalized children in the prevention and early identification of complications associated with IVT through the peripheral route. METHODS: it was a methodological study of construction and validation of the content of an instructional material. The validation process took place using the Delphi Technique, adopting a content validation index equal to or greater than 0.80 as a desirable consensus. RESULTS: the handbook was validated in the second assessment round in all categories: content, language, illustration, layout, motivation, culture, and applicability. The Global Content Validation Index was 0.98. CONCLUSIONS: because of the high values obtained (> 0.8), after the second evaluation, the handbook is considered validated in terms of content, by expert judges.

Elaboration and validation of an algorithm for treating peripheral intravenous infiltration and extravasation in children.

OBJECTIVE: to elaborate and validate the content and appearance of an algorithm for treating infiltration and extravasation of non-chemotherapy drugs and solutions administered to children. METHOD: a methodological study of the technology formulation and validation type. To elaborate the algorithm, a bibliographic review was carried out to list the scientific evidence on the treatment of infiltration and extravasation. Content and appearance validation was in charge of 14 specialists in pediatric nursing, using the Delphi technique, adopting a value equal to or greater than 0.80 as Content Validation Index. RESULTS: the algorithm was validated in the third evaluation by the judges, reaching a Global Content Validation Index of 0.99, being composed by the perception of the occurrence of the complication; discontinuation of intravenous therapy infusion; verification of signs and symptoms; measurement of edema; application of an infiltration and extravasation assessment scale and conduits to be used according to the characteristics of the fluid administered and the type of complication. CONCLUSION: the algorithm was validated and can be used in a practical and objective way by health professionals, in order to promote safety in the care of hospitalized children, with regard to reducing harms caused by infiltration and extravasation.

Risk factors for site complications of intravenous therapy in children and adolescents with cancer.

OBJECTIVES: to analyze predictive factors for the incidence of complications related to peripheral venous catheters in children and adolescents with cancer. METHODS: a longitudinal follow-up study, conducted at a pediatric oncology clinic unit of a hospital in Bahia, with 333 peripheral venous catheters inserted in 77 children and 26 adolescents. Data collection took place between April 2015 and December 2016 through direct observation of peripheral intravenous catheter insertion, medical record data collection and daily observation of the puncture site. RESULTS: the incidence of complications was 18.6%. The modeling of the variables confirmed that the risk factors for complications in children/adolescents with cancer were: prolonged peripheral intravenous therapy (p=0.002), history of complications (p=0.000), non-irritating/vesicant medications (p=0.003) and vesicant solutions (p=0.000). CONCLUSIONS: the goal has been achieved. Results can contribute to the theoretical, practical and social context.

Resources for health literacy among caregivers of prematurely born children: a scoping review / Recursos para el alfabetismo en salud de cuidadores de niños nacidos prematuramente: revisión de alcance / Recursos para o letramento em saúde de cuidadores de crianças nascidas prematuras: revisão de escopo

ABSTRACT Objectives: to map the available evidence on resources used to promote health literacy among caregivers of prematurely born children during outpatient follow-up. Methods: the Joanna Briggs Institute's scope review protocol was utilized. The search encompassed six databases, incorporating studies from 2012 to 2022. Results: the three included publications revealed that the resources employed are: mobile applications, phone calls, individual counseling, videos, educational pamphlets, and group discussions. Implementing an education protocol during the transition home enhances scientifically grounded health promotion rates. Conclusions: there is limited literature addressing the health literacy of these caregivers. The nursing team plays a crucial role in health education and in developing resources applicable to these families.

RESUMEN Objetivos: mapear las evidencias disponibles sobre los recursos utilizados para la promoción del alfabetismo en salud de cuidadores de niños nacidos prematuramente en el seguimiento ambulatorio. Métodos: se utilizó el protocolo de revisión de alcance del Joanna Briggs Institute. La búsqueda se realizó en seis bases de datos, incluyendo estudios entre 2012 y 2022. Resultados: las tres publicaciones incluidas evidenciaron que los recursos utilizados son: aplicaciones para teléfonos móviles, llamadas telefónicas, asesoramiento individual, videos y folletos educativos, y discusiones en grupos. Implementar un protocolo educativo en la transición al hogar aumenta los índices de promoción de la salud respaldada científicamente. Conclusiones: hay poca información en la literatura sobre el alfabetismo en salud de estos cuidadores. El equipo de enfermería juega un papel fundamental en la educación en salud y en la creación de recursos que pueden aplicarse a estas familias.

RESUMO Objetivos: mapear as evidências disponíveis sobre os recursos utilizados para a promoção do letramento em saúde de cuidadores de crianças nascidas prematuras no seguimento ambulatorial. Métodos: utilizou-se o protocolo de revisão de escopo do Joanna Briggs Institute. A busca foi realizada em seis bases de dados, incluindo estudos entre 2012 e 2022. Resultados: as três publicações incluídas evidenciaram que os recursos utilizados são: aplicativos para celulares, ligações telefônicas, aconselhamento individual, vídeos e folhetos educativos e discussões em grupos. Efetivar um protocolo de educação na transição para casa aumenta os índices de promoção da saúde cientificamente embasada. Conclusões: pouco se aborda na literatura sobre o letramento em saúde desses cuidadores. A equipe de enfermagem desempenha um papel fundamental na educação em saúde e na construção de recursos que podem ser aplicados a essas famílias.

Bundle para quantificação de perda sanguínea pós-parto vaginal / Bundle para la cuantificación de pérdida sanguínea posparto vaginal / Bundle for quantifying vaginal blood loss after childbirth

Resumo Objetivo Construir e validar o conteúdo de um bundle para quantificação da perda sanguínea pós-parto vaginal. Métodos Estudo metodológico desenvolvido de fevereiro a agosto de 2022, em três etapas: levantamento bibliográfico, construção do instrumento e validação de conteúdo por 14 experts. O instrumento para validação foi composto por 11 itens selecionados a partir de revisão sistemática. Para cada item do bundle aplicou-se escala Likert e para verificar a concordância entre experts, calculou-se o Índice de Concordância. Consideraram-se válidos os itens com concordância acima de 80%. A validação de conteúdo foi realizada em uma única rodada de avaliação. Resultados A versão final do bundle foi composta por nove itens. Os cuidados propostos estão relacionados à quantificação direta do sangramento pós-parto e seu registro, observação da puérpera, a utilização de protocolos institucionais em casos de hemorragia pós-parto, assim como a capacitação da equipe. Conclusão O estudo permitiu construir e validar bundle para quantificação da perda sanguínea pós-parto vaginal, com vistas à melhora do diagnóstico de hemorragia pós-parto.

Resumen Objetivo Elaborar y validar el contenido de un bundle para la cuantificación de pérdida sanguínea posparto vaginal. Métodos Estudio metodológico, llevado a cabo de febrero a agosto de 2022, en tres etapas: análisis bibliográfico, construcción del instrumento y validación de contenido por 14 expertos. El instrumento para validación consistió en 11 ítems seleccionados a partir de revisión sistemática. Se aplicó la escala Likert para cada ítem del bundle; y para verificar la concordancia entre expertos, se calculó el Índice de Concordancia. Se consideraron válidos los ítems con concordancia superior a 80 %. La validación de contenido se realizó en una única ronda de evaluación. Resultados La versión final del bundle consistió en nueve ítems. Los cuidados propuestos están relacionados con la cuantificación directa del sangrado posparto y su registro, la observación de la puérpera, la utilización de protocolos institucionales en casos de hemorragia posparto, así como también la capacitación del equipo. Conclusión El estudio permitió elaborar y validar un bundle para la cuantificación de pérdida sanguínea posparto vaginal, con el fin de mejorar el diagnóstico de hemorragia posparto.

Abstract Objective To construct and validate the content of a bundle to quantify vaginal blood loss after childbirth. Methods This is a methodological study developed from February to August 2022, divided into bibliographic survey, instrument construction and content validity, by 14 experts. The instrument for validity consisted of 11 items selected from a systematic review. For each item in the bundle, a Likert scale was applied, and to check agreement among experts, the Concordance Index was calculated. Items with agreement above 80% were considered valid. Content validity was carried out in a single round of assessment. Results The final version of the bundle consisted of nine items. The proposed care is related to direct quantification of postpartum bleeding and its recording, observation of postpartum women, use of institutional protocols in cases of postpartum hemorrhage as well as team training. Conclusion The study allowed constructing and validating a bundle for quantifying vaginal blood loss after childbirth, with a view to improving postpartum hemorrhage diagnosis.

Development and validity of an algorithm for planning intravenous medication administration in infants / Desarrollo y validación de un algoritmo para la planificación de la administración de medicamentos intravenosos en neonatos / Elaboração e validação de algoritmo para o planejamento da administração de medicamentos intravenosos em neonatos

ABSTRACT Objective: to develop and validate the content of an algorithm for planning intravenous medication administration in infants. Method: this is a methodological study of technology development and validity. A scoping review was carried out, which supported the creation of an algorithm by the researchers and its subsequent validity by 13 expert nurses, which took place between November 2021 and March 2022. Items with a Content Validity Index ≥ 0.8 were considered acceptable. Results: thirty-one references were included in the scoping review, organized into five categories: "recommendation for intravenous access", "polypharmacy-related care", "care prior to intravenous medication administration", "venous catheter handling-related care" and "medication infusion-related care". This division supported the algorithm development, which was validated after three rounds, with an overall Content Validity Index of the instrument of 0.91. Conclusion: algorithm validity indicates reliability and accuracy of its content.

RESUMEN Objetivo: desarrollar y validar el contenido de un algoritmo para la planificación de la administración de medicamentos intravenosos en neonatos. Método: se trata de un estudio metodológico de desarrollo y validación de tecnología. Se realizó una revisión de alcance que apoyó la creación del algoritmo por parte de los investigadores y su posterior validación por 13 enfermeras especialistas, que se llevó a cabo entre noviembre de 2021 y marzo de 2022. Se consideraron aceptables los ítems con un Índice de Validez de Contenido ≥ 0,8. Resultados: se incluyeron 31 referencias en la revisión de alcance, organizadas en cinco categorías: "indicación de acceso intravenoso", "cuidados relacionados con la polifarmacia", "cuidados previos a la administración de medicamentos intravenosos", "cuidados relacionados con la manipulación del catéter venoso" y "cuidados relacionados con la infusión de medicamentos". Esta división apoyó el desarrollo del algoritmo, que fue validado después de tres rondas, con un Índice de Validez de Contenido global del instrumento de 0,91. Conclusión: la validación del algoritmo indica confiabilidad y precisión de su contenido.

RESUMO Objetivo: elaborar e validar o conteúdo de um algoritmo para o planejamento da administração de medicamentos intravenosos em neonatos. Método: estudo metodológico de elaboração e de validação de tecnologia. Foi realizada a revisão de escopo que subsidiou a elaboração do algoritmo pelas pesquisadoras e sua posterior validação por 13 enfermeiros especialistas, a qual ocorreu entre novembro de 2021 e março de 2022. Foram considerados aceitáveis os itens com Índice de Validade de Conteúdo ≥ 0,8. Resultados: foram incluídas 31 referências na revisão de escopo, organizadas em cinco categorias: "indicação de acesso intravenoso", "cuidados relacionados à polifarmácia", "cuidados prévios à administração de medicamentos intravenosos", "cuidados relacionados à manipulação do cateter venoso" e "cuidados relacionados à infusão de medicamentos". Essa divisão subsidiou a elaboração do algoritmo, que foi validado após três rodadas, com Índice de Validade de Conteúdo geral do instrumento de 0,91. Conclusão: a validação do algoritmo indica confiabilidade e precisão do seu conteúdo.

Experiências e rede de apoio de estudantes de Enfermagem durante o período de infecção pelo SARS-CoV-2 / Experiencias y red de apoyo de estudiantes de Enfermería durante elperíodo de infección por SARS-CoV-2 / Experiences And Support Network Of Nursing Students During The Sars-Cov-2 Infection Period

Objetivo: apreender como estudantes de Enfermagem perceberam a atuação da rede de apoio diante da experiência com a infecção pelo SARS-CoV-2. Método: estudo descritivo, de abordagem qualitativa. Os dados foram coletados entre novembrode 2021 e maiode 2022, mediante entrevistas remotas e presenciais, audiogravadas com 15 estudantes, selecionadas por conveniência.Os dados foram submetidos à análise de conteúdo, modalidade temática,e interpretados à luz do modelo de adaptação de Roy.Resultados: as participantes foram todas do sexo feminino, as quais,durante o período de infecção pelo SARS-CoV-2, experienciaram diferentes necessidades, que levaram a três modos adaptativos: fisiológico, função na vida real e interdependência. A rede informal (familiares, amigos, vizinhos e membros deigreja) ofertou apoio instrumental, informacional, emocional e espiritual, sobretudo por telefone e aplicativos de mensagens. O apoio da rede formal (serviços e profissionais de saúde) foi percebido como insuficiente e, por vezes, desumano. Conclusão: afamília, mesmoquando distante, constituiu a principal fonte de apoio. A atuação do sistema de saúde limitou-se a uma assistência pontual e ao repasse de orientações sobre cuidados, sendoconsiderada insuficiente em algumas situações.(AU)

Objetivo:comprender cómo los estudiantes de Enfermería percibieron la actuación de la red de apoyo frente a la experiencia con la infección por SARS-CoV-2. Método:estudio descriptivo, de enfoque cualitativo. Los datos se recopilaron entre noviembre de 2021 y mayo de 2022, mediante entrevistas remotas y presenciales, grabadas en audio con 15 estudiantes, seleccionadas por conveniencia. Los datos se sometieron a análisis de contenido, modalidad temática, e interpretados a la luz del modelo de adaptación de Roy. Resultados:las participantes fueron todas mujeres, quienes, durante el período de infección por SARS-CoV-2, experimentaron diferentes necesidades, que llevaron a tres modos adaptativos: fisiológico, función en la vida real e interdependencia. La red informal (familiares, amigos, vecinos y miembros de la iglesia) ofreció apoyo instrumental, informativo, emocional y espiritual, principalmente por teléfono y aplicaciones de mensajería. El apoyo de la red formal (servicios y profesionales de la salud) fuepercibido como insuficiente y, en ocasiones, deshumano. Conclusión:la familia, incluso a distancia, constituyó la principal fuente de apoyo. La actuación del sistema de salud se limitó a una asistencia puntual y a proporcionar orientaciones sobre cuidados, siendo considerada insuficiente en algunas situaciones.(AU)

Objective: To understand how Nursing students perceived the role of the support network in the face of their experience with SARS-CoV-2 infection. Method: Descriptive study, with a qualitative approach. Data were collected between November 2021 and May 2022, through remote and in-person, audio-recorded interviews with 15 students, selected for convenience. The data were subjected to content analysis, thematic modality, and interpreted in light of Roy's adaptation model. Results: The subjects were all female, who, during the SARS-CoV-2 infection period, experienced different needs, which led to three adaptive modes: physiological, real-life function and interdependence. The informal network (family, friends, neighbors, and church members) offered instrumental, informational, emotional, and spiritual support, especially via telephone and messaging apps. Support from the formal network (healthcare services and professionals) was perceived as insufficient and, at times, inhumane. Conclusion: The family, even when distant, was the main source of support. The health system's actions were limited to punctual assistance and the provision of guidance on care, being considered insufficient in some situations.(AU)

Fatores associados ao insucesso da cateterização intravenosa periférica em crianças com câncer / Factores asociados al fracaso del cateterismo intravenoso periférico en niños con cáncer / Factors associated with peripheral intravenous catheterization failure in children with cancer

Resumo Objetivo Estimar a prevalência de insucesso na inserção de cateteres intravenosos periféricos em crianças com câncer e sua associação com características demográficas, clínicas, da cateterização e terapia intravenosa utilizada previamente. Métodos Estudo de corte transversal e exploratório realizado na unidade de clínica oncológica pediátrica de um hospital público. Foram utilizados dados provenientes da observação de 130 cateterizações intravenosas periféricas e prontuários das crianças. Analisadas as características demográficas, clínicas, da cateterização intravenosa periférica e terapia intravenosa utilizada e sua relação com o insucesso da cateterização. Utilizou-se regressão de Poisson com variância robusta para determinar os fatores associados ao desfecho estudado, considerando p<0,05. Resultados A prevalência do insucesso foi de 38,5% e esteve estatisticamente associada ao tempo de hospitalização (RP=1,6; IC95% 1,05-2,56), uso de terapia intravenosa prévia prolongada (RP=2,1; IC95% 1,32-3,20), antecedente de extravasamento (RP=1,99; IC95% 1,15-3,28) e agitação da criança (RP=1,41; IC95% 1,02-1,94). Conclusão Observou-se elevada prevalência de insucesso da cateterização intravenosa periférica em crianças com câncer, associada ao tempo de hospitalização maior ou igual a oito dias, uso de TIV prévia prolongada, antecedente de extravasamento e agitação da criança durante a inserção do cateter.

Resumen Objetivo Estimar la prevalencia de fracaso en la inserción de catéteres intravenosos periféricos en niños con cáncer y su relación con características demográficas, clínicas, del cateterismo y de terapia intravenosa previamente utilizada. Métodos Estudio de corte transversal y exploratorio realizado en la unidad de clínica oncológica pediátrica de un hospital público. Se utilizaron datos provenientes de la observación de 130 cateterismos intravenosos periféricos y las historias clínicas de los niños. Se analizaron las características demográficas, clínicas, del cateterismo intravenoso periférico y terapia intravenosa utilizada y su relación con el fracaso del cateterismo. Se utilizó regresión de Poisson con varianza robusta para determinar los factores asociados al evento estudiado, considerando p<0,05. Resultados La prevalencia del fracaso fue del 38,5 % y estuvo estadísticamente relacionada con el tiempo de internación (RP=1,6; IC95% 1,05-2,56), el uso de terapia intravenosa previa prolongada (RP=2,1; IC95% 1,32-3,20), antecedentes de extravasación (RP=1,99; IC95% 1,15-3,28) y la agitación del niño (RP=1,41; IC95% 1,02-1,94). Conclusión Se observó una elevada prevalencia de fracaso del cateterismo intravenoso periférico en niños con cáncer, relacionada con el tiempo de internación mayor o igual a ocho días, el uso de TIV previa prolongada, antecedentes de extravasación y agitación del niño durante la inserción del catéter.

Abstract Objective To estimate the prevalence of peripheral intravenous catheter insertion failure in children with cancer and its association with demographic, clinical, catheterization and previously used intravenous therapy characteristics. Methods This is a cross-sectional and exploratory study conducted at the pediatric oncology clinic of a public hospital. Data from the observation of 130 peripheral intravenous catheterizations and medical records of children were used. We analyzed the demographic and clinical characteristics of peripheral intravenous catheterization and intravenous therapy used and its relationship with catheterization failure. Poisson regression with robust variance was used to determine the factors associated with the outcome studied, considering p<0.05. Results The prevalence of failure was 38.5% and was statistically associated with length of stay (PR=1.6; 95%CI 1.05-2.56), previous prolonged intravenous therapy use (PR=2.1; 95%CI % 1.32-3.20), history of extravasation (PR=1.99; 95%CI 1.15-3.28) and child agitation (PR=1.41; 95%CI 1.02-1.94). Conclusion There was a high prevalence of peripheral intravenous catheterization failure in children with cancer, associated with length of hospitalization greater than or equal to eight days, previous prolonged IVT use, history of extravasation and child agitation during catheter insertion.

Impetrações judiciais de mães de crianças com síndrome congênita do vírus zika: das motivações aos desfechos / Impetracciones judiciales de madres de personas menores con síndrome congénito del virus zika: De las motivaciones a los resultados / Judicial impetractions of mothers of children with congenital zika virus syndrome: From motivations to outcomes

Introdução: As famílias de crianças com Síndrome Congênita do Zika (SCZ) convivem com dificuldades para suprir suas necessidades de saúde, portanto acionam o poder judiciário para gozar do seu direito à saúde. Objetivo: Apreender as principais motivações das impetrações judiciais requeridas por mães de crianças com SCZ e seus desfechos. Metodologia: Estudo exploratório documental com abordagem qualitativa, realizado no sítio eletrônico JusBrasil e coleta procedida em março de 2020. Foram incluídas 15 impetrações judiciais publicadas entre janeiro de 2016 e junho de 2019. A análise lexical através do software IRaMuTeQ e a análise de conteúdo temática foram realizadas. Resultados: O acesso às tecnologias assistivas é a principal motivação para impetrações judiciais, com vistas a assegurar melhora no desenvolvimento da criança e consequente independência da criança. As decisões judiciais beneficiaram as crianças com SCZ, fundamentadas no direito à saúde, direito à vida e proteção, e o direito de ir e vir. Conclusão: Para mitigar os impactos da judicialização da saúde as autoridades sanitárias e judiciárias podem investir em melhor vigilância e monitoramento dos fatores de risco e morbidades; rigor nos protocolos sanitários que envolvem migração de pessoas em zonas fronteiriças; ofertas de condições ambientais e de moradia dignas; realização de cuidados preventivos com destaque para a eficiência da imunização; além da organização e funcionamento de uma rede de atenção à saúde eficaz com abordagem interdisciplinar.

Introducción: Las familias de personas menores con síndrome de zika congénito (SZC) viven con dificultades para satisfacer sus necesidades de salud, por lo que hacen un llamado al Poder Judicial para gozar de este derecho. Objetivo: Conocer las principales motivaciones de las demandas presentadas por madres de niños y niñas con SZC y sus desenlaces. Metodología: Estudio documental exploratorio con enfoque cualitativo, realizado en el sitio web de JusBrasil y recogido en marzo de 2020. Se incluyeron 15 juicios publicados entre enero de 2016 y junio de 2019 en JusBrasil. Se realizó el análisis léxico a través del software IRaMuTeQ y el análisis de contenido temático. Resultados: El acceso a las tecnologías asistenciales es la principal motivación de las demandas, con el fin de asegurar la mejora en el desarrollo de la persona menor y su consecuente independencia. Las decisiones judiciales beneficiaron a niñas y niños con SZC, basadas en los derechos a la salud, a la vida y protección y a ir y venir. Conclusiones: Para mitigar los impactos de la judicialización en salud, las autoridades sanitarias y judiciales pueden invertir en una mejor vigilancia y seguimiento de los factores de riesgo y morbilidades, rigor en los protocolos sanitarios que implican la migración de personas en zonas fronterizas, ofrecer condiciones ambientales y habitacionales dignas, realizar cuidados preventivos, con énfasis en la eficiencia de la inmunización, además de la organización y operación de una red de atención de salud efectiva con enfoque interdisciplinario.

Introduction: Families of children with Congenital Zika Syndrome (CSZ) live with difficulties to meet their health needs; therefore, they resort to the law system in order claim their right to health. Objective: To apprehend the main motivations and outcomes of the lawsuits filed by mothers of children with CSZ. Methodology: Exploratory documentary study with a qualitative approach carried out on the JusBrasil website and collected in March 2020. The study included 15 lawsuits published between January 2016 and June 2019 in JusBrasil. A lexical analysis through the IRaMuTeQ software and a thematic content analysis were performed. Results: The access to assistive technologies is the main motivation for the lawsuits; these are issued with the objective to ensure improvement in the child's development and further independence of the child. Court decisions benefited children with CSZ based on the right to health, the right to life and protection, and the right to come and go. Conclusion: To mitigate the impacts of health judicialization, health and judicial authorities can invest in better surveillance and monitoring of the risk factors and morbidities, strictness in the health protocols that involve migration of people in border areas, offering of decent environmental and housing conditions, execution of preventive care with emphasis on the efficiency of immunization, as well as the organization and execution of an effective health care network with an interdisciplinary approach.

Perspectivas dos profissionais de saúde sobre fatores que facilitam e dificultam o aleitamento materno de prematuros em unidade neonatal / Perspectives of health professionals on factors that facilitate and hinder breastfeeding in premature infants in a neonatal unit / Perspectivas de profesionales de salud sobre factores que facilitan y dificultan la lactancia materna de recién nacidos prematuros en una unidad neonatal

Objetivo: analisar os principais fatores que dificultam e facilitam o aleitamento materno de recém-nascidos prematuros na unidade neonatal, na perspectiva dos profissionais de saúde. Métodos: estudo transversal realizado com 148 profissionais de duas unidades neonatais. Os dados foram analisados por meio de estatística descritiva, teste de χ2 de Pearson, Exato de Fisher ou Mann-Whitney, com nível de significância de 5%. Resultados: destacaram-se entre os dificultadores de aleitamento materno de prematuros em unidades neonatais a condição clínica do prematuro (29,0%) e a condição emocional materna (27,0%). Como principal facilitador a vontade/desejo da mãe de amamentar (24,3%) e o apoio dos profissionais de saúde (23,0%); estes fatores foram distribuídos de modo semelhante nas instituições estudas, exceto infraestrutura da unidade neonatal, apontada como dificultador de aleitamento materno mais preponderante em uma das instituições (p = 0,002). Conclusão: profissionais de saúde consideraram o aleitamento materno do recém-nascido prematuro dependente, principalmente, das condições mãe-bebê. A promoção e o apoio ao aleitamento materno nas unidades neonatais ainda são um desafio para a prática profissional. Melhorar as condições de infraestrutura das unidades neonatais e reforçar as condições que favorecem a vontade/desejo da mãe de amamentar apresentam-se como perspectivas importantes.

Objective: to analyze the main factors that hinder and facilitate breastfeeding of preterm infants in the neonatal unit from the perspective of health professionals. Methods: cross-sectional study conducted with 148 professionals in two neonatal units. Data were analyzed using descriptive statistics, Pearson's χ2 test, and Fisher's Exact or Mann-Whitney's test, with a significance level of 5%. Results: the clinical condition of the preterm infant (29.0%) and the mother's emotional condition (27.0%) stood out among the main factors hindering breastfeeding preterm infants in neonatal units. The main facilitators were the mother's willingness/desire to breastfeed (24.3%) and the health professionals' support (23.0%); these factors were similarly distributed in the studied institutions, except for the neonatal unit's infrastructure, which was indicated as a more predominant breastfeeding hindering factor in one of the institutions (p = 0.002). Conclusion: healthcare professionals considered breastfeeding in premature newborns to depend mainly on mother-baby conditions. The promotion and support of breastfeeding in neonatal units are still a challenge for professional practice. Improving the infrastructure of neonatal units and strengthening the conditions that favor mothers' willingness/desire to breastfeed are important perspectives.

Objetivo: analizar los principales factores que dificultan y facilitan la lactancia materna de recién nacidos prematuros en unidad neonatal, desde la perspectiva de profesionales de salud. Métodos: estudio transversal realizado con 148 profesionales de dos unidades neonatales. Los datos se analizaron mediante estadística descriptiva, (prueba χ2 de Pearson, prueba exacta de Fisher o prueba exacta de Mann-Whitney), con un nivel de significación del 5%. Resultados: estado clínico del niño prematuro (29,0%) y estado emocional materno (27,0%) se destacaron entre los impedimentos para la lactancia materna de los niños prematuros. Principales facilitadores: voluntad/deseo de la madre de amamantar (24,3%) y apoyo de profesionales de salud (23,0%) los cuales se distribuyeron similarmente en las instituciones estudiadas, excepto la infraestructura de la unidad neonatal de una de las instituciones (p = 0,002). Conclusión: profesionales de salud consideraron que la lactancia materna del recién nacido prematuro dependía, principalmente, de condiciones materno-infantiles. La promoción y el apoyo a la lactancia materna en unidades neonatales es un reto para la práctica profesional. La mejora de condiciones de infraestructura de unidades neonatales y el refuerzo de condiciones que favorecen la voluntad/deseo de la madre de amamantar son perspectivas importantes.