Psychometric properties of the Portuguese version of the Personality Assessment Inventory: normative data and reliability.

Introduction: Originally published in the United States of America in 1991, the Personality Assessment Inventory (PAI) has been translated and adapted to a growing number of countries, but Portugal had yet to study its adequacy to the Portuguese population. Methods: The current study aimed to investigate the Portuguese normative data, the predictive effect of sociodemographic variables on the PAI scores, and the reliability of the Portuguese version of the PAI. Additionally, results were compared with other international versions of the PAI. The sample was comprised of 900 participants (age: M = 43.13, SD = 14.28, range = 18-75), recruited from various regions of Portugal. Results: Findings showed that the Portuguese sample scored higher than the U.S. and other international versions of the PAI in most scales. Sociodemographic variables (e.g., gender, age, and educational level) were significant predictors on PAI scores. The internal consistency of the Portuguese sample revealed lower values on the validity scales, but adequate on the clinical, treatment, and interpersonal scales. Overall, the Portuguese PAI revealed adequate psychometric properties, with normative results often superior to other international versions of the inventory. Discussion: It is a crucial step into the Portuguese adaptation and validation of this instrument, a measure with considerable potential in clinical, forensic, and research contexts. This adaptation may lead to the growth and development of the psychological assessment field in Portugal, and the opportunity to develop future cross-cultural studies with other international versions of the PAI.

Evaluating Personality Assessment Inventory Response Patterns in Active-Duty Personnel With Head Injury Using a Latent Class Approach.

OBJECTIVE: Previous research has found that among those with brain injury, individuals have a variety of different potential symptom sets, which will be seen on the Personality Assessment Inventory (PAI). The number of different groups and what they measure have varied depending on the study. METHOD: In active-duty personnel with a remote history of mild traumatic brain injury (n = 384) who were evaluated at a neuropsychology clinic, we used a retrospective database to examine if there are different groups of individuals who have distinct sets of symptoms as measured on the PAI. We examined the potential of distinct groups of respondents by conducting a latent class analysis of the clinical scales. Post hoc testing of group structures was conducted on concurrently administered cognitive testing, performance validity tests, and the PAI subscales. RESULTS: Findings indicate a pattern of broad symptom severity as the most probable reason for multiple groups of respondents, suggesting that there are no distinct symptom sets observed within this population. Pathology levels were the most elevated on internalizing and thought disorder scales across the various class solutions. CONCLUSION: Findings indicate that among active-duty service members with remote brain injury, there are no distinct groups of respondents with different sets of symptom types as has been found in prior work with other neuropsychology samples. We conclude that the groups found are likely a function of general psychopathology present in the population/sample rather than bona fide differences.

Marine litter on the beaches of the Kanyakumari, Southern India: An assessment of their abundance and pollution indices.

The problem of marine litter is increasing along the Indian coast. For conducting a baseline study to identify and assess the abundance, clean-coast index (CCI), and plastics abundance index (PAI) of marine litter were calculated on the beaches of Kanyakumari, Southern India. A total of 11,439 marine litter items were collected and classified into 33 groups along the 7 beaches of Kanyakumari. From the results, plastics were the most abundant items (65.08 %) followed by foam (21.93 %), along with cloths (4.59 %), rubber (3.09 %), papers (2.26 %), glass (2.16 %), metal (0.38 %), wood (0.26 %), and others (0.26 %). The average CCI value (27.24) indicates that all beaches are 'extremely dirty'; however, the PAI average value (4.37) indicates 'high abundance'. About 96.87 % of the marine litter originates from the land-based sources. This study provides an interpretive framework for further plastic pollution assessment, which could lead to a better marine litter management on Indian beaches.

Casa Colina Fall Risk Assessment Scale-Revised: Predicting Falls in Inpatient Rehabilitation Facilities.

Objective: To revise the Casa Colina Fall risk assessment scale (CCFRAS) using the new Medicare standards required functional ability quality measures and to assess the sensitivity and specificity of this revised fall risk assessment tool. Design: The Casa Colina Fall risk assessment scale-revised (CCFRAS-R) was assessed both retrospectively and prospectively on consecutive patients at 3 inpatient rehabilitation facilities (IRFs) to determine the sensitivity and specificity of this tool in predicting fall risk. Setting: Three IRFs. Participants: A total of 6253 adult patients (N=6253) admitted to 1 of 3 IRF settings including those with stroke, brain injury, spinal cord injury, and other conditions requiring medical rehabilitation, with mean age of 66 years; 50% were female and 50% were male. Interventions: Not applicable. Main Outcomes: Each IRF quantified the number of falls detected for the patient population under evaluation and determined the site-specific sensitivity and specificity of the CCFRAS-R. Results: Quality measures were analyzed for predicting fall risk using logistic regression analyses and found that impaired toileting hygiene, impaired toilet transfer, impaired chair/bed transfer, and difficulty walking 3 meters were the most significant predictors for falls. The area under the curve was used to determine the cut-off score and new scoring for the revised falls scale. A second data set was used to validate the tool showing a sensitivity and specificity of 0.6 and 0.62, respectively (P=.001). The degree of "agreeability" between the original scale and the revised scale was 0.72. Conclusion: This multi-site data set predicted quality measures for the risk of falling resulting in a revised fall risk assessment scale for IRFs. Evaluation of this revised assessment tool indicates that the CCFRAS-R is effective and broadly generalizable for predicting patients at high risk for falling although the sensitivity and specificity of the tool may vary slightly based on environmental differences and patient acuity.

Using smartphone-based ecological momentary assessment and personalized feedback for patients with chronic cancer-related fatigue: A proof-of-concept study.

Introduction: Chronic cancer-related fatigue (CCRF) is a complex multidimensional problem warranting person-centered care. Providing patients and therapists personalized feedback based on network analysis applied to ecological momentary assessment (EMA) data could facilitate case conceptualization in psycho-oncological care. The aim was to explore patients' and therapists' experiences of using an EMA app and personalized feedback based on network theory to aid case conceptualization in psycho-oncological care. Methods: A n = 5 proof-of-concept study was implemented in routine psycho-oncological care. We purposively selected adult cancer patients suffering from severe CCRF who were on the waitlist for psycho-oncological care. During a 3-week period participants filled out the EMA app Energy InSight (fatigue, mood, activity, responding, and context) five times a day. Participants received a descriptive and network feedback report, which they reflected upon during the first therapy sessions. Thematic analysis was used to analyze user experiences. Results: Patients experienced that filling out the Energy InSight app, as well as receiving descriptive and network-based personalized feedback provided them with insight into their CCRF. Although therapists experienced the discussion of network feedback as challenging, it facilitated the case conceptualization. Discussion: Using EMA during waitlist for psychological care seemed feasible. Patients experienced beneficial effects from filling out the EMA app and talking over the personalized feedback reports, which in turn aided case conceptualization and personalized care. Based on this evaluation, an improved version of the Energy InSight app and a therapist training for providing network feedback is developed for implementation in psycho-oncological care.

Psychopathy Profiles and Personality Assessment Inventory Scores in a Sex Offender Risk Assessment Field Setting.

A growing body of research suggests there are identifiable psychopathy subtypes among offenders scored on Hare's Psychopathy Checklist-Revised (PCL-R; Hare, 2003). We used latent profile analysis to examine the generalizability of these subtype findings to PCL-R scores (N = 615) assigned in a sex offender risk assessment field setting and to examine how offender subtypes differ on measures of comorbid psychopathology, risk, and treatment amenability from the Personality Assessment Inventory. Consistent with prior research, we identified four subtypes when using PCL-R scores from all offenders: Prototypic psychopathy (n = 239, 38.9%), callous-conning (n = 154, 25.0%), sociopathic (n = 96, 15.6%), and general offenders (n = 126, 20.5%). Prototypic and sociopathic subtypes exhibited the highest levels of comorbid psychopathology and risk for potential violence. We identified classes consistent with primary (n = 66, 36.7%) and secondary (n = 114, 63.3%) psychopathy among offenders with PCL-R total scores ≥ 25, and found higher levels of comorbid psychopathology and potential for violence among those in the secondary psychopathy class. Findings provide support the generalizability of existing PCL-R subtype findings to field scores and show how those with similar PCL-R total scores may differ on scores from commonly used multiscale inventories.

The Influence of Service Era: Comparing Personality Assessment Inventory (PAI) Scale Scores Within a Posttraumatic Stress Disorder Treatment Clinic (PCT).

Research is mixed on the role of service era in symptom endorsement among Veterans, with differences emerging depending on the instrument evaluated. This study compares Personality Assessment Inventory (PAI) scale scores of VA test-takers who served during the Vietnam, Desert Storm, or Post-9/11 service eras. The sample was collected at a VA Posttraumatic Stress Disorder Clinical Team. Associations between gender and combat exposure were also examined as covariates. Results suggest that Veterans' self-report on the PAI is influenced by service era, even after accounting for gender and combat exposure during deployment. The largest differences were between Vietnam or Post-9/11 Veterans and those from the Gulf War era. Symptom differences typically varied across scales commonly associated with symptoms of trauma exposure/posttraumatic stress disorder. Implications for the clinical use of, and research with, the PAI and other broadband personality assessments within the VA healthcare system and trauma treatment settings are discussed.

Relationship of Personality Assessment Inventory (PAI) over-reporting scales to performance validity testing in a military neuropsychological sample.

This study evaluated the Personality Assessment Inventory's (PAI) symptom validity-based over-reporting scales with concurrently administered performance validity testing in a sample of active-duty military personnel seen within a neuropsychology clinic. We utilize two measures of performance validity to identify problematic performance validity (pass all/fail any) in 468 participants. Scale means, sensitivity, specificity, predictive value, and risk ratios were contrasted across symptom validity-based over-reporting scales. Results indicate that the Negative Impression Management (NIM), Malingering Index (MAL), and Multiscale Feigning Index (MFI) scales are the best at classifying failed performance validity testing with medium to large effects (d = .61-.73). In general, these scales demonstrated high specificity and low sensitivity. Roger's Discriminant Function (RDF) had negligible group differences and poor classification. The Feigned Adult ADHD index (FAA) performed inconsistently. This study provides support for the use of several PAI over-reporting scales at detecting probable patterns of performance-based invalid responses within a military sample. Military clinicians using NIM, MAL, or MFI are confident that those who elevate these scales at recommended cut scores are likely to fail concurrent performance validity testing. Use of the Feigned Adult FAA and RDF scales is discouraged due to their poor or mixed performance.

Defining the Value of Analgesia for Total Knee Arthroplasty Using Time-Driven Activity-Based Costing: A Novel Approach to Clinical Practice Transformation.

OBJECTIVE: To compare the relative value of 3 analgesic pathways for total knee arthroplasty (TKA). PATIENTS AND METHODS: Time-driven activity-based costing analyses were performed on 3 common analgesic pathways for patients undergoing TKA: periarticular infiltration (PAI) only, PAI and single-injection adductor canal blockade (SACB), and PAI and continuous adductor canal blockade (CACB). Additionally, adult patients who underwent elective primary TKA from November 1, 2017, to May 1, 2018, were retrospectively identified to analyze analgesic (pain score, opiate use) and hospital outcomes (distance walked, length of stay) after TKA based on analgesic pathway. RESULTS: There was no difference in patient demographic characteristics, specifically complexity (American Society of Anesthesiologists score) or preoperative opiate use, between groups. Compared with PAI, total cost (labor and material) was 1.4-times greater for PAI plus SACB and 2.3-times greater for PAI plus CACB. The addition of SACB to PAI resulted in lower average and maximum pain scores and opiate use on the day of operation compared with PAI alone. Average and maximum pain scores and opiate use between SACB and CACB were not significantly different. Walking distance and hospital length of stay were not significantly different between groups. CONCLUSION: Perioperative care teams should consider the cost and relative value of pain management when selecting the optimal analgesic strategy for TKA. Despite slightly higher relative cost, the combination of SACB with PAI may offer short-term analgesic benefit compared with PAI alone, which could enhance its relative value in TKA.

Longitudinal Assessment of Cytokine Expression and Plasminogen Activation in Hantavirus Cardiopulmonary Syndrome Reveals Immune Regulatory Dysfunction in End-Stage Disease.

Pathogenic New World orthohantaviruses cause hantavirus cardiopulmonary syndrome (HCPS), a severe immunopathogenic disease in humans manifested by pulmonary edema and respiratory distress, with case fatality rates approaching 40%. High levels of inflammatory mediators are present in the lungs and systemic circulation of HCPS patients. Previous studies have provided insights into the pathophysiology of HCPS. However, the longitudinal correlations of innate and adaptive immune responses and disease outcomes remain unresolved. This study analyzed serial immune responses in 13 HCPS cases due to Sin Nombre orthohantavirus (SNV), with 11 severe cases requiring extracorporeal membrane oxygenation (ECMO) treatment and two mild cases. We measured viral load, levels of various cytokines, urokinase plasminogen activator (uPA), and plasminogen activator inhibitor-1 (PAI-1). We found significantly elevated levels of proinflammatory cytokines and PAI-1 in five end-stage cases. There was no difference between the expression of active uPA in survivors' and decedents' cases. However, total uPA in decedents' cases was significantly higher compared to survivors'. In some end-stage cases, uPA was refractory to PAI-1 inhibition as measured by zymography, where uPA and PAI-1 were strongly correlated to lymphocyte counts and IFN-γ. We also found bacterial co-infection influencing the etiology and outcome of immune response in two cases. Unsupervised Principal Component Analysis and hierarchical cluster analyses resolved separate waves of correlated immune mediators expressed in one case patient due to a sequential co-infection of bacteria and SNV. Overall, a robust proinflammatory immune response, characterized by an imbalance in T helper 17 (Th17) and regulatory T-cells (Treg) subsets, was correlated with dysregulated inflammation and mortality. Our sample size is small; however, the core differences correlated to survivors and end-stage HCPS are instructive.

Specificity and item endorsement rates of personality assessment inventory over-reporting scales across ethnic, gender, and diagnostic groups in a forensic inpatient sample.

The accurate evaluation of response style, particularly with respect to overreporting, is imperative in forensic settings wherein an external incentive to feign exists. Given the high cost of false positive errors in this context, as well as the associated cost of false negative errors, evaluators need to ensure that overreporting methods are effective with the unique patient populations with whom they work. Complicating this issue is that forensic samples often differ in predictable ways from the normative samples upon which typical psychological assessment instruments were normed. The purpose of the present investigation was to evaluate the specificity of the overreporting indices on the Personality Assessment Inventory, one of the most commonly used personality inventories, in a forensic sample with no ostensible incentive to feign. Although item endorsement and configural elevations on the Negative Impression Management (NIM) scale and the Malingering Index (MAL) were associated with genuine psychopathology, results indicated that the overall specificity estimates across groups were generally adequate. Further, and consistent with prior research, Rogers Discriminant Function (RDF) performed poorly in this sample.

Personality Assessment Inventory Cognitive Bias Scale: Validation in a Military Sample.

OBJECTIVE: Recently, in a mixed neuropsychological outpatient sample, a measure of cognitive response bias has been developed for the Personality Assessment Inventory (PAI) called the Cognitive Bias Scale (CBS). This study sought to cross-validate this measure in a military sample. METHOD: Retrospective review of 197 active duty soldiers referred to an Army outpatient clinic for neuropsychological evaluation. Groups were created based on the number of failed performance validity tests (0, 1, or 2-3 performance validity testing [PVT] failures). RESULTS: The magnitude of effect for the 10-item CBS scale was medium-to-large when comparing those with one PVT failure to those with two to three (d = .98) and those with no failures (d = 1.21); however, effects between the 1 and 2-3 PVT failure groups were less pronounced. In 1 and 2-3 PVT failure groups, a score of $\ge$16 had high specificity (.92 and .95, respectively) and low to moderate sensitivity (.20 and .55, respectively). CONCLUSIONS: In a military sample, the CBS demonstrated high specificity with relatively low sensitivity. The measure operated similarly to the original study and the current data supports the CBS to rule in, but not rule out, over-reported cognitive symptoms on the PAI.

A comparison of sociodemographic and psychological characteristics among intended parents, surrogates, and partners involved in Australian altruistic surrogacy arrangements.

OBJECTIVE: To characterize the sociodemographic and psychological profiles of participant groups involved in altruistic surrogacy in Australia. DESIGN: Cross-sectional study. SETTING: Single psychological practice in Sydney, Australia. PATIENT(S): Six hundred and two individuals involved in 160 altruistic surrogacy arrangements: 143 intended mothers, 175 intended fathers (including 17 same-sex intended father couples), 160 surrogates, and 124 surrogate partners. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Responses to a presurrogacy sociodemographic assessment counseling protocol and the Personality Assessment Inventory (PAI). RESULT(S): The surrogates were primarily sisters, sisters-in-law, mothers (48.6%), or other extended family or friends (46.3%) of the intended parents. Most participants resided in residential postcode areas within the highest socioeconomic status quintile; however, intended mothers were more likely than surrogates to live in the most advantaged residential areas, to be younger and be more educated, and to be employed in professional occupations. Most participant psychological profiles were normal. A statistically significantly elevated PAI Somatic Complaints-Health Concerns subscale for intended mothers was observed compared with other participant groups. The higher PAI Warmth scale scores of intended mothers and surrogates were statistically significantly different from their respective partners, although not different from each other. CONCLUSION(S): Sociodemographic and some psychological differences between participant groups were observed that warrant exploration in pretreatment surrogacy counseling. Importantly, the higher scores on the PAI Warmth scale exhibited by intended mothers and surrogates in the context of close family and friendship relationships are likely to serve as protective mechanisms for the altruistic surrogacy outcome.

Assessing Autism Spectrum Disorder in Intellectually Able Adults with the Personality Assessment Inventory: Normative Data and a Novel Supplemental Indicator.

Differential diagnosis of autism spectrum disorder (ASD) among intellectually-able adults often presents a clinical challenge, particularly when individuals present in crisis without diagnostic history. The Personality Assessment Inventory (PAI) is a multiscale personality and psychopathology instrument utilized across clinical settings, but to date there are no published normative data for use of the PAI with adults with ASD. This study provides normative PAI data for adults diagnosed with ASD, with effect size comparisons to the PAI clinical standardization sample and an inpatient sample. Additionally, a discriminant function was developed and cross-validated for identification of ASD-like symptomatology in a clinical population, which demonstrates promise as a screening tool to aid in the identification of individuals in need of specialized ASD assessment.

Malingering and Defensiveness on the Spanish Personality Assessment Inventory: An Initial Investigation with Mostly Spanish-Speaking Outpatients.

Psychological assessments can be essentially invalidated by examinees' intentional response styles, such as feigning (i.e., fabrication or marked overreporting of symptoms/impairment) and defensiveness (i.e., denial or minimization of symptoms/impairment). As a psychometric strength, the Personality Assessment Inventory (PAI) has established validity indicators for identifying both response styles. With the United States' increasing ethnic and cultural diversity, predominantly Spanish-speaking individuals are now estimated in the range of 15 million persons. Unfortunately, very little research has been conducted on the Spanish-translated PAI regarding its effectiveness in clinical populations. Using a between-subjects design, a sample of mostly Spanish-speaking outpatients was randomly assigned to genuine, feigning, or defensive conditions. For feigning, PAI malingering indicators using rare symptoms strategies (i.e., Negative Impression [NIM] and Negative Distortion [NDS] scales) demonstrated moderate to large effect sizes. For defensiveness, the Defensive (DEF) index proved the most effective with a very large effect size (M = 1.68). Different cut scores were examined to increase the clinical utility of the Spanish PAI for determining response styles.

The Personality Assessment Inventory Alcohol Scale in Veterans With PTSD: Convergent and Discriminant Relations With the Alcohol Use Disorders Identification Test.

In this study, we examined the validity of the Personality Assessment Inventory Alcohol (ALC) scale in 736 male veterans presenting for formal evaluation of posttraumatic stress disorder (PTSD). The ALC scale exhibited convergence with other measures of alcohol problems, and this convergence was similar for veterans with and without formal PTSD diagnosis. When predicting alcohol consumption via the Alcohol Use Disorders Identification Test (AUDIT), the ALC scale also displayed substantial incremental validity over the effects of demographics and MMPI-2 MacAndrew Alcohol Scale. Using a standard alcohol consumption cut score on the AUDIT, the ALC scale displayed good specificity and (generally) good sensitivity across three common cut scores. PTSD severity did not significantly affect the association between the ALC composite and alcohol consumption via the AUDIT. Taken together, results suggested that the ALC can provide valid assessment of alcohol use among treatment seeking veterans.

A novel machine learning-derived decision tree including uPA/PAI-1 for breast cancer care.

Background uPA and PAI-1 are breast cancer biomarkers that evaluate the benefit of chemotherapy (CT) for HER2-negative, estrogen receptor-positive, low or intermediate grade patients. Our objectives were to observe clinical routine use of uPA/PAI-1 and to build a new therapeutic decision tree integrating uPA/PAI-1. Methods We observed the concordance between CT indications proposed by a canonical decision tree representative of French practices (not including uPA/PAI-1) and actual CT prescriptions decided by a medical board which included uPA/PAI-1. We used a method of machine learning for the analysis of concordant and non-concordant CT prescriptions to generate a novel scheme for CT indications. Results We observed a concordance rate of 71% between indications proposed by the canonical decision tree and actual prescriptions. Discrepancies were due to CT contraindications, high tumor grade and uPA/PAI-1 level. Altogether, uPA/PAI-1 were a decisive factor for the final decision in 17% of cases by avoiding CT prescription in two-thirds of cases and inducing CT in other cases. Remarkably, we noted that in routine practice, elevated uPA/PAI-1 levels seem not to be considered as a sufficient indication for CT for N≤3, Ki 67≤30% tumors, but are considered in association with at least one additional marker such as Ki 67>14%, vascular invasion and ER-H score <150. Conclusions This study highlights that in the routine clinical practice uPA/PAI-1 are never used as the sole indication for CT. Combined with other routinely used biomarkers, uPA/PAI-1 present an added value to orientate the therapeutic choice.

Longitudinal assessment of D-dimer and plasminogen activator inhibitor type-1 plasma levels in pregnant women with risk factors for preeclampsia.

OBJECTIVE: Investigating D-Dimer/D-Di and plasminogen activator inhibitor type-1/PAI-1 levels throughout gestation in women with preeclampsia/PE risk factors. METHODS: D-Di and PAI-1 plasma levels were determined in 28 women at 12-19, 20-29, 30-34 and 35-40 weeks of gestation. RESULTS: D-Di was lower at 12-19 weeks and higher at 30-34 weeks in women who developed PE versus who did not develop it. D-Di increased throughout gestation in both groups, peaking earlier in pregnant women who developed PE versus who did not develop it. PA1-1 increased across gestation, but it didn't differ between groups. CONCLUSION: D-Di was able to discriminate these groups of women at 12-19 and 30-34 weeks of gestation.

Who Are the Turkers? A Characterization of MTurk Workers Using the Personality Assessment Inventory.

As online data collection services such as Amazon's Mechanical Turk (MTurk) gain popularity, the quality and representativeness of such data sources have gained research attention. To date, the majority of existing studies have compared MTurk workers with undergraduate samples, localized community samples, or other Internet-based samples, and thus, there remains little known about the personality and mental health constructs of MTurk workers relative to a national representative sample. The present study addresses these limitations and broadens the scope of existing research through the use of the Personality Assessment Inventory, a multiscale, self-report questionnaire which provides information regarding data validity and personality and psychopathology features standardized against a national U.S. census-matched normative sample. Results indicate that MTurk workers generally provide high-quality data and are reasonably representative of the general population across most psychological dimensions assessed. However, several distinguishing features of MTurk workers emerged that were consistent with prior findings of such individuals, primarily involving somewhat higher negative affect and lower social engagement.

Participação paterna no cuidado e no acompanhamento do crescimento e desenvolvimento da criança / Parental involvement in the care and monitoring of child growth and development

Objetivo: conhecer a participação paterna no cuidado e no acompanhamento do crescimento e desenvolvimento da criança em uma Unidade de Saúde da Família. Metodologia: estudo descritivo e exploratório, com abordagem qualitativa, realizado em uma Unidade de Saúde da Família do município de Novo Hamburgo/RS. Os dados foram coletados pela entrevista semiestruturada individual e analisados utilizando-se a análise temática de conteúdo. Resultados: as categorias "Participação paterna no pré-natal, nascimento e convívio com a criança"; "Cuidado integral à saúde da criança" e "Sentimento paterno" mostraram que o homem está mais atuante desde o pré-natal ao nascimento do filho, com repercussões no seu envolvimento no cuidado integral da criança. Isto é evidenciado na forma de cuidados de higiene e alimentação e pelo acompanhamento de saúde e vacinas. As interações pai-filho por meio das atividades que realizam juntos nem sempre ocorrem de maneira clara e consciente, evidenciando que existe uma carência de informações a ser suprida. Conclusões: a equipe de saúde deve estar atenta no sentido de compreender a importância da participação paterna no crescimento e desenvolvimento da criança, e, dessa forma, fornecer aos pais as informações necessárias para que ela se concretize em sua amplitude. (AU)