The process in-between: Parents' perceptions about how practitioners promote the outcomes of the Incredible Years Basic program.

Practitioners are recognized as one of the key components that make parenting interventions meaningful and helpful to families, and the impact of practitioners' skills on the outcomes of parenting interventions has been consistently recognized in research. However, the mechanisms and ongoing processes through which the practitioners' actions and skills may impact parental engagement and other outcomes remain unknown. This qualitative study explored parents' perceptions about the processes through which specific practitioners' skills contribute to the outcomes of the Incredible Years Basic Parent Program (IYPP). Twenty-four Portuguese parents who had completed the IYPP were interviewed in four focus groups, and the data were analyzed through thematic analysis. Practitioners' skills were perceived by parents as having an impact on their engagement in the program, their process of change, and their interpersonal relationships. Practitioners were perceived to demonstrate their influence in the intervention process through six different roles: the roles of a confidant, a positive coach, a partner, a maestro, a tailor, and a congruent person. This study reinforces the prominent role of practitioners in enabling parental outcomes of an evidence-based parenting program and suggests that more attention should be paid to continuing supervision and other professional development processes.

Does Social and Economic Disadvantage Predict Lower Engagement with Parenting Interventions? An Integrative Analysis Using Individual Participant Data.

There is a social gradient to the determinants of health; low socioeconomic status (SES) has been linked to reduced educational attainment and employment prospects, which in turn affect physical and mental wellbeing. One goal of preventive interventions, such as parenting programs, is to reduce these health inequalities by supporting families with difficulties that are often patterned by SES. Despite these intentions, a recent individual participant data (IPD) meta-analysis of the Incredible Years (IY) parenting program found no evidence for differential benefit by socioeconomic disadvantage (Gardner et al. in Public Health Resesearch 5, 1-144, 2017). However, it did not examine whether this was influenced by engagement in the intervention. Using intervention arm data from this pooled dataset (13 trials; N = 1078), we examined whether there was an SES gradient to intervention attendance (an indicator of engagement). We ran mixed-effects Poisson regression models to estimate incidence rate ratios (IRRs) for program attendance for each of five (binary) markers of SES: low income; unemployment; low education status; teen parent; and lone parent status. The multilevel structure of the data allowed for comparison of within-trial and between-trial effects, including tests for contextual effects. We found evidence that low SES was associated with reduced attendance at parenting programs-an 8-19% reduction depending on the SES marker. However, there was no evidence that this association is impacted by differences in SES composition between trials or by the attendance levels of higher-SES families. The findings underscore the importance of developing and prioritizing strategies that enable engagement in parenting interventions and encourage program attendance by low-SES families.

Therapist Factors Matter: A Systematic Review of Parent Interventions Directed at Children's Behavior Problems.

The present review systematically explored research examining the relationship between therapist-related factors and the outcomes of parent interventions directed at children's behavior problems. A systematic search of the literature was conducted with online scientific databases, parenting programs, web sites, and bibliographic references of the selected articles, according to PRISMA guidelines. A total of 24 quantitative studies met the inclusion criteria. Although some methodological limitations were identified with respect to the measurement of therapist factors, the reviewed research strongly suggests that the therapist plays a critical role in parent interventions directed at behavior problems. In particular, many parent outcomes are found to be related to the parent-therapist alliance, the therapist's fidelity to the intervention, specific therapist's in-session actions, and the therapist's personal variables. The parent-therapist alliance and therapist fidelity to the intervention consistently relate to changes in parenting practices, and alliance additionally relates to fewer perceived barriers to participation in treatment, more treatment acceptability, and greater parenting satisfaction and self-efficacy. In addition, specific in-session therapist interpersonal actions relate to parents' engagement and satisfaction, while both the therapist's interpersonal actions and more active skills relate to parent change. Therapist's personal variables have been scarcely or poorly studied to date, but the results found justify the need to develop further research in this area. In conclusion, more attention should be given to the role of the therapist when implementing parenting programs directed at behavior problems, and more and better research is needed that can overcome the methodological limitations identified.

La presente revisión exploró de forma sistemática las investigaciones que examinam la relación entre los factores relacionados con el terapeuta y los resultados de intervenciones para padres de niños con problemas de conducta. Se realizó una búsqueda sistemática de la bibliografía con bases de datos científicas en línea, sitios web de programas de entrenamiento para padres y referencias bibliográficas de los artículos seleccionados, de acuerdo con las pautas de PRISMA. Un total de 24 estudios cuantitativos reunieron los criterios de inclusión. Aunque se identificaron algunas limitaciones metodológicas con respecto a la medición de los factores del terapeuta, la investigación analizada sugiere marcadamente que el terapeuta desempeña un papel crítico en las intervenciones dirigidas a padres de niños con problemas de conducta. En particular, muchos resultados de los padres se encuentran relacionados con la alianza entre los padres y el terapeuta, la fidelidad del terapeuta a la intervención, las acciones específicas del terapeuta dentro de la sesión y las variables personales del terapeuta. La alianza entre los padres y el terapeuta y la fidelidad del terapeuta a la intervención se relacionan constantemente con los cambios en las prácticas parentales, y la alianza además se relaciona con menos obstáculos percibidos para la participación en el tratamiento, una mayor aceptabilidad de lo mismo y una mayor satisfacción y autoeficacia de los padres. Además, las acciones interpersonales específicas del terapeuta dentro de la sesión se relacionan con la participación y la satisfacción de los padres, mientras que tanto las acciones interpersonales del terapeuta como las habilidades más activas se relacionan con el cambio de las praticas parentales. Hasta la fecha, las variables personales del terapeuta se han estudiado poco o deficientemente, pero los resultados encontrados justifican la necesidad de desarrollar la investigación en esta área. Para concluir, se debe prestar más atención al papel del terapeuta a la hora de implementar programas de entrenamiento para padres de niños con problemas de conducta, y se necesitan más y mejores investigaciones que puedan superar las limitaciones metodológicas identificadas.

The Brazilian-Portuguese version of the Parental Burnout Assessment: Transcultural adaptation and initial validity evidence.

This study aimed to examine the validity of the Brazilian-Portuguese version of the Parental Burnout Assessment (PBA), the current gold-standard measure of parental burnout (PB). We surveyed parents in Portugal (N = 407) and Brazil (N = 301). We (a) compared the factor structure of the Brazilian-Portuguese version with the original structure of the PBA, (b) tested the adequacy of a second-order factor structure, (c) evaluated invariance across gender and countries, (d) examined reliability, and (e) evaluated whether PB levels are related to gender, satisfaction with life, and parental self-efficacy (PSE). Results provided evidence for the validity of the Brazilian-Portuguese PBA and its four facets. Factor models supported the use of both individual facet scores and a global PB score. The structures tested were invariant across countries and gender, and all factors had good reliability. Relations with PSE, life satisfaction, and gender provided initial evidence for validity, and suggested a possible influence of intensive motherhood models.

Co-occurring change in children's conduct problems and maternal depression: Latent class individual participant data meta-analysis of the Incredible Years parenting program.

Children vary in the extent to which they benefit from parenting programs for conduct problems. How does parental mental health change if children benefit less or more? We assessed whether changes in conduct problems and maternal depressive symptoms co-occur following participation in the Incredible Years parenting program. We integrated individual participant data from 10 randomized trials (N = 1280; children aged 2-10 years) and distinguished latent classes based on families' baseline and post-test conduct problems and maternal depressive symptoms, using repeated measures latent class analysis (RMLCA) and latent transition analysis (LTA). Classes differed mainly in severity of conduct problems and depression (RMLCA; 4 classes). Conduct problems reduced in all classes. Depressive symptoms did not change in most classes, except in a class of families where conduct problems and depression were particularly severe. Incredible Years led to a greater likelihood of families with particularly severe conduct problems and depression moving to a class with mild problems (LTA; 3 classes). Our findings suggest that for the majority of families, children's conduct problems reduce, but maternal depressive symptoms do not, suggesting relative independence, with the exception of families with severe depression and severe conduct problems where changes for the better do co-occur.

Conjunctival melanoma: association of cyclooxygenase-2 tumor expression to prognosis.

PURPOSE: Conjunctival melanoma is a rare but potentially lethal tumor. Its biologic profile is still largely unknown, with recent studies aiming at establishing histopathological and genetic tumor profiles. The aim of this study was to analyze the association between clinicopathological characteristics and tumor expression of cyclooxygenase-2 (COX-2) to prognosis, assessing its usefulness as a possible prognostic marker. METHODS: Case series of 50 patients from 1991 to 2008 with pathologically proven conjunctival melanoma. Demographic, clinical, and pathological characteristics were evaluated by reviewing clinical files and pathology. Expression of COX-2 was studied by immunohistochemistry of formalin-fixed paraffin-embedded tissue samples of 20 melanomas. Samples were classified in a score which included intensity of staining and percentage of cells with positive reactivity. RESULTS: Clinicopathological features significantly associated (p < .05) with a poor prognosis (death) included involvement of fornix and tarsal conjunctiva, tumor thickness exceeding 2 mm, local tumor recurrence, lymph node, and systemic metastasis. In the immunohistochemistry study (n = 20), 18 cases expressed COX-2 although with different scores. However, only cases with a high score were associated with a poor outcome. Multivariate association analysis revealed that recurrence rate, metastasis, corneal invasion, and tumor thickness were associated with high score cases and, therefore, with a clinical profile with a higher risk of death. CONCLUSIONS: Results suggest that higher COX-2 expression may be a negative prognostic factor in conjunctival melanoma. Further studies can address the potential use of anti-COX-2 drugs as adjuvant therapy of this disease.

Quality of the leader-member relationship and the organizational commitment of nurses. / A qualidade da relação líder-membro e o empenhamento organizacional dos enfermeiros.

OBJECTIVE: To understand the perception of the quality of leadership relationships and the organizational commitment of nurses, and to analyze the influence of this relationship quality. METHOD: Cross-sectional and correlational study, with a quantitative approach, using a non-probability convenience sampling with 408 nurses. The data were collected through questionnaires at Central Hospital in Lisbon, between January and March 2013. The statistical analysis of the data was carried out using IBM® SPSS® Statistics 19 software. RESULTS: Three hundred forty-two questionnaires were considered valid. The quality of the leadership relationship was satisfactory, and the nurses were poorly committed to the organization. The quality of the leadership relationship was statistically correlated with organizational commitment: there was found a moderate association to affective commitment (rs=0.42, p<0.05), a low association with the normative commitment (rs=0.37, p<0.05), and a very low association with the calculative commitment (rs=0.14, p<0.05). CONCLUSION: Leadership exerts influence on organizational commitment. An opportunity to improve the quality of the leadership relationship between nurses and their leaders was found, with the consequent possibility of developing organizational commitment.

Leadership in nursing and patient satisfaction in hospital context. / A liderança em enfermagem e a satisfação dos pacientes em contexto hospitalar.

Objectives to know the quality of the leadership relationship from the perspective of a chief nurse and nurse, patient satisfaction, the relationship between the quality of the relationship perceived for both and patient satisfaction. Methods a quantitative, transverse and correlational approach. Non-probabilistic convenience sample consists of 15 chief nurses, 342 nurses, 273 patients. Data collected at the Central Lisbon Hospital Center, between January and March 2013, through the LMX-7, CLMX-7 and SUCEH21 scales. Statistical analysis was performed through SPSS ® Statistics 19. Results the chief nurse considers the quality of the leadership relationship good, the nurses consider it satisfactory, patients are considered to be satisfied with nursing care; there is a statistically significant correlation between the quality of the leadership relationship from the perspective of chief nurses and patient satisfaction, there is no statistically significant correlation between the quality of the leadership relationship in the nurse's perspective and satisfaction. Conclusion the chief nurse has a major role in patient satisfaction.

A parent-based intervention programme involving preschoolers with AD/HD behaviours: are children's and mothers' effects sustained over time?

To evaluate the 12-month efficacy of a parent-based intervention programme on children's and mothers' outcomes in a sample of Portuguese preschoolers displaying early hyperactive and inattentive behaviours (AD/HD behaviours), 52 preschool children whose mothers had received the Incredible Years basic parent training (IY) were followed from baseline to 12 months of follow-up. Reported and observational measures were used. Effects were found in the children's reported AD/HD behaviours at home and at school after 12 months. Large effect sizes were also found in mothers' variables: a decrease in self-reported dysfunctional parenting practices and an improved sense of competence and observed positive parenting. However, the improvements in coaching skills that have been observed after 6 months of follow-up decreased over time. No other significant differences were found between 6 and 12 months follow-up, with small effect sizes indicating that the significant post-intervention changes in child and parenting measures were maintained. After 12 months of follow-up, there was a clinically important reduction of over 30 % in reported AD/HD behaviours in 59 % of children. The sustained effects observed both for children and their mothers suggest long-term benefits of IY. Therefore, efforts should be made by Portuguese policy makers and professionals to deliver IY as an early preventive intervention for children displaying early AD/HD behaviours.

Implementation in the "real world" of an evidence-based social and emotional learning program for teachers: effects on children social, emotional, behavioral and problem solving skills.

Introduction: The delivery of social and emotional learning (SEL) programs that are developmentally school-based and evidence-based has the potential to benefit many children, and as such, greater efforts are needed to disseminate these programs more widely within the community. The Incredible Years® Teacher Classroom Management (IY-TCM) has shown promising results when applied by teachers in preschool centers and primary schools, as seen in several randomized control trials conducted worldwide, including in Portugal. Methods: The current study presents a model of the implementation of the program within the framework of a nationwide initiative undertaken in Portugal: the Academias Gulbenkian do Conhecimento. Additionally, results of the program's impact on children were explored using ANOVA, which compared pre- to post- treatment outcomes. To assess which factors affected the efficacy of the intervention, moderation analyses were conducted using the MEMORE macro. Ninety teachers and 535 children (2 to 10 years old) were assessed. Results: Results revealed that children showed significant increases in social and emotional skills (e.g., social adjustment, empathy) and significant reductions in problem behavior when assessed by their teachers, and in social-cognitive problem solving strategies as evaluated by a set of problem-solving tasks. Moderation analyses showed that, in general, interaction effects were not found, meaning that the intervention was effective for almost all conditions. Nevertheless, significant moderation effects were found for factors pertaining to the child and the mother with respect to pro-social and emotional skills (children who benefited most from the intervention exhibited more behavioral difficulties at the baseline according to the teachers' perceptions and had mothers without a university degree; children attending primary school took less benefit from the intervention than those attending pre-school). Discussion: The findings contribute both to the reinforcement of the effectiveness of the IY-TCM program as a universal intervention in "real world" schools and to the development of some guidelines for the promotion of effective scaling up and sustainability of program effects.

Developing a Valid and Reliable Cross-cultural Measure of Coparenting Conflict between Divorced Parents: The Portuguese Version of the Acrimony Scale.

Coparenting conflict is predictive of parents' and children's adjustment to divorce. An accurate assessment of postdivorce acrimonious coparenting relationships is critical for research, clinical, forensic, and public policy purposes. The Acrimony Scale (AS) is a measure commonly used to assess coparenting conflict. We translated and cross-culturally adapted the AS to the Portuguese context, testing its reliability and validity. Using a web-based survey, data were collected from a community and convenience sample of 196 unrelated divorced parents, assessing sociodemographic characteristics, coparenting conflict, and divorce adjustment. The study consisted of two phases: (1) forward-backward translation and cultural adaptation and (2) psychometric properties analyses: construct and criterion-related validity and internal consistency reliability. The 25-item AS was successfully translated and cross-culturally adapted to the Portuguese language. Principal component analyses (PCA) suggested a three-factor structure solution of 22-items, explaining 57.5% of the variance. Confirmatory factor analysis (CFA) showed the goodness of fit of this tridimensional model. The results also demonstrated acceptable convergent and good discriminant validity and high internal reliability. Scores on the AS suggested good known-groups validity and high discriminative power with 86.7% classification accuracy. The area under the ROC curve was 0.91, establishing a very good predictive value of the scale. We suggest that the AS is a reliable multidimensional measure to assess coparenting conflict after divorce and may be useful, namely, in the psychological assessment of child custody and evaluation of the effectiveness of coparenting conflict-based interventions. We discussed future research and practical implications.

Do Parents Perceive Practitioners to Have a Specific Role in Change? A Longitudinal Study Following Participation in an Evidence-Based Program.

Little attention has been given to the role of practitioners in evidence-based parenting programs and to the evaluation that parents make of their importance in the process of change. This study aims to explore the role that parents assign to the facilitators of the Incredible Years (IY) program in enabling long-term life changes, as well as the association between parents' evaluation of the practitioners' skills and specific changes perceived after the intervention. In this longitudinal study, we applied 1 survey to 80 community parents who had participated in an IY group 2 years before, and we retrieved archival data to assess changes in parents' ratings of sense of competence and in children's behaviors immediately after the end of the intervention. Two years after the intervention, parents perceived significant improvements, especially in their parenting and their children's behaviors, and they recognized that their IY practitioners had played a significant role in these life changes. Parents who attributed a greater role to the practitioners' skills reported a greater number of improvements in parental sense of competence and in children's behaviors. The practitioners' skills relating more broadly to these specific changes are the practitioners' sensitivity and flexibility towards parents' needs and the practitioners' ability to clearly share knowledge with parents. The practitioner's assigned role when implementing an evidence-based parenting program seems to go far beyond the mere conveyance of the program's specific contents and methods and deserves to be researched further.

Instruments for measuring incidents related to patient safety in the context of paediatric intensive care-protocol for a scoping review.

BACKGROUND: Patient safety is a fundamental principle of health care but is one of the biggest challenges currently faced and a serious public health problem, since the occurrence of adverse events is probably one of the main causes of morbidity and mortality worldwide. The vulnerability of the paediatric population, combined with the potentially dangerous context of intensive care, makes Paediatric Intensive Care Units services of particular complexity in matters of safety, where there is a greater likelihood of incidents with serious consequences. It is agreed that research on the topic of PS should start with the measuring of different types of harm that exist in the contexts, to identify high-risk areas and define priorities. For this, it is necessary to resort to a multiplicity of valid, reliable and specific measurement instruments and to learn their advantages and limitations. The objective of this review will be to identify and map in scientific literature the instruments for measuring incidents related to patient safety applicable in the context of paediatric intensive care. METHODS: This review will cover studies and documents that refer to all measurement instruments used in the field of patient safety in a context of paediatric intensive care. Quantitative, qualitative, or mixed nature published studies, as well as grey literature, produced in the last 5 years and relevant to the topic will be included, in Portuguese, English or Spanish languages. The sources of information include several databases (such as MEDLINE, CINAHL, Cochrane Library, JBI Databases) and sources relevant to grey literature. Two reviewers will independently screen all citations, full-text articles and abstract data. The extracted data, after being organised in the extraction table, will be mapped in a descriptive and logical way, taking into account the defined review questions. DISCUSSION: The mapping of the tools in these protocols will allow to summarise the most widely used instruments, to know their specificities and to guide researchers to use the most appropriate measurement tools for their context, specifically, in paediatric intensive care. SYSTEMATIC REVIEW REGISTRATION: Open Science Framework ( osf.io/b5m7j ).

Parental Burnout and the COVID-19 Pandemic: How Portuguese Parents Experienced Lockdown Measures.

Objective: This work aimed to analyze parental burnout (PB) and establish a comparison between the times before (Wave 1) and during (Wave 2) the COVID-19 pandemic. Background: The COVID-19 pandemic brought additional stress to families. The pandemic could be particularly difficult for parents experiencing parental burnout, a condition that involves four dimensions: an overwhelming sense of exhaustion, emotional distancing from the child, saturation or a loss of fulfillment with the parental role, and a sharp contrast between how parents used to be and how they see themselves now. Method: A quasi-longitudinal research design was adopted, comparing two cross-sectional studies among Portuguese parents (N = 995), with an interval of 2 years between each wave of data collection. Participants were surveyed voluntarily through an online questionnaire located on the institutional web platform of the universities involved in the study. Multivariate analysis of covariance was used to take into account the associations among variables, alongside controlling the possible confounding effects. Results: Parents have overall higher parental burnout scores in Wave 2 than Wave 1, with increased exhaustion, emotional distancing, and contrast, but decreased saturation. Although parental burnout levels remain higher for mothers across the two Waves, the growth is greater for fathers than for mothers. Conclusion: Reconciling childcare with paid work is a stressful and new experience for many fathers. However, results suggest that even amid a crisis, some parents had the opportunity to deeply bond with their children. Implications: We expect this work to encourage stakeholders to consider proper intervention strategies to address potential parental burnout. Also, initiatives that strengthen gender equity within parenting context are needed.

[Risk of contracting HIV]. / Riesgo de contagio por el VIH. Representaciones sociales de estudiantes universitarios en Lisboa-Portugal.

The authors identify social activities related to the risk of contracting HIV in nursing students, bearing in mind their influence while using bio-secure methods, by means of an exploratory and qualitative study; 168 Superior School of Nursing in Lisbon, Portugal students participated in this study. Data were gathered by means of a Free Association Word Test which includes social demographic variables related to the participants. 90% of the 168 students in this study were female and 10% male. The majority 79,2%, of the participants age fell between 21 and 25 years and 97,6% of these participants were Portuguese. In the free association word test when responding to the stimulus HIV/AIDS, participants expressed disease (which is contagious in a clinical setting), and death as the awaited outcome for it. For the test term "risk of contagion when dealing with an AIDS patient" the participants often mentioned the words protection against contagion, as well as fear to contact blood and gloves as the main prevention method. To the stimulus measures of bio-security the words most frequently cited were glove as a protective measure in the context of professional activity and preservative (condom) to avoid contagion in other social contexts experienced by the participants.

[Tobacco and health in the view of univerity students]. / Tabaco e saúde no olhar de estudantes universitários.

Smoking is a serious public health problem. This study aims at understanding how social representation about smoke/tobacco and health are shared by young university students through the impact of figures contained in cigarettes package in heath. This exploratory study was carried with 63 nursing students in Lisboa, Portugal. Data were collected by the technique of free association of words that were submitted to the software Tri-Deux Mots. Students associate "tobacco" like pleasure but also as cancer, disrespect, bad smell, something mean; the health, happiness, joy and self and sickness. Health is represented by hospital but also as something good positive and energetic. "Tobacco/smoking" for the subjects concerned disease as the cancer in addition to causing bad smell and be unpleasant configuring itself as a bad and associated with father.

Challenges of motherhood in the voice of primiparous mothers: initial difficulties.

OBJECTIVES: To identify the main difficulties first-time mothers experience in the postpartum period, during the first six months of the baby's life. METHODS: Level I qualitative, exploratory-descriptive study. The sample consisted of 11 first-time mothers of full-term healthy newborns. The data were collected through the "focus group" method. The mothers' discourse was subject to content analysis, categorizing the registry units. RESULTS: Three categories emerged from the data analyzed that indicate the mothers' main difficulties in this period: postpartum recovery; baby care; marital relationship. CONCLUSIONS: The results indicate that, although motherhood is an event marked by positive emotions, the difficulties that emerge in the mothers' daily life can interfere negatively in the quality of parenthood. In this scenario, the nurses play a determinant role in the enhancement of interventions that are sensitive to these needs and that, at the same time, favor these mothers and their families' empowerment, thus optimizing the children's development trajectories.

Programa de educação para a autogestão em adolescentes com spina bífida: o que dizem os jovens e seus cuidadores / Programa educativo de autogestión para adolescentes con espina bífida: qué dicen los jóvenes y cuidadores / Educational program for self-management on adolescents with spina bifida: what do youths and their caregivers have to say?

RESUMO Objetivo: avaliar um programa e os seus efeitos nas competências de autogestão, na perspetiva dos jovens e de seus pais/cuidadores. Método: entrevistas em grupo focal, com os 51 jovens com Spina Bifida (10-18 anos) que realizaram o programa e 30 pais/cuidadores. Resultados: revelam melhoria no comportamento de autogestão dos jovens, mais responsáveis, proactivos, confiantes, competentes na resolução de problemas, e autónomos. Quanto ao programa, destacam as estratégias psicoeducativas utilizadas, como a técnica de resolução de problemas, o roleplaying, os vídeos, o regime de tutoria entre pares e a modelagem (Lay led's). Conclusão: o programa obteve resultados positivos na capacitação dos jovens para a autonomia. As mudanças verificadas no jovem ao assumir o papel de tutor permitem destacar a eficácia desta estratégia e o seu potencial na criança com condição crónica.

RESUMEN Objetivo: Evaluar un programa y sus efectos en las competencias de autogestión, conforme la visión de los jóvenes y de sus padres/cuidadores. Método: Entrevistas en grupo focal, con los 51 jóvenes con espina bífida (10-18 años) que realizaron el programa y 30 padres/cuidadores. Resultados: Expresan mejora conductual de la autogestión de los jóvenes, más responsables, proactivos, confiados, competentes para resolver problema, autónomos. Respecto del programa, destacan las estrategias psicoeducativas utilizadas, como la técnica de resolución de problemas, el roleplaying, los vídeos, el régimen de tutoría entre pares y el modelado (Lay led's). Conclusión: El programa tuvo resultados positivos en la capacitación de los jóvenes para su autonomía. Los cambios verificados en el joven al asumir el rol de tutor permiten destacar la eficacia de esta estrategia y su potencial en el niño con enfermedad crónica.

ABSTRACT Objective: To evaluate an educational program and its effects on self-management skills, from the perspective of youths and their parents/caregivers. Method: The present study conducted interviews in focus groups with 51 youths with spina bifida (10-18 years old) who participated in the program and 30 parents/caregivers. Results: Improvements were observed in the youths' self-management skills, who displayed greater responsibility, proactivity, confidence, problem-solving skills and autonomy. In terms of the psychoeducational strategies used in the program, emphasis goes to the problem-solving technique, role-playing, videos, peer mentorship, and modeling (lay led model). Conclusion: The results of the program showed that the youths built skills that fostered their autonomy. The changes observed in the youths on taking on the role of mentors point to the effectiveness of this strategy and its potential for children with chronic conditions.

Observação da interação professor-aluno no jardim de infância: O Teacher-Pupil Observation Tool / Observation of teacher-student interaction in preschool: the teacher-pupil observation tool / Observación de la interacción profesor-alumno en la educación infantil: el teacher-pupil observation tool

Este estudo teve como objetivo apresentar a versão portuguesa do Teacher-Pupil Observation Tool (T-POT), no que diz respeito ao acordo e fidedignidade entre observadores e às categorias de comportamentos observadas nos professores na sua utilização em contexto pré-escolar. Três observadores receberam treinamento na cotação de 11 categorias de comportamentos do professor do T-POT. Posteriormente, 65 professoras de jardim de infância foram observadas durante 25 minutos, numa situação de interação nas suas salas com um pequeno grupo de crianças. Obteve-se uma média de acordo entre observadores de 74% nas sessões de treinamento e coeficientes de correlação intraclasse de 0,90-0,99. Os resultados indicam que as categorias do T-POT mais utilizadas pelas professoras nas suas interações com as crianças são questões, confirmações e ordens. A discussão salienta as implicações para a prática e a pesquisa da utilização de medidas de observação na avaliação da interação professor-aluno nas salas de jardim de infância. (AU)

The purpose of this study was to present the Portuguese version of the Teacher-Pupil Observation Tool (T-POT), in terms of agreement and reliability among observers and the categories of behaviors observed in teachers when used in preschool setting. Three observers were trained in scoring 11 T-POT teacher's behavior categories. Subsequently, 65 preschool teachers were observed with T-POT during 25 minutes, while interacting in their classrooms with a small group of children. A mean of 74% of agreement was reached between observers for the training sessions and intraclass correlation coefficients of 0,90-0,99. The results indicate that the T-POT categories most used by teachers in their interactions with children are questions, acknowledgments and commands. The discussion highlights the implications for practice and research on the use of observation measures in the assessment of teacher-student interaction in preschool classrooms. (AU)

Este estudio tuvo como objetivo presentar la versión portuguesa del Teacher-Pupil Observation Tool (T-POT), en lo que se refiere al acuerdo y la confiabilidad entre observadores y, por otro lado, las categorías de comportamiento observadas en los profesores en la utilización del test en el contexto preescolar. Tres observadores recibieron entrenamiento en la cotización de 11 categorías de comportamiento del profesor del T-POT. Posteriormente, 65 profesoras de la educación infantil fueron observadas utilizando el T-POT durante 25 minutos, en una situación de interacción en sus aulas con un pequeño grupo de niños. Se obtuvo un acuerdo medio del 74% entre observadores en las sesiones de entrenamiento y coeficientes de correlación intraclase de 0,90-0,99. Los resultados indican que las categorías del T-POT más utilizadas por las profesoras en sus interacciones con los niños son cuestiones, confirmaciones y órdenes. La discusión destaca las implicaciones para la práctica y la investigación de la utilización de medidas de observación en la evaluación de la interacción profesor-alumno en la educación infantil. (AU)

A qualidade da relação líder-membro e o empenhamento organizacional dos enfermeiros / La calidad de la relación líder-miembro y el empeño organizativo de los enfermeros / Quality of the leader-member relationship and the organizational commitment of nurses

RESUMO Objetivo: Conhecer a perceção da qualidade da relação de liderança e o empenhamento organizacional dos enfermeiros e analisar a influência da qualidade desta relação. Método: Abordagem quantitativa, transversal e correlacional. Amostra não probabilística por conveniência com 408 enfermeiros. Dados obtidos através de questionário no Centro Hospitalar de Lisboa Central, entre janeiro e março 2013. A análise estatística dos dados foi efetuada através do software estatístico IBM® SPSS® Statistics 19. Resultados: Consideraram-se válidos 342 questionários. A qualidade da relação de liderança é satisfatória e os enfermeiros encontram-se fracamente empenhados na organização. A qualidade de relação de liderança encontra-se estatisticamente correlacionada com o empenhamento organizacional: existe uma associação moderada com o empenhamento afetivo (rs=0,42, p<0,05), baixa com o empenhamento normativo (rs=0,37, p<0,05) e muito baixa com o empenhamento calculativo (rs=0,14, p<0,05). Conclusão: A liderança exerce influência no empenhamento organizacional. Existe oportunidade de melhoria da qualidade da relação de liderança entre enfermeiro e enfermeiro líder, com a consequente possibilidade de incrementar o empenhamento organizacional.

RESUMEN Objetivo: Conocer la percepción de la calidad de la relación de liderazgo y el empeño organizativo de los enfermeros y analizar la influencia de la calidad de esa relación. Método: Abordaje cuantitativo, transversal y correlacional. Muestra no probabilística por conveniencia con 408 enfermeros. Datos obtenidos mediante cuestionario en el Centro Hospitalario de Lisboa Central, entre enero y marzo de 2013. El análisis estadístico de los datos fue llevado a cabo mediante el software estadístico IBM® SPSS® Statistics 19. Resultados: Fueron considerados válidos 342 cuestionarios. La calidad de la relación de liderazgo es satisfactoria y los enfermeros se hallan débilmente empeñados en la organización. La calidad de relación de liderazgo se encuentra estadísticamente correlacionada con el empeño organizativo: existe una asociación moderada con el empeño afectivo (rs=0,42, p<0,05), baja con el empeño normativo (rs=0,37, p<0,05) y muy baja con el empeño calculativo (rs=0,14, p<0,05). Conclusión: El liderazgo ejerce influencia en el empeño organizativo. Existe oportunidad de mejoría de la calidad de la relación de liderazgo entre enfermero y enfermero líder, con la consecuente posibilidad de incrementar el empeño organizativo.

ABSTRACT Objective: To understand the perception of the quality of leadership relationships and the organizational commitment of nurses, and to analyze the influence of this relationship quality. Method: Cross-sectional and correlational study, with a quantitative approach, using a non-probability convenience sampling with 408 nurses. The data were collected through questionnaires at Central Hospital in Lisbon, between January and March 2013. The statistical analysis of the data was carried out using IBM® SPSS® Statistics 19 software. Results: Three hundred forty-two questionnaires were considered valid. The quality of the leadership relationship was satisfactory, and the nurses were poorly committed to the organization. The quality of the leadership relationship was statistically correlated with organizational commitment: there was found a moderate association to affective commitment (rs=0.42, p<0.05), a low association with the normative commitment (rs=0.37, p<0.05), and a very low association with the calculative commitment (rs=0.14, p<0.05). Conclusion: Leadership exerts influence on organizational commitment. An opportunity to improve the quality of the leadership relationship between nurses and their leaders was found, with the consequent possibility of developing organizational commitment.