Prevalence of children with special healthcare needs: An epidemiological survey in Brazil.

PURPOSE: We aimed to estimate the prevalence and delineate the profile of children with special healthcare needs (CSHCN) in the three municipalities of Brazil's southern and southeastern regions from 2015 to 2017. DESIGN AND METHODS: This cross-sectional study included 6853 children aged 0-11 years. Participants were selected through complex sampling in 32 primary healthcare units. The Brazilian version of the Children with Special Healthcare Needs Screener© and a questionnaire were used to identify sociodemographic and family characteristics, health status, and health services utilization. Simple and multiple logistic regression models were used to evaluate the association between family and child characteristics and prevalence (P < 0.05). RESULTS: The prevalence of CSHCN was 25.3% (95% confidence interval: 21.0-30.0). Most participants required health services or were on long-term medication for a current chronic condition; approximately 53% of CSHCN had no formally recorded diagnoses. The most frequent health problems were respiratory conditions, asthma, and allergies. Approximately 60% of the CSHCN patients underwent follow-up examinations of the specialties pneumology, pediatrics, otorhinolaryngology, speech therapy, neurology, and psychology. Children of school age, of male sex, with premature birth, with a history of recurrent hospitalization, from non-nuclear families, and from underprivileged social classes were identified as risk factors for classification as CSHCN. PRACTICE IMPLICATION: These results contribute to the unprecedented mapping of these children in healthcare networks in Brazil. CONCLUSION: The high prevalence of CSHCN in medium and large municipalities in the southern and southeastern regions was associated with the child's previous health conditions and family structure.

Factors associated with family risk of children with special health care needs.

OBJECTIVE: To identify the factors associated with family risk of children with special health care needs. METHODS: Bicentric study, with a cross-sectional design and a quantitative approach, with family caregivers of children with special health care needs. Instruments were applied to obtain a sociodemographic characterization, and identify and classify the family risk. For analysis between variables, Mann-Whitney and Fisher's exact tests were used and the Spearman's correlation coefficient was calculated. RESULTS: One hundred and eighteen caregivers participated in the study. The average family risk score was 3.53 (±3.76), with a median of 3.0, and minimum and maximum values of 0 and 16, respectively, with no significant difference between the two studied Brazilian municipalities. In municipality 1, the number of siblings presented a positive correlation with the average family risk score (0.011, p<0.05). Level of education and marital status of the caregiver showed a significant association with the result (0.038 and 0.002, respectively). The social classification variable presented a negative correlation with the outcome in municipalities 1 (0.003, p<0.01) and 2 (0.006, p<0.01). CONCLUSION: To classify the family risk and recognize associated factors can be taken as a basis for fair home care to children with special health care needs.

[Factors associated with involuntary hospital admissions in technology-dependent children]. / Fatores associados às internações não eletivas em crianças dependentes de tecnologia.

OBJECTIVE: To identify the factors associated with involuntary hospital admissions of technology-dependent children, in the municipality of Ribeirão Preto, São Paulo State, Brazil. METHOD: A cross-sectional study, with a quantitative approach. After an active search, 124 children who qualified under the inclusion criteria, that is to say, children from birth to age 12, were identified. Data was collected in home visits to mothers or the people responsible for the children, through the application of a questionnaire. Analysis of the data followed the assumptions of the Generalized Linear Models technique. RESULTS: 102 technology-dependent children aged between 6 months and 12 years participated in the study, of whom 57% were male. The average number of involuntary hospital admissions in the previous year among the children studied was 0.71 (±1.29). In the final model the following variables were significantly associated with the outcome: age (OR=0.991; CI95%=0.985-0.997), and the number of devices (OR=0.387; CI95%=0.219-0.684), which were characterized as factors of protection and quantity of medications (OR=1.532; CI95%=1.297-1.810), representing a risk factor for involuntary hospital admissions in technology-dependent children. CONCLUSION: The results constitute input data for consideration of the process of care for technology-dependent children by supplying an explanatory model for involuntary hospital admissions for this client group.

Mental health of parents of children and adolescents who require special health care.

OBJECTIVE: To identify the manifestations presented by parents of children and adolescents who require special health attention that can impact their mental health. METHODS: exploratory, qualitative research, based on the concept of vulnerability, with data collection carried out through interviews with 18 parents of children and adolescents with special health care needs, hospitalized in the pediatric ward of a hospital in Paraná, between May/2017 and May/ 2018. Data analyzed by inductive thematic analysis. RESULTS: parents experienced situations of vulnerability when providing care at home, with repercussions on their mental health, expressed by manifestations of lack of protection, anxiety and depression. FINAL CONSIDERATIONS: It is important that health professionals seek to expand actions to promote care and reduce situations that generate threats, insecurities, concerns and damage to the health of parents, which can impact and further weaken care for children and adolescents who need attention especially health.

Contributions of telesimulation to the knowledge of mothers about foreign body airway obstruction.

OBJECTIVE: To analyze the contributions of telesimulation to the knowledge of mothers faced with foreign body airway obstruction in children under 1 year of age and identify the related factors. METHODS: A quasi-experimental study of the pre- and post-test design carried out between April and September 2021 with 49 mothers from a city in São Paulo. It was organized into four stages: pre-test, telesimulation, immediate and late post-test (60 days later). All steps were carried out remotely via the free online platform Google Hangouts® and Google Forms®. Data analyzed by descriptive and analytical statistics. RESULTS: There was a significant difference in the knowledge score between the assessments (p<0.001). Statistically significant relationships were identified between pre-test knowledge and choking experience (p=0.012), promotion of immediate knowledge and another child's choking (p=0.040) and schooling (p=0.006) and promotion of late knowledge with occupation (p=0.012) and choking of another child (p=0.011). CONCLUSIONS: There was a significant improvement in knowledge after telesimulation, especially among those who had never experienced a choking situation and had a higher level of education.

Knowledge and experience of Primary Education teachers regarding childhood asthma: mixed study.

OBJECTIVE: To analyze the knowledge of Primary Education teachers regarding asthma and learn about their experiences with the exacerbation of symptoms at school. METHOD: Sequential explanatory mixed study. In the quantitative stage, the Newcastle Asthma Knowledge Questionnaire and the characterization instrument were applied. Data analyzed by descriptive and inferential statistics. The production of qualitative data occurred from written statements analyzed using the deductive content analysis method. RESULTS: Two hundred and seven teachers, mostly women (92%) and working in public schools (82%). As for knowledge, 132 (63.8%) had unsatisfactory performance. The questions with the lowest rates of correct answers were about medications used regularly and during the attacks. Teachers with higher scores had less time in the occupation (p = 0.017) and had been diagnosed with asthma (p = 0.006). In the qualitative stage, 35 teachers participated and the statements corroborated the quantitative findings, especially in relation to the knowledge gap and feeling of greater safety among asthmatic teachers. CONCLUSION: Teachers showed insufficient knowledge and reported fear and unpreparedness in the face of the situation.

Meanings of nurses' role in Child and Adolescent Psychosocial Care Centers.

OBJECTIVE: to analyze the meaning attributed to nurses' role in mental health care in Child and Adolescent Psychosocial Care Centers. METHODS: qualitative research, anchored in the paradigm of complexity. Data collection was carried out through online semi-structured interviews with ten nurses from São Paulo, between March and September 2022, being analyzed thematically. RESULTS: the diversity and specificity of a child and adolescent mental health clinic, with the need for expanded, territorial and intersectoral care, were unveiled in addition to a fragmented training in the area. There was a need for a deconstruction of being a nurse to make it possible to produce more inclusive and salutogenic practices. FINAL CONSIDERATIONS: the need for training nurses with adequate knowledge and skills to care for the mental health of children, adolescents and their families is reinforced as well as permanent education of working teams.

[Technology-dependent children: the maternal care experience]. / Criança dependente de tecnologia: a experiência do cuidado materno.

The objective of this study is to understand the maternal experience of caring for a technology-dependent child. We used the ethnographic case study approach, as well as the genogram, ecomap, open interview and observation methods as data collection instruments. The data were organized into three meaning units: the search for causes and culprits; hospital discharge and the demand for care; and the support networks. The study allowed for an understanding of the mother's experience of searching for explanations, as well as feelings of distrust, insecurity and dissatisfaction towards the health service provided. In addition, the mother's organization regarding the child's care and in terms of readying the home environment to receive the child, the use of support networks, and particularly the need for attachment with family and neighbors and the formal and informal search to assure the subsistence of her ill child as well as her other children were explored.

School inclusion of children and adolescents with epidermolysis bullosa: The mothers' perspective.

OBJECTIVE: to understand the school inclusion of children and adolescents with Epidermolysis Bullosa from the mothers' perspective. METHOD: qualitative study, based on Urie Bronfenbrenner's Bioecological Theory of Development, conducted between September and November 2021. Interviews were conducted with six mothers from different Brazilian locations, recording audio and video using the Google Meet® platform. The statements were analyzed using thematic analysis. RESULTS: two categories were identified: i) The school microsystem: challenges and adaptations for inclusion of children and adolescents with Epidermolysis Bullosa; ii) The school-family mesosystem: possibilities to promote better school inclusion. Mothers highlighted the challenges in school inclusion as well as the benefits provided by social interaction. In order to facilitate the inclusion, the school microsystem promoted adaptations in the teaching-learning process, structural changes, hiring of caregivers, and dialogues with family members. CONCLUSION: initially, school inclusion was permeated by feelings such as fear and anguish, but the adaptations contributed to promote well-being, welcoming, and social integration of children and adolescents.

Biomarkers of stress in caregivers of children with special health care needs: A protocol for systematic review.

BACKGROUND: Children with Special Health Care Needs (CSHCN) require greater attention from family caregivers as they present temporary or permanent physical, developmental, behavioral, or emotional issues. This demand for care generates overload and stress among family caregivers. So far, there is no study that gathers the available literature regarding the use of biomarkers to assess stress among caregivers of CSHCN. Hence, we aimed to synthetize and to assess the scientific evidence on biomarkers associated with stress in caregivers of CSHCN. METHODS: This systematic review and meta-analysis protocol was elaborated following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). The search strategy will be undertaken through 7 electronic bibliographic databases: Embase, MEDLINE/PubMed, Cochrane Library, Web of Science, CINAHL, Scopus, and PsycINFO. In addition, secondary searches in other sources, such as Clinical trials.gov-NIH, The British Library, Pro Quest Dissertations Database, Google Scholar, and medRXiv will be also carried out. The reference section of the included studies will be hand searched for additional relevant studies. There will be no restriction regarding the publication dates or languages for this systematic review. Moreover, in an independently manner, 2 investigators will select studies, perform data extraction, as well as perform a critical appraisal of the risk of bias and overall quality of the selected studies, based on their designs. The heterogeneity among the studies will be assessed using the I2 statistic test. According to the results of this test, we will verify whether a meta-analysis is feasible. If feasibility is confirmed, a random-effect model analysis will be carried out. For data analysis, the calculation of the pooled effect estimates will consider a 95% CI and alpha will be set in 0.05 using the SPSS version 23.0. RESULTS: This systematic review and meta-analysis will provide better insights regarding the biomarkers associated with stress in caregivers of CSHCN. Hence, consistent data and robust evidence will be provided to help practitioners and decision-makers in this area. CONCLUSIONS: To the best of our knowledge this study, will be the first to synthetize and critically evaluate the scientific evidence on biomarkers associated with stress in caregivers of CSHCN.

Cultural adaptation and assessment of the reliability of the Special Needs Kids Questionnaire for the Brazilian context.

OBJECTIVE: To carry out the cultural adaptation of the Special Needs Kids Questionnaire into Brazilian Portuguese and assess its reliability. METHODS: Methodological study conducted between September 2019 and June 2020 from the stages of translation, back-translation, content validation, semantic validation and pilot test. Content Validation Index, Cronbach's Alpha Coefficient and Intraclass Correlation Coefficient were calculated. RESULTS: After the second round, the adapted version had a Content Validation Index greater than 0.80 in all items and was considered understandable by the mothers. The pilot test included 89 mothers of children born prematurely from the Neonatal Intensive Care Unit in the test and 44 in the retest. All items had Cronbach's Alpha greater than 0.70. Of the 20 items, 15 showed moderate reliability, three high and two weak. CONCLUSION: The instrument proved to be reliable and has the potential to identify the fragmentation and discontinuity of the care received.

Effect of parental mutuality on the quality of life of mothers of children with special health needs.

OBJECTIVE: to analyze the effect of parental mutuality on the quality of life related to the health of mothers who care for children with special health needs. METHOD: an observational, analytical and cross-sectional study with a quantitative approach. The following instruments were applied to 181 caregiving mothers: The Medical Outcomes Study 36-Item Short Form and Family Management Measure (Parental Mutuality subscale). In the statistical analysis, Spearman's correlation and univariate and multivariate linear regression were used. RESULTS: the total score of parental mutuality was 30.8, indicating a satisfactory perception of the caregiving mother about the way the couple shares decisions regarding the care of the child. In the multivariate regression analysis, parental mutuality maintained a statistically significant association with the domains of pain, social aspects and emotional limitations of quality of life related to health (p=<0.001, 0.003, 0.002), respectively. CONCLUSION: parental mutuality has a positive effect on some domains of quality of life related to health. It is recommended to plan actions aimed at strengthening the complicity and connection between the couple, especially in matters related to the care of the child with special health needs.

Hospitalization perceived by children and adolescents undergoing cancer treatment.

OBJECTIVE: To know the perception of children and adolescents undergoing cancer treatment about hospitalization. METHODS: Qualitative research conducted with 13 children and adolescents hospitalized for cancer treatment at a referral hospital in southern Brazil. Semi-structured interviews mediated by the drawing technique were conducted from May to November 2018. Data was submitted to inductive thematic analysis based on the theoretical framework of Brazil's National Humanization Policy. RESULTS: Disturbances were detected in the professionals' communication with the hospitalized children and adolescents. The participants felt socially isolated and highlighted the importance of recreational activities during hospitalization. CONCLUSION: Infant cancer is complex and needs multidisciplinary care during the treatment, enabling the organization of healthy and welcoming spaces that favor humanization of care.

The hospital designed by hospitalized children and adolescents.

OBJECTIVE: to identify, through the contributions of hospitalized children and adolescents, the characteristics they consider necessary for a hospital that promotes well-being and development. METHOD: descriptive and exploratory study, with qualitative data analysis, carried out with a total of 30 hospitalized children and adolescents. Data were collected through semi-structured interviews, mediated by drawing, and analyzed by inductive thematic analysis, supported by the theoretical framework of the humanization of health care and the Florence Nightingale's Environmental Theory. RESULTS: the designed hospital takes up the principles of Florence Nightingale's Environmental Theory, as well as one of the guidelines of the National Humanization Policy, the environment, from two perspectives: elements and material resources from the physical environment; elements of comfort and well-being environment. FINAL CONSIDERATIONS: hospitals such as the projected institution corroborate what is recommended in public policies, as they qualify health care.

Influence of health care practices on the burden of caregiver mothers.

OBJECTIVES: to explore the influence of health care practices on the burden of caregiver mothers of children with special health needs. METHODS: observational, analytical, cross-sectional, quantitative study. Participation of 100 caregiver mothers, who responded the following instruments: characterization instrument; Burden Interview for Informal Caregivers; Perceptions of Family-Centered Care - Parents version; Evaluation Instrument for Primary Care - Child Version. For statistical analysis, were used the Spearman's Correlation and univariate and multivariate linear regression analysis. RESULTS: the mean burden score was 47.99. There was a negative correlation between the burden and the domains of collaboration and support of the Perceptions of Family-Centered Care scale. In the multivariate linear regression model, the longitudinality variable maintained a significant relation with the burden (p = 0.023). CONCLUSIONS: a shared, longitudinal and integrated care between families and health services can ease the burden of caregiver mothers.

Family dynamics and social network of families of children with special needs for complex/continuous cares.

OBJECTIVE: To describe the family dynamics and the social support network for families of children with special needs of multiple, complex and continuous care. METHODS: A descriptive study of a qualitative approach, carried out in Maringá - PR, having as theoretical and methodological reference the Calgary Model of Family Assessment (CMFA). Data was collected through semi-structured audio-video interviews, carried out in the homes, together with 11 family caregivers of 13 children. RESULTS: Data is presented in the following categories: structural, developmental and functional evaluation, which show the changes in the family routine and the needs for the adjustment of the roles of its members, in order to better implement the care at home. CONCLUSIONS: Using the CMFA made it possible to identify and understand the composition, fragilities and potentialities of the family, as well as the relationships among its members and rearrangements to better enable care at home. This information favors interventions congruent with the needs of these families.

Self-confidence in the management of health complications at school: contributions of the in situ simulation. / Autoconfiança no manejo das intercorrências de saúde na escola: contribuições da simulação in situ.

OBJECTIVE: to analyze the contributions of the in situ simulation in the self-confidence of early childhood and elementary education teachers regarding the initial management of health complications in school. METHOD: this is a pre-post testing quasi-experimental study. Two pre and post in situ simulation instruments were applied to 76 teachers, namely: visual analogue scale of teachers' self-confidence in the management of health complications at school, and a questionnaire to assess their knowledge on the subject. The educational activity was composed of four scenarios of in situ simulation. The data were analyzed by descriptive and analytical statistics using univariate and multivariate linear regression. RESULTS: the comparison of results of pre and post in situ simulation self-confidence identified promotion of self-confidence (p<0.001), especially for those teachers with less professional experience (p=0.008), without previous similar experience (p=0.003) and who actively participated in the simulation (p=0.009). CONCLUSION: the teachers feel uncomfortable to handle health complications. The in situ simulation elevated the perception of self-confidence among teachers.

Accessibility of children with special health needs to the health care network.

OBJECTIVE: To know how children with special health needs access the health care network. METHOD: This is a qualitative research of descriptive-exploratory type, developed using semi-structured interviews mediated by the Talking Map design. Participants were 19 family caregivers of these children in two Brazilian municipalities. Data were submitted to inductive thematic analysis. RESULTS: Difficulties were mentioned from the diagnosis moment to the specialized follow-up, something represented by the itinerary of the c hild and his/her family in the search for the definition of the medical diagnosis and the access to a specialized professional; a gap between the children's needs and the care offered was observed in primary health care. CONCLUSION: The access of children with special health needs is filled with obstacles such as slowness in the process of defining the child's diagnosis and referral to a specialist. Primary health care services were replaced by care in emergency care units.

Perfil de crianças e adolescentes dependentes de tecnologia em um hospital pediátrico do Sul do país / Perfil de niños e adolescentes dependientes de tecnología en un hospital pediátrico de referencia del sur del país / Profile of technology-dependent children and adolescents in a referral pediatric hospital in the south of the country

Resumo Objetivo identificar o perfil de crianças e adolescentes dependentes de tecnologia de um hospital de referência pediátrica do sul do país. Método estudo descritivo, com abordagem quantitativa. A coleta de dados ocorreu por meio da análise de prontuários, entre janeiro de 2016 e dezembro de 2019, armazenados em planilha Microsoft Excel para a análise estatística descritiva. Um projeto aprovado pelo Comitê de Ética sob o parecer 5.115.194. Resultados prevaleceu o sexo masculino (50,8%), em idade pré-escolar (30,8%), proveniente da Grande Florianópolis (60,1%). Os diagnósticos mais frequentes foram relacionados à prematuridade/período neonatal, anomalias congênitas/defeitos genéticos, doenças neurológicas e/ou neuromusculares, correspondendo a 37%, 33,2% e 18,5%. Os dispositivos tecnológicos mais utilizados foram gastrostomia (56,3%) e traqueostomia (36,6%). A utilização de medicamentos contínuos se deu em 93,4% e 49,2% utilizavam quatro ou mais medicamentos. As mães foram as principais cuidadoras (80,9%). Ocorreram 31 óbitos no período. Conclusão e implicação para a prática este grupo apresenta grande demanda de cuidados decorrentes do diagnóstico principal, dos dispositivos tecnológicos, das medicações e das possíveis complicações. A identificação do perfil das crianças e adolescentes dependentes de tecnologia contribuiu para ampliar a visibilidade de uma população que está em constante crescimento e, assim, prestar uma assistência integral, de acordo com suas especificidades e reais necessidades.

Resumen Objetivo identificar el perfil de niños y adolescentes dependientes de tecnología atendidos en un hospital de referência pediátrica del sur del país. Método estudio descriptivo con enfoque cuantitativo. La recolección de datos ocurrió através del análisis de las historias clínicas, desde enero de 2016 hasta diciembre de 2019, almacenadas en una hoja de cálculo de Microsoft Excel para el análisis estadístico descriptivo. El proyecto fue aprobado por el Comité de Ética bajo el parecer 5.115.194. Resultados predominaron varones (50,8%), en período de desarrollo preescolar (30,8%), la región más frecuentada de la Gran Florianópolis (60,1%). Los diagnósticos más frecuentes estuvieron relacionados con prematuridad/el período neonatal, anomalías congénitas/defectos genéticos, enfermedades neurológicas y/o neuromusculares, correspondiendo al 37%, 33,2% y 18,5%, respectivamente. Los dispositivos tecnológicos más utilizados fueron la gastrostomía (56,3%) y la traqueotomía (36,6%). El uso de medicación continua ocurrió en el 93,4% y el 49,2% utilizó cuatro o más medicamentos. Las madres fueron las principales cuidadoras en 80,9% de los casos, ocurriendo 31 óbitos en el período. Conclusión e implicación para la práctica este grupo tiene una alta demanda de atención debido al diagnóstico principal, dispositivos tecnológicos, medicamentos y posibles complicaciones. Identificar el perfil de niños y adolescentes dependientes de tecnología contribuye a aumentar la visibilidad de una población en constante crecimiento y, por lo tanto, calificar la asistencia, de acuerdo com sus especificidades y reales necesidades.

Abstract Objective to identify the profile of technology-dependent children and adolescents at a pediatric referral hospital in southern Brazil. Method a descriptive study with a quantitative approach. Data was collected by analyzing medical records between January 2016 and December 2019 and stored in a Microsoft Excel spreadsheet for descriptive statistical analysis. The project was approved by the Ethics Committee under protocol number 5.115.194. Results: The prevalence was male (50.8%), pre-school age (30.8%), from Greater Florianópolis (60.1%). The most frequent diagnoses were related to prematurity/neonatal period, congenital anomalies/genetic defects, and neurological and/or neuromuscular diseases, corresponding to 37%, 33.2%, and 18.5%. The most commonly used technological devices were gastrostomy (56.3%) and tracheostomy (36.6%). 93.4% used continuous medication and 49.2% used four or more medications. Mothers were the main caregivers (80.9%). There were 31 deaths during the period. Conclusion and implications for practice this group has a high demand for care due to the main diagnosis, technological devices, medications, and possible complications. Identifying the profile of technology-dependent children and adolescents has helped to increase the visibility of a population that is constantly growing and thus provides comprehensive care according to their specific needs.

Identificação do contexto familiar e social em registros de consultas de enfermagem ao binômio mãe-bebê / Identificación del contexto familiar y social en registros de consultas de enfermería para el binomio madre-bebé / Identification of the family and social context in records of nursing consultations with the mother-baby binomial

Objetivo: identificar informações relacionadas ao contexto familiar e social em registros da primeira consulta de enfermagem ao binômio mãe-bebê. Método: estudo de Métodos Mistos com Estratégia Incorporada Concomitante de Dados. Utilizou-se roteiro composto por oito questões com respostas do tipo dicotômicas e espaço para transcrever as sentenças relacionadas ao contexto familiar e social. Dados analisados por estatística descritiva e análise de conteúdo dedutiva. Resultados: dos 326 registros, 30% descreveram a presença de outros familiares na consulta e o estado emocional da puérpera. Informações sobre estrutura familiar e rede de apoio estavam presentes em 27,3 e 21,8% deles, respectivamente. A experiência da gestação foi o aspecto menos mencionado (4,3%). O diagnóstico comumente incluído foi "Vínculo mãe e filho preservado". As sentenças convergiram com os dados quantitativos ao indicar limitada exploração do contexto e centralidade no modelo biomédico. Conclusão: na maioria dos registros não constava informações sobre o contexto familiar e social.

Objective: to identify information related to the family and social context in records of the first nursing consultation with the mother-baby binomial. Method: Mixed-methods study with Concomitant Data Incorporated Strategy. A script was used consisting of eight questions with dichotomous answers and space to transcribe the sentences related to the family and social context. Data was analyzed using descriptive statistics and deductive content analysis. Results: of the 326 records, 30% described the presence of other family members at the appointment and the emotional state of the puerperal woman. Information on family structure and support networks was present in 27.3 and 21.8% of them, respectively. The experience of pregnancy was the least mentioned aspect (4.3%). The diagnosis most commonly included was "Mother-child bond preserved". The sentences converged and indicated a limited exploration of the context and a focus on the biomedical model. Conclusion: the majority of records lacked information on the family and social context.

Objetivo: identificar información relacionada al contexto familiar y social en registros de la primera consulta de enfermería para el binomio madre-bebé. Método: estudio de métodos mixtos con estrategia integrada de datos concomitantes. Se utilizó un guion compuesto por ocho preguntas con respuestas dicotómicas y espacio para transcribir las frases relacionadas con el contexto familiar y social. Datos analizados mediante estadística descriptiva y análisis de contenido deductivo. Resultados: de los 326 registros, el 30% describió la presencia de otros familiares en la consulta y el estado emocional de la puérpera. La información sobre la estructura familiar y la red de apoyo estuvo presente en el 27,3 y el 21,8% de ellos, respectivamente. La experiencia del embarazo fue el aspecto menos mencionado (4,3%). El diagnóstico comúnmente incluido fue "Vínculo preservado entre madre e hijo". Las frases convergieron con los datos cuantitativos al indicar una exploración limitada del contexto y la centralidad en el modelo biomédico. Conclusión: la mayoría de los registros no contenían información sobre el contexto familiar y social.