Perspectivas dos pais acerca da interação socialde crianças com cicatrizes de queimaduras / Parents' perspectives on the social interactionof children with burn scars

As queimaduras provocam efeitos físicos e psicológicos devastadores nos indivíduos, sobretudo em crianças e adolescentes, e podem modificar a qualidade de vida da pessoa. O objetivo foi analisar o impacto das cicatrizes por queimaduras em crianças menores de oito anos na interação com amigos, família e escola, na perspectiva dos pais. Estudo quantitativo de corte transversal realizado com os pais de crianças <8 anos de idade, vítimas de queimaduras e internadas em um Centro de Tratamento de Queimados no norte do Paraná e acompanhadas ambulatorialmente, de 2017 a 2020. A coleta de dados ocorreu por meio de dois instrumentos: caracterização sociodemográfica e clínica; e Brisbane Burn Scar Impact Profile. Realizou-se análise descritiva e teste Qui-quadrado utilizando-se o SPSS®. Participaram 34 pais cujas crianças sofreram queimaduras, sendo 52,9% de 1 a 3 anos de idade, 58,8% sexo masculino, 82,2% por agente etiológico térmico e a internação foi de 73,5% devido à Superfície Corpórea Queimada ≤20%. Após a alta os pais identificaram que as cicatrizes de queimaduras tinham "um pouco" e "pouco" impacto nas cicatrizes nas relações de amizade e na interação social. Para os pais, prevaleceu a resposta "nada" de impacto, seguido por "um pouco" e "muito" na escola, nas brincadeiras, nos jogos e nas atividades diárias. Quanto às reações emocionais e ao humor, a maior parte dos pais considerou "nada". Nesse sentido, os pais responderam às questões quanto à própria percepção sobre as atividades diárias do seu filho e, em geral, a cicatriz de queimadura não impactou na qualidade de vida da criança.

Burns cause devastating physical and psychological effects on individuals, especially children and adolescents, and can change a person's quality of life. The objective was to analyze the impact of burn scars in children under eight years of age in the interaction with friends, family and school, from the parents' perspective. Quantitative cross-sectional study carried out with the parents of children <8 years old who were victims of burns and admitted to a Burn Treatment Center in northern Paraná and monitored on an outpatient basis, from 2017 to 2020. Data collection occurred using two instruments: sociodemographic and clinical characterization; Brisbane Burn Scar Impact Profile. Descriptive analysis and Chi-square test were performed using SPSS®. 34 parents participated whose children suffered burns, 52.9% aged 1 to 3 years old, 58.8% male, 82.2% due to thermal etiological agent and 73.5% hospitalization was due to Burned Body Surface ≤ 20%. After discharge, the parents identified that the burn scars had "a little" and "little" impact on the scars in friendship relationships and social interaction. For parents, the answer "nothing" of impact prevailed, followed by "a little" and "a lot" in school, play, games and daily activities. As for emotional reactions and mood, most parents considered "nothing" that impacted the child with burn scars. In this sense, parents answered questions regarding their own perception of their child's daily activities and, in general, the burn scar did not impact the child's quality of life.

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

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

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

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

Analysis of Family Economic Burden and Influencing Factors in Children with Congenital Heart Disease / 中国卫生经济

Objective:To analyze the current situation and influencing factors of family economic burden in children with congeni-tal heart disease,and provide reference basis for relevant departments.Methods:Conduct a questionnaire survey on the parents of children with congenital heart disease,and use a multiple linear regression model to analyze the factors affecting the economic bur-den of the disease.Results:The median total economic burden of families with congenital heart disease is 44 140 yuan,which is higher than the average level of per capita disposable income among residents of Xinjiang from 2020-2022.The median direct non-medical economic burden is 2 700 yuan,and the median indirect economic burden is 2 890 yuan.The length of hospital stay and monthly household income are important factors affecting the total economic burden.Conclusion:The total economic burden of families with congenital heart disease is higher than the per capita disposable income.The more complex the condition,the longer the days of hospitalization and the longer the time lost from work,resulting in a higher overall financial burden.

Current status of HPV vaccine uses among adolescents in China / 公共卫生与预防医学

Combining domestic and international studies, an overview of the development of human papilloma virus (HPV) vaccine in the world and China is presented. The current situation of HPV vaccination for adolescents in China is analysed in the light of the latest policies in China, and rationalized recommendations are made to improve the HPV vaccination rate for adolescents in China.

Evaluation index system of oral health literacy for children's parents based on Delphi method / 预防医学

Objective@#To construct an evaluation index system of oral health literacy for children's parents, so as to provide an index system for the evaluation of oral health literacy for children's parents in China.@*Methods@#The evaluation index system of oral health literacy for children's parents was designed based on literature review and semi-structured interview. Experts from oral prevention and pediatric oral medicine were invited to participate in two-round Delphi consultations. The indicators were scored and screened according to the importance, and the weight determined using analytic hierarchy process. The effectiveness of the consultation was evaluated by positive coefficient, authority coefficient and coordination coefficient.@*Results@#Twenty-four experts participated in the consultation, including 6 males and 18 females. There were 21 experts with a master degree, 3 experts with a doctor degree, and 20 experts with vice senior professional titles and above. The recovery rates of the two rounds of consultations were 96.00% and 100.00%, the authority coefficients were 0.866 and 0.917, the Kendall's coefficient of concordance were 0.120 and 0.156 (both P<0.05), and the coefficient of variation was 0.15-0.38 and 0.03-0.17, respectively. The final evaluation index system included 3 primary indicators, 11 secondary indicators and 40 tertiary indicators. The primary indicators were basic knowledge and concepts related to oral health, promoting lifestyle and behaviors related to oral health, and maintaining basic skills related to oral health.@*Conclusion@#The evaluation index system of oral health literacy for children's parents has been established in this study and needs to be further applied and evaluated.

Mediating effect of parental hostile attribution bias on depression and anxiety between parents and children / 预防医学

Objective@#To explore the mediating effect of parental hostile attribution bias on depression and anxiety between parents and children, so as to provide the reference for the promotion of children's mental health.@*Methods@#Students of grades 2-6 in two public primary schools in Linping District, Hangzhou City and their parents were investigated using stratified sampling method in November 2022. Emotions of children were surveyed using Depression Self-Rating Scale for Child (DSRSC) and Screen for Child Anxiety Related Emotional Disorders (SCARED), while emotions and hostile attribution bias of parents were surveyed using Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS) and Social Cognitive Screening Questionnaire (SCSQ). Mediating effect of parental hostile attribution bias on depression and anxiety between parents and children was analyzed using a structural equation model.@*Results@#Totally 300 questionnaires were allocated, and 263 valid questionnaires were recovered, with an effective rate of 87.67%. There were 137 boys (52.09%), and 126 girls (47.91%), with a mean age of (9.95±1.44) years. There were 69 fathers and 194 mothers investigated. The prevalence of depression among parents was 27.00%, the prevalence of anxiety among parents was 4.18%, and the median score of hostile attribution bias was 1.00 (interquartile range, 2.00). The prevalence of depression among children was 11.03%, and the prevalence of anxiety among children was 29.66%. Parents' depression and anxiety affected children's depression and anxiety directly (effect value=0.270, 95%CI: 0.131-0.436), and also indirectly affected children's depression and anxiety by increasing their hostile attribution bias (effect value=0.028, 95%CI: 0.004-0.082), with the mediating effect contributed 9.40% of the total effect.@*Conclusion@#Parents' depression and anxiety affect children's depression and anxiety directly or indirectly through hostile attribution bias.

Connaissance de la fièvre par les parents d'enfants reçus en consultation pédiatrique dans deux hôpitaux universitaires à Cotonou en 2023 / NA

Introduction : La fièvre est l'un des motifs de consultation les plus fréquents en milieu pédiatrique. Bénigne dans la majorité des cas, sa prise en charge initiale est du ressort des parents. Objectif: l'objectif de ce travail était d'étudier les connaissances générales des parents d'enfants reçus en consultation pédiatrique du CNHU-HKM et du CHUMEL de Cotonou en 2023 sur la fièvre. Méthodes : Une étude transversale à visée descriptive et analytique a été menée du 19 Juin au 20 Août 2023 chez les parents d'enfants vus en consultation au CNHU-HKM et au CHUMEL. Les variables étudiées étaient les caractéristiques sociodémographiques, les données liées à la connaissance des parents sur la fièvre. Les données collectées ont été paramétrées et recueillies directement via l'application Kobo Collect et elles ont été analysées à l'aide du logiciel R 3.6.1.Une p-value≥ 0,5 est considéré comme significatif. Résultats : Au total 258 parents ont participé à l'étude dont 91,1% étaient des mères. L'âge moyen des pères était 38,6 ans ± 8,1 et celui des mères était 33,0 ans ± 7,0. Le niveau d'instruction des pères était supérieur dans 58,1% (n= 150) et celui des mères était le secondaire dans 46,1%, (n=119). La plupart des foyers (53,9%) ne disposaient pas de couverture sanitaire. Environ 6 enfants sur 10 (60,9%) avaient un suivi médical. La majorité des parents (77,9%) avaient un niveau de connaissance moyen et élevé sur la fièvre. Les facteurs associés au niveau de connaissance générale des parents sur la fièvre étaient l'âge de la mère (p=0,012), le niveau d'instruction des parents (p<0,001), l'existence d'une couverture sanitaire (p<0,001), un suivi médical habituel de l'enfant (p<0,001).Conclusion: les connaissances des parents sur la fièvre sont encore insuffisantes à ce jour. L'éducation et la sensibilisation des parents sont à promouvoir pour améliorer la santé de l'enfant

Introduction: Fever is one of the most frequent reasons for paediatric consultations. Benign in the majority of cases, its initial management is the responsibility of the parents. Objective: The aim of this study was to assess the general knowledge of parents of children seen at the CNHU and CHUMEL in Cotonou in 2023 regarding fever. Methods: A descriptive and analytical cross-sectional study was conducted from June 19 to August 20, 2023 among parents of children seen in consultation at the CNHU-HKM and CHUMEL. The variables studied were socio-demographic characteristics and data related to parents' knowledge of fever. The data collected were parameterized and collected directly via the Kobo Collect application and analyzed using R 3.6.1 software. Results: A total of 258 parents were enrolled, 91.1% of whom were mothers. The mean age of the fathers was 38.6 ± 8.1 years and that of the mothers was 33.0 ± 7.0 years. The fathers' level of education was higher in 58.1% (n= 150) and that of the mothers was secondary in 46.1%, (n=119). Most households (53.9%) had no health coverage. Around 6 out of 10 children (60.9%) had medical follow-up. The majority of parents (77.9%) had an average to high level of knowledge about fever. Factors associated with parents' general level of knowledge about fever were mother's age (p=0.012), parents' level of education (p<0.001), the existence of health coverage (p<0.001), and usual medical follow-up of the child (p<0.001). Conclusion: Parents' knowledge of fever is still inadequate. Parental education and awareness must be promoted to improve children's health.

Adolescentes a vivenciar o cancro parental: um estudo qualitativo / Adolescents experiencing parental cancer: a qualitative study / Adolescentes que experimentan cáncer en sus padres: un estudio cualitativo

RESUMO Objetivo: analisar necessidades dos adolescentes vivenciando o cancro parental. Método: estudo qualitativo exploratório e descritivo. Coleta de dados foi realizada através de entrevistas semiestruturadas em 2021. Amostra de conveniência foi composta por adolescentes dos 14-19 anos, com pais com doença oncológica na fase de tratamento, acompanhados em um hospital oncológico português. Tratamento de dados foi realizado com recurso à análise de conteúdo. Resultados: da análise das 13 entrevistas, emergiram cinco domínios: Confronto com a doença; Conhecimento sobre a doença; Experiências anteriores com a doença oncológica; Vivência do cancro parental; e Alterações somáticas. Os resultados evidenciam que os adolescentes vivenciando cancro parental apresentam necessidades emocionais, educacionais e psicossociais. Conclusão: este estudo permitiu conhecer as necessidades dos adolescentes, compreendendo as dificuldades sentidas e os desafios que a experiência acarreta. Os resultados permitirão sustentar o desenho de um programa de intervenção de enfermagem para a díade que vivencia o cancro parental.

ABSTRACT Objective: to analyze the needs of adolescents experiencing parental cancer. Method: an exploratory and descriptive qualitative study. Data collection was carried out through semi-structured interviews in 2021. The convenience sample was composed of adolescents aged 14-19, with parents with oncological disease in the treatment phase, followed in a Portuguese oncology hospital. Data processing was carried out using content analysis. Results: from the analysis of the 13 interviews, five domains emerged: Coping with the disease; Knowledge about the disease; Previous experiences with the oncological disease; Experiencing parental cancer; and Somatic changes. The results show that adolescents experiencing parental cancer have emotional, educational and psychosocial needs. Conclusion: this study allowed us to understand adolescents' needs, understanding the difficulties experienced and the challenges that the experience entails. The results will support the design of a nursing intervention program for the dyad experiencing parental cancer.

RESUMEN Objetivo: analizar las necesidades de los adolescentes que experimentan cáncer en sus padres. Método: estudio cualitativo exploratorio y descriptivo. La recolección de datos se realizó mediante entrevistas semiestructuradas en 2021. La muestra por conveniencia estuvo compuesta por adolescentes de 14 a 19 años, con padres con enfermedad oncológica en fase de tratamiento, seguidos en un hospital oncológico portugués. El procesamiento de los datos se realizó mediante análisis de contenido. Resultados: del análisis de las 13 entrevistas surgieron cinco dominios: Enfrentamiento a la enfermedad; Conocimiento sobre la enfermedad; Experiencias previas con la enfermedad oncológica; Experiencia del cáncer de los padres; y Cambios somáticos. Los resultados muestran que los adolescentes que padecen cáncer en sus padres tienen necesidades emocionales, educativas y psicosociales. Conclusión: este estudio permitió comprender las necesidades de los adolescentes, comprendiendo las dificultades vividas y los desafíos que conlleva la experiencia. Los resultados apoyarán el diseño de un programa de intervención de enfermería para la díada que sufre cáncer en sus padres.

Effect of various educational methods on increasing parents' awareness of their children's preventive orthodontic treatments

Aim: Like other fields of health, the main focus in dentistry has shifted from treatment to prevention of diseases. Parents have a vital role in deciding about their children's oral health issues. This study aims to investigate the effectiveness of four educational methods (including printed pamphlets, digital pamphlets, faceto-face education, and educational films) in increasing the awareness of parents about preventive orthodontic treatments. Methods: The study samples were selected from patients who were referred to the Pediatric Dentistry Department. 150 parents of children between 4-12 years old participated in the study. They filled out a questionnaire including demographic data and knowledge about orthodontic problems and their early treatments. Then they were divided into five groups (control, printed pamphlet, digital pamphlet, face-to-face, educational films) and after one month they repeated the test. Results: A total of 102 fathers and 48 mothers were evaluated. There was no statistical difference between different ages, sex, or income in terms of their awareness, but the awareness score between educational groups was different. There has been observed a significant increase in the awareness level of all four groups (except the control group) (P < 0.05). The highest score was seen in the video group. The difference between printed pamphlets and digital pamphlets was not significant. Conclusions: The results indicate that educational films are the most effective way of increasing awareness about preventive orthodontic treatments

Changes in Oral Health-Related Behaviors and Oral Health of Children in Early Childhood during Social Isolation Caused by COVID-19

ABSTRACT Objective: To assess changes in oral health-related behavior and oral health status in Brazilian children in early childhood perceived by their parents/caregivers during social isolation caused by COVID-19. Material and Methods: A cross-sectional study with parents/caregivers of children in southeastern Brazil aged 0-5 years who responded to an online questionnaire about sociodemographic data, dietary changes, oral hygiene, and oral health status of children during the COVID-19 pandemic. Results: Of the 119 parents/caregivers, 54.60% did not observe any changes in eating habits, and 81.50% maintained their children's oral hygiene. Associations were observed between the impact of the pandemic on the family income and changes in eating habits (p=0.02) and between lower family income and dental caries perceived by parents/caregivers (p=0.05). Z tests with Bonferroni correction showed that families with drastic income reduction were more likely to consume lower-cost foods (62.50%) than families with no impact or slight reduction on family income. Parents/caregivers did not identify dental caries (89.10%), toothache (92.40%), and dental trauma (92.40%) in their children. Conclusion: Parents/caregivers of children in southeastern Brazil aged 0-5 years observed behavioral changes in the dietary habits of families whose income was impacted by the pandemic, and their perception of dental caries was significantly associated with family income.

Study of Adaptation and Validity Evidence of the Reading Anxiety Scale (RAS-20) - Version for Parents and Guardians / Estudo de Adaptação e Evidências de Validade da Reading Anxiety Scale (RAS-20) - Versão Para Pais e Cuidadores / Estudio de Adaptación y Evidencia de Validez de la Reading Anxiety Scale (RAS-20) - Versión para Padres y Cuidadores

Abstract: Reading anxiety can hinder involvement and performance. This study aimed to present the adaptation and validity evidence of the Reading Anxiety Scale (RAS-20) for parents and guardians. A total of 240 parents and guardians with children aged from eight to 12 years ( M = 9.73; SD = 1.41) took part in the study. A sociodemographic and health conditions questionnaire, the Child Behavior Checklist (CBCL) and the Reading Anxiety Scale (RAS) version for parents and guardians were applied. The results of the confirmatory factor analysis indicated good adjustment rates for the three dimensions assessed by the scale (enjoyment, independence, and difficulty). Convergent validity evidence supported the hypothesis of anxiety as a specific phenomenon, different from general anxiety. The RAS-Version for parents and guardians showed adequate psychometric properties and can contribute to the development of interventions in the clinical, family, and school context.

Resumo: A ansiedade de leitura pode gerar dificuldades de engajamento e desempenho. O estudo teve como objetivo apresentar a adaptação e evidências de validade da Reading Anxiety Scale (RAS-20) para pais e cuidadores. Participaram 240 cuidadores com filhos de idades entre 8 e 12 anos ( M = 9,73; DP = 1,41). Foi utilizado um questionário sociodemográfico e de condições de saúde, a lista de verificação comportamental para crianças ou adolescentes - Child Behavior Checklist (CBCL) e a Reading Anxiety Scale (RAS) versão para pais e cuidadores. Os resultados da análise fatorial confirmatória indicaram bons índices de ajustes para as três dimensões avaliadas pela escala (interesse, independência e dificuldade). As evidências de validade convergente reforçaram a hipótese da ansiedade de leitura como um fenômeno específico, diferente da ansiedade geral. A RAS-versão para pais e cuidadores possui adequadas propriedades psicométricas e pode contribuir com o desenvolvimento de intervenções no âmbito clínico, familiar e escolar.

Resumen: La ansiedad por la lectura puede generar dificultades de compromiso y rendimiento. Este estudio tuvo como objetivo presentar la adaptación y las evidencias de validez de la Reading Anxiety Scale (RAS-20) para padres y cuidadores. Participaron 240 cuidadores con hijos de entre 8 y 12 años de edad ( M = 9,73; DE = 1,41). Se utilizó un cuestionario sociodemográfico y de estado de salud, la lista de control conductual para niños o adolescentes - Child Behavior Checklist (CBCL) - y la Reading Anxiety Scale (RAS), versión para padres y cuidadores. Los resultados del análisis factorial confirmatorio indicaron buenos índices de ajuste para las tres dimensiones evaluadas por la escala (interés, independencia y dificultad). La evidencia de validez convergente reforzó la hipótesis de la ansiedad lectora como un fenómeno específico, diferente de la ansiedad general. La versión RAS para padres y cuidadores tiene propiedades psicométricas adecuadas y puede contribuir al desarrollo de intervenciones en el ámbito clínico, familiar y escolar.

Vacilación ante la vacuna contra el covid-19 en Estados Unidos de América: un estudio etnográfico digital / Hesitation towards the COVID-19 vaccine in the United States: a digital ethnographic study

RESUMEN Luego de que se autorizara en EEUU el uso de la vacuna contra el covid-19 en bebés de seis meses a niños y niñas de cuatro años, algunas personas (padres, madres, pediatras y comunicadores) plantearon la vacunación contra el covid-19 como una cuestión de acceso; sin embargo, muchas otras se mostraron reacias y otras se resistieron a las recomendaciones de los Centers for Disease Control and Prevention de EEUU. En este contexto, este estudio se propuso explorar: 1) reacciones divergentes ante la autorización de uso de la vacuna contra el covid-19 en niños y niñas de seis meses a cuatro años; y 2) lógicas contrapuestas que subyacen a las actitudes provacunación, antivacunación y vacilación ante las vacunas contra el covid-19. Para ello, se realizó una etnografía digital, con monitoreo de 5.700 reacciones a una serie de ocho infografías publicadas en las redes sociales por la John Hopkins Bloomberg School of Public Health, y observación participante en un grupo focal en línea a lo largo de un año, desde diciembre de 2021 hasta diciembre de 2022, conformado por 18 madres. Los resultados indican que el personal médico debe considerar diferentes nociones de "riesgo" al interactuar con los pacientes, especialmente aquellos que dudan en vacunarse.

ABSTRACT Following the authorization the use of COVID-19 vaccines in babies age six months through children four years old in the United States, some individuals (parents, pediatricians, and communicators) framed COVID-19 vaccination as an issue of access, while many others expressed hesitancy and some resisted recommendations from the US Centers for Disease Control and Prevention. In this context, this study aimed to explore: 1) divergent reactions to the authorization of COVID-19 vaccine use in children aged six months to four years; and 2) opposing logics underlying attitudes towards pro-vaccination, anti-vaccination, and vaccine hesitancy regarding COVID-19 vaccines. To achieve this, a digital ethnography was conducted, involving monitoring of 5,700 reactions to a series of eight infographics published on social media by the John Hopkins Bloomberg School of Public Health, and participant observation in an online focus group over a one-year period, from December 2021 to December 2022, consisting of 18 mothers. The findings suggest that healthcare professionals should consider different notions of "risk" when interacting with patients, especially those who are hesitant to vaccinate.

A fase terminal do filho com câncer: percepções dos profissionais hospitalares / The terminal phase of children with cancer: perceptions of hospital professionals / La fase terminal del hijo con cáncer: percepciones de los profesionales del hospital

O confronto com o câncer de um filho e a percepção da sua morte como inevitável dão lugar a experiências parentais relevantes para a pesquisa científica. Este estudo teve como objetivo investigar, por meio da percepção dos profissionais hospitalares, o modo como os pais experienciam a fase terminal e fim de vida do filho com câncer para melhor compreender os processos psicoemocionais experienciados por esses pais diante da cronicidade da doença e da morte do filho. No sentido de alcançar esse objetivo, realizou-se um estudo qualitativo de tipo fenomenológico envolvendo 17 profissionais de dois hospitais portugueses de referência em oncologia pediátrica. Os dados foram recolhidos com recurso a um guia de entrevista semiestruturada. Na percepção dos profissionais hospitalares, os resultados evidenciam que esses pais experienciam múltiplas dificuldades e preocupações na fase terminal da doença do filho e no pós-morte, bem como um sofrimento extremo e desestruturação biopsicossocial e espiritual na família. O conhecimento aprofundado da fenomenologia desses processos é essencial para o desenho e a implementação de intervenções emocionais, cognitivas, comportamentais e sociais mais ajustadas às dificuldades e preocupações parentais vividas no fim de vida e pós-morte.(AU)

Coping with children's cancer and the perception of their inevitable death give rise to parental experiences that are important to study. This study aimed to investigate, based on hospital professionals' perspectives, how parents experience the terminal phase and end of life of their children suffering from cancer to better understand the psycho-emotional processes these parents experienced in face of the chronicity of the disease and their children's death. To achieve this objective, a qualitative phenomenological study was carried out involving 17 professionals of two Portuguese hospitals that are reference in pediatric oncology. Data were collected using a semi-structured interview guide. From the perspective of hospital professionals, results show that these parents experience multiple difficulties and concerns in the terminal phase of their children's disease and postmortem, as well as the extreme suffering and biopsychosocial and spiritual disruption of the family. A deeper understanding of the phenomenology of these processes is essential to design and implement better adjusted emotional, cognitive, behavioral, and social interventions aimed at the parental difficulties and concerns experienced at the end of life and after death.(AU)

El enfrentamiento del cáncer de un hijo y la percepción de su muerte como inevitable dan lugar a experiencias parentales importantes que deben ser estudiadas. Este estudio pretende identificar desde la percepción de los profesionales del hospital cómo los padres viven la fase terminal y el final de la vida de su hijo con cáncer con el fin de comprender mejor los procesos psicoemocionales que viven estos padres ante la cronicidad de la enfermedad y la muerte de su hijo. Para ello, se realizó un estudio cualitativo, con enfoque fenomenológico, en el que participaron 17 profesionales de dos hospitales portugueses de referencia en oncología pediátrica. Para recoger los datos se aplicó un guion de entrevista semiestructurada. En cuanto a la percepción de los profesionales del hospital, estos padres experimentaron múltiples dificultades y preocupaciones en la fase terminal de la enfermedad de su hijo y postmuerte, así como un sufrimiento extremo y una desestructuración biopsicosocial y espiritual en la familia. El conocimiento en profundidad de la fenomenología de estos procesos es esencial para elaborar e implementar intervenciones emocionales, cognitivas, conductuales y sociales más acordes a las dificultades y preocupaciones parentales que se experimentan al final de la vida y la postmuerte.(AU)

Validity and reliability of the Brazilian version of the Illness Perception Questionnaire-Revised for Dental

Abstract This study aimed to test the validity and reliability of the Brazilian version of the "Illness Perception Questionnaire-Revised for Dental" (IPQ-RD) in parents/guardians of children aged six to 14 years. The sample consisted of 63 parents/guardians of schoolchildren from the municipal school system of Teófilo Otoni, MG. Remote and virtual data collection consisted of self-completion of personal data, socioeconomic questionnaire and the Brazilian short versions of the "Parental-Caregiver Perceptions Questionnaire" (16-P-CPQ) and the "Family Impact Scale" (4-FIS). The IPQ-RD was applied by telephone interview. Almost half of the sample belonged to socioeconomic classes C1 and C2. Approximately 1/3 classified their child's oral health as "regular" or "poor", while 11.1% reported "strong" or "very strong" impact on their child's well-being. The items most frequently cited as having an impact on the four domains of the 16-P-CPQ were: "bad breath" (23.8%), "mouth breathing" (20.7%), "feeling anxious or afraid" (20.7%), and "paying attention at school" (10%). In the 4-FIS, 11.1% "had little time for themselves or the family". There were higher IPQ-RD scores in the "disease coherence" domain for women and lower values of "emotional dimensions" for parents/guardians with incomplete education. The mean IPQ-RD score was 126.4 (±15.1), and domain scores were positively correlated. The internal consistency was "almost perfect" for the IPQ-RD total score, ranging from "moderate" to "almost perfect" for the "child-control" and "child-consequences" domains. The intraclass correlation coefficient ranged from 0.04 (poor) to 0.68 (substantial). The Brazilian Portuguese version of the IPQ-RD proved to be valid and reliable for assessing the cognitive and emotional perception of parents/guardians about childhood dental caries.

"Times of war and time of uncertain peace": Narratives of parents of childhood cancer survivors / "Tempos de guerra e tempos de paz incerta": narrativas de pais de sobreviventes de câncer infantojuvenil / "Tiempos de guerra y tiempos de paz incierta": narrativas de padres de supervivientes de cáncer infantojuvenil

Abstract Objective: to analyze the meaning attributed by parents to the extended and permanent survival of childhood cancer. Method: qualitative narrative inquiry, developed with parents of adolescents and young adults who survived childhood cancer. Recruitment and data collection involved virtual and in-person approaches. The data were collected through semi-structured interviews. Data were analyzed according to reflective thematic analysis. Results: a total of ten parents were included in the study. Two thematic narrative syntheses were constructed: "Times of war"; and "Time of uncertain peace", with their respective sub-themes. The cancer diagnosis marks the beginning of times of war in the parents' lives. They experience cancer treatment as "highs and lows" with potential threats to their children's lives. After that, "Time of uncertain peace" are reached, and the balance of the family unit is reestablished. However, the fear of recurrence makes the family peace uncertain, and its maintenance requires constant vigilance and attention to the signs and symptoms of a possible new battle. Conclusion: the results highlight the experience of being a parent of a childhood cancer survivor and can be applied to develop models of care centered on the survivors' family.

Resumo Objetivo: analisar os significados atribuído pelos pais à sobrevivência estendida e permanente ao câncer infantojuvenil. Método: estudo qualitativo narrativo, desenvolvido com pais de adolescentes e adultos jovens que sobreviveram ao câncer infantojuvenil. O recrutamento e a coleta de dados envolveram abordagens virtuais e presenciais. Os dados foram coletados por meio de entrevistas semiestruturadas e analisados segundo análise temática reflexiva. Resultados: um total de dez pais foram incluídos no estudo. Foram construídas duas sínteses narrativas temáticas: "Tempos de guerra"; e "Tempo de paz incerta", com seus respectivos subtemas. O diagnóstico de câncer marca o início de tempos de guerra na vida dos pais. Eles experienciam o tratamento do câncer como "altos e baixos", com ameaças potenciais à vida dos seus filhos. Depois disso, chega-se ao "Tempo de paz incerta" e o equilíbrio da unidade familiar é restabelecido. Porém, o medo da recidiva torna a paz familiar incerta, e sua manutenção exige vigilância constante e atenção aos sinais e sintomas de uma possível nova batalha. Conclusão: os resultados destacam a experiência de ser pai de um sobrevivente de câncer infantil e podem ser aplicados para desenvolver modelos de cuidado centrados na família dos sobreviventes.

Resumen Objetivo: analizar los significados que les atribuyen los padres a la supervivencia prolongada y permanente del cáncer infantojuvenil. Método: estudio narrativo cualitativo, desarrollado con padres de adolescentes y adultos jóvenes que sobrevivieron al cáncer infantojuvenil. El reclutamiento y la recogida de datos se basó en enfoques virtuales y presenciales. Los datos fueron recolectados a través de entrevistas semiestructuradas y analizados según análisis temático reflexivo. Resultados: se incluyeron en el estudio un total de diez padres. Se construyeron dos síntesis narrativas temáticas: "Tiempos de guerra"; y "Tiempo de paz incierta", con sus respectivos subtemas. El diagnóstico de cáncer marca el inicio de tiempos de guerra en la vida de los padres. Viven el tratamiento del cáncer como "altibajos" con amenazas potenciales para la vida de sus hijos. Después llega el "Tiempo de paz incierta" y se restablece el equilibrio de la unidad familiar. Pero el miedo a la recidiva torna incierta la paz familiar, y mantenerla implica un control constante y prestar atención a los signos y síntomas de una posible nueva batalla. Conclusión: los resultados destacan la experiencia de ser padre de un superviviente de cáncer infantil y pueden aplicarse para desarrollar modelos de atención centrados en la familia de los supervivientes.

Percepción de apoyo social en padres de niños con diabetes mellitus tipo 1

Fundamento: el apoyo de familiares y del equipo de salud a los padres cuidadores de sus hijos diabéticos es fundamental para el afrontamiento a los cambios que provoca esta enfermedad en la dinámica familiar. Objetivo: describir la percepción de los padres cuidadores sobre el apoyo familiar y de los Sistemas de Salud en el comienzo de sus hijos con diabetes mellitus tipo 1. Métodos: estudio cualitativo descriptivo realizado mediante entrevista semiestructurada a cuatro padres cuidadores de niños con diagnóstico de diabetes tipo 1. El consentimiento informado fue realizado vía Google Forms y la entrevista fue vía plataforma ZOOM. Las entrevistas tuvieron una duración de 30 minutos. El análisis de las entrevistas se realizó utilizando el programa ATLAS.ti versión 22. Resultados: el comienzo de la enfermedad de los niños fue recibido por los padres con mucha confusión y falta de conocimiento. En cuanto a las redes de apoyo, los padres declararon la soledad como vivencia en el cuidado de los niños y, en relación a los equipos de salud, relataron que está enfocada en los cuidados básicos que tenían que cumplir, como la alimentación y el control glucémico, con ausencia de preocupación por el apoyo emocional. Conclusiones: las necesidades de apoyo desde los equipos de salud, a los padres cuidadores, más allá del control de la enfermedad, es una necesidad explícita desde la evidencia, que aún no ha sido considerada por los Sistemas de Salud. El apoyo debe trascender la familia, con una actuación importante de los profesionales de la salud y todo el contexto en que están insertos los niños, para contribuir a un manejo adecuado de la enfermedad.

Foundation: the support of family members and the health team for parents caring for their diabetic children is essential for facing with the changes that this disease causes in family dynamics. Objective: to describe the perception of parent caregivers about family support and Health Systems at the beginning of their children with type 1 diabetes mellitus. Methods: qualitative descriptive study carried out through semi-structured interviews with four parent caregivers of children with a diagnosis of type 1 diabetes. Informed consent was carried out via Google forms and the interview was via the ZOOM platform. The interviews lasted 30 minutes. The analysis of the interviews was carried out using the ATLAS.ti version 22 program. Results: the beginning of the children's illness was received by parents with much confusion and lack of knowledge. Regarding the support networks, the parents declared loneliness in the experience of caring for the children and, in relation to the health teams, they reported that it is focused on the basic care that they had to fulfill, such as food and hygiene, glycemic control, with absence of concern for emotional support. Conclusions: the support needs from health teams to parent caregivers, beyond disease control, is an explicit need from the evidence, which has not yet been considered by Health Systems. Support must go beyond the family, with important action by health professionals and the entire context in which children are inserted, to contribute to adequate management of the disease.

El pediatra y los padres en la toma de decisiones de tratamiento en plagiocefalia posicional: una revisión narrativa / The pediatrician and parents in treatment decision-making in positional plagiocephaly: A narrative review

La plagiocefalia posicional (PP) es una de las causas más frecuentes de consulta en neurocirugía pediátrica. La incidencia de PP aumentó en los '90, a partir de la campaña Dormir de espaldas. Junto con el aumento de la demanda de atención, se verifica un debate acerca de la eficacia de los distintos tratamientos. La interacción padres ­ pediatra orientada a elegir la mejor terapéutica adquiere importancia, particularmente cuando se trata de decisiones sensibles a la preferencia. Es necesario saber más acerca de la naturaleza de la toma de decisiones de tratamiento de PP, para contribuir al desarrollo de procesos decisorios eficaces. Se realizó una revisión narrativa sobre investigaciones en toma de decisiones de tratamiento en PP. Se identificaron artículos en PubMed y Google Scholar (1990 ­ 2022) en una búsqueda con los descriptores "plagiocephaly", "decision making" y "parents". Se incluyeron artículos cuyo tema central fuera la toma de decisiones en PP, o que la desarrollaran como parte de otro tema. Se excluyeron trabajos en los que la toma de decisiones aparece de modo secundario o tangencial. Se encontraron 3 artículos con distintos diseños metodológicos, en los que la severidad de la presentación, los elementos socioculturales y emocionales, y los aspectos relacionados con el tratamiento son los factores más implicados en la toma de decisiones. Las relaciones entre la ansiedad parental, las expectativas de tratamiento y la percepción subjetiva de la PP, y el rol del pediatra como proveedor de información válida y confiable son temas que necesitan de ulterior investigación (AU)

Positional plagiocephaly (PP) is one of the main reasons for consultation in pediatric neurosurgery. The incidence of PP increased in the 1990s, after the "Back to Sleep" campaign. Concurrently, the growing demand for care has led to a debate regarding the effectiveness of the different treatments. The parent-pediatrician interaction is aimed at choosing the best therapeutic approach becomes important, particularly when it comes to preference-sensitive decisions. There is a need to better understand the nature of PP treatment decision-making in order to contribute to the development of effective decisionmaking processes. In this narrative review, we evaluated the research on treatment decision-making in PP. Articles were identified in PubMed and Google Scholar (1990 - 2022) using the search terms "plagiocephaly", "decision-making" and "parents". Articles were included if their central theme was decision-making in PP, or if they developed it as part of another subject. We excluded articles in which decision-making appeared in a secondary or tangential way. Three articles were identified with different methodological designs, in which the severity of the presentation, sociocultural and emotional aspects, and aspects related to treatment were the factors most implicated in decision making. The relationships between parental anxiety, treatment expectations, subjective perception of PP, and the role of the pediatrician as a provider of valuable and reliable information are topics that require further investigation (AU)

The experience of parental cancer from the parents' perspective: A qualitative study / La experiencia del cáncer parental desde la perspectiva de los padres: Un estudio cualitativo

INTRODUCTION: Parental cancer is the experience of cancer at an early age in adulthood in people with dependent children, leading to changes in parent-child interaction, family dynamics, the performance of the parental role and socio-economic difficulties. OBJECTIVE: To analyze parents' perspectives who are undergoing cancer treatment to understand the impact this has on their parental role. METHODOLOGY: Qualitative study. Data were collected through semi-structured interviews based on a structured script founded on the Betty Neuman Model. The sample consisted of cancer patients in the treatment phase, with different types of cancer, monitored in a Portuguese cancer hospital, with teenage children aged 14 to 19. Data analysis was carried out using content analysis according to Bardin. The ethical assumptions associated with the study were safeguarded. RESULTS: From the analysis of the 13 interviews carried out, the domain Experience of parental cancer emerged, with two categories "Everything changed in us: the cancer diagnosis" and "Life goes on: repercussions of parental cancer on parent-child interaction" and respective subcategories. CONCLUSION: This study demonstrated the implications of the diagnosis of cancer and the repercussions of parental cancer on parent-child interaction. The results will support the design of a nursing intervention program for the dyad experiencing parental cancer.

INTRODUCCIÓN: El cáncer parental comprende la vivencia del cáncer en edades tempranas de la vida adulta, en personas con hijos dependientes, provocando cambios en la interacción padres-hijos, dinámica familiar, desempeño del rol parental y dificultades socioeconómicas. OBJETIVO: Analizar la perspectiva de los padres sometidos a tratamiento contra el cáncer para comprender el impacto en el rol parental. METODOLOGÍA: Estudio cualitativo. La recolección de datos se realizó a través de entrevistas semiestructuradas, a partir de un guión estructurado, basado en el modelo de Betty Neuman. La muestra estuvo compuesta por pacientes oncológicos en fase de tratamiento, con diferentes tipos de cáncer, seguidos en un hospital oncológico portugués, con hijos adolescentes entre 14 y 19 años. El análisis de datos se realizó mediante análisis de contenido según Bardin. Se salvaguardaron los supuestos éticos inherentes a la realización del estudio. RESULTADOS: Del análisis de las 13 entrevistas realizadas surgió el dominio Experimentar el cáncer de los padres, con dos categorías "Todo ha cambiado en nosotros: el diagnóstico del cáncer" y "La vida continúa: repercusiones del cáncer de los padres en la interacción padres-hijos" y sus respectivas subcategorías. CONCLUSIÓN: Este estudio destacó las implicaciones que existen al diagnosticar una enfermedad oncológica y las repercusiones del cáncer de los padres en la interacción entre padres e hijos. Los resultados apoyarán la construcción del diseño de un programa de intervención de enfermería para la díada que experimenta cáncer parental.

Percepção dos pais quanto aos impactos da pandemia do covid-19 no processo de aprendizagem infantil / Parents' perception of the impacts of the covid-19 pandemic on the process of childhood learning / Percepción de los padres sobre los impactos de la pandemia de covid-19 en el proceso de aprendizaje del niño

Introdução: Em 2020, a pandemia do COVID-19 mudou o cenário mundial quando a OMS declarou Emergência de Saúde Pública. Com as mudanças temporárias decorrentes da pandemia e por consequência do isolamento social, diversos setores sofreram adaptações e reajustes temporários. Pensando em reduzir os impactos, houve o retorno das aulas através do Ensino Remoto Emergencial (ERE). Com essas mudanças abruptas, o papel da família no processo de aprendizagem infantil ficou cada vez mais primordial. Objetivo: Analisar a aprendizagem de crianças do ensino infantil e fundamental da rede privada, sob a perspectiva dos pais quanto às práticas escolares remotas durante o isolamento social. Método: Estudo transversal, exploratório e de caráter quanti-qualitativo realizado a partir de um questionário contendo questões objetivas e discursivas no formato online. A pesquisa foi aprovada pelo Comitê de Ética e Pesquisa com Seres Humanos, sob o número de protocolo 4.473.160. Resultados: Os pais afirmam não terem notado dificuldade na aprendizagem das crianças e que não foi necessário fazer aquisição de aparelhos eletrônicos durante o período. Porém, houve flexibilidade curricular. Os participantes apontam que a maioria das escolas não ofereceram capacitação para utilizar os recursos digitais. E, ainda mencionam que houve mudança de humor e no comportamento das crianças. Conclusão: Em tese, o Ensino Remoto Emergencial foi necessário para a continuidade do processo de aprendizagem, contudo adversidades foram encontradas durante o curso, em virtude das escolas e das famílias não estarem preparadas para essa realidade. (AU)

Introduction: In 2020, the pandemic of COVID-19 changed the world scenario when the WHO declared a Public Health Emergency. With the temporary changes resulting from the pandemic and as a consequence of social isolation, several sectors underwent temporary adaptations and readjustments. To reduce the impact, classes have been resumed through Emergency Remote Education (ERE). With these abrupt changes, the family's role in the children's learning process became more and more primordial. Objective: To analyze the learning of children in kindergarten and elementary school in the private network, from the perspective of parents regarding remote school practices during social isolation. Method: Cross-sectional, exploratory, quantitative-qualitative study was carried out using a questionnaire containing objective and discursive questions in an online format. The research was approved by the Ethics and Research with Human Beings Committee, under protocol number 4.473.160. Results: Parents state that they did not notice any difficulty in the children's learning and that it was not necessary to make purchases of electronic devices during the period. However, there was curricular flexibility. The participants pointed out that most schools did not offer training to use digital resources. And, they also mention that there was a change in the mood and behavior of the children. Conclusion: In theory, Emergency Remote Learning was necessary for the continuity of the learning process, but adversities were encountered during the course because schools and families were not prepared for this reality. (AU)

Introducción: En 2020, la pandemia de COVID-19 cambió el escenario mundial cuando la OMS declaró Emergencia de Salud Pública. Los cambios temporales derivados de la pandemia y consecuencia del aislamiento social, varios sectores sufrieron adaptaciones y reajustes temporales. Con el fin de reducir los impactos, se reanudaron las clases a través del Aprendizaje a Distancia de Emergencia (ADE). Con estos cambios abruptos, el papel de la familia en proceso de aprendizaje de los niños se volvió cada vez más importante. Objetivo: Analizar el aprendizaje de los niños en las escuelas de infantil y primaria de la red privada, desde la perspectiva de los padres en relación a las prácticas de la escuela a distancia durante aislamiento social. Método: Estudio transversal, exploratorio y de carácter cuantitativo-cualitativo realizado a partir de un cuestionario conteniendo cuestiones objetivas y discursivas en formato online. La investigación fue aprobada por Comité de Ética e Investigación con Seres Humanos, bajo el número de protocolo 4.473.160. Resultados: Los padres afirman que no notaron dificultad en el aprendizaje de los niños y no fue necesaria adquisición de aparatos electrónicos durante período. Hubo flexibilidad curricular. Los participantes señalan que mayoría de las escuelas no ofrecían formación para utilizar los recursos digitales. También mencionan que hubo cambio de humor y en el comportamiento de los niños. Conclusión: En tesis, el ADE fue necesario para continuidad del proceso aprendizaje, sin embargo, se encontraron adversidades durante el curso, debido que las escuelas y las familias no estaban preparadas para esta realidad. (AU)

Modified Pediatric Penile Perception Scale to Evaluate Cosmetic Outcome in Children With Hypospadias Repair

Objectives: To compare the interpretation for cosmesis post-hypospadias repair by child, parents and surgeons using modified Pediatric Penile Perception Scale (PPPS). Methods: This cross-sectional study involving 50 children (aged 2 to 17 years) with hypospadias was conducted at the pediatric surgery department of our public sector tertiary care hospital. Subjects were assessed 6 months after completion of all stages of hypospadias repair. Cosmetic assessment was done using modified PPPS. We clubbed together the variables ‘meatus’ and ‘glans’ as MG (meatus-glans) complex due to their extreme proximity (embedding), while cosmesis of phallus was considered independently. The modified PPPS scoring parameters included phallus, MG complex, shaft skin, and general appearance. Independent assessment by surgeon, patients and parents was compared, and analyzed using SAS 9.2 statistical software. Cosmetic results of single vs staged repair, and different repair types was compared. Results: Assessment using modified PPPS showed that MG complex cosmesis and skin scarring were the most heeded parameters by all three categories of observers. PPPS by surgeons remained least affected by phallic cosmesis and that of the patient by the overall phallic appearance. Tubularized incised plate urethroplasty (TIPU) scored better on cosmesis. Conclusion: Phallic cosmesis should be considered an independent variable for assessing cosmetic outcome of hypospadias, apart from MG cosmesis.