ABSTRACT
Introducción: el presente trabajo es una revisión de las prácticas que abordan la salud mental perinatal de las familias que atraviesan una internación en Unidades de Cuidados Intensivos Neonatales (UCIN). Los logros en la mayor sobrevida de recién nacidos de alto riesgo implican internaciones prolongadas y el cuidado emocional de sus familias. Estado del arte: el marco conceptual se refiere al cuidado centrado en las personas y su expresión perinatal en el modelo de Maternidades Seguras y Centradas en la Familia (MSCF). Se incluyen experiencias de referentes locales e internacionales que orientan las intervenciones en el campo. Conclusiones: se destaca la importancia del cuidado emocional en escenarios altamente estresantes, dado su impacto en el cuidado y la construcción de los vínculos tempranos entre los recién nacidos (RN) internados y sus referentes primarios. Se mencionan factores psicológicos de riesgo y posibles modos de abordaje. Se plantean acciones de promoción, prevención y asistencia en este contexto. (AU)
Introduction: This paper reviews practices addressing the perinatal mental health of families hospitalized in Neonatal Intensive Care Units (NICU). Achievements in increased survival of high-risk newborns involve prolonged hospitalization and emotional care of their families. State of the art:the conceptual framework refers to person-centered care and its perinatal expression in the Safe and Family-Centered Maternity Model (SFCMM). It includes experiences of local and international referents that guide interventions in the field. Conclusions:the importance of emotional care in highly stressful scenarios is highlighted, given its impact on the care and construction of early bonds between hospitalized newborns (NB) and their primary referents. It mentions psychological risk factors and possible approaches. We propose actions for promotion, prevention, and assistance in this context. (AU)
Subject(s)
Humans , Mental Health , Family Health , Patient-Centered Care/methods , Humanization of Assistance , Infant Care/methods , Perinatology , Professional-Family Relations , Infant, Newborn , Intensive Care Units, Neonatal , Psychological Distress , Hospitalization , NeonatologyABSTRACT
Objetivo: Desenvolver uma tecnologia educacional para familiares sobre o banho de ofurô no domicílio em RN. Método: Estudo metodológico de desenvolvimento tecnológico, realizado em três etapas: revisão da literatura, produção tecnológica, validação de conteúdo a partir da manifestação de juízes-especialistas. Coleta de dados por meio de instrumento com escala de Likert. Análise dos dados por aplicação do Índice Kappa e do Índice de Validade de Conteúdo. Resultados: Na etapa de revisão emergiram os temas geradores. Na etapa de produção obteve-se um livro ilustrado digital intitulado "Banho de Ofurô em Casa: Guia de Orientação aos Pais e Familiares de Recém-Nascidos Prematuros e com Baixo Peso". Na etapa de validação verificou-se que a tecnologia é válida e adequada, apresentando informações coerentes com a literatura, organizadas de forma objetiva e clara, contendo descrição detalhada da técnica, com ilustrações expressivas e sincrônicas com o texto. Conclusão: A tecnologia desenvolvida revelou-se válida para a preparação dos familiares para a alta e, com potencial para a difusão do conhecimento quanto ao cuidado neonatal. (AU)
Objective: To develop an educational technology for family members about the hot tub bathing at home for premature and/ or low weight newborns. Methods: Methodological study of technological development, carried out in three stages: literature review, technological production, content validation based on the opinion of 17 expert judges. Data collection using a Likert scale instrument. In the data analysis, the Kappa Index and Content Validity Index were applied. Results: In the review stage, the generating themes emerged. In the production stage, a digital illustrated book was obtained entitled "Bath of Ofuro at Home: Orientation Guide for Parents and Family of Premature and Low Weight Newborns". In the validation stage, it was found that the technology is valid and adequate, presenting information consistent with the literature, organized in an objective and clear manner, containing a detailed description of the technique, with expressive and synchronous illustrations with the text. Conclusion: The technology developed proved to be valid for the preparation of family members for discharge and, with the potential for the dissemination of knowledge regarding neonatal care. (AU)
Objetivo: Desarrollar una tecnología educativa para familiares sobre el baño de ofuro en casa para recién nacidos prematuros y/o de bajo peso. Métodos: Estudio metodológico del desarrollo tecnológico, realizado en tres etapas: revisión de literatura, producción tecnológica, validación de contenido en base a la opinión de 17 jueces expertos. Recolección de datos utilizando un instrumento de escala Likert. En el análisis de datos se aplicó el Índice Kappa y el Índice de Validez de Contenido. Resultados: En la etapa de revisión surgieron los temas generadores. En la etapa de producción se obtuvo un libro ilustrado digital titulado "Baño de ofuro en casa: Guía de Orientación para Padres y Familia de Recién Nacidos Prematuros y de Bajo Peso". En la etapa de validación, se encontró que la tecnología es válida y adecuada, presentando información consistente con la literatura, organizada de manera objetiva y clara, conteniendo una descripción detallada de la técnica, con ilustraciones expresivas y sincrónicas con el texto. Conclusión: La tecnología desarrollada demostró ser válida para la preparación de los familiares para el alta y, con potencial para la difusión de conocimientos sobre la atención neonatal. (AU)
Subject(s)
Humans , Infant, Newborn , Baths/methods , Infant, Low Birth Weight , Infant, Premature , Family , Educational Technology , Humanization of Assistance , Infant Care/methodsABSTRACT
Introducción: La leche materna es el mejor seguro de vida para niños menores de seis meses, pero los alimentados exclusivamente con esta leche no llegan al 40 %, razón para promover la lactancia materna. Objetivo: Evaluar el efecto del cuidado enfermero basado en la teoría de Kristen Swanson en el conocimiento y aceptación de la práctica de la lactancia materna en madres primigestas. Métodos: Investigación cuasi experimental, con pre-test, post-test, en el servicio maternidad y alojamiento conjunto del Hospital Augusto Hernández Mendoza-ESSALUD-ICA, Perú, durante 2016. Universo de 30 primigestas. Información obtenida de las variables cuidado enfermero, nivel de conocimientos y aceptación de la práctica de lactancia materna, con encuesta y lista de chequeo, la intervención consistió en aplicar a las madres cuidados de enfermería basados en Modelo de Kristen Swanson. La información se procesó con distribuciones de frecuencias absolutas, porcentaje, media, desviación típica, varianza, valor mínimo y máximo, la asociación entre variables se obtuvo con las pruebas no paramétrica de Wilcoxon y McNemar, con regla de decisión: Si p ≤ 8804; 0,05 se rechaza Ho. Resultados: El conocimiento de las madres sobre lactancia materna cambió entre las mediciones antes y después de la intervención (z = -5,203, p < 0,05). La proporción de madres que no acepta la lactancia materna disminuyó de 30 por ciento en la medición antes de la intervención a 6,66 por ciento después de la intervención. Conclusión: La aplicación del cuidado de enfermería basado en el modelo de Kristen Swanson fue efectivo en la mejora del conocimiento y aceptación de la práctica de la lactancia materna de las madres primigestas estudiadas(AU)
Introduction: Breast milk is the best life insurance for children under six months, but those fed exclusively with this milk do not reach 40 percent, a reason to promote breastfeeding. Objective: To evaluate the effect of nursing care based on Kristen Swanson's theory on the knowledge and acceptance of the practice of breastfeeding in first-time mothers. Methods: Quasi-experimental research, with pre-test, post-test, in the maternity service and joint accommodation of the Augusto Hernández Mendoza-ESSALUD-ICA hospital, Peru, during 2016. Universe 30 primiparas. Iinformation obtained from the variables of nursing care, level of knowledge and acceptance of breastfeeding practice, with a survey and checklist, the intervention consisted of applying nursing care based on the Kristen Swanson Model to mothers. The information was processed with distributions of absolute frequencies, percentage, mean, standard deviation, variance, minimum and maximum value, the association between variables was obtained with the non-parametric tests of Wilcoxon and McNemar. with decision rule: If p ≤ 0.05, Ho is rejected. Results: Mothers' knowledge of breastfeeding changed between measurements before and after the intervention (z = -5.203, p < 0.05). The proportion of mothers who do not accept breastfeeding decreased from 30.00 percent in the measurement before to 6.66 percent after the intervention. Conclusion: The application of nursing care based on the model of Kristen Swanson was effective in improving the knowledge and acceptance of the practice of breastfeeding in the first-time mothers studied(AU)
Subject(s)
Humans , Female , Infant , Adult , Breast Feeding/adverse effects , Knowledge , Infant Care/methods , Nursing Care/methods , ParentingABSTRACT
INTRODUCCIÓN: La nutrición adecuada durante los primeros dos años de vida es fundamental para el desarrollo pleno del potencial del ser humano. La introducción inadecuada, precoz o tardía de la alimentación complementaria trae consecuencias a corto y largo plazo. La alimentación complementaria depende en gran medida de los conocimientos del cuidador que en los países de Latinoamérica generalmente es la madre. OBJETIVO: construir y validar un instrumento para medir los conocimientos maternos y de cuidadores sobre alimentación complementaria. SUJETOS Y MÉTODO: Estudio de observación. Participaron 80 madres comunitarias y 12 pediatras expertos. Se desarrolló en dos etapas: la creación del instrumento a partir de las 7 fases propuestas por Sampieri, y la validación mediante la evaluación de validez aparente, de constructo, de contenido, consistencia interna y fiabilidad intra-observador. RESULTADOS: Se creó un instrumento autoadministrado que incluyó inicialmente 14 preguntas sobre conocimientos maternos y de cuidadores. Durante la validación de constructo se identificaron 3 dominios y se eliminaron cuatro preguntas. En la validación de contenido, 10 preguntas del instrumento definitivo obtuvieron calificaciones superiores a 9 (en una escala de 0-10) en las características: calidad, vocabulario, relevancia y actualidad. La consistencia interna global del instrumento fue moderada (Alfa de Cronbach: 0,64) y la fiabilidad intra-observador fue aceptable (k: 0,21-0,40) para el 80% de ítems del instrumento. CONCLUSIONES: Se presenta el primer instrumento autoadministrado validado en la región, que permite medir conocimientos de las madres y los cuidadores sobre alimentación complementaria. A futuro, permitirá diseñar y desarrollar estrategias de evaluación e intervención en relación con los conocimientos maternos y de los cuidadores sobre alimentación complementaria.
INTRODUCTION: Adequate nutrition during the first two years of life is crucial for the full development of human potential. Inadequate, early, or late introduction of complementary feeding has consequences in the short- and long-term. Complementary feeding depends largely on the knowledge of the caregiver who, in Latin American countries, is usually the mother. OBJECTIVE: To create and validate an ins trument to measure knowledge about complementary feeding. SUBJECTS AND METHOD: Observational study in which 80 community mothers and 12 expert pediatricians participated. It was carried out in two stages, the creation of the instrument (following the 7 phases proposed by Sampieri) and the va lidation through the evaluation of the apparent validity, construct and content validity, internal con sistency, and intra-observer reliability. RESULTS: A self-administered instrument was created that ini tially included 14 questions about maternal and caregiver's knowledge. During the validation of the construct, 3 domains were identified and four questions were eliminated. In the content validation, 10 questions of the final instrument scored higher than 9 (on a scale of 0-10) in the characteristics of quality, vocabulary, relevance, and topicality. The global internal consistency of the instrument was moderate (Cronbach's alpha: 0.64) and the intra-observer reliability was acceptable (k: 0.21-0.40) for 80% of its items. CONCLUSIONS: the first self-administered instrument validated in the region to measure the knowledge of mothers and caregivers about complementary feeding is presented. It will allow to design and develop strategies in relation to maternal and caregiver's knowledge of comple mentary feeding.
Subject(s)
Humans , Male , Female , Infant , Adult , Middle Aged , Health Knowledge, Attitudes, Practice , Surveys and Questionnaires , Caregivers/psychology , Infant Care/methods , Infant Nutritional Physiological Phenomena , Mothers/psychology , Psychometrics , Observer Variation , Reproducibility of Results , Infant Care/psychologyABSTRACT
INTRODUCCIÓN: La Academia Americana de Pediatría recomienda que los lactantes menores de un año duerman en posición supina para prevenir el síndrome de muerte súbita en lactantes (SMSL). OBJETIVO: Describir la posición en que duermen un grupo de lactantes y factores de riesgo asociados al SMSL. SUJETOS Y MÉTODO: Estudio piloto, prospectivo concurrente, de lactantes < 45 días de vida en control sano en Centro Médico San Joaquín UC Christus. Criterios de exclusión: prematurez (edad gestacional < 37 semanas) y patología de base (respiratorias, metabólicas, cardiológicas). Se aplicó encuesta al cuidador principal respecto a datos demográficos y hábitos de sueño, basada en encuesta BISQ (Brief Screening Questionnaire for Infant Sleep Problems) validada en español, dado la inexistencia de instru mentos para < 3 meses. RESULTADOS: Se obtuvo muestra de 100 lactantes de edad 16,78 ± 12,88 días de vida, siendo 57% mujeres. La madre fue el principal informante (84%). El 79% de los lactantes dor mían en decúbito supino, 19% lo hacía de lado y 2% en prono. El 66% dormía en cuna en habitación de los padres, 31% en la cama de los padres. El 74% se quedaban dormidos durante la alimentación. El 28% de los lactantes estaban expuestos a tabaquismo pasivo. El 91% cuidadores estaba informa do sobre la posición segura de sueño, siendo el principal informante el pediatra (54%). CONCLUSIONES: En esta muestra se encontró alto porcentaje de lactantes < 45 días que duermen en posición no segura, siendo frecuente el colecho. Es importante implementar campañas locales de prevención del SMSL que refuercen el hábito de dormir seguro.
INTRODUCTION: The American Academy of Pediatrics recommends, through the implementation of the "Back to Sleep (BTS)" campaign, the supine sleeping position for infant sleeping since it prevents to prevent Sudden Infant Death Syndrome (SIDS). OBJECTIVE: To describe the sleeping position of a group of infants and the risk factors associated with sudden infant death syndrome (SIDS). SUBJECTS AND METHOD: Prospective pilot study, including infants < 45 days of life in well-child care visits at a medical center. Exclusion criteria: Preterm-born infant (gestational age < 37 weeks) and/or comorbidities (pulmonary, metabolic, cardiologic). A brief parental questionnaire was conducted regarding general demographic data and sleep habits. The questioner was based on the BISQ - Spanish version, due to the lack of validated instruments for infants < 3-month-old. RESULTS: We included a sample of 100 infants between 16.78 ± 12.88 days old (57% girls). Mothers were the main information source (84%). 79% of the infants slept in supine position, 19% slept on their sides, and 2% in prone position. Regarding the place where the infants slept, 66% did in their crib in the parents' room and 31% slept in parents' bed. 74% of infants fell asleep while being fed. 28% of infants were exposed to passive smoking at home. 91% of parents were informed about safe sleep positions, reporting that pediatricians were the main source of information (54%). CONCLUSION: We found a high percentage of infants < 45 days of life who slept in an unsafe position, and frequently co-sleep with their parents. Thus, it is important to implement local SIDS prevention campaigns to reinforce safe infant sleep.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Sleep , Sudden Infant Death/etiology , Sudden Infant Death/prevention & control , Supine Position , Infant Care/methods , Logistic Models , Chile , Pilot Projects , Prospective Studies , Risk Factors , Practice Guidelines as Topic , Protective Factors , Infant Care/standards , Infant Care/statistics & numerical dataABSTRACT
ABSTRACT Objectives: to develop and assess the serious game e-Baby Família with parents of premature infants. Methods: a methodological study regarding the development of the serious game, with participatory design in scope definition, starting from parents' learning needs about premature infant care. A qualitative approach was performed in the assessment stage with parents, with content analysis of the speech of the eight participants. Results: the following categories emerged: Realistic appearance of the virtual setting and game content and Gameplay implications for the use of e-Baby Família. The game was satisfactorily assessed regarding content, appearance and dynamics use, motivating participants to learn. Final Considerations: in the context of prematurity as a public health problem in Brazil and the need to strengthen family health education for care, the serious game was assessed as motivating and appropriate for health learning.
RESUMEN Objetivos: desarrollar y evaluar el serious game e-Baby Família junto a los familiares de los bebés prematuros. Métodos: estudio metodológico en cuanto al desarrollo del juego, con diseño participativo en la definición del tema, partiendo de las necesidades de aprendizaje de los padres sobre los cuidados con el bebé prematuro. Enfoque cualitativo en la etapa de evaluación junto a los familiares, con análisis de contenido de las hablas de los ocho participantes. Resultados: en la evaluación surgieron las categorías: A. Apariencia realista del escenario virtual y contenido del juego, y B. Implicaciones de la jugabilidad para el uso del e-Baby Familia. El juego fue evaluado satisfactoriamente con relación al contenido, apariencia y dinámica de uso, motivando a los participantes al aprendizaje. Consideraciones Finales: en el contexto de la prematuridad como problema de salud pública en Brasil, y de la necesidad de fortalecimiento de la educación en salud de las familias para el cuidado, el serio juego fue evaluado como motivador y adecuado para el aprendizaje en salud.
RESUMO Objetivos: desenvolver e avaliar o Serious Game e-Baby Família junto aos pais de bebês prematuros. Métodos: estudo metodológico quanto ao desenvolvimento do serious game, com design participativo na definição do escopo, partindo-se das necessidades de aprendizagem dos pais sobre os cuidados com o bebê prematuro. Abordagem qualitativa na etapa de avaliação junto aos pais, com análise de conteúdo das falas dos oito participantes. Resultados: na avaliação, emergiram as categorias: Aparência realística do cenário virtual e conteúdo do jogo e Implicações da jogabilidade para o uso do e-Baby Família. O jogo foi avaliado satisfatoriamente com relação ao conteúdo, aparência e dinâmica de uso, motivando os participantes ao aprendizado. Considerações Finais: no contexto da prematuridade enquanto problema de saúde pública no Brasil e da necessidade de fortalecimento da educação em saúde das famílias para o cuidado, o serious game foi avaliado como motivador e adequado para a aprendizagem em saúde.
Subject(s)
Humans , Infant , Infant, Newborn , Parents/education , Infant, Premature , Video Games/trends , Infant Care/methods , Parents/psychology , Brazil , Educational Technology , Infant Care/instrumentationABSTRACT
ABSTRACT Objective: To describe the experience of the 25-year-old trajectory of the Baby Friendly Hospital Initiative (BFHI) in Brazil. The first unit was implemented in 1992. Methods: Information and data were collected from publications on the World Health Organization (WHO), the United Nations International Children's Emergency Fund (UNICEF) and the Ministry of Health websites and in national and international journals, about the period 1990-2017. The descriptors used were: "iniciativa hospital amigo da criança", "hospital amigo da criança", "baby friendly initiative hospital", "aleitamento materno" and "breastfeeding". The number of hospitals in the 25 years, the course of the BFHI and its repercussions on breastfeeding in Brazil were evaluated. Results: The BFHI is an intervention strategy in hospital care at birth focused on the implementation of practices that promote exclusive breastfeeding from the first hours of life and with the support, among other measures of positive impact on breastfeeding, of the International Code of Marketing of Breastmilk Substitutes. Currently, the initiative has been revised, updated and expanded to integrate care for newborns in neonatal units and care for women since prenatal care. It can be concluded that, during these 25 years, the quantity of hospitals varied greatly, with numbers still below the capacity of hospital beds. BFHI shows higher rates of breastfeeding than non-accredited hospitals. However, the number of hospitals are still few when compared to other countries. Conclusions: The BFHI has contributed to breastfeeding in Brazil in recent decades. Greater support for public policies is needed to expand the number of accredited institutions in the country.
RESUMO Objetivo: Descrever a experiência de 25 anos da Iniciativa Hospital Amigo da Criança (IHAC) no Brasil, cuja primeira unidade foi implementada em 1992. Métodos: Informações e dados foram obtidos em publicações nos sites da Organização Mundial da Saúde (OMS), do Fundo Internacional de Emergência para a Infância das Nações Unidas (UNICEF) e do Ministério da Saúde e em periódicos nacionais e internacionais, abrangendo o período de 1990 a 2017. Utilizaram-se os descritores: "iniciativa hospital amigo da criança", "hospital amigo da criança", "baby friendly initiative hospital", "aleitamento materno" e "breastfeeding". Foram avaliados o número de hospitais nos 25 anos, a trajetória da IHAC e suas repercussões sobre o aleitamento materno no Brasil. Resultados: A IHAC é uma estratégia de intervenção na assistência hospitalar ao nascimento com foco na implementação de práticas que promovem o aleitamento materno exclusivo desde as primeiras horas de vida e com o apoio, entre outras medidas de impacto positivo na amamentação, do Código Internacional de Comercialização de Substitutos do Leite Materno. Atualmente, a iniciativa foi revisada, atualizada e expandida para integrar o cuidado aos recém-nascidos nas unidades neonatais e na atenção à mulher desde o pré-natal. Pôde-se concluir que, ao longo desses 25 anos, a quantidade de hospitais variou muito, com números ainda aquém da capacidade de leitos hospitalares. Hospitais credenciados como o Hospital Amigo da Criança mostram índices de amamentação superiores ao de hospitais não credenciados, entretanto o número de hospitais credenciados no Brasil ainda é pouco se comparado com outros países. Conclusões: A IHAC contribuiu para o aleitamento materno no Brasil nessas últimas décadas. Mais apoio pelas políticas públicas é necessário para ampliar o número de instituições credenciadas no país.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adult , Breast Feeding/methods , Breast Feeding/statistics & numerical data , Health Promotion/standards , Hospitals/standards , Infant Care/standards , Brazil , Quality Improvement/statistics & numerical data , Health Promotion/methods , Health Promotion/statistics & numerical data , Infant Care/methods , Infant Care/statistics & numerical dataABSTRACT
Resumen: Introducción: La alimentación complementaria (AC) comprende un periodo en la vida del lactante que inicia cuando se introducen alimentos diferentes a la leche materna. Está determinada por fac tores sociales y del medio ambiente, que facilitan o limitan el inicio adecuado de esta práctica, inci diendo directamente en el estado nutricional y de salud de los niños. Objetivo: Identificar barreras y facilidades para el seguimiento de las recomendaciones nutricionales en relación al inicio temprano de la AC en niños y niñas entre 0 y 24 meses de edad en una población perteneciente a un programa de atención integral a la primera infancia. Sujetos y métodos: Estudio cualitativo fenomenológico, longitudinal, seleccionando a través de una muestra intencionada 43 madres, a las que se les realizó entrevistas en profundidad y 11 grupos focales. Las categorías predefinidas fueron el contexto de la madre, representaciones y experiencias frente a la gestación, significados y experiencias de la lactan cia materna (LM), y la AC. El análisis comprendió las relaciones entre las unidades de significado y categorías predefinidas y emergentes. Resultados: AC es una práctica social que resulta de la mezcla de saberes médicos y populares, sin embargo, el grado de influencia que tienen estos últimos en las madres es mayor debido al grado de acompañamiento que tienen de su círculo cercano, en especial madres, abuelas y mujeres de la familia. El desconocimiento sobre lactancia materna exclusiva (LME) y AC en términos conceptuales y prácticos, impide que las madres puedan llevar a cabo prácticas ade cuadas. La gran mayoría no tiene claridad sobre lo que implica la exclusividad de la LM, resultando en un inicio temprano de la AC, o no cuentan con criterios objetivos para valorar su producción de leche. A pesar de haber recibido capacitación, la AC inició de manera temprana en la mayoría de los casos, hecho en el que la influencia familiar cercana fue decisiva. Conclusiones: La experiencia de la AC está fuertemente influenciada por el entorno cercano de la madre y las recomendaciones que reciben de profesionales de la salud no son suficientes para transformar sus prácticas. Por lo anterior se hace necesario el mejoramiento de las intervenciones de apoyo en materia de AC.
Abstract: Introduction: The complementary feeding (CF) comprises a period in the life of the infant that starts with the introduction of foods other than breast-milk. It is determined by social and environmental factors which facilitate or limit the appropriate initiation of this practice, directly affecting the nutri tional and health status of children. Objective: To identify barriers and facilities for the follow-up of nutritional recommendations regarding the early start of CF in children between 0 and 24 months of age belonging to a comprehensive early childhood care program. Materials and methods: Phenome nological, longitudinal, qualitative study in which 43 in-depth interviews and 11 focus-groups were carried out. Predefined categories were the context of the mother, representations and experiences of gestation, meanings and experiences of breastfeeding (BF), and CF. The analysis included the rela tionships between the units of meaning and predefined and emerging categories. Results: The CF is a social practice which is the result of medical and popular knowledge mixture, however, the degree of influence that the latter has on mothers is higher due to the degree of support that they have from their close circle, especially from mothers, grandmothers, and women of the family. The lack of con ceptual and practical knowledge about exclusive breastfeeding (EBF) and CF prevents mothers from carrying out good practices. Most of them do not know clearly what is involved in the EBF, resulting in an early start of CF, or do not have objective criteria to assess their milk production. Despite having received specific training, CF started early in most cases, a fact in which close family influence was decisive. Conclusions: The CF experience is strongly influenced by sociocultural aspects not only of the mother but of her immediate circle, and the recommendations they received from health pro fessionals are not enough to change their practices. Therefore, it is necessary to improve CF support interventions.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Adolescent , Adult , Young Adult , Social Behavior , Health Knowledge, Attitudes, Practice , Infant Care/methods , Infant Nutritional Physiological Phenomena , Maternal Behavior/psychology , Breast Feeding/psychology , Interviews as Topic , Longitudinal Studies , Focus Groups , Colombia , Qualitative Research , Family Relations , Infant Care/psychologyABSTRACT
Conclusão: A vivência de mães de crianças com SD é difícil, mas prazerosa, visto que dela depende todos os cuidados direcionados a criança. Desde o impacto do diagnóstico até o cotidiano do cuidado, muitas são as dificuldades enfrentadas por elas, incluindo a descriminação e os cuidados diários que exige muito amor e determinação. Suas crianças necessitam participar de inúmeras atividades que lhes estimulem ao máximo, para que possam desenvolver suas habilidades. Além disso, as idas e vindas a diferentes especialistas também contribuem para a sobrecarga de trabalho. Para tanto, estas mães devem receber apoio tanto da família, quanto da equipe multiprofissional e dos grupos de apoio, com vista a empoderá-las para o cuidado.
Subject(s)
Humans , Female , Infant, Newborn , Infant , Down Syndrome/nursing , Infant Care/methods , Maternal-Child Health Services , Child Care/methodsABSTRACT
Resumo Este estudo teve por objetivo conhecer a opinião das mães e identificar os fatores associados à intenção de colocar o bebê para dormir em decúbito dorsal em Rio Grande, RS. Foi aplicado questionário padronizado a todas as mães que tiveram filho nas duas únicas maternidades, entre 01/01 a 31/12/2010, e que residiam neste município. Utilizou-se teste do qui-quadrado para comparar proporções e regressão de Poisson, com ajuste robusto da variância na análise multivariável. A medida de efeito utilizada foi razão de prevalências (RP). Dentre as 2.395 (97,2% do total) mães entrevistadas, 20,5% (IC95%: 18,4%-21,6%) manifestaram intenção de colocar o bebê para dormir de barriga para cima. Esta intenção variou de 11% (IC95%: 8,1-13,7), entre mães com três ou mais filhos, a 35% (IC95% 31,1-40,2), entre aquelas com 12 anos ou mais de escolaridade. Após analise ajustada, mães de menor idade, de maior escolaridade e renda familiar, que realizaram pré-natal na rede privada, ou que tiveram três ou mais filhos, apresentaram RP significativamente maior para colocar o bebê para dormir de barriga para cima, em relação às demais. Campanhas de incentivo a esta prática devem priorizar mães de pior nível socioeconômico, de maior idade e que realizam pré-natal em unidades básicas de saúde.
Abstract This study aimed to identify mother's opinion on infant sleep position and the factors associated with the intention to place the infant in the supine position in the municipality of Rio Grande, Southern Brazil. A standardized questionnaire was applied to all mothers residing in this municipality who gave birth to a child in the only two local maternity wards from January 1 to December 31, 2010. Chi-square test was used to compare proportions, along with a Poisson regression with robust adjustment in the multivariate analysis. The effect measure used was prevalence ratio (PR). Of the 2,395 mothers interviewed (972% of the total), 20.5% (95%CI: 18.4%-21.6%) intended to place the newborn to sleep in the supine position. This prevalence varied from 11% (95%CI: 8.1-13.7) for mothers with three or more children to 35% (CI95%: 31.1-40.2) among those with 12 or more years of schooling. After adjusted analysis, younger mothers with higher education and household income who performed prenatal care in the private system or who have had three or more children had significantly higher PR to place the baby to sleep in the supine position compared to others. Campaigns encouraging this practice should focus primarily on older mothers of lower socioeconomic level and performing prenatal care in PHC facilities.
Subject(s)
Humans , Infant, Newborn , Adult , Young Adult , Sleep/physiology , Supine Position , Infant Care/methods , Mothers/statistics & numerical data , Prenatal Care/methods , Socioeconomic Factors , Brazil , Poisson Distribution , Multivariate Analysis , Age Factors , Intention , Educational Status , Income , Mothers/psychologyABSTRACT
Durante la infancia es muy frecuente encontrar alteraciones del desarrollo,las cuales derivan de una defi ciente formación de las estructurasanatómicas durante la embriogénesis. Puede encontrarse un sinnúmerode alteraciones del desarrollo que afectan la región bucal y maxilofacial.La gran mayoría de estas alteraciones han sido catalogadas como síndromes de orden genético; sin embargo, no todas pueden describirse como tales, pues existen anomalías del desarrollo que aparecen como consecuencia de una deficiente embriogénesis de la región facial, provocando alteraciones anatómicas y funcionales, pero que se apartan de componentes genéticos y cromosómicos específi cos. La secuencia malformativa de Pierre Robin es una de ellas, ya que esta condición es producida por una afección inicial, de la cual derivarán otras afeccionesadicionales a nivel del paladar y de la mandíbula que ocasionarán en elpaciente dificultad para la alimentación y respiración. Debido a que las alteraciones de esta condición afectan directamente la cavidad bucal,es crucial que el odontólogo se encuentre familiarizado con esta anomalía. El objetivo del presente artículo es describir las característicasque configuran esta entidad nosológica mediante la exposición de un caso clínico y revisión de la literatura.
During childhood, it is frequent to find development disorders whichare linked to the weak formation of anatomic structures duringembryogenesis. It is possible to find a plethora of developmentdisorders that aff ect the oral and maxillofacial region. The majorityof these disorders has been classifi ed as genetic malformations butnot all can be described as such. That is because some developmentdisorders appear as a result of a defi cient embryogenesis of the face,producing thus anatomic and functional malformations but that standapart from genetic and chromosomic specifi c components. The Pierre Robin sequence is one of them, given that this condition is producedby an initial disorder, followed by other disorders in the palate andjaw; provoking alimentary and breathing disabilities in the patient.Due to these disorders and their impact on the mouth, it is crucial thatdentists be familiarized with such anomalies. The aim of this article isto describe the key characteristics that defi ne this disease through thepresentation of a clinical case and a literature review.
Subject(s)
Male , Humans , Infant, Newborn , Dental Care for Chronically Ill/methods , Infant Care/methods , Pierre Robin Syndrome/etiology , Pierre Robin Syndrome/genetics , Pierre Robin Syndrome/pathology , Cleft Palate/etiology , Deglutition Disorders/etiology , Mexico , Maxillofacial Development/physiology , Micrognathism/etiology , Palatal ObturatorsABSTRACT
Compreender as vivências de pais cegos nos cuidados relacionados à amamentação e alimentação complementar dos filhos. Métodos: pesquisa qualitativa, com participação de quatro mães e cinco pais cegos. Realizaram-se entrevistas domiciliares sobre a experiência de alimentar crianças no contexto da cegueira, categorizadas pela técnica de análise temática. Resultados: emergiram três categorias: Amamentação e alimentação complementar ofertadas por mães cegas; Pais cegos e a alimentação dos filhos; e Cuidado dos filhos e a cegueira: estratégias de enfrentamento, em que foram ressaltadas dificuldades e alternativas desenvolvidas para alimentar os filhos. Conclusão: os pais cegos possuem dificuldades semelhantes aos pais videntes, porém com demandas específicas, associadas ao manuseio de utensílios na oferta segura e satisfatória do alimento.
Objective: to understand the experiences of blind parents in care related to breastfeeding and complementary feeding of children. Methods: qualitative research with the participation of four blind mothers and five blind fathers. Home interviews were carried out to address the experience of feeding children in the context of blindness, categorized by the technique of thematic analysis. Results: Three categories emerged: Breastfeeding and complementary feeding offered by blind mothers; Blind fathers and the feeding of children; and Care of the children and blindness: coping strategies, in which difficulties and alternatives developed to feed the children were highlighted. Conclusion: blind parents have difficulties similar to those seer parents but with specific demands associated with the handling of utensils in safe and satisfactory supply of food.
Subject(s)
Humans , Male , Female , Young Adult , Infant Care/methods , Infant Nutrition , Visually Impaired Persons , Parent-Child Relations , Surveys and QuestionnairesABSTRACT
Introducción: cuando la mujer vive la experiencia del nacimiento de un hijo se ve enfrentada a una serie de tareas nuevas relacionadas con el rol de madre; el nivel de seguridad que ella tenga en el inicio de su maternidad puede estar fuertemente ligado a su visión de futuro en la forma de criar a su hijo. Objetivo: determinar las expectativas de crianza en madres de recién nacidos a término y pretérmino. Métodos: estudio de corte transversal realizado durante septiembre de 2013 y enero de 2014. Muestra no probabilística, conformada por 340 madres: 162 (47,65 por ciento) madres de recién nacidos a término y 178 (52, 35 por ciento) madres de recién nacidos pretérmino, nacidos en Bucaramanga (Colombia). La información se recolectó mediante el Inventario de Paternidad para Adultos y Adolescentes. Se utilizó el programa Stata versión 12R para el procesamiento y análisis de la información según instructivo. Resultados: el grupo de madres de recién nacidos pretérmino presentaron mejores expectativas de crianza que el grupo de las madres de recién nacidos a término, cuyos puntajes en las cuatro dimensiones se ubicaron en alto riesgo de negligencia en el cuidado. Conclusiones: el conocimiento de las expectativas de crianza de las madres, tanto de recién nacidos a término como de recién nacidos pretérmino, permitirá establecer intervenciones de enfermería para el fortalecimiento del rol materno(AU)
Introduction: When women live the experience of childbirth is faced with a number of new tasks related to the role of mother; the level of security that she has at the start of her maternity may be strongly linked to its vision on how to raise your child. Objective: To determine parenting expectations of mothers of term and preterm infants. Methods: This was a cross-sectional study conducted between September 2013 and January 2014. The sample was non-probabilistic and included 340 mothers: 162 (47,65 percent) mothers of term infants and 178 (52,35 percent) mothers of preterm infants, from Bucaramanga (Colombia). The information was collected using the Adult-Adolescent Parenting Inventory. The Stata version 12R program was used for data processing and analysis according to the instructions. Results: The group of mothers of preterm infants had better parenting expectations than the group of mothers of term infants, whose scores on the four dimensions indicated a high risk of negligence in child care. Conclusions: Knowing the parenting expectations of mothers of term and preterm infants will allow to establish nursing interventions aimed at strengthening the maternal role(AU)
Subject(s)
Humans , Female , Infant, Newborn , Infant , Child Rearing/trends , Data Collection , Infant Care/methods , Mother-Child Relations , Infant, Premature , Cross-Sectional StudiesABSTRACT
Introducción: durante el nacimiento del primer hijo, la madre brinda prácticas de cuidado de acuerdo a sus mitos y creencias, adquiridos por transmisión generacional tanto familiar como cultural. Objetivo: describir los mitos, creencias y prácticas de las puérperas en relación al cuidado de su primer hijo. Métodos: estudio fenomenológico y hermenéutico. Población de 15 madres puérperas primigestantes, con edades entre 14 y 30 años. La información se obtuvo mediante entrevistas. Resultados: mujeres amas de casa con una tipología familiar extensa, con características socioculturales muy marcadas que facilitan la falta de conocimientos frente al cuidado de su primer hijo. De igual manera, el significado de tener un primer hijo se asocia a una experiencia nueva, con sentimientos de felicidad, alegría, amor y unión familiar. Conclusiones: las madres jóvenes presentaron una serie de creencias y mitos que repercuten en el bienestar el niño. Describen la experiencia de su primer hijo como algo nuevo que requiere un proceso de aprendizaje único aunque complicado, se evidenció fuerte influencia de las mujeres cercanas a la familia(AU)
Introduction: During the birth of the first child, the mother provides care practices by her myths and beliefs, generationally transmitted by both the family and the cultural context. Objective: To describe the myths, beliefs and practices of the puerperae regarding the care for the first child. Methods: Phenomenological and hermeneutic study. Target group of 15 first-time puerperae mothers, at ages 14-30. The information was obtained by interview. Results: Housewives women with diverse family typologies, much marked sociocultural characteristics that foster the lack of knowledge regarding the care for the first child. Also, the meaning of having the first child is associated with a new experience, with feelings of happiness, love and family junction. Conclusions: The young mothers presented a series of beliefs and myths that have a repercussion in the child welfare. They describe the first child experience as something new requiring a unique learning process, complicated though. A strong influence was observed from the family close women(AU)
Subject(s)
Humans , Female , Infant , Adult , Postnatal Care/trends , Cultural Characteristics , Infant Care/methods , Religion , Data Collection/methodsABSTRACT
OBJECTIVE To assess the determinants of exclusive breastfeeding abandonment. METHODS Longitudinal study based on a birth cohort in Viçosa, MG, Southeastern Brazil. In 2011/2012, 168 new mothers accessing the public health network were followed. Three interviews, at 30, 60, and 120 days postpartum, with the new mothers were conducted. Exclusive breastfeeding abandonment was analyzed in the first, second, and fourth months after childbirth. The Edinburgh Postnatal Depression Scale was applied to identify depressive symptoms in the first and second meetings, with a score of ≥ 12 considered as the cutoff point. Socioeconomic, demographic, and obstetric variables were investigated, along with emotional conditions and the new mothers’ social network during pregnancy and the postpartum period. RESULTS The prevalence of exclusive breastfeeding abandonment at 30, 60, and 120 days postpartum was 53.6% (n = 90), 47.6% (n = 80), and 69.6% (n = 117), respectively, and its incidence in the fourth month compared with the first was 48.7%. Depressive symptoms and traumatic delivery were associated with exclusive breastfeeding abandonment in the second month after childbirth. In the fourth month, the following variables were significant: lower maternal education levels, lack of homeownership, returning to work, not receiving guidance on breastfeeding in the postpartum period, mother’s negative reaction to the news of pregnancy, and not receiving assistance from their partners for infant care. CONCLUSIONS Psychosocial and sociodemographic factors were strong predictors of early exclusive breastfeeding abandonment. Therefore, it is necessary to identify and provide early treatment to nursing mothers with depressive symptoms, decreasing the associated morbidity and promoting greater duration of exclusive breastfeeding. Support from health professionals, as well as that received at home and at work, can assist in this process. .
OBJETIVO Avaliar os determinantes ao abandono do aleitamento materno exclusivo. MÉTODOS Estudo longitudinal baseado em coorte de nascimentos realizado em Viçosa, Minas Gerais. Acompanharam-se 168 puérperas provenientes da rede pública de saúde em 2011/2012. Foram realizadas três entrevistas com as puérperas: aos 30, 60 e 120 dias após o parto. O abandono do aleitamento materno exclusivo foi analisado no segundo e quarto meses após o parto. Aplicou-se escala Edinburgh Post-Natal Depression Escale para identificar os sintomas depressivos no primeiro e segundo encontros, adotando-se o ponto de corte ≥ 12. Foram investigadas variáveis socioeconômicas, demográficas, obstétricas, condições emocionais e rede social da puérpera durante a gestação e puerpério. RESULTADOS As prevalências de abandono do aleitamento materno exclusivo aos 30, 60 e 120 dias após o parto foram 53,6% (n = 90), 47,6% (n = 80) e 69,6% (n = 117), respectivamente, e sua incidência no quarto mês em relação ao primeiro foi 48,7%. Sintomas de depressão pós-parto e parto traumático associaram-se com abandono do aleitamento materno exclusivo no segundo mês após o parto. No quarto mês, mostraram significância as variáveis: menor escolaridade materna, não possuir imóvel próprio, ter voltado a trabalhar, não ter recebido orientações sobre amamentação no puerpério, reação negativa da mulher com a notícia da gestação e não receber ajuda do companheiro com a criança. CONCLUSÕES Fatores psicossociais e sociodemográficos se mostraram fortes preditores do abandono precoce do aleitamento materno exclusivo. Dessa forma, é necessário identificar e tratar precocemente as nutrizes com sintomatologia depressiva, reduzindo ...
Subject(s)
Adult , Female , Humans , Infant , Infant, Newborn , Young Adult , Breast Feeding/psychology , Infant Care/methods , Mothers/psychology , Brazil , Breast Feeding/statistics & numerical data , Depression, Postpartum , Longitudinal Studies , Mother-Child Relations , Postpartum Period/psychology , Risk Factors , Socioeconomic FactorsABSTRACT
Introducción: el avance científico y tecnológico en la salud perinatal ayudó a mejorar el índice de supervivencia de niños que nacen con tiempo de gestación de entre 34 y 36 semanas y 6 días,denominados pretérmino o prematuros. El estudio tuvo como objetivo conocer la producción científica sobre prematuridad tardía. Métodos: revisión integradora, debido a que permite incluir diferentes tipos de estudios, ofreciendo una perspectiva más amplia sobre el tema en cuestión. Las investigaciones se publicaron en el periodo de julio de 2002 a julio de 2012, en las bases de datos SciELO, CINAHAL y ScienceDirect. Los datos se analizaron y se categorizaron en tres semanas. El primer grupo fue de riesgos relacionados a la morbimortalidad en la prematuridad tardía; el segundo, conducta terapéutica y condición de salud en la prematuridad tardía; y el último consideró las repercusiones de la prematuridad en la infancia. Resultados: la mayoría de las investigaciones publicadas -aun así, escasas- se referían a losriesgos relacionados a la morbimortalidad en la prematuridad tardía, con un incremento en los últimos cuatro años. Predominaron las publicaciones estadounidenses. Conclusión: se percibe la necesidad de publicaciones sobre el cuidado de enfermería pensado para estos prematuros(AU)
Introduction: Scientific and technological advances in perinatal heath have helped improve survival among children born at gestational ages between 34 and 36 weeks and 6 days, known as preterm or premature children. The study was aimed at acquiring knowledge about the scientific production on late prematurity. Methods: An integrating review was conducted which included various types of studies, thus offering a broader outlook on the topic. The papers surveyed were published from July 2002 to July 2012 in databases SciELO, CINAHAL and ScienceDirect. Data were analyzed and classified into three categories: risks related to morbidity and mortality in late prematurity; therapeutic management and health status in late prematurity; and effects of prematurity upon childhood. Results: Most of the studies published -scarce as they were- referred to risks related to morbidity and mortality in late prematurity, with an increase in the last four years. There was a predominance of US publications. Conclusion: A need is perceived of studies about the nursing care of preterm babies(AU)
Subject(s)
Humans , Infant, Newborn , Infant, Premature/growth & development , Indicators of Morbidity and Mortality , Infant Care/methods , Nursing Care/methods , Review Literature as Topic , Databases, BibliographicABSTRACT
O estudo objetivou apreender o significado do centro de educação infantil (CEI) para mães que tinham filhos ingressantes nestas instituições e analisar a percepção delas quanto aos cuidados prestados a seus filhos. Trata-se de um estudo descritivo-exploratório com abordagem quantiqualitativa, realizado por meio de entrevista semiestruturada, em junho de 2009, junto a 12 mães residentes no município de Maringá/PR, tendo como referencial a Teoria do Apego de Bowlby e os dados submetidos à análise de conteúdo temática. Percebe-se que a decisão ou necessidade em deixar a criança em CEI traz consequências positivas, como realização profissional e/ou melhor remuneração da mãe e maior socialização da criança, mas o cuidado ao filho por terceiros ainda é percebido com restrições. Conclui-se que os profissionais envolvidos no processo de cuidado em CEI precisam estar habilitados para apoiar e ajudar o binômio mãe-filho na adaptação, visando reduzir os receios e os sentimentos negativos nesse momento.
This study aimed both at understanding the relevance of the child education center (CEI) to the mothers whose children were admitted there and at analyzing their perceptions regarding the care their children had. This is a descriptive-exploratory study with quantitative-qualitative approach, undertaken by means of semi-structured interview in June, 2009, with twelve mothers residing in Maringá, PR, Brazil. The theoretical framework consisted of Bowlbys Attachment Theory and the data underwent thematic content analysis. The decision or the need to leave the child at CEI proved to bring about positive consequences, namely, professional achievements and/or better remuneration to the mother, and higher socialization to the child. However, the use of third parties in child care is still regarded with restrictions. Conclusions show that the professionals involved in child care at CEI must have the skills to support the mother-child relation in the adaptation process so that negative feelings can be attenuated.
El estudio objetivó capturar el significado del centro de educación infantil (CEI) para madres que tenían hijos ingresantes en esas instituciones y analizar la percepción de ellas cuanto a los cuidados prestados a sus hijos. Se trata de un estudio descriptivo-exploratorio con enfoque cuantitativo y cualitativo, realizado por medio de entrevista semiestructurada, en junio de 2009, con 12 madres residentes en el municipio de Maringá-PR-Brasil, teniendo como referencial la Teoría del Afecto de Bowlby, y los datos sometidos al análisis de contenido temático. Se percibe que la decisión o necesidad en dejar el niño en CEI tras consecuencias positivas, como realización profesional y/o mejor remuneración de la madre y mayor socialización del niño, pero el cuidado al niño por otras personas aún es percibido con restricciones. Se concluye que los profesionales participantes del proceso de cuidado en CEI necesitan estar habilitados para apoyar y ayudar el binomio madre-hijo en la adaptación, mirando reducir los miedos y los sentimentos negativos en ese momento.
Subject(s)
Infant , Affect , Infant Care/methods , Child Rearing , Nursing/methods , Mother-Child Relations , Data Interpretation, Statistical , Brazil , Child Day Care Centers , Parental Leave , Qualitative Research , Nursing TheoryABSTRACT
La sobrevida creciente en recién nacidos con bajo peso presenta varios dilemas a la salud materno-infantil. Se realizó un estudio de intervención, pre experimental, descriptivo, con el objetivo de implementar el método Madre Canguro como alternativa al método convencional en la atención a los recién nacidos pretérmino y de bajo peso durante el año 2007 al 2010 en el Hospital Provincial Dr Antonio Luaces Iraola. Se implementó el método en el 51,7 por ciento de los recién nacidos pretérmino y bajo peso. El 70,9 por ciento de las madres estuvieron satisfechas con el mismo; el 56,6 percent de los niños egresaron con lactancia materna exclusiva; las complicaciones respiratorias fueron la apnea del pretérmino y la broncoaspiración con un 2 por ciento cada una, presentaron hipotermia solo el 3,1 por ciento de los niños, el 93 por ciento de los neonatos tuvieron una ganancia normal o superior de peso, el estado neurológico al egreso fue normal en el 91 por ciento de los niños, el 7 por ciento de los neonatos presentaron infección nosocomial durante su estancia en la sala Piel a Piel y no se presentó mortalidad infantil. Se recomienda extender la aplicación de este método a recién nacidos de menor peso y, de ser posible, de forma más precoz.
Increasing survival in low birth weight has several dilemmas to the maternal-child health. An interventional, pre experimental, descriptive study, was conducted with the aim of implementing the Kangaroo-Mother care method as an alternative to the conventional method in attention to the preterm and low weight infants from 2007 to 2010 in the Provincial Hospital Dr Antonio Luaces Iraola in Ciego de Avila. The method was implemented in 51.7 percent of the preterm birth and a low birth weight. 70.9 percent of mothers were satisfied; 56.6 percent of children was withdrew with exclusive breastfeeding; respiratory complications were the preterm apnea and bronchoaspiration with 2 percent each, only 3.1 percent of children presented hypothermia, 93 percent of infants had a higher or normal weight gain; neurological status at discharge was normal in 91 percent of children, 7 percent of neonates presented nosocomial infection during their stay in Skin to Skin room and there was not infant mortality. It is recommended to extend the application of skin to skin method to less weight newborns and, if it is possible, more early.