Family-Centered Early Intervention Program for Brazilian Infants with Congenital Zika Virus Syndrome: A Pilot Study.

Aims: To evaluate the effects of a 16-week program based on Goals-Activity-Motor Enrichment (GAME) principles on infants with congenital Zika virus syndrome (CZS)'s mother report of functional goal achievement, motor and cognitive abilities, home enrichment, and parents' perceptions regarding the service provided. Methods: Quasi-experimental study with infants (n = 32) with CZS and their mothers. Twenty-two infants composed the GAME-based group and 10 were included in the control group. The primary outcome measure was the Canadian Occupational Performance Measure. Secondary outcome measures were the Bayley Scales of Infant and Toddler Development, the Affordances in the Home Environment for Motor Development-Infant Scale, and the Measure of Processes of Care. All measures were performed by blinded assessors. Results: Mothers of infants in the GAME-based group reported significant improvements in their infants' performance on functional priorities (p = 0.0001) and satisfaction with their infants' performance (p = 0.0001), the extent in which services promoted enabling and partnership (p = 0.021), provided general information (p = 0.039), specific information (p = 0.0001), and an enriched home environment (p = 0.0001). Infants in both groups did not improve in motor or cognitive abilities. Conclusions: A family-centered early intervention program based on GAME principles improved mothers' individualized outcomes and enriched infants with CZS's environment. Future studies should elucidate long-term benefits of interventions for this population.

Children with congenital Zika syndrome: symptoms, comorbidities and gross motor development at 24 months of age.

BACKGROUND: Children with congenital Zika syndrome (CZS) maintain severe motor impairments at the end of the first year of life. Presence of certain symptoms and comorbidities increase these children's vulnerability. AIMS: To evaluate gross motor function of a group of Brazilian children with CZS at 24 months of age and to investigate the association between the presence of CZS symptoms and comorbidities with gross motor development. METHODS AND PROCEDURES: Fifty children with CZS participated in the study. Information was collected from medical charts, and gross motor development was evaluated by the Gross Motor Function Measure (GMFM)-88. GMFM-88 scores were compared among comorbid groups. Three subgroups of children were identified by cluster analysis, based on information from head circumference at birth, symptoms, comorbidities and gross motor function. OUTCOMES AND RESULTS: Significant associations (p < 0.001) were observed between number of comorbidities/symptoms and dimensions A (r = -0.57) and B (r = -0.58) of the GMFM-88. Children were grouped into 3 clusters, with different gross motor skills. Children with epilepsy and dysphagia composed the cluster with smaller median scores for dimensions A and B of the GMFM-88. CONCLUSIONS AND IMPLICATIONS: The presence of CZS symptoms and comorbidities compromise the gross motor repertoire of children with CZS at 24 months.

Intervenções de educação em saúde em mães de crianças com paralisia cerebral / Interventions of health education in mothers of children with cerebral palsy

INTRODUCTION: The functional performance of children with cerebral palsy is directly influenced by the therapeutic guidelines offered to caregivers. OBJECTIVE: To evaluate the impact of educational health interventions in mothers of children with cerebral palsy about the guidelines of care. METHODS: A qualitative interventional study developed in three stages between April and October of 2015 in the Núcleo de Tratamento e Estimulação Precoce of the Universidade Federal do Ceará, Brazil. The participants were six mothers of children with cerebral palsy. In the first stage we used the technique of individual semi-structured interviews, full recorded and transcribed for the apprehension and exploration of the speeches; In the second stage, taking into account the saturation and categorization of the speeches, a protocol was developed and applied by the researchers divided into eight interventions of health education in the group of mothers then in the third stage the individual interviews were redone for new exploration and comparison of speeches. The analysis of the data of the speeches was made through content analysis according to the proposal of Bardin. RESULTS: Satisfaction reports on receiving care, improvements in the handling of children, greater safety in the implementation of therapeutic guidelines, better perception about the development of the child with the treatment and higher concern with self-care. CONCLUSIONS: The educational interventions promoted a better perception of mothers of children with cerebral palsy about the therapeutic orientations received from the health team, since they are based on the family-centered model offering conditions to the mothers for the confrontation and reduction of the physical overload, emotional and psychological; through self-care in health, and information about means and adaptations for the adequate continuity of child care.

INTRODUÇÃO: O desempenho funcional de crianças portadoras de paralisia cerebral sofre influência direta das orientações terapêuticas oferecidas aos cuidadores. OBJETIVO: Avaliar os efeitos de intervenções educativas em saúde no conhecimento de mães de crianças com paralisia cerebral sobre as orientações recebidas da equipe multiprofissional em relação ao tratamento de seus filhos MÉTODO: Estudo intervencional qualitativo desenvolvido em três etapas entre os meses de abril a outubro de 2015 no Núcleo de Tratamento e Estimulação Precoce da Universidade Federal do Ceará. As participantes foram seis mães de crianças com paralisia cerebral. Na 1ª etapa utilizou-se a técnica de entrevistas individuais semiestruturadas gravadas e transcritas na íntegra para apreensão e exploração dos discursos; na 2º etapa, levando-se em conta a saturação e categorização dos discursos, foi desenvolvido e aplicado pelas pesquisadoras um protocolo dividido em oito intervenções de educação em saúde no grupo de mães e na 3ª etapa as entrevistas individuais foram refeitas para nova exploração e comparação dos discursos. A análise dos dados dos discursos foi feita por meio de análise de conteúdo conforme a proposta de Bardin RESULTADOS: Relatos de satisfação em receber o cuidado, melhoras no manuseio das crianças, maior segurança na execução das orientações terapêuticas, maior percepção sobre o desenvolvimento da criança com o tratamento e maior preocupação com o autocuidado. CONCLUSÃO: As intervenções promoveram uma melhor percepção das mães de crianças com paralisia cerebral acerca das orientações terapêuticas recebidas da equipe de saúde, na medida em que se baseiam no modelo centrado na família oferecendo condições às mães para o o enfrentamento e redução da sobrecarga física, emocional e psicológica; através do autocuidado em saúde, e informações acerca de meios e adaptações para a continuidade adequada da assistência à criança.

Qualidade de vida de mulheres submetidas à cirurgia de revascularização do miocárdio em um hospital público / Quality of life of women submitted to myocardial revascularization surgery in a public hospital

Analisar o perfil sociodemográfico, fatores de risco e a qualidade de vida de mulheres submetidas à cirurgia de revascularização do miocárdio. Métodos: Realizou-se um estudo qualitativo através da aplicação de um formulário sobre estilo de vida e fatores de risco e de uma entrevista contendo quatro perguntas norteadoras a 15 pacientes revascularizadas internadas nas unidades cardiológicas de um hospital de referência da rede pública e que não apresentavam quadros de depressão anteriores à cirurgia. Resultados: O perfil das pesquisadas mostrou que 9 (60%) eram pardas, 8 (54%) possuíam o ensino fundamental incompleto, 4 (27%) eram donas de casa, 9 (60%) residiam em perímetro urbano, 10 (67%) eram casadas, todas tinham renda familiar abaixo de três salários mínimos e 4 (27%) tinham apenas dois filhos. A partir da análise do conteúdo das entrevistas, emergiram as seguintes categorias: religiosidade, ruptura com o cotidiano, família e qualidade de vida. Conclusão: Constatou-se que o conhecimento a respeito da estrutura psicossocial de cada paciente ajuda no tratamento do indivíduo submetido à cirurgia de revascularização do miocárdio. Ao identificar o estilo de vida e os fatores de risco, as mulheres promovem o autoconhecimento, o que poderá evitar hábitos que levem ao aparecimento de doenças cardiovasculares. Sugerese a elaboração de estratégias de prevenção e promoção de saúde que envolvam as pacientes e seus familiares para que haja uma extensão dos cuidados hospitalares em casa e uma melhor adaptação à nova condição clínica.

To analyze the sociodemografic profile, risck factors and the quality of life of women submitted to myocardial revascularization surgery. Methods: We conducted a qualitative study by applying a questionnaire on lifestyle and risk factors and an interview with four guiding questions to 15 revascularized inpatients of cardiology units of a referral public hospital and who had no manifestations of depression prior to surgery. Results: The patients profile showed that 9 (60%) were Caucasian, 8 (54%) had incomplete primary education, 4(27%) were housewives, 9 (60%) lived in urban area, 10 (67%) were married, all had a family income lower than three minimum wages and 4(27%) had only two kids. From the content analysis of the interviews, the following categories aroused: religiosity, disruption with everyday life, family and quality of life. Conclusion: We found out that the knowledge about the psychosocial structure of each patient helps in the treatment of the individual submitted to myocardial revascularization. By identifying the lifestyle and risk factors, women promote self-knowledge, which can avoid habits that lead to cardiovascular diseases. We suggest the development of strategies for prevention and health promotion involving the patients and their families so that there is an extension of hospital care at home and a betteradaptation to the new condition.