Meanings attributed to health-related quality of life by caregivers of adolescents with diabetes.

OBJECTIVE: to interpret the meanings attributed to the health-related quality of life by caregivers of adolescents with type 1 diabetes mellitus. METHODS: qualitative, descriptive-exploratory study of 14 caregivers of adolescents with diabetes developed at the reference outpatient clinic for endocrine diseases in a city in the state of Paraíba. Interviews were performed between May and September 2021. Inductive thematic analysis of the empirical material, and its interpretation in light of the concepts of health-related quality of life and family functioning were performed. RESULTS: the meanings attributed by caregivers to the health-related quality of life of adolescents converged on the feeling of being healthy, healthy eating, satisfactory family income, family involvement in care and effective access to the care network. FINAL CONSIDERATIONS: knowledge of these meanings enables health professionals to develop strategies that meet the unique demands of caregivers experiencing this diagnosis.

Clinical and sociodemographic factors associated with the quality of life of children and adolescents with type 1 diabetes.

OBJECTIVE: To analyze clinical and sociodemographic factors associated with the health-related quality of life of children and adolescents with type 1 Diabetes Mellitus. METHOD: A quantitative, cross-sectional and analytical study, developed in a municipality in northeastern Brazil, between March and September 2021, with 81 children/adolescents with type 1 Diabetes Mellitus and their guardians/caregivers. A questionnaire containing sociodemographic and clinical variables and two quality of life instruments were used. Descriptive and inferential analysis was carried out. RESULTS: Adolescents whose parents had a family income greater than a minimum wage had a lower prevalence of impaired quality of life when compared to those with a lower income. Adolescents with time since diagnosis of less than four years had a satisfactory quality of life, and children aged 8 to 12 years who self-administered insulin had a lower prevalence of high quality of life compared to those who did not. CONCLUSION: Adolescents with a family income of less than a minimum wage, diagnosis time of more than four years and children aged 8-12 who self-administer insulin need greater professional support to have a better quality of life.

Educational action to monitor children's growth and development based on the theory of meaningful learning.

OBJECTIVE: Evaluating the effect of an educational program on the knowledge of Primary Health Care nurses regarding the surveillance of growth and development during childcare appointments. METHOD: A before-after intervention study with 30 nurses. The nurses' knowledge and practice assessment were done using a tool that had been developed and validated. The educational activity was carried out, linking child growth and development indicators with public policies for early childhood and nurses' practices. David Ausubel's Significant Learning Theory was used as a teaching-learning strategy. The same instrument was reapplied after one month. Descriptive statistics were used in the analysis and the proportion test, Wilcoxon test and Item Response Theory with the Rasch model were applied. RESULTS: The nurses checked more items right in the instrument after the intervention; there was an increase in the scores of correct answers and a decrease in the item response difficulty index in the knowledge and practice section, post-intervention. CONCLUSION: The educational activity had a positive effect, affecting changes in nurses' knowledge and practice, which enabled childcare consultations to become more qualified.

Meanings attributed to health-related quality of life by caregivers of adolescents with diabetes / Significados atribuídos a la calidad de vida relacionada con la salud por cuidadores de adolescentes con diabetes / Sentidos atribuídos à qualidade de vida relacionada à saúde pelas cuidadoras de adolescentes com diabetes

ABSTRACT Objective: to interpret the meanings attributed to the health-related quality of life by caregivers of adolescents with type 1 diabetes mellitus. Methods: qualitative, descriptive-exploratory study of 14 caregivers of adolescents with diabetes developed at the reference outpatient clinic for endocrine diseases in a city in the state of Paraíba. Interviews were performed between May and September 2021. Inductive thematic analysis of the empirical material, and its interpretation in light of the concepts of health-related quality of life and family functioning were performed. Results: the meanings attributed by caregivers to the health-related quality of life of adolescents converged on the feeling of being healthy, healthy eating, satisfactory family income, family involvement in care and effective access to the care network. Final Considerations: knowledge of these meanings enables health professionals to develop strategies that meet the unique demands of caregivers experiencing this diagnosis.

RESUMEN Objetivo: interpretar los significados atribuídos a la calidad de vida relacionada con la salud por cuidadores de adolescentes con diabetes mellitus tipo 1. Métodos: estudio cualitativo, descriptivo-exploratorio con 14 cuidadores de adolescentes con diabetes desarrollado en el ambulatorio de referencia para enfermedades endocrinas de una ciudad del estado de Paraíba. Las entrevistas se realizaron entre mayo y septiembre de 2021. Se realizó un análisis temático inductivo del material empírico y su interpretación a la luz de los conceptos de calidad de vida relacionada con la salud y funcionamiento familiar. Resultados: los significados atribuídos por los cuidadores a la calidad de vida relacionada con la salud de los adolescentes convergieron en el sentimiento de estar sano, alimentación saludable, ingreso familiar satisfactorio, involucramiento familiar en el cuidado y acceso efectivo a la red de cuidados. Consideraciones Finales: el conocimiento de estos significados permite a los profesionales de la salud desarrollar estrategias que atiendan las demandas únicas de los cuidadores que experimentan este diagnóstico.

RESUMO Objetivo: interpretar os sentidos atribuídos à qualidade de vida relacionada à saúde por cuidadoras de adolescentes com diabetes mellitus tipo 1. Métodos: estudo qualitativo, descritivo-exploratório desenvolvido no ambulatório de referência para doenças endócrinas em uma cidade da Paraíba com 14 cuidadoras de adolescentes com diabetes. As entrevistas ocorreram entre maio e setembro de 2021. O material empírico foi submetido à análise temática indutiva e interpretado à luz dos conceitos de qualidade de vida relacionada à saúde e do funcionamento familiar. Resultados: os sentidos atribuídos pelas cuidadoras à qualidade de vida relacionada à saúde dos adolescentes convergiram para sensação de estar com saúde, alimentação saudável, renda familiar satisfatória, envolvimento da família no cuidado e acesso efetivo à rede assistencial. Considerações Finais: o conhecimento destes sentidos possibilita que os profissionais de saúde elaborem estratégias que atendam às demandas singulares de cuidadores que vivenciam esse diagnóstico.

Impact of the Covid-19 pandemic on the use of screens in early childhood.

OBJECTIVE: To identify the impact of the Covid-19 pandemic on the use of digital screens in early childhood, from the perspective of mothers and education professionals. METHOD: Qualitative study, based on Bronfenbrenner's Bioecological Theory. Nine mothers of children under three years of age, enrolled in daycare centers in a municipality in the state of Paraíba, Brazil, and six education professionals who worked in these daycare centers participated. The data were collected between July and October 2021 via virtual interviews and analyzed according to inductive thematic analysis. RESULTS: The restrictions imposed by the pandemic made screens the only available resource for children's educational activities, interaction, leisure, and distraction, causing an exponential increase in the time they spent in front of screens. CONCLUSION: The pandemic had a direct impact on the use of digital screens in early childhood, increasing the child's exposure time, according to parents and education professionals.

Hospital discharge intervention developed in a dialogical way with families to prepare them to care for children with chronic diseases at home: Mixed methods study.

A convergent parallel mixed methods design with qualitative data collection embedded in a quasi-experimental study was developed to examine the potential of three modalities of preparation for hospital discharge of the families of children with chronic diseases in terms of uncertainty levels and management of the disease at home. Caregivers of these children were divided into three groups: two experimental groups and one control group. Two scales were applied: one measured family management, and the other evaluated uncertainties in relation to the disease. In addition, an in-depth interview was conducted. Wilcoxon's test and the integrated response index were used in data analysis to compare performance between the groups. Inductive thematic analysis was employed for the qualitative data. The data were integrated, comparing the groups before and after preparation for hospital discharge. Twenty-five family caregivers completed this study. Data integration showed that the intervention group, in which the families developed planning to prepare for discharge in a dialogical way with professionals, presented better perceptions regarding care management when compared to structured guide and usual care groups. Participation of families in planning for hospital discharge showed a reduction in uncertainties regarding the disease and better care management of children at home.

Impact of the Covid-19 pandemic on the use of screens in early childhood / Repercusión de la pandemia de Covid-19 en el uso de pantallas en la primera infancia / Repercussão da pandemia da Covid-19 no uso de telas na primeiríssima infância

ABSTRACT Objective: To identify the impact of the Covid-19 pandemic on the use of digital screens in early childhood, from the perspective of mothers and education professionals. Method: Qualitative study, based on Bronfenbrenner's Bioecological Theory. Nine mothers of children under three years of age, enrolled in daycare centers in a municipality in the state of Paraíba, Brazil, and six education professionals who worked in these daycare centers participated. The data were collected between July and October 2021 via virtual interviews and analyzed according to inductive thematic analysis. Results: The restrictions imposed by the pandemic made screens the only available resource for children's educational activities, interaction, leisure, and distraction, causing an exponential increase in the time they spent in front of screens. Conclusion: The pandemic had a direct impact on the use of digital screens in early childhood, increasing the child's exposure time, according to parents and education professionals.

RESUMEN Objetivo: Identificar las repercusiones de la pandemia de Covid-19 en el uso de pantallas digitales en la primera infancia, desde la perspectiva de las madres y los profesionales de la educación. Método: Estudio cualitativo, basado en la Teoría Bioecológica de Bronfenbrenner. Participaron nueve madres de niños menores de tres años, matriculados en guarderías de un municipio del estado de Paraíba, Brasil, y seis profesionales de la educación que actuaban en esas guarderías. Los datos se recogieron entre julio y octubre de 2021 mediante entrevista virtual y se analizaron según un análisis temático inductivo. Resultados: Las restricciones impuestas por la pandemia convirtieron a las pantallas en el único recurso disponible para las actividades educativas, la interacción, el ocio y la distracción de los niños, lo que provocó un aumento exponencial del tiempo que pasaban frente a ellas. Conclusión: La pandemia tuvo un impacto directo en el uso de pantallas digitales en la primera infancia, repercutiendo en el aumento del tiempo de exposición del niño, según padres y profesionales de la educación.

RESUMO Objetivo: Identificar a repercussão da pandemia da Covid-19 no uso de telas digitais na primeiríssima infância, na perspectiva de mães e profissionais da educação. Método: Estudo qualitativo, baseado na Teoria Bioecológica de Bronfenbrenner. Participaram nove mães de crianças menores de três anos, matriculadas em creches de um município do estado da Paraíba, Brasil e seis profissionais da educação, que atuavam nessas creches. Os dados foram coletados entre julho e outubro de 2021 por meio de entrevista virtual e analisados conforme a análise temática indutiva. Resultados: As restrições impostas pela pandemia fizeram das telas o único recurso disponível para as atividades educativas, interação, lazer e distração das crianças, causando aumento exponencial no tempo em que essas passaram diante das telas. Conclusão: A pandemia repercutiu diretamente no uso de telas digitais na primeiríssima infância, impactando no aumento do tempo de exposição da criança, segundo os pais e profissionais da educação.

Educational intervention with nurses regarding childcare consultation: a mixed method study / Intervención educativa con enfermeras en la consulta de puericultura: un estudio de método mixto / Intervenção educativa com enfermeiros sobre consulta de puericultura: um estudo de método misto

ABSTRACT Objective: to determine the effect and influence of an educational intervention on childcare consultation on nurses' knowledge and practice. Method: a mixed research method was adopted, with a sequential explanatory design, characterized by a stage with a quantitative approach, developed in a quasi-experimental study, with 30 nurses, followed by a qualitative one, carried out by in-depth interview, with 11 nurses working in the Family Health Units of João Pessoa, Paraíba, Brazil. In quantitative analysis, descriptive statistics and proportion test were used, and in qualitative analysis, thematic analysis was used. Results: the effect of the educational intervention was statistically significant in the consultation dimensions: consultation frequency; child nutrition; physical examination; growth assessment; development assessment; and health education. In the qualitative stage, the influence of the intervention in expanding knowledge and changing some nurses' practices in the aforementioned dimensions was understood, with agreement between the data found. Conclusion: the positive effect of the educational intervention on nurses' knowledge and practice in childcare consultations was evident, enabling them to reflect on the content covered and promote changes in their daily lives.

RESUMEN Objetivo: determinar el efecto e influencia de una intervención educativa en la consulta de puericultura sobre el conocimiento y la práctica de las enfermeras. Método: se adoptó un método de investigación mixto, con diseño explicativo secuencial, caracterizado por una etapa con enfoque cuantitativo, desarrollado en un estudio cuasiexperimental, con 30 enfermeros, seguido de uno cualitativo, realizado por entrevista en profundidad. con 11 enfermeros trabajando en las Unidades de Salud de la Familia de João Pessoa, Paraíba, Brasil. En el análisis cuantitativo se utilizó estadística descriptiva y prueba de proporciones, y en el análisis cualitativo se utilizó análisis temático. Resultados: el efecto de la intervención educativa fue estadísticamente significativo en las dimensiones de la consulta: frecuencia de consulta; nutrición infantil; examen físico; evaluación del crecimiento; evaluación del desarrollo; y educación sanitaria. En la etapa cualitativa se comprendió la influencia de la intervención en la ampliación del conocimiento y el cambio de algunas prácticas de enfermería en las dimensiones before mencionadas, existiendo concordancia entre los datos encontrados. Conclusión: fue evidente el efecto positivo de la intervención educativa en el conocimiento y la práctica de los enfermeros en las consultas de puericultura, permitiéndoles reflexionar sobre los contenidos tratados y promover cambios en su vida cotidiana.

RESUMO Objetivo: determinar o efeito e a influência de uma intervenção educativa sobre consulta de puericultura no conhecimento e na prática de enfermeiros. Método: adotou-se o método misto de pesquisa, com o desenho explanatório sequencial, caracterizado por uma etapa com abordagem quantitativa, desenvolvida no estudo quase-experimental, com 30 enfermeiros, seguida por uma qualitativa, realizada por entrevista em profundidade, com 11 enfermeiros atuantes nas Unidades de Saúde da Família de João Pessoa, Paraíba, Brasil. Na análise quantitativa, utilizou-se estatística descritiva e o teste de proporção, e na qualitativa a análise temática. Resultados: o efeito da intervenção educativa foi estatisticamente significante nas dimensões da consulta: Periodicidade da consulta, Alimentação da criança, Exame físico, Avaliação do crescimento, Avaliação do desenvolvimento e Educação em saúde. Na etapa qualitativa, compreendeu-se a influência da intervenção na ampliação do conhecimento e mudança de algumas práticas dos enfermeiros nas dimensões supracitadas, havendo concordância entre os dados encontrados. Conclusão: evidenciou-se o efeito positivo da intervenção educativa no conhecimento e na prática dos enfermeiros nas consultas de puericultura, possibilitando-lhes refletir sobre os conteúdos abordados e promover mudanças no seu cotidiano.

Educational action to monitor children's growth and development based on the theory of meaningful learning / Acción educativa para controlar el crecimiento y el desarrollo del niño basada en la teoría del aprendizaje significativo / Ação educativa para vigilância do crescimento e desenvolvimento infantil fundamentada na teoria da aprendizagem significativa

ABSTRACT Objective: Evaluating the effect of an educational program on the knowledge of Primary Health Care nurses regarding the surveillance of growth and development during childcare appointments. Method: A before-after intervention study with 30 nurses. The nurses' knowledge and practice assessment were done using a tool that had been developed and validated. The educational activity was carried out, linking child growth and development indicators with public policies for early childhood and nurses' practices. David Ausubel's Significant Learning Theory was used as a teaching-learning strategy. The same instrument was reapplied after one month. Descriptive statistics were used in the analysis and the proportion test, Wilcoxon test and Item Response Theory with the Rasch model were applied. Results: The nurses checked more items right in the instrument after the intervention; there was an increase in the scores of correct answers and a decrease in the item response difficulty index in the knowledge and practice section, post-intervention. Conclusion: The educational activity had a positive effect, affecting changes in nurses' knowledge and practice, which enabled childcare consultations to become more qualified.

RESUMEN Objetivo: Evaluar el efecto de un programa educativo sobre los conocimientos de las enfermeras de atención primaria acerca del seguimiento del crecimiento y el desarrollo durante las consultas de puericultura. Método: Estudio de intervención antes-después realizado con 30 enfermeras. Se evaluaron los conocimientos y la práctica de las enfermeras mediante un instrumento elaborado y validado. Se realizó la actividad educativa, articulando los indicadores de crecimiento y desarrollo infantil con las políticas públicas para la primera infancia y las prácticas de las enfermeras. Se utilizó la Teoría del Aprendizaje Significativo de David Ausubel como estrategia de enseñanza-aprendizaje. El mismo instrumento fue reaplicado después de un mes. En el análisis se utilizó estadística descriptiva y se aplicó la prueba de proporciones, la prueba de Wilcoxon y la Teoría de Respuesta al Ítem con el modelo de Rasch. Resultados: Las enfermeras acertaron más ítems del instrumento después de la intervención; hubo un aumento en las puntuaciones de respuestas correctas y una disminución en el índice de dificultad de respuesta al ítem en la sección de conocimientos y práctica, post-intervención. Conclusión: La actividad educativa tuvo un efecto positivo, que se tradujo en cambios en los conocimientos y la práctica de las enfermeras, lo que permitió que las consultas de puericultura fueran más cualificadas.

RESUMO Objetivo: Avaliar o efeito de uma ação educativa no conhecimento de enfermeiros da Atenção Primária à Saúde, para a vigilância do crescimento e do desenvolvimento na consulta de puericultura. Método: Estudo de intervenção do tipo antes-depois realizado com 30 enfermeiros. Avaliou-se o conhecimento e a prática dos enfermeiros mediante instrumento construído e validado. Realizou-se a atividade educativa, articulando indicadores de crescimento e desenvolvimento infantil com políticas públicas da primeira infância e as práticas do enfermeiro. Utilizou-se a Teoria da Aprendizagem Significativa de David Ausubel como estratégia de ensino-aprendizagem. O mesmo instrumento foi reaplicado após um mês. Na análise, utilizou-se estatística descritiva e aplicaram-se os testes de proporção, Wilcoxon e a Teoria da Resposta ao Item com o modelo de Rasch. Resultados: Os enfermeiros acertaram mais itens do instrumento após a intervenção; houve elevação dos escores de acertos e diminuição do índice de dificuldade de resposta ao item na seção do conhecimento e da prática, pós-intervenção. Conclusão: A atividade educativa teve efeito positivo, repercutindo mudanças do conhecimento e da prática dos enfermeiros, a qual possibilitou que a consulta de puericultura se tornasse mais qualificada.

Perfil social e clínico de crianças e adolescentes com diabetes mellitus tipo 1 / Perfil social y clínico de niños y adolescentes con diabetes mellitus tipo 1 / Social and clinical profile of children and adolescents with type 1 diabetes mellitus

Objetivo: identificar o perfil social e clínico de crianças e adolescentes com diabetes mellitus tipo 1. Método: pesquisa quantitativa, transversal e descritiva, desenvolvida com 81 responsáveis de crianças e adolescentes com diabetes mellitus tipo 1 entre março e setembro/2021, em dois centros de referência da Paraíba. A análise descritiva foi realizada com auxílio do software Statistical Package for the Social Science, versão 18. Resultados: predominantemente, os acompanhantes das crianças e adolescentes eram as próprias mães, 90,1%, e cerca de 40% viviam com renda familiar menor que um salário mínimo. Entre as crianças e adolescentes, 54% apresentaram valores elevados de hemoglobina glicada, mesmo estando em tratamento; 65,4% indicaram desconhecimento na forma correta de armazenamento da insulina, e 77,6% possuía lipohipertrofia. Conclusão: foram preponderantes a vulnerabilidade socioeconômica e o manejo clínico ineficaz do diabetes mellitus tipo 1 em crianças e adolescentes.

Objective: to identify the social and clinical profile of children and adolescents with type 1 diabetes mellitus. Method: quantitative, cross-sectional and descriptive research, developed with 81 guardians of children and adolescents with type 1 diabetes mellitus between March and September/2021, in two reference centers in Paraiba. The descriptive analysis was performed using the Statistical Package for the Social Science software, version 18. Results: predominantly, the companions of the children and adolescents were the mothers themselves, 90.1%, and about 40% lived with family income lower than a minimum wage. Among the children and adolescents, 54% had high glycated hemoglobin values, even though they were undergoing treatment; 65.4% indicated ignorance of the correct form of insulin storage, and 77.6% had lipohypertrophy. Conclusion: socioeconomic vulnerability and ineffective clinical management of type 1 diabetes mellitus in children and adolescents were predominant.

Objetivo: identificar el perfil social y clínico de niños y adolescentes con diabetes mellitus tipo 1. Método: investigación cuantitativa, transversal y descriptiva, realizada con 81 cuidadores de niños y adolescentes con diabetes mellitus tipo 1 entre marzo y septiembre/2021, en dos centros de referencia en Paraíba. El análisis descriptivo fue realizado mediante el software Statistical Package for Social Science, versión 18. Resultados: predominantemente, los acompañantes de los niños y adolescentes eran sus madres, el 90,1%, y cerca del 40% vivían con renta familiar inferior a un salario mínimo. Entre los niños y adolescentes, el 54% presentaba niveles elevados de hemoglobina glucosilada, a pesar de estar en tratamiento; El 65,4% indicó desconocer la forma correcta de almacenar la insulina y el 77,6% presentaba lipohipertrofia. Conclusión: predominó la vulnerabilidad socioeconómica y el manejo clínico ineficaz de la diabetes mellitus tipo 1 en niños y adolescentes.

Clinical and sociodemographic factors associated with the quality of life of children and adolescents with type 1 diabetes / Factores clínicos y sociodemográficos asociados a la calidad de vida de niños y adolescentes con diabetes tipo 1 / Fatores clínicos e sociodemográficos associados à qualidade de vida do público infantojuvenil com diabetes tipo 1

ABSTRACT Objective: To analyze clinical and sociodemographic factors associated with the health-related quality of life of children and adolescents with type 1 Diabetes Mellitus. Method: A quantitative, cross-sectional and analytical study, developed in a municipality in northeastern Brazil, between March and September 2021, with 81 children/adolescents with type 1 Diabetes Mellitus and their guardians/caregivers. A questionnaire containing sociodemographic and clinical variables and two quality of life instruments were used. Descriptive and inferential analysis was carried out. Results: Adolescents whose parents had a family income greater than a minimum wage had a lower prevalence of impaired quality of life when compared to those with a lower income. Adolescents with time since diagnosis of less than four years had a satisfactory quality of life, and children aged 8 to 12 years who self-administered insulin had a lower prevalence of high quality of life compared to those who did not. Conclusion: Adolescents with a family income of less than a minimum wage, diagnosis time of more than four years and children aged 8-12 who self-administer insulin need greater professional support to have a better quality of life.

RESUMEN Objetivo: Analizar los factores clínicos y sociodemográficos asociados a la calidad de vida relacionada con la salud de niños y adolescentes con Diabetes Mellitus tipo 1. Método: Estudio cuantitativo, transversal y analítico, desarrollado en un municipio del Nordeste brasileño, entre marzo y septiembre de 2021, con 81 niños/adolescentes con Diabetes Mellitus tipo 1 y sus tutores/cuidadores. Se utilizó un cuestionario que contenía variables sociodemográficas y clínicas y dos instrumentos de calidad de vida. Se realizó análisis descriptivo e inferencial. Resultados: los adolescentes cuyos padres tenían un ingreso familiar superior a un salario mínimo tuvieron una menor prevalencia de deterioro de la calidad de vida en comparación con aquellos con menores ingresos. Los adolescentes con un tiempo de diagnóstico menor a cuatro años tuvieron una calidad de vida satisfactoria, y los niños de 8 a 12 años que se autoadministraron insulina tuvieron una menor prevalencia de alta calidad de vida en comparación con los que no lo hicieron. Conclusión: Los adolescentes con ingreso familiar menor a un salario mínimo, tiempo de diagnóstico mayor a cuatro años y niños de 8 a 12 años que se autoadministran insulina necesitan mayor apoyo profesional para tener una mejor calidad de vida.

RESUMO Objetivo: Analisar os fatores clínicos e sociodemográficos associados à qualidade de vida relacionada à saúde de crianças e adolescentes com Diabetes Mellitus tipo 1. Método: Estudo quantitativo, transversal e analítico, desenvolvido em um município do Nordeste brasileiro, entre março e setembro de 2021, com 81 crianças/adolescentes com Diabetes Mellitus tipo 1 e seus responsáveis/cuidadores. Utilizaram-se um questionário contendo as variáveis sociodemográficas e clínicas e dois instrumentos de qualidade de vida. Realizou-se análise descritiva e inferencial. Resultados: Adolescentes cujos pais tinham renda familiar superior a um salário mínimo apresentaram prevalência menor de qualidade de vida prejudicada, quando comparados àqueles com renda inferior. Adolescentes com tempo de diagnóstico menor que quatro anos apresentaram qualidade de vida satisfatória, e crianças de 8 a 12 anos que faziam autoaplicação de insulina apresentaram prevalência menor de qualidade de vida alta em relação às que não realizavam. Conclusão: Adolescentes com renda familiar inferior a um salário mínimo, tempo de diagnóstico superior a quatro anos e crianças de 8-12 anos que realizam autoaplicação de insulina necessitam de maior suporte profissional para ter melhor qualidade de vida.

Percepção materna acerca da efetividade de intervenções educativas para estimulação de crianças de risco desenvolvimental / Maternal perception about the effectiveness of educational interventions to stimulate children at developmental risk / Percepción materna sobre la efectividad de las intervenciones educativas para estimular a los niños en riesgo de desarrollo

Objetivo: Evidenciar a percepção materna acerca da efetividade de uma intervenção educativa para estimulação de crianças com risco para o desenvolvimento neuropsicomotor. Métodos: Pesquisa qualitativa, realizada com mães que participaram de uma intervenção educativa em Centros Públicos de Referência em Educação Infantil em um município da Paraíba, sobre a estimulação do desenvolvimento infantil. Os dados foram coletados por meio de entrevista semiestruturada, nos meses de março a julho 2018, e interpretados por meio da análise temática. Resultados: Destacaram-se a falta de orientação profissional como fragilidades para a estimulação infantil no domicílio, antes da intervenção. A sobrecarga física materna e a ausência paterna na estimulação da criança foram evidenciadas como dificultadores para realização da estimulação domiciliar. Por outro lado, o uso de metodologia ativa e os materiais educativos utilizados na intervenção educativa foram considerados facilitadores para melhora do conhecimento e empoderamento acerca da estimulação infantil. Conclusão: A intervenção educativa, na percepção materna, se mostrou efetiva por proporcionar transformação de atitudes quanto à estimulação dos seus filhos. Ademais, trouxe satisfação e motivação às mães para implementar os estímulos adequados após o novo conhecimento construído. (AU)

Objective: To highlight the maternal perception about the effectiveness of an educational intervention to stimulate children at risk for neuropsychomotor development. Methods: Qualitative research, carried out with mothers who participated in an educational intervention in Public Reference Centers in Early Childhood Education in a city in Paraíba, on the stimulation of child development. Data were collected through semi-structured interviews, from March to July 2018, and interpreted through thematic analysis. Results: The lack of professional guidance was highlighted as weaknesses for child stimulation at home, before the intervention. The maternal physical overload and the father's absence in stimulation of the child were evidenced as difficulties to perform home stimulation. On the other hand, the use of active methodology and the educational materials used in the educational intervention were considered facilitators to improve knowledge and empowerment about child stimulation. Conclusion: The educational intervention, in the maternal perception, proved to be effective in providing a transformation of attitudes regarding the stimulation of their children. In addition, it brought satisfaction and motivation to the mothers to implement the appropriate stimuli after the new knowledge built. (AU)

Objetivo: Resaltar la percepción materna sobre la efectividad de una intervención educativa para estimular a niños en riesgo de desarrollo neuropsicomotor. Métodos: Investigación cualitativa, realizada con madres que participaron en una intervención educativa en Centros Públicos de Referencia en Educación Infantil de una ciudad de Paraíba, sobre la estimulación del desarrollo infantil. Los datos fueron recolectados a través de entrevistas semiestructuradas, de marzo a julio de 2018, e interpretados mediante análisis temático. Resultados: La falta de orientación profesional se destacó como debilidades para la estimulación infantil en el hogar, antes de la intervención. La sobrecarga física materna y la ausencia del padre en la estimulación del niño se evidenciaron como dificultades para realizar la estimulación domiciliaria. Por otro lado, el uso de metodología activa y los materiales educativos utilizados en la intervención educativa fueron considerados facilitadores para mejorar el conocimiento y empoderamiento sobre la estimulación infantil. Conclusión: La intervención educativa, en la percepción materna, demostró ser efectiva en brindar una transformación de actitudes con respecto a la estimulación de sus hijos. Además, trajo satisfacción y motivación a las madres para implementar los estímulos adecuados luego de los nuevos conocimientos construidos. (AU)

Management of overweight and obesity in children and adolescents by nurses: a mixed-method study.

OBJECTIVE: to analyze the management of overweight and obesity in children and adolescents by nurses of the Family Health Strategy. METHOD: this is a study of convergent parallel mixed methods, developed in Health Centers of a municipality in northeastern Brazil. In the quantitative stage, data were collected from a questionnaire applied to 98 nurses and analyzed by descriptive statistics. For the qualitative stage, semi-structured interviews were conducted with seven nurses, interpreted by inductive thematic analysis. The quantitative and qualitative results were integrated and presented by a joint display. RESULTS: most nurses rarely checked waist circumference (77.6%), dyslipidemia (55.7%), blood glucose (42.3%), and neither evaluated blood pressure (75.3%). In the qualitative results, we identified that there are nurses who did not classify body mass index according to sex and age. As for medical tests, the requests were mainly related to the routine of childcare. Guidance on physical activity and diet were given in a basic way or attributed to other professionals, and referrals to other services or professionals were not followed up. CONCLUSION: it is imperative to train nurses for the management of overweight and obesity in primary care for children and adolescents, with a view to quality of care for the prevention of comorbidities. KEYPOINTS: (1) There are weaknesses in the management of obesity in children and adolescents by nurses. (2) A mixed method was adopted, which is new and has understanding and inference in a single study. (3) The study suggests the development of specific protocols for nurses. (4) The research suggests continuing education actions for nurses. (5) With proper management, it will be possible to reduce this morbidity and comorbidities.

Nurse's performance in the hospital discharge process of children with chronic disease.

OBJECTIVE: To analyze the nurse's performance in the hospital discharge process of children with chronic disease. METHOD: Qualitative research conducted from May to August/2019 with ten nurses working in a pediatric unit of a public hospital. The data, collected through semi-structured interviews, were submitted to inductive thematic analysis. RESULTS: In the preparation for hospital discharge, nurses recognize health education as their attribution, valuing family knowledge in the training regarding home care. Nevertheless, their practice is weakened by the little articulation among the multiprofessional team, reduced nursing sizing and disarticulation in the health care network. CONCLUSION: There is a paradox between the report and the practice of the hospital discharge process accomplished by nurses. Although they have theoretical knowledge, their work process is influenced by the disarticulated way in which the multiprofessional team interacts, and the conditions provided by the institution to work in the preparation for hospital discharge of these children.

Complex care for children with chronic diseases from the perspective of care management.

OBJECTIVE: To analyze the actions developed in hospitals for children with chronic diseases from the perspective of care management. METHOD: Qualitative research, conducted with 14 health professionals from pediatric units in two northeastern hospitals, between November 2018 and March 2019, through semi-structured interviews. The empirical material was interpreted by thematic inductive analysis considering the care management construct. RESULTS: The actions of the multi-professional team are fragmented, making it challenging to prepare and involve the family in care and not always responding to the child's unique and complex demands. The insufficient number of professionals, lack of material resources and inadequate infrastructure of hospital services reflect in the care practice, generating work overload and inadequate actions. FINAL CONSIDERATIONS: Care management is an indispensable tool in coping with chronic childhood illnesses. The actions carried out by the multi-professional teams in hospitals must develop support to expand the care.

The family of the child with special health care needs and their social relationships.

OBJECTIVES: to identify aspects that can influence the types of bonds developed in the social support network of family members of children with special health care needs. METHODS: qualitative research conducted through interviews with 15 family members/guardians in the city of Rio de Janeiro, from January to February 2020. Sanicola's theoretical-methodological framework and Bardin's thematic analysis technique were used. RESULTS: social distancing, lack of responsibility for coordinating care, lack of supplies and lack of individualized care were weaknesses found in the families' social relationships. However, the bonds were strengthened by the relationship of familiarity and availability of professionals in the care of children with special health needs. FINAL CONSIDERATIONS: understanding the configuration of primary and secondary social networks and the types of support offered can improve the care of children and strengthen bonds that provide security for families.

Structure of social networks of people living with HIV and AIDS.

OBJECTIVE: To analyze the structure of the social network of people living with HIV and AIDS. METHOD: Exploratory and descriptive research with a qualitative approach, developed through interviews with twenty-two people living with HIV and AIDS, from November to December 2019. For analysis, the theoretical-methodological framework of social network was used. RESULTS: The primary networks were of medium size and low density, formed by family members, relatives, friends, neighbors, and colleagues. The secondary networks were characterized by public, private, third sector institutions, workplaces, and by the informal network, which provided support according to the need for care. CONCLUSION: The family was considered the center of the primary social network structure; however, weaknesses in these social relationships were evidenced. The family relational context of the person with HIV and AIDS was influenced by the secrecy of the diagnosis due to the fear of prejudice and discrimination for being HIV-positive. There was a predilection for the services of the secondary social network that took on the role of specific care for the disease.

Professional Care in Home for Children and Teenagers with Special Health Needs: An Integrative Review / Assistência profissional no cuidado domiciliar de crianças e adolescentes com necessidades especiais de saúde: revisão integrativa / Atención profesional en atención domiciliaria para niños y adolescentes con necesidades especiales de salud: una revisión integradora

Objective: Analyzing the results of scientific publications on professional home care for children and teenagers with special health needs. Materials and method: An integrative review with articles published between 2009 and 2020 conducted in the BDEnf, Lilacs, Medline/PubMed databases and in the SciELO electronic library. The data were analyzed in four stages: data reduction; display of the data; comparison of data; drawing and verification of completion. Results: There were identified 5,641 articles; after the application of the inclusion and exclusion criteria and disposal of duplicates, 637 articles were chosen for the reading of titles and abstracts, of which 61 were selected for full reading and of these, 28 composed the final sample. The offer of remote support actions and concern in training caregivers regarding the technical-scientific aspects of home care was identified, in addition to promoting the improvement of the quality of life of children/teenagers and their families. A gap was evidenced regarding the identification and management of pain by home service professionals. Conclusions: The performance of home services to this specific population focuses on the demands of care with health technologies and on promoting symptom relief, reducing the workload of caregivers and assisting in dehospitalization.

Objetivo: analisar os resultados de publicações científicas acerca da assistência domiciliar profissional às crianças e adolescentes com necessidades especiais de saúde. Materiais e método: revisão integrativa, com artigos publicados entre 2009 e 2020, realizada nas bases de dados BDEnf, Lilacs, Medline/PubMed e na biblioteca eletrônica SciELO. Os dados foram analisados em quatro etapas: redução dos dados; exibição dos dados; comparação dos dados; desenho e verificação da conclusão. Resultados: foram identificados 5 641 artigos; após a aplicação dos critérios de inclusão e exclusão e descarte das duplicatas, foram eleitos 637 artigos para a leitura de títulos e resumos, dos quais 61 foram selecionados para a leitura na íntegra e destes, 28 compuseram a amostra final. Identificaram-se oferta de ações de suporte remoto e preocupação em capacitar os cuidadores quanto aos aspectos técnico-científicos do cuidado no domicílio, além da promoção da melhora da qualidade de vida das crianças/adolescentes e seus familiares. Evidenciou-se lacuna com relação à identificação e ao manejo da dor pelos profissionais dos serviços domiciliares. Conclusões: a atuação dos serviços domiciliares a essa população específica tem foco nas demandas de cuidados com as tecnologias em saúde e na promoção de alívio dos sintomas, diminuindo a carga de trabalho dos cuidadores e auxiliando na desospitalização.

Objetivo: Analizar los resultados de publicaciones científicas acerca de la atención domiciliar profesional a niños y adolescentes con necesidades especiales de salud. Materiales y método: Una revisión integradora con artículos publicados entre 2009 y 2020 realizada en las bases de datos BDEnf, Lilacs, Medline/PubMed y en la biblioteca electrónica SciELO. Se analizaron los datos en cuatro etapas: reducción de los datos; presentación de los datos; comparación de los datos; diseño y verificación de la conclusión. Resultados: Se identificaron 5 641 artículos; luego de la aplicación de los criterios de inclusión y exclusión y descarte de los duplicados, se seleccionaron 637 artículos para la lectura de títulos y resúmenes, de los que 61 se seleccionaron para la lectura integral y de estos 28 compusieron la muestra final. Se identificaron la oferta de acciones de soporte remoto y la preocupación en capacitar los cuidadores en cuanto a los aspectos técnico-científicos del cuidado en el domicilio, además de la promoción de la mejoría de la calidad de vida de niños/adolescentes y sus familiares. Se evidenció la laguna en relación con la identificación y el manejo del dolor por los profesionales de los servicios domiciliares. Conclusiones: La actuación de los servicios domiciliares a esta población específica enfoca en las demandas de cuidados con las tecnologías en salud y promoción de alivio de los síntomas, disminuyendo la carga de trabajo de los cuidadores y auxiliando en la deshospitalización.

Structure of social networks of people living with HIV and AIDS / Estructura de las redes sociales de personas viviendo con VIH y SIDA / Estrutura das redes sociais de pessoas vivendo com HIV e AIDS

ABSTRACT Objective: To analyze the structure of the social network of people living with HIV and AIDS. Method: Exploratory and descriptive research with a qualitative approach, developed through interviews with twenty-two people living with HIV and AIDS, from November to December 2019. For analysis, the theoretical-methodological framework of social network was used. Results: The primary networks were of medium size and low density, formed by family members, relatives, friends, neighbors, and colleagues. The secondary networks were characterized by public, private, third sector institutions, workplaces, and by the informal network, which provided support according to the need for care. Conclusion: The family was considered the center of the primary social network structure; however, weaknesses in these social relationships were evidenced. The family relational context of the person with HIV and AIDS was influenced by the secrecy of the diagnosis due to the fear of prejudice and discrimination for being HIV-positive. There was a predilection for the services of the secondary social network that took on the role of specific care for the disease.

RESUMEN Objetivo: Analizar la estructura de la red social de personas viviendo con VIH y SIDA. Método: Investigación exploratoria y descriptiva de abordaje cualitativo, desarrollada por medio de entrevista con veintidós personas viviendo con VIH y SIDA, de noviembre a diciembre de 2019. Para tal análisis, se utilizó el referencial teórico-metodológico de la red social. Resultados: Las redes primarias se configuraron de tamaño medio y con baja densidad, formadas por familiares, parientes, amigos, vecinos y colegas. Las redes secundarias se caracterizaron por instituciones públicas, privadas, del tercer sector, locales de trabajo y por la red informal, que aportaron soporte de acuerdo con la necesidad de cuidado. Conclusión: La familia fue considerada el eje de la estructura de la red social primaria, sin embargo fueron evidenciadas debilidades en esas relaciones sociales. El contexto relacional familiar de la persona con VIH y SIDA tuvo influencia del sigilo del diagnóstico decurrente del miedo de sufrir perjuicio y discriminación por su condición seropositiva. Hubo preferencia por los servicios de la red social secundaria que asumieron la función de cuidado específico para la enfermedad.

RESUMO Objetivo: Analisar a estrutura da rede social de pessoas vivendo com HIV e Aids. Método: Pesquisa exploratória e descritiva de abordagem qualitativa, desenvolvida por meio de entrevista com vinte e duas pessoas vivendo com HIV e Aids, de novembro a dezembro de 2019. Para análise, utilizou-se o referencial teórico-metodológico de rede social. Resultados: as redes primárias configuraram-se de tamanho médio e com baixa densidade, formadas por familiares, parentes, amigos, vizinhos e colegas. As redes secundárias foram caracterizadas por instituições públicas, privadas, de terceiro setor, locais de trabalho e pela rede informal, que forneceram suporte conforme a necessidade de cuidado. Conclusão: A família foi considerada o nó central da estrutura da rede social primária; no entanto, foram evidenciadas fragilidades nessas relações sociais. O contexto relacional familiar da pessoa com HIV e Aids sofreu influência do sigilo do diagnóstico decorrente do medo de sofrer preconceito e discriminação por ser soropositiva. Houve predileção pelos serviços da rede social secundária que assumiram a função de cuidado específico para a doença.

The family of the child with special health care needs and their social relationships / La familia del niño con necesidades especiales de salud y sus relaciones sociales / A família da criança com necessidades especiais de saúde e suas relações sociais

ABSTRACT Objectives: to identify aspects that can influence the types of bonds developed in the social support network of family members of children with special health care needs. Methods: qualitative research conducted through interviews with 15 family members/guardians in the city of Rio de Janeiro, from January to February 2020. Sanicola's theoretical-methodological framework and Bardin's thematic analysis technique were used. Results: social distancing, lack of responsibility for coordinating care, lack of supplies and lack of individualized care were weaknesses found in the families' social relationships. However, the bonds were strengthened by the relationship of familiarity and availability of professionals in the care of children with special health needs. Final Considerations: understanding the configuration of primary and secondary social networks and the types of support offered can improve the care of children and strengthen bonds that provide security for families.

RESUMEN Objetivos: identificar aspectos que puedan influenciar los vínculos establecidos en la red de apoyo social de familiares de niños con necesidades especiales de salud. Métodos: se trata de una investigación cualitativa, llevada a cabo con entrevista de 15 familiares/responsables residentes en el municipio de Río de Janeiro, entre enero y febrero de 2020. Se utilizó el marco teórico y metodológico de Sanicola y la técnica de análisis temático de Bardin. Resultados: el distanciamiento social, la irresponsabilidad en la coordinación de los cuidados, la falta de insumos y de una acogida singular pusieron de manifiesto las debilidades de las relaciones sociales familiares. Sin embargo, los vínculos se vieron reforzados por la relación de confianza y disponibilidad de los profesionales en el cuidado del niño con necesidad sanitaria especial. Consideraciones Finales: comprender la configuración de las redes sociales primarias y secundarias y los tipos de apoyo que ofrecen puede contribuir para mejorar el cuidado de los niños y reforzar los vínculos que generan seguridad para las familias.

RESUMO Objetivos: identificar aspectos que podem influenciar os tipos de vínculos estabelecidos na rede de apoio social de familiares de crianças com necessidades especiais de saúde. Métodos: pesquisa qualitativa, realizada mediante entrevista com 15 familiares/responsáveis residentes no município do Rio de Janeiro, no período de janeiro a fevereiro de 2020. Utilizaram-se o referencial teórico-metodológico de Sanicola e a técnica de análise temática de Bardin. Resultados: o distanciamento social, a desresponsabilização pela coordenação do cuidado, a falta de insumos e de um acolhimento singular evidenciaram as fragilidades nas relações sociais familiares. No entanto, os vínculos foram fortalecidos pela relação de familiaridade e disponibilidade dos profissionais no cuidado à criança com uma necessidade especial de saúde. Considerações Finais: compreender a configuração das redes sociais primária e secundária e os tipos de apoios ofertados pode contribuir para a melhoria do cuidado às crianças e fortalecer laços que geram segurança às famílias.