Caderneta da Criança: análise situacional de sua utilização por profissionais no nordeste brasileiro / Child's Handbook: situational analysis of its use by professionals in Northeastern Brazil

Objetivo: analisar as habilidades e as práticas de profissionais de saúde da Estratégia Saúde da Família e demais áreas, educação e serviço social em municípios do nordeste brasileiro (Rio Grande do Norte, Maranhão e Piauí), precedente à formação acerca da utilização da Caderneta da Criança. Métodos: Estudo transversal que faz parte de um projeto de Formação de profissionais para o uso da Caderneta da Criança. A população do estudo foi constituída de 140 profissionais que atuam na atenção à criança, em saúde, educação e assistência social. O instrumento de coleta de dados foi formulário Google Forms, com questionário estruturado com 55 questões. A pesquisa tem Parecer Nº3554302. Resultados: observa-se que 15,71% avaliam como ruim a capacidade de conhecê-la de forma minuciosa, e apenas 45% e 3,57% como bom e excelente. Quarenta e seis por cento (46,43%) dos profissionais consideram que utilizam muito a caderneta em sua rotina, porém 24,29% dizem que não a utilizam. Apenas 0,71% sempre preenche a CC com dados relativos à aferição da pressão arterial das crianças e 6,45% sempre registram na CC as intercorrências relativas às doenças, os relatórios de internações, acidentes, as alergias e outros agravos da criança. Conclusões: o estudo aponta ser necessário que haja uma formação de profissionais das unidades de saúde, utilizando metodologias mais criativas, de forma alusiva acerca da necessidade de compreensão da CC como um documento de cidadania, com registros de todas as etapas de crescimento e desenvolvimento da criança, além do acompanhamento da vigilância das vacinas administradas.

Objective: to analyze the skills and practices of health professionals of the Family Health Strategy and other areas, education, and social service in municipalities of northeastern Brazil (Rio Grande do Norte, Maranhão, and Piauí), preceding the training on the use of the Child's Handbook. Methods: cross-sectional study that is part of a project for training professionals to use the Child's Handbook. The study population consisted of 140 professionals working in child care, health, education, and social. The data collection instrument was Google Forms form, with a structured questionnaire with 55 questions. Results: it is observed that 15.71% evaluate as bad the ability to know it thoroughly, and only 45% and 3.57% as good and excellent. Forty-six percent (46.43%) of professionals consider that they use the handbook a lot in their routine, but 24.29% say they do not use it. Only 0.71% always fill out the handbook with data related to the measurement of children's blood pressure and 6.45% always record in the handbook the complications related to diseases, reports of hospitalizations, accidents, allergies, and other injuries of the child. Conclusions: the study points to the need for training of professionals in health units, using more creative methodologies, alluding to the need to understand the child handbook as a citizenship document, with records of all stages of growth and development of the child, in addition to monitoring the surveillance of administered vaccines.

Cohort profile: maternal and child health and parenting practices during the COVID-19 pandemic in Ceará, Brazil: birth cohort study (Iracema-COVID).

PURPOSE: Maternal and child health and parenting practices during the COVID-19 pandemic in Ceará (Iracema-COVID) is a longitudinal, prospective population-based birth cohort designed to understand the effects of the pandemic and social withdrawal in maternal mental health, child development and parenting practices of mothers and families. PARTICIPANTS: A sample of mothers who gave birth in July and August 2020 (n=351) was enrolled in the study in January 2021. Interviews were conducted by telephone. Data were collected through standardised questionnaires that, in addition to sociodemographic and economic data, collected information on breast feeding, mental health status and COVID-19. FINDINGS TO DATE: Results from the first wave show that the majority of participants have 9-11 years of schooling (54.4%; 95% CI 61.0 to 70.9) and are of mixed race (71.5%; 95% CI 66.5 to 76.0). At the time of the survey, 27.9% of the participants were out of the labor force (95% CI 23.5 to 32.9) and 78.6% reported a decrease in family income after restrictions imposed due to the pandemic (95% CI 74.0 to 82.6). The prevalence of maternal common mental disorder symptoms was 32.5% (95% CI 27.8 to 37.6). FUTURE PLANS: Follow-up visits are planned to occur every 6 months for the next five years (2021-2025). Additional topics will be included in future waves (eg, food insecurity and parenting practices). Communication strategies for bonding, such as picture cards, pictures of mothers with their children and phone calls to the participants, will be used to minimise attrition. Results of this prospective cohort will generate novel knowledge on the impact of the COVID-19 pandemic on maternal and child health and parenting practices in a population of women and children living in fifth largest city of Brazil.

Implicações da covid-19 no cotidiano das famílias nordestinas e no cuidado infantil / Implications of covid-19 in the daily lives of northeastern families and childcare

Resumo Este estudo explora o cotidiano das famílias com filhos de 0 a 6 anos, residentes em Fortaleza, no Ceará, durante o período de distanciamento físico, estipulado pelo Governo do Estado do Ceará. Esta pesquisa qualitativa se utilizou do referencial da teoria de formação de vínculos na adversidade. Foram entrevistadas 30 mães, entre os meses de julho e agosto de 2020, utilizando videochamadas ou telefonemas. Para análise do material empírico, recorreu-se à análise de conteúdo de Bardin, possibilitando a criação de duas categorias temáticas: (1) o exercício do cuidado parental em tempos de covid-19; (2) o cotidiano das crianças diante da pandemia. A interpretação das narrativas revelou que alguns cuidadores buscaram realizar brincadeiras e atividades manuais com os filhos, e explicavam o que estava acontecendo no cenário mundial, exercendo a parentalidade positiva. Ademais, o distanciamento físico favoreceu o aumento da tolerância dos pais no tempo em que os filhos ficaram expostos às telas. Percebeu-se que os pais influenciaram a prática de hábitos alimentares não saudáveis entre as crianças e a manifestação de mudanças no comportamento dos filhos. Como conclusão, destaca-se a necessidade de um acompanhamento contínuo dos aspectos referentes ao desenvolvimento dessas crianças e do retorno delas às atividades presenciais.

Abstract This study sought to explore the daily life of families with children aged 0 - 6 years old, living in Fortaleza, Ceará - Brazil, during the period of social distancing stipulated by the State Government. This qualitative research was conducted with data collected by means of video or phone interviews with thirty mothers, between July and August 2020. The empirical material was analyzed in the light of Bardin's content analysis, generating two thematic categories: (1) the exercise of parental care in Covid-19 times; and (2) the daily life of children in the face of the pandemic. The narratives revealed that some caregivers tried to play games and practice arts and crafts with their children, besides explaining what was happening in the world scenario - thus exercising positive parenting. Moreover, the social distancing measures promoted parental tolerance during the time children were exposed to screens, and parents showed to influence the practice of unhealthy eating habits and the manifestation of behavior changes in their children. These findings highlight the need for a continuous monitoring of aspects related to these children's development, as well as for their return to face-to-face activities.

COVID-19 and mental health of pregnant women in Ceará, Brazil.

OBJECTIVE: To assess the perceptions of pregnant women about COVID-19 and the prevalence of common mental disorders during the implemented social distancing period. METHODS: This was an observational, cross-sectional study using digital media, of pregnant women exposed to social distancing due to the COVID-19 pandemic, in Fortaleza, Ceará, Northeastern Brazil. Common mental disorders were estimated using the modified Self-Report Questionnaire-20 (SRQ-20) scale, and the feelings towards COVID-19 were assessed using the Fear of COVID-19 scale through telephone calls made in May 2020. COX multivariate regression models were used to verify the associations. RESULTS: Of the 1,041 pregnant women, 45.7% (95%CI: 42.7-48.8) had common mental disorders (CMD). All items of the Fear of COVID-19 Scale showed a significant association with the prevalence of CMD (p < 0.001). A CMD risk gradient was observed, going from a prevalence ratio of 1.52 (95%CI: 1.13-2.04) in pregnant women with two positive items to 2.70 (95%CI: 2.08-3.51) for those with four positive items. Early gestational age and the lack of prenatal care were also associated with CMD. CONCLUSIONS: The prevalence of common mental disorders in pregnant women was high during the period of social distancing and was aggravated by negative feelings towards COVID-19.

A prática de atividades lúdicas para promoção da saúde à pessoa idosa: uma experiência com oficinas educativas / The practice of recreational activities for health promotion to the elderly person: an experience with educational workshops

Objetivo: Descrever experiências de oficinas educativas realizadas por acadêmicos de enfermagem com idosas de um Centro de Convivência de Fortaleza, tendo como eixo norteador a promoção à saúde. Desenvolvimento: Trata-se de um relato de experiência, fruto da realização de oficinas educativas com 30 idosas, com o propósito de promover ações de promoção à saúde. As atividades aconteceram em quatro encontros nos meses de janeiro a março de 2017. Utilizaram-se atividades lúdicas, metodologias ativas e rodas de conversa, favorecendo a reflexão e construção de saberes das idosas envolvidas. Os encontros foram fundamentados pelo referencial teórico do Ciclo do Conhecimento proposto por Paulo Freire. Conclusão: O desenvolvimento das atividades possibilitou perceber o quanto essas idosas adquiriram conhecimentos e melhoraram o seu autocuidado. Desse modo, faz-se premente fortalecer as ações preventivas e de promoção da saúde visando promover práticas saudáveis que repercutam no processo de envelhecimento ativo.

Objective: To describe the experiences of educational workshops carried out by nursing academics with elderly women from a Center for Coexistence in Fortaleza, based on health promotion. Development: This is an experience report, the result of educational workshops with 25 elderly women, with the purpose of promoting health promotion actions. The activities took place in four meetings in the months of January to March of 2017. Play activities, active methodologies and conversation wheels were used, favoring the reflection and knowledge construction of the elderly women involved. The meetings were based on the theoretical reference of the Knowledge Cycle proposed by Paulo Freire. Conclusion: The development of activities made it possible to perceive how these elderly women acquired knowledge and improved their self-care. In this way, it is necessary to strengthen preventive and health promotion actions aimed at promoting healthy practices that have repercussions on the process of active aging.

COVID-19 and mental health of pregnant women in Ceará, Brazil

ABSTRACT OBJECTIVE To assess the perceptions of pregnant women about COVID-19 and the prevalence of common mental disorders during the implemented social distancing period. METHODS This was an observational, cross-sectional study using digital media, of pregnant women exposed to social distancing due to the COVID-19 pandemic, in Fortaleza, Ceará, Northeastern Brazil. Common mental disorders were estimated using the modified Self-Report Questionnaire-20 (SRQ-20) scale, and the feelings towards COVID-19 were assessed using the Fear of COVID-19 scale through telephone calls made in May 2020. COX multivariate regression models were used to verify the associations. RESULTS Of the 1,041 pregnant women, 45.7% (95%CI: 42.7-48.8) had common mental disorders (CMD). All items of the Fear of COVID-19 Scale showed a significant association with the prevalence of CMD (p < 0.001). A CMD risk gradient was observed, going from a prevalence ratio of 1.52 (95%CI: 1.13-2.04) in pregnant women with two positive items to 2.70 (95%CI: 2.08-3.51) for those with four positive items. Early gestational age and the lack of prenatal care were also associated with CMD. CONCLUSIONS The prevalence of common mental disorders in pregnant women was high during the period of social distancing and was aggravated by negative feelings towards COVID-19.

Competências familiares relacionadas à prevenção e tratamento das doenças nas crianças de até seis anos / Family competence related to prevention and treatment of diseases in up to six-year-old children

Objetivou-se avaliar as competências familiares relacionadas à prevenção e ao tratamento das doenças nas crianças de até seis anos de idade cadastradas em uma Unidade de Atenção Primária à Saúde da Estratégia Saúde da Família de Fortaleza (CE). Trata-se de um estudo transversal, descritivo e quantitativo. Os dados foram coletados nos meses de fevereiro a maio de 2017, envolvendo uma amostra de 217 famílias. Os resultados demonstraram que 98,2% das crianças estão com o calendário vacinal básico atualizado. Identificou-se que 67,7% dos cuidadores lavam as mãos das crianças depois de ir ao banheiro e 76,0% adotam essa medida de higiene antes de comer algum alimento. Verificou-se que mais de 90% das famílias identificam sinais comuns de adoecimento que requerem tratamento em hospitais e levam as crianças para esses serviços. Nessa perspectiva, acredita-se que a Estratégia Saúde da Família é um importante espaço de produção de saúde e de fortalecimento das competências familiares da população adscrita.

Current study evaluates family competence related to the prevention and treatment of disease in up to six-year-old children enrolled in a Basic Health Care Unit for Family Health Strategy in Fortaleza CE Brazil. The transversal, descriptive and quantitative study comprised data retrieved between February and May 2017, from a sample of 217 families. Results showed that 98.2% of the children received basic vaccine and that 67.7% of caretakers wash children´s hands after toilet use and 76.0% wash their hands prior to feeding. More than 90% of families identified common signs for diseases that needed treatment in hospitals. Within this perspective, Family Health Strategy is an important element for health production and improvement within family competences of the population.

Avaliação Geriátrica Ampla e sua Utilização no Cuidado de Enfermagem a Pessoas Idosas / Wide Geriatric Assessment and its use in Nursing care for the Elderly

O envelhecimento humano é considerado um fenômeno populacional reconhecidamente heterogêneo e multidimensional. Objetivou-se, nesse estudo, investigar a utilização da Avaliação Geriátrica Ampla (AGA) como subsídio para o processo de cuidar em enfermagem a pessoas idosas, em uma Caixa de Autogestão em Saúde, na cidade de Fortaleza-CE. Trata-se de um estudo documental, transversal, de abordagem quantitativa. A amostra foi composta de 70 prontuários de acompanhamento de idosos acima de 80 anos. A coleta dos dados ocorreu, por meio de um formulário semiestruturado, realizada no período de maio a junho de 2015. Constatou-se que 50% dos participantes apresentaram mais de oito anos de estudo. Verificou-se, ainda, que 57,1% são independentes para as atividades de vida diária (AVDs) e que 78,6% dos domicílios estão adequados para redução de risco de quedas. Dentre as comorbidades clínicas existentes, a hipertensão arterial está presente em 22%, seguida de Diabetes Mellitus, com 14,3%. Considera-se, nesse estudo, que a perda funcional ainda se constitui como uma condição de atenção ao cuidado de enfermagem para a população idosa, porquanto pode causar fraturas, síndrome da imobilidade, aumento do grau de dependência, depressão, isolamento social, dentre outras questões referentes ao processo de senilidade, implicando, desse modo, a necessidade de atuação de forma contínua e dinâmica em estratégias de educação em saúde a essa parcela crescente da população. (AU)

Human aging is considered a population phenomenon that is admittedly heterogeneous and multidimensional. The purpose of this study was to investigate the use of the Ample Geriatric Assessment (AGA) as a subsidy for the nursing care process for elderly people in a Health Self- Management Box in the city of Fortaleza-CE. This is a documentary study, cross-sectional with a quantitative approach. The sample consisted of 70 follow-up charts for the elderly over 80 years. The data were collected through a semi-structured form, carried out from May to June 2015. It was verified that 50% of the participants presented more than 8 years of study. It was also verified that 57.1% are independent for activities of daily living (ADLs) and that 78.6% of the households are adequate to reduce the risk of falls. Among the existing clinical comorbidities, arterial hypertension is present in 22%, followed by Diabetes Mellitus, with 14.3%. It is considered in this study that functional loss is still a condition of attention to nursing care for the elderly population, as it can cause fractures, immobility syndrome, increased dependency, depression, social isolation, among other issues relating to the senility process, implying, therefore, the need to act in a continuous and dynamic form in health education strategies to this growing part of the population. (AU)