[General movement assessment as a tool for determining the prognosis in infantile cerebral palsy in preterm infants: a systematic review]. / Valoración de movimientos generales como herramienta pronóstica de parálisis cerebral infantil en prematuros: revisión sistemática.

INTRODUCTION: Cerebral palsy is considered to be the main cause of physical disability in childhood. General movements are an assessment tool in order to predict the neurological and long-term outcome of the newborn. AIM: To analyze the current evidence on the general movements assessment in preterm infants as cerebral palsy prognostic tool. SUBJECTS AND METHODS: Systematic review following PRISMA statements. Databases consulted were: PubMed/Medline, Lilacs, IBECS, Cochrane, PEDro, Cinhal, Sport Discuss, Phyinfo, Academic Search Complete, Web of Science, and SciELO. We included studies that evaluated general movements in the first 20 weeks premature newborns. We excluded studies where the sample submit other pathologies or medication was administered. Newcastle-Ottawa Scale was used to assessment the risk of bias. RESULTS: Ten cohort studies form this review. 2243 premature, with an average of 30.9 weeks of gestation, were analyzed. General movements recording was carried out between 5 and 30 minutes. When there are abnormal general movements, the chances of neurological involvement increase during development, whereas when normal general movements are evaluated, there will rarely be a subsequent cerebral palsy diagnosis. CONCLUSIONS: The predictive validity of the preterm general movements assessment is confirmed as a tool to predict cerebral palsy early. Since preterm infants are more likely to trigger abnormal general movements, it is interesting to promote this type of assessment.

TITLE: Valoración de movimientos generales como herramienta pronóstica de parálisis cerebral infantil en prematuros: revisión sistemática.Introducción. La parálisis cerebral infantil se considera la principal causa de discapacidad física en la infancia. La valoración de los movimientos generales es una herramienta de evaluación con el fin de pronosticar la afectación neurológica y el desenlace a largo plazo del recién nacido. Objetivo. Analizar la evidencia científica sobre la valoración de los movimientos generales en recién nacidos prematuros como medida pronóstica de parálisis cerebral infantil. Sujetos y métodos. Revisión sistemática siguiendo la normativa PRISMA. Se consultaron las bases de datos PubMed/Medline, Lilacs, IBECS, Cochrane, PEDro, Cinhal, Sport Discuss, Phyinfo, Academic Search Complete, Web of Science y SciELO. Se incluyeron estudios donde se valoraban movimientos generales en las primeras 20 semanas de recién nacidos prematuros y se excluyeron aquellos donde la muestra presentaba otras patologías o administraba medicación. Se utilizó la Newcastle-Ottawa Scale para valorar el riesgo de sesgo. Resultados. Se seleccionaron 10 estudios de cohortes para esta revisión y se analizaron un total de 2.243 prematuros, con una media de 30,9 semanas de gestación. Se llevó a cabo la grabación de movimientos generales entre 5 y 30 minutos. Cuando se observan movimientos generales anormales, aumentan las posibilidades de afectación neurológica durante el desarrollo, mientras que cuando se valoran movimientos generales normales, raramente habrá un posterior diagnóstico de parálisis cerebral. Conclusiones. Se confirma la validez predictiva de la valoración de los movimientos generales en prematuros para pronosticar parálisis cerebral de forma precoz. Como los recién nacidos prematuros tienen mayor posibilidad de desencadenar movimientos generales anormales, es interesante promover este tipo de valoración.

Influencia del ámbito, rural o urbano, en la percepción de los apoyos y las necesidades de las personas cuidadoras en el hospital / Influence of environment, rural or urban, in the perception of the supports and needs of caregivers in hospitals

Fundamento. Tras implementar un Plan Funcional con medidas de apoyo a personas cuidadoras en dos hospitales de Granada, se analizan la eficacia y el efecto del medio en la percepción y las necesidades de la persona cuidadora. Material y método. Se realizó un estudio cualitativo, fenomenológico, a través de entrevistas semi-estructuradas. Participaron 45 personas cuidadoras incluidas en el Plan Funcional. Se midieron además apoyo social percibido, función familiar y nivel de ansiedad mediante los cuestionarios Duke-unc, Apgar familiar y Escala de Goldberg, respectivamente. El análisis de los datos cualitativos se llevó a cabo mediante codificación abierta, axial y selectiva, y los cuestionarios mediante estadística descriptiva .Resultado. Las personas cuidadoras del ámbito urbano valoraron más los apoyos que les facilitaban la vida en el hospital y los apoyos sociales para el domicilio y las del ámbito rural los apoyos hospitalarios orientados a educación en cuidados para cuando estuviesen en su domicilio, todos ellos vinculados a la personalización de cuidados. Las alteraciones personales por el cuidado están presentes en ambos ámbitos aunque difieren en las repercusiones psíquicas y en el tipo de fármacos y su consumo. Existen diferencias en cuanto a los apoyos necesarios y las dificultades encontradas. Conclusiones. El ámbito donde habitualmente viven las personas cuidadoras condiciona sus percepciones del cuidado y algunas de sus necesidades en el hospital. Se deberán revisar las medidas del Plan Funcional cuestionadas, redefinir algunas prioridades e incluir medidas adicionales en función de la situación familiar de las personas cuidadoras (AU)

Background. After the Functional Plan was implemented with support measures for caregivers in hospitals of Granada (Spain), the effectiveness and impact of environment on the perception and needs of caregivers was analysed. Materials and methods. A qualitative, phenomenological study was made through semi-structured interviews. A total of 45 caregivers included in the Functional Plan participated. In addition, perceived social support, family functioning, and the anxiety level was measured, respectively, through the Duke-UNC, Apgar Family, and Goldberg Scale questionnaires. The data were qualitatively analysed by open, axial, and selective coding, and the questionnaires by descriptive statistics. Results. The caregivers of the urban setting valued more the support that made their life easier in the hospital and the social support at home, while caregivers in rural settings valued the hospital support oriented towards education in care for life after returning home, all linked to the personalization of care. The personal disturbances due to care occurred in all the settings, although differences appeared in psychic repercussions and in the type of drugs and their consumption. There were differences in terms of support needed and the difficulties encountered. Conclusions. The setting where caregivers live determine their perceptions of the care and some of their needs in the hospital. The measures questioned in the Functional Plan should be reviewed and some priorities should be redefined, including additional measures, depending on the family situation of the caregivers (AU)

[Influence of rural or urban environment on perception of the supports and needs of caregivers in hospitals]. / Influencia del ámbito, rural o urbano, en la percepción de los apoyos y las necesidades de las personas cuidadoras en el hospital.

BACKGROUND: After the Functional Plan was implemented with support measures for caregivers in hospitals of Granada (Spain), the effectiveness and impact of environment on the perception and needs of caregivers was analysed. MATERIALS AND METHODS: A qualitative, phenomenological study was made through semi-structured interviews. A total of 45 caregivers included in the Functional Plan took part. In addition, perceived social support, family functioning, and anxiety level were measured, respectively, through the Duke-UNC, Apgar Family, and Goldberg Scale questionnaires. The data were qualitatively analysed by open, axial, and selective coding, and the questionnaires by descriptive statistics. RESULTS: The caregivers of the urban setting valued the support that made their life easier in hospital and the social support received at home more highly, while caregivers in rural settings valued hospital support oriented towards education in care for life after returning home, all linked to the personalization of care. Personal disturbances due to care occurred in all settings, although differences appeared in psychic repercussions and in the type of drugs and their consumption. There were differences in terms of support needed and the difficulties encountered. CONCLUSIONS: The setting where caregivers live determines their perceptions of care and some of their needs in the hospital. The measures questioned in the Functional Plan should be reviewed and some priorities should be redefined, including additional measures, depending on the family situation of the caregivers.