My child is growing and now? Exploring the environmental needs of children with congenital Zika syndrome according to their caregivers' perceptions.

INTRODUCTION: Promoting social inclusion of children with congenital Zika virus syndrome (CZS) is challenging, mostly, when there is a transport problem, low access to information and a long distance between the house and health services. Participation can be understood as involvement in a life situation and is strongly influenced by physical, social and attitudinal environmental factors; however, was still little explored in the case of children with CZS. In this sense, this study aimed to explore the perception of caregivers about the environmental needs of children with CZS, differentiating barriers and facilitators. METHODS: This is qualitative research. Thematic analysis was used to identify the environmental needs perceived by caregivers of children with CZS. The patient public involvement (PPI) approach was incorporated with the purpose of validating the data analysis performed by the researchers. After this step, the data were categorized in terms of barriers and facilitators and validated by the group of researchers. RESULTS: A relevant environmental need reported by caregivers as a barrier was social support for children with CZS. Ableism was also evidenced as an important attitudinal barrier. Health services were essential for the lives of children with CZS and the availability of auxiliary devices as facilitators of participation. Environmental factors related to medication and food routines were, for the most part, facilitators. CONCLUSION: This study contributes to critical approaches to the impacts linked to environmental factors of children with CZS, recognition of these children is an evolving process and fundamental to basic rights for adequate living in society. The data point to the need to implement public policies aimed at children with CZS, as well as the availability of qualified professionals to apply family-centred care and skills-focused management. Building friendly environments that promote broad social participation will contribute to the healthy growth of children with CZS. PATIENT OR PUBLIC CONTRIBUTION: Six caregivers (20% of the caregivers) as part of the PPI approach were contacted and participated in individual virtual meetings to discuss the results of the thematic analysis regarding the environmental needs of children with CZS.

Disability and functioning of women with low-risk pregnancy: Assessment using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0).

OBJECTIVE: To evaluate the disability and functioning of women with low-risk pregnancy in the second and third gestational trimesters. METHODS: A longitudinal observational study was conducted from June 5, 2015, to April 30, 2016, in Family Health Units in the city of Santa Cruz, Rio Grande do Norte, Brazil, involving women who were in the second trimester of pregnancy where the pregnancy had been classified as low-risk. A form was designed specifically for the study to collect sociodemographic, urogynecological, and obstetric data. Functioning and disability were assessed using WHODAS 2.0, and descriptive and inferential statistical analyses were performed. RESULTS: Higher levels of disability were observed in cognition in the second trimester (P=0.021), while mobility and life activities domains had higher scores (higher score meaning the woman was more adversely affected) in the third trimester (P=0.007 and P=0.029). Urinary incontinence in the second trimester affected functioning in participation (P=0.023). Pain affected life activities (P=0.023) in the second trimester and participation in the third trimester (P=0.044); and general functioning (P=0.050 and P=0.025), mobility (P=0.002 and P=0.001), and self-care (P=0.0446 and P=0.023) in the second and third trimesters, respectively. CONCLUSION: The findings showed that, even in a low-risk pregnancy, functioning can be affected in different domains. The identification of impairments to functioning could enable improvement in care. Longitudinal studies involving the first trimester and postpartum are necessary to gain insight into women's disability and functioning during the pregnancy-puerperal period.