Initial psychometric properties of the Denver II in a sample from Northeast Brazil.

This paper assesses the initial psychometric properties of the Denver Developmental Screening Test (Denver II), a widely used child development measure in its first population-level administration in Brazil. The Portuguese version was administered to 2755 children under three years of age who were eligible for a home visiting program in Fortaleza, Northeast Brazil. We examine the measure's internal consistency and verify construct validity by testing the dimensionality through confirmatory factor analysis (CFA) and estimating associations with household socioeconomic variables (e.g., poverty, maternal education, stunting, and parenting practices). The test was found to be psychometrically robust and culturally relevant. Although we found a good fit with the structure proposed by the instrument's author, a structure of two latent variables (motor and cognitive) provided a better fit. This validity exercise provides useful information for policymakers and researchers interested in using this instrument in the Brazilian context or a similar one in the region.

A quantitative, cross-sectional study of depression and self-esteem in teenage and young adult burn victims in rehabilitation.

Burns can have a negative physiological and emotional impact, particularly among teenage victims. To assess the presence of depression and level of self-esteem, a cross-sectional study was conducted among 63 teenage and young adult burn victims ages 12 to 20 years undergoing physical and psychological rehabilitation at the Outpatient Unit for Plastic Surgery and Burns at the Central Institute of the Clínicas Hospital of the Faculty of Medicine of the University of São Paulo, São Paulo, Brazil. Assessment instruments included Beck's Depression Inventory (BDI) and the Rosenberg Self-Esteem Scale (RSE). Internal consistency within and between the two scales was established via Cronbach's-α coefficient. All variables were analyzed using descriptive statistics, and the statistical difference between means was compared using Student's t-test. The majority of participants were female (38, 60.3%) and unmarried (59, 93.7%) with a mean total body surface area (TBSA) burn of 23.84%. Most burns (58, 92.10%) were the result of accidents and were located on the trunk (47, 74.6%), head (43, 68%), arms (41, 65%), hands (38, 60%), neck (34, 54%), and forearm (29, 46%). Participants had received physical and psychological rehabilitation for an average of 124.74 months (SD 63.67) from a multidisciplinary team. The majority of participants (33, 52.4%) reported functional and aesthetic after-effects and appraised their scar as visible (51, 81.0%). BDI results showed low levels or absence of depression (mean = 7.63, SD 8.72; scale 0 = no depression to 63 = serious depression); the RSE showed adequate levels of self-esteem (mean = 8.41, SD 4.74; scale 0-30, where higher scores indicate worst levels of self-esteem). Burn location did not affect depression (BDI: P = 0.26) or self-esteem (RSE: P = 0.21). However, depression and self-esteem were more significant in participants who were not able to work and/or go to school than in those who were (BDI: P = 0.04 and self-esteem RSE: P = 0.03). Contrary to the initial hypothesis, this population of teenage burn victims did not experience depression and low self-esteem compared with the normal population described in the literature, which may demonstrate the importance of multidisciplinary rehabilitation programs.

Family living through sickness and child?s hospitalization: qualitative study / A familia vivenciando a doenca e a hospitalizacao da crianca: estudo qualitativo

Problem: Brazilian family needs during the disease process and child?s hospitalization are not completed understood. Thus, it is difficulty to develop a family nursing care plan. Objectives: to understand the family experience during the disease process and the child?s hospitalization period and to identify what this experience causes to the family system. Method: it was performed a descriptive qualitative study. Family Systems theory was used as a theoretical framework. The sample was composed of seven families including five mothers, one father, one grandmother and seven inpatient children, who were three to six years old. Data were collected in an inpatient Pediatric Unit through an open semi-structured interview and therapeutic dramatic toys. Data were analyzed according to Analysis of content proposed by Bardin. Main results: the results obtained were clustered in six categories: the impact of disease in the family, needing provide care, experiencing the child?s hospitalization, the movement in the dynamic of family, needing provide help and support, and searching for homeostasis. The articulation of these categories made possible to built the category ?Protecting the son of the world and not the world of the son?. Conclusion: it was observed that families expected to protect their children against disease, pain, emotional suffering, invasive procedures, and hospitalization.

Problema: as necessidades das familias brasileiras, durante o processo de doenca e hospitalizacao da crianca, nao sao totalmente conhecidas dificultando o planejamento da assistencia de enfermagem centrada na familia. Objetivo: compreender a vivencia da familia no processo da doenca e hospitalizacao da crianca e identificar o que essa experiencia provoca no sistema familiar. Metodo: Foi realizado um estudo qualitativo descritivo. A teoria de Familia numa Perspectiva Sistemica foi utilizada como referencial teorico. A amostra foi composta por sete familias incluindo cinco maes, um pai, uma avo e sete criancas de tres a seis anos de idade hospitalizadas em uma Unidade Pediatrica. Os dados foram coletados por meio de uma sessao de brinquedo terapeutico dramatico e de uma entrevista semi-estruturada e submetidos a Analise de Conteudo segundo Bardin. Resultados: os resultados foram agrupados em seis categorias: o impacto da doenca na familia; necessitando prestar cuidado; vivenciando a hospitalizacao da crianca; o movimento na dinamica familiar; precisando de ajuda e de apoio e buscando a homeostase. A articulacao dessas categorias permitiu construir a categoria central ?Protegendo o filho do mundo e nao o mundo do filho?. Conclusao: evidenciou-se que a familia espera proteger a crianca da doenca, da dor, do sofrimento emocional, dos procedimentos invasivos e da hospitalizacao.