Estimulación temprana en el hogar de infantes que asisten a un centro infantil / Home-based early stimulation for infants attending a daycare center

Introducción: En el ambiente del hogar se propician estilos de crianza, aprendizajes, actividades, experiencias y estímulos que modulan la estimulación del niño(a). Objetivo: Identificar el grado de estimulación temprana y su relación con variables de tipología familiar y participación en el cuidado de niños(as) entre 1 y 4 años de un centro de desarrollo infantil en Pereira, Colombia, en 2019. Métodos: Estudio transversal. Se realizó un muestreo tipo censo que incluyó a todos los niños y cuidadores, que cumplían con los criterios de selección (niños sin antecedente de patologías neurológicas, consentimiento informado de cuidadores). Se midieron variables sociodemográficas y de tipología familiar. Se empleó el Inventario de estimulación temprana en el hogar HOME45 (Home Observation for Measurement of the Environment). Se realizó análisis univariado y bivariado. Para la asociación entre predictores y el puntaje global de estimulación temprana (desenlace: alta/media/baja) se efectuó una regresión logística ordinal. Resultados: Participaron 76 diadas madre-hijo. La mediana de edad de los niños fue 36 meses (RIQ=11, 12-48). El cuidado diario fue brindado en un 67% por la madre. Se evidenció una alta estimulación en el 50% de las diadas. Los predictores que redujeron la probabilidad de estimulación alta fueron (p<0,05): hábito de lectura (No, RP=0,29 (0,09-0,87)), participación en fiestas infantiles (No, RP=0,24 (0,07­0,79)), edad del cuidador (mayor a 36 años, RP=0,95 (0,92-1,00)), estrategia de corrección (castigo verbal o físico, RP=0,16 (0,03-0,98)). Conclusión: Corregir al niño mediante diálogo, incentivar la lectura y participar de fiestas infantiles, además de tener un cuidador menor de 35 años, fueron variables que incrementaron la probabilidad de presentar una alta estimulación.

Introduction: Home environment fosters parenting styles, learning, activities, experiences, and stimuli modulating children's stimulation. Objective: To identify the degree of home-based early stimulation and its relationship with family variables and participation in the care of children aged 1 to 4 years attending a daycare center in Pereira, Colombia in 2019. Materials and Methods: A cross-sectional study was conducted by means of a census sampling including all children and caregivers who met the selection criteria (children with no history of neurological disorders and caregiver informed consent.) Sociodemographic and family variables were also measured. The Early Childhood HOME45 (Home Observation for Measurement of the Environment) inventory was administered. Univariate and bivariate analyses were carried out. Ordinal logistic regression was performed for associating predictors and total early stimulation score (high/medium/low). Results: The average age of children was 36 months (RIQ=11, 12-48). 67% of mothers gave children daily care. High stimulation was observed for 50% of the dyads. Predictors that reduced the probability of high stimulation (p<0.05) were reading habit (No, PR=0.29 (0.09-0.87)), participation in children's parties (No, PR=0.24 (0.07-0.79)), caregiver age (older than 36 years old, PR=0.95 (0.92-1.00)), child discipline strategy applied (verbal or physical abuse) (PR=0.16 (0.03-0.98)). Conclusions: Educating children through dialogue, encouraging reading and participating in children's parties, as well as having a caregiver under 35 years of age, were variables that increased the probability of high stimulation in children.

Introdução: O ambiente familiar fomenta estilos de criação, aprendizagem, atividades, experiências e estímulos que modulam a estimulação das crianças. Objetivo: Identificar o grau de estimulação precoce e sua relação com variáveis de tipologia familiar e participação no cuidado de crianças entre 1 e 4 anos de idade em um centro de desenvolvimento infantil em Pereira, Colômbia, em 2019. Métodos: Estudo de corte transversal. Foi realizada uma amostragem tipo censo que incluiu todas as crianças e cuidadores que preenchiam os critérios de seleção (crianças sem histórico de patologias neurológicas, consentimento informado dos cuidadores). As variáveis sociodemográficas e de tipologia familiar foram medidas. O inventário de estimulação precoce HOME45 (Home Observation for Measurement of the Environment) foi utilizado. Foram realizadas análises univariadas e bivariadas. Para a associação entre os preditores e a pontuação global de estimulação precoce (resultado: alto/médio/baixo), foi realizada uma regressão logística ordinal. Resultados: Setenta e seis díades mãe-filho participaram. A idade média das crianças era de 36 meses (RIQ=11, 12-48). O cuidado diário era de 67% fornecido pela mãe. A alta estimulação era evidente em 50% das díades. Os preditores que reduziram a probabilidade de alta estimulação foram (p<0,05): hábito de leitura (Não, PR=0,29 (0,09-0,87)), participação em festas infantis (Não, PR=0,24 (0,07-0,79)), idade do cuidador (mais de 36 anos, PR=0,95 (0,92-1,00)), estratégia de correção (castigo verbal ou físico, PR=0,16 (0,03-0,98)). Conclusão. Corrigir a criança através do diálogo, incentivar a leitura e a participação em festas infantis, assim como ter um cuidador com menos de 35 anos de idade, foram variáveis que aumentaram a probabilidade de apresentar um alto nível de estimulação.

Impact of an Educational Intervention Aimed at Nursing Staff on Oral Hygiene Care on the Incidence of Ventilator-Associated Pneumonia in Adults Ventilated in Intensive Care Unit.

OBJECTIVES: This work sought to evaluate the impact of an educational intervention on oral hygiene care aimed at nursing care staff, on the incidence of Ventilator-Associated Pneumonia (VAP) in adults from an ICU in Colombia. METHODS: Quasi-experimental study pre- and post-educational intervention aimed at nursing staff in which theoretical-practical sessions were conducted during 12 weeks to explain different oral hygiene techniques according to the oral conditions of patients. The study gathered sociodemographic, clinical, and characteristic variables of the oral and dental care received. The VAP was diagnosed according with international criteria. RESULTS: The educational intervention received participation from 60 individuals (40 nurses and 20 nursing aides), 80% were women. The work collected data from 171 patients, 70 (40.9%) cared for after the educational intervention. Daily oral and dental care by the staff increased from 29.6% to 92.8% after the intervention. Although the accumulated incidence of VAP diminished from 8.9% to 2.8% and the rate of incidence dropped from 9 to 3.5 cases per 1,000 days of intubation, these changes were not statistically significant. CONCLUSIONS: The educational intervention aimed at the nursing staff in oral care reduced the incidence of VAP in adults connected to ventilator in ICU; although this decrease was not statistically significant, it was a clinically relevant result for the institution, which is why it is necessary to continue the educational strategies on oral health studied in this staff.

Impact of an Educational Intervention Aimed at Nursing Staff on Oral Hygiene Care on the Incidence of Ventilator-Associated Pneumonia in Adults Ventilated in Intensive Care Unit / Impacto de una intervención educativa dirigida a personal de enfermería sobre los cuidados de higiene oral en la incidencia de neumonía asociada a ventilador en adultos en Unidad de Cuidado Intensivo / Impacto de uma intervenção educativa dirigida à equipe de enfermagem sobre os cuidados de higiene bucal na incidência de pneumonia associada à ventilação mecânica em adultos ventilados em Unidade de Terapia Intensiva

Objective. This work sought to evaluate the impact of an educational intervention on oral hygiene care aimed at nursing care staff, on the incidence of Ventilator-Associated Pneumonia (VAP) in adults from an ICU in Colombia. Methods. Quasi-experimental study pre- and post-educational intervention aimed at nursing staff in which theoretical-practical sessions were conducted during 12 weeks to explain different oral hygiene techniques according to the oral conditions of patients. The study gathered sociodemographic, clinical, and characteristic variables of the oral and dental care received. The VAP was diagnosed according with international criteria. Results. The educational intervention received participation from 60 individuals (40 nurses and 20 nursing aides), 80% were women. The work collected data from 171 patients, 70 (40.9%) cared for after the educational intervention. Daily oral and dental care by the staff increased from 29.6% to 92.8% after the intervention. Although the accumulated incidence of VAP diminished from 8.9% to 2.8% and the rate of incidence dropped from 9 to 3.5 cases per 1,000 days of intubation, these changes were not statistically significant. Conclusion. The educational intervention aimed at the nursing staff in oral care reduced the incidence of VAP in adults connected to ventilator in ICU; although this decrease was not statistically significant, it was a clinically relevant result for the institution, which is why it is necessary to continue the educational strategies on oral health studied in this staff.

Objetivo. Evaluar el impacto de una intervención educativa sobre los cuidados de higiene oral dirigida a personal asistencial de enfermería, en la incidencia de Neumonia Asociada a Ventilador (NAV) en adultos de una UCI en un hospital de Pereira, Colombia. Métodos. Estudio cuasiexperimental pre y posintervención educativa dirigida a personal de enfermería en la que se realizaron sesiones teórico-prácticas durante 12 semanas para explicar diferentes técnicas de higiene oral según la condición bucal de los pacientes. Se recolectaron variables sociodemográficas, clínicas y características de la atención bucodental recibida. Se diagnosticó la NAV de acuerdo con criterios internacionales. Resultados. En la intervención educativa participaron 60 personas (40 enfermeros y 20 auxiliares de enfermería), 80% eran mujeres. Se recolectaron datos de 171 pacientes, 70 (40.9%) atendidos después de la intervención educativa. La atención bucodental diaria por parte del personal se incrementó de 29.6% a 92.8%, después de la intervención. Aunque la incidencia acumulada de NAV disminuyó de 8.9% a 2.8% y la tasa de incidencia bajó de 9 a 3.5 casos por 1000 días de intubación, estos cambios no fueron estadísticamente significantes. Conclusión. La intervención educativa dirigida al personal de enfermería en cuidado oral redujo la incidencia de NAV en los adultos conectados a ventilador en UCI; si bien esta disminución no fue estadísticamente significativa, sí fue un resultado clínicamente relevante para la institución, por lo que deben continuarse las estrategias educativas estudiadas en salud bucal.

Objetivo. Avaliar o impacto de uma intervenção educacional sobre cuidados de higiene bucal dirigida a profissionais de enfermagem sobre a incidência de Pneumonia Associada à Ventilação (PAV) em adultos ventilados em uma UTI na Colômbia. Métodos. Estudo quase experimental antes e após intervenção educativa dirigido a trabalhadores de enfermagem em que foram realizadas sessões teórico-práticas durante 12 semanas para explicar as diferentes técnicas de higiene bucal de acordo com a condição bucal dos pacientes. Foram coletadas variáveis sociodemográficas, clínicas e características dos cuidados bucais recebidos. A PAV foi diagnosticada de acordo com critérios internacionais. Resultados. Na intervenção educativa, participaram 60 pessoas (40 enfermeiras e 20 auxiliares de enfermagem), 80% eram mulheres. Os dados foram coletados de 171 pacientes, 70 (40.9%) compareceram após a intervenção educativa. A higiene bucal diária pela equipe aumentou de 29,6% para 92.8% após a intervenção. Embora a incidência cumulativa de VAP tenha diminuído de 8.9% para 2.8% e a taxa de incidência tenha diminuído de 9 para 3,5 casos por 1000 dias de intubação, essas alterações não foram estatisticamente significativas. Conclusão. A intervenção educativa direcionada à equipe de enfermagem em higiene bucal reduziu a incidência de PAV em adultos conectados a um ventilador na UTI; embora essa redução não tenha sido estatisticamente significativa, foi um resultado clinicamente relevante para a instituição, portanto, as estratégias educacionais em saúde bucal estudadas nessas pessoas devem ser mantidas.

Association between oral health, pneumonia and mortality in patients of intensive care.

INTRODUCCIÓN: Los pacientes con ventilación mecánica corren riesgo de adquirir neumonía cuando la higiene bucodental es deficiente, a causa de la colonización bacteriana del tracto respiratorio. Se sugiere verificar esta asociación para implementar acciones de prevención. OBJETIVO: Identificar la asociación entre el estado de salud bucal, la neumonía asociada a ventilador y la mortalidad en pacientes con ventilación mecánica en un hospital de tercer nivel de Pereira, Colombia. MATERIAL Y MÉTODOS: Estudio transversal realizado entre mayo y septiembre de 2018. Pacientes mayores de 18 años con ventilación mecánica > 48 horas. Se excluyeron casos con diagnóstico de neumonía previo a la intubación endotraqueal, traqueostomía y broncoaspiración. Se midieron variables sociodemográficas, referentes al cuidado bucal, clínicas y propias de la estancia hospitalaria, además del examen odontológico. Se emplearon análisis univariado, bivariado y multivariado de ajuste. RESULTADOS: Se incluyeron 99 pacientes con mediana de edad de 56 años; el 41.4% eran de sexo femenino. El diagnóstico de ingreso más frecuente fue trauma craneoencefálico. El 75% de la población evaluada presentó al menos 26 dientes perdidos por caries; los hallazgos más prevalentes fueron queilitis, úlceras y periodontitis. Se diagnosticaron nueve casos de neumonía (9.1%). La úlcera bucal (odds ratio ajustada [ORa] = 14.3; intervalo de confianza del 95% [IC95%]: 1.5-137), la periodontitis (ORa = 5,4; IC95%: 1.0-28.1) y la enfermedad renal crónica (ORa = 10; IC95%: 1.4-71-7) derivaron de neumonía asociada a ventilador, mientras que la apertura bucal ≤ 35 mm (OR cruda = 5.3; IC95% = 2.1-13.5) presentó asociación no ajustada con la mortalidad intrahospitalaria. CONCLUSIONES: Son convenientes los cuidados de higiene bucal en los pacientes con ventilación mecánica. Convendría mantener bajo vigilancia a los pacientes con úlcera bucal, periodontitis e insuficiencia renal, por el riesgo de neumonía. BACKGROUND: Patients mechanically ventilated, are under potential risk of acquiring pneumonia, when there is poor oral hygiene, and due to bacterial colonization of respiratory tract. It is required to verify the association among oral health, mechanical ventilation and pneumonia to implement effective prevention. OBJECTIVE: Identify the association between oral health conditions with ventilator-associated pneumonia, and mortality in patients with mechanical ventilation in a third-level hospital in Pereira, Colombia. MATERIAL AND METHODS: Cross-sectional study performed between May and September 2018. Patients older than 18 years with mechanical ventilation over 48 hours were evaluated. Cases of diagnosed pneumonia prior to endotracheal intubation, tracheostomy, bronchial aspiration were excluded. Measured variables: sociodemographic, clinical and characteristics of hospital stay, dental examination and conditions related to oral care. Univariate, bivariate and adjusted multivariate analysis were performed. RESULTS: 99 patients with median age of 56 years were included; 41.4% female. Most frequent admission diagnosis was traumatic brain injury. 75% of evaluated population had at least, 26 teeth lost due to caries; most prevalent findings were cheilitis, ulcers, periodontitis. Nine cases of pneumonia were diagnosed (9.1%). Oral ulcer (adjusted odds ratio [Ora] = 14.3; 95% confidence interval [95% CI]: 1.5-137), ­periodontitis (ORa = 5.4; 95% CI: 1.0-28.1) and chronic kidney disease (ORa = 10; 95% CI: 1.4-71.7), derived from ventilator-associated pneumonia; while mouth opening ≤ 35 mm (OR: 5.3; 95%CI = 2.1-13.5) had an unadjusted association with in-hospital mortality. CONCLUSIONS: It is required to implement oral hygiene care in patients treated with mechanical ventilation. Patients with mouth ulcer, periodontitis, kidney failure should be especially monitored for the risk of pneumonia.

Alimentación y crecimiento de infantes de 0-2 años hijos de madres adolescentes de Dosquebradas, Colombia, año 2018 / Feeding and growth of infants from 0-2 years old children of adolescent mothers

Objetivo El presente artículo pretende describir el crecimiento y alimentación de un grupo de niños hijos de madres adolescentes en el rango de edad de 0-2 años. Metodología Se realizó un estudio cuantitativo, descriptivo, transversal, desarrollado a partir de la información recolectada por aplicación de dos instrumentos. La muestra fue determinada por muestreo no probabilístico a conveniencia, conformada por 100 infantes en el rango de edad de 0 a 2 años. Resultados El 93% de los infantes recibieron lactancia materna por lo menos la primera semanade vida, un 7% inició su alimentación con leche de fórmula, el 27% recibieron lactancia materna exclusiva durante los primeros 6 meses. Se observó que 18% de las madres abandonaron la lactancia materna, refiriendo como principal causa baja producción de leche. De las madres que dieron lactancia materna exclusiva 62,9% pertenecían al rango de edad entre los 20 y 21 años. Con respecto al crecimiento, el 75% de los infantes estaban en rango de normalidad, 10% presentaron riesgo de desnutrición, 1% se encontrada en desnutrición y 14% en riesgo de sobrepeso, se evidenció un porcentaje superior del IMC en rangos de normalidad y otros en riesgo de sobrepeso. Conclusiones Se evidenció la necesidad de educación con respecto a introducción adecuada de alimentos en la dieta infantil, así como el trabajo continuo de las pautas de crianza y dinámicas familiares saludables. La promoción de la salud en el área materno-infantil debe ser considerada en políticas implementadas por planes de gobierno a nivel local.

Objective To describe the growth and nutrition of a group of children of teenage mothers in the age range of 0-2 years old. Methodology A quantitative, descriptive, cross-sectional study was performed, developed from the information collected by applying two instruments. The sample was determined by non-probability sampling at convenience, made up of 100 infants in the age range of 0 to 2 years. Results 93% of infants were breastfed for at least the first week of life, 7% started formula feeding, 27% exclusively breastfed for the first 6 months. It was observed that 18% of the mothers abandoned breastfeeding, referring to low milk production as the main cause. Of the mothers who exclusively breastfed, 62.9% belonged to the age range between 20 and 21 years. Regarding growth, 75% of infants were in the normal range, 10% were at risk of malnutrition, 1% were undernourished and 14% at risk of overweight, a higher percentage of BMI was evident in normal ranges and others at risk of being overweight. Conclusions The need for education regarding the adequate introduction of food in the children's diet was evident, as well as the continuous work on parenting guidelines and healthy family dynamics. Health promotion in the mother-child area must be considered in policies implemented by government plans at the local level.