Use of new technologies and promotion of breastfeeding: integrative literature review.

OBJECTIVE: To identify the most used social networks and the most consumed contents by women seeking support and further understanding of breastfeeding/breast milk. DATA SOURCE: An integrative literature review was performed using the Psychology & Behavioral Sciences Collection, MEDLINE Complete, CINAHL Complete, MedicLatina, Academic Search Complete and ERIC databases. The search was conducted in April, 2020. The inclusion criteria were: publications in Portuguese, English or Spanish with several keywords, such as "Breastfeeding", "Social Networking", "Social Media", "Breastfeeding Promotion", in the title and in the abstract, with the combination of the Boolean operators "AND" and "OR", in original articles of primary source, which were available in full text and were published between 2015 and 2020. DATA SYNTHESIS: Out of the 93 articles that were first examined, 10 were used in the descriptive summary. Studies from the United States, Sweden, New Zealand, Brazil, Australia, Indonesia, and Switzerland were included in the review. Women were found to use several social networks, which is facilitated by an easy access to the Internet and to its content through several electronic resources, often using more than one device simultaneously. Most issues were universally recognized as some of the most common reasons for interrupting breastfeeding. CONCLUSIONS: The analyzed studies show that women seek to clarify their doubts outside the traditional health services' environment, using Facebook, apps, websites, online videos, podcasts and e-mail. We stress the importance of these support groups for promoting breastfeeding and the need for health professionals to introduce themselves in social networks to reach mothers.

Conhecimentos dos adolescentes sobre sexualidade e afetos / Adolescent knowledge on sexuality and affects

Background: In the school environment, sex education is included in health education, and it is essential to address it clearly in the various age groups. With a view to healthy sexuality, adolescents should acquire knowledge in this area. Objectives: To identify the interlocutor of adolescents, attending the 6th grade, to talk about sexuality and affections. To evaluate the effect of formative intervention on adolescents' level of knowledge on the subject. Methods: Longitudinal study in a short panel, conducted in an accidental nonprobabilistic sample, for convenience, consisting of 110 adolescents attending the 6th grade. A self-completed questionnaire with sociodemographic characterization of students / parents, a person with whom they talk about sexuality and affections and a scale of knowledge was used. Results: Participants are between 10 and 14 years old with an average of 11.53 (+/- 0.591SD). The adolescents are mostly male (60.1%), living in urban areas (82.5%) with their father and mother (82.2%). They revealed adequate knowledge on the theme of sexuality and affection (44.7%); they highlighted teachers as interlocutors to talk about sex (54.5%) and parents to talk about affect (60.0%). In the present study, it is the younger adolescents and those living in urban areas who have the best levels of knowledge about sexuality and affection. Conclusion: Adolescents improved their level of knowledge after the formative intervention on "Sexuality & Affections", a fact that reinforces the importance of this type of health education sessions in the school context

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Promoção da saúde mental das crianças: contributos dos enfermeiros / Promoción de la salud mental de los niños: contribución de los enfermeros / Promotion of children's mental health: nurses' contributions

Resumo Objetivo Descrever as intervenções de enfermagem para a promoção da saúde mental das crianças. Métodos Revisão integrativa da literatura realizada nas bases de dados PubMed, B-On e CINAHL utilizando os descritores "promoção da saúde", "saúde mental", "criança", "enfermagem" ou "papel do enfermeiro" ou "enfermagem pediátrica" ou "enfermagem de atenção primária", com a combinação dos operadores booleanos "AND" e "OR". Foram elegíveis artigos completos dos últimos 10 anos, nos idiomas português e inglês, coadunando aos critérios de inclusão e exclusão. Realizou-se análise qualitativa com a construção de três categorias. Resultados Incluíram-se quinze artigos que descreviam as intervenções de enfermagem com as crianças e adolescentes na escola, junto da família e com a comunidade, sendo que a maioria abordava as intervenções na escola com ênfase para a promoção da resiliência e comportamentos saudáveis. Conclusão Os estudos analisados evidenciam a importância dos enfermeiros na promoção da saúde mental das crianças em programas de educação em saúde mental, sensibilização e apoio às necessidades psicoafectivas, biológicas e sociais. Apresenta-se um leque de intervenções a serem organizadas e desenvolvidas pelos enfermeiros que trabalham na escola, com as famílias e em interligação com a comunidade.

Resumen Objetivo Describir las intervenciones de enfermería para la promoción de la salud mental de los niños. Métodos Revisión integradora de la literatura realizada en las bases de datos PubMed, B-On y CINAHL utilizando los descriptores "promoción de la salud", "salud mental", "niño", "enfermería" o "papel del enfermero" o "enfermería pediátrica" o "enfermería de atención primaria", con la combinación de los operadores booleanos "AND" y "OR". Se incluyeron artículos completos de los últimos 10 años en los idiomas portugués e inglés, junto con los criterios de inclusión y exclusión. Se realizó un análisis cualitativo con la construcción de tres categorías. Resultados Se incluyeron 15 artículos que describían las intervenciones de enfermería con niños y adolescentes en la escuela, junto con la familia y la comunidad, y la mayoría abordaba las intervenciones en la escuela con énfasis en la promoción de la resiliencia y comportamientos saludables. Conclusión Los estudios analizados demuestran la importancia de los enfermeros en la promoción de la salud mental de los niños en programas de educación en salud mental, sensibilización y apoyo a las necesidades psicoafectivas, biológicas y sociales. Se presenta un abanico de intervenciones que los enfermeros que trabajan en escuelas deben organizar y llevar a cabo, junto con las familias e interconectados con la comunidad.

Abstract Objective To describe nursing intervention to promote children's mental health. Methods This was an integrative review using PubMed, B-On, and CINAHL databases using the following keywords "health promotion", "mental health, "child", "nursing", or "role of nursing" or "pediatric nursing" or "primary nursing care", with combination of Boolean operators "AND" and "OR". Full-text articles published in Portuguese and English within 10 years were included, after application of inclusion and exclusion criteria. A qualitative analysis with construction of three categories were included. Results We included 15 articles describing nursing interventions for children and adolescents at school, for family and community. The majority of interventions were approach at school with an emphasis on promotion of resilience and a healthy behavior. Conclusion The analyzed studies showed the importance of nurses to promote children's mental health in mental health education programs, sensibilization and support to psychoaffective, biologic and social needs. A large variety of interventions organized and developed by nurses were observed at school, with families and as well as in the interrelationship with community.

Estudo comparativo da perceção de resiliência por pais e crianças/adolescentes / Estudio comparativo de la percepción de resiliencia por padres y niños/adolescentes / Perception of resilience in parents and children/adolescents: a comparative study

Resumo Objetivo Caracterizar a auto-perceção de resiliência das crianças e adolescentes; analisar as diferenças na perceção dos pais e sua relação com algumas variáveis de contexto sociodemográfico. Métodos Estudo transversal realizado no âmbito do Projeto MaiSaúdeMental, numa amostra não probabilística de conveniência de 567 crianças e adolescentes, 50,6% do sexo feminino, idade entre 9-17 anos (média= 12,40; Dp= 1,59 anos) de escolas do ensino básico da região centro de Portugal e 592 pais (média idade= 40,43 anos; Dp= 2,58 anos). Utilizou-se um questionário de caracterização sociodemográfica e a subescala Internal Assets do Healthy Kids Resilience Assessment Module (versão 6.0), adaptada à população Portuguesa por Martins (2005), composta por 18 itens e seis dimensões. Resultados Das crianças / adolescentes 78,8% moravam com os pais. Dos progenitores a maioria tinha entre 40 e 41 anos. A resiliência foi classificada como moderada por 47,8%, das crianças / adolescentes, numa distribuição idêntica pelos pais. O test-t mostrou que as crianças têm uma auto-percepção mais positiva de resiliência, face à percepção dos pais, com diferenças significativas em todas as dimensões (p <0,000). Os pais mais jovens têm uma perceção mais positiva da resiliência dos filhos, mas apenas significativa na empatia (p = 0,036) e resolução de problemas (p = 0,001). A resiliência diminuiu significativamente com o aumento da idade e escolaridade e foi mais elevada em crianças que vivem com os pais. Conclusão Os resultados do estudo evidenciam diferenças entre a perceção de resiliência nas crianças e pais, sendo esta influenciada por características sociodemográficas.

Resumen Objetivo Caracterizar la autopercepción de resiliencia de los niños y adolescentes; analizar las diferencias en la percepción de los padres y su relación con algunas variables de contexto sociodemográfico. Métodos Estudio transversal realizado en el ámbito del Proyecto "MaiSaúdeMental" (Más Salud Mental), en un muestreo no probabilístico de conveniencia de 567 niños y adolescentes, 50,6% de sexo femenino, edad entre 9 y 17 años (promedio= 12,40; Dp= 1,59 años) de escuelas primarias de la región centro de Portugal y 592 padres (edad promedio= 40,43 años; Dp= 2,58 años). Se utilizó un cuestionario de caracterización sociodemográfica y la subescala Internal Assets del Healthy Kids Resilience Assessment Module (versión 6.0), adaptada a la población portuguesa por Martins (2005), compuesta por 18 ítems y 6 dimensiones. Resultados De los niños/adolescentes, 78,8% vivían con los padres. De los progenitores, la mayoría tenía entre 40 y 41 años. La resiliencia fue clasificada como moderada por el 47,8% de los niños/adolescentes, en una distribución idéntica por los padres. El test-T mostró que los niños tienen una autopercepción más positiva de resiliencia, frente a la percepción de los padres, con diferencias significativas en todas las dimensiones (p<0,000). Los padres más jóvenes tienen una percepción más positiva de la resiliencia de los hijos, pero poco significativa en la empatía (p=0,036) y resolución de problemas (p=0,001). La resiliencia se redujo significativamente con el aumento de la edad y escolaridad y fue más elevada en niños que viven con los padres. Conclusión Los resultados del estudio dejan en evidencia diferencias entre la percepción de resiliencia en los niños y padres, de modo que está influenciada por características sociodemográficas.

Abstract Objective To characterize self-perception of resilience in children and adolescents, and to analyze how this self-perception differs from the perception of their parents in correlation with sociodemographic variables. Methods This was a cross-sectional study conducted as part of the MAISaúdeMental (More Mental Health) project with a nonprobability convenience sample including 567 children and adolescents, 50.6% of whom were females aged between 9 and 17 years old (mean = 12.40; SD = 1.59 years old) enrolled in basic education schools from Central Portugal, and 592 parents (mean age = 40.43 years old; SD = 2.58 years old). A questionnaire for sociodemographic characterization was used, along with the Healthy Kids Resilience Assessment Module (version 6.0) Internal Assets subscale, adapted to the Portuguese population by Martins (2005), composed of 18 items and 6 dimensions. Results Out of the total number of children/adolescents, 78.8% lived with their parents. Out of the total number of parents, most were between the ages of 40 and 41 years old. Resilience was classified as moderate by 47.8% of children/adolescents at an identical distribution in parents. The t-test showed children's self-perception of resilience to be more positive when compared to their parents with significant differences seen in all dimensions (p <0.000). Younger parents showed a more positive perception of their children's resilience, significant only for "empathy and respect" (0.036) and "problem-solving skills" (0.001). Resilience decreased significantly with age and higher education levels, and children living with their parents showed higher resilience. Conclusion Study results show differences between the perceptions of resilience in children and their parents, which are influenced by sociodemographic characteristics.

Influência sociodemográfica na qualidade de vida relacionada com a saúde dos adolescentes / Influencia sociodemográfica en la calidad de vida relacionada con la salud de los adolescentes / Sociodemographic influence in health-related quality of life in adolescents

Resumo Objetivo Identificar as variáveis sociodemográficas (sexo, idade, escolaridade e coabitação) que influenciam a perceção da qualidade de vida relacionada com a saúde dos adolescentes. Métodos Estudo descritivo-correlacional de natureza quantitativa, numa amostra não probabilística por conveniência, constituída por 567 adolescentes, a frequentar o 2º e 3º Ciclo do Ensino Básico num Agrupamento de Escolas do centro de Portugal. Os participantes apresentavam média de idade de 12,4 anos (Dp=1,59), os rapazes entre 9-16 anos, e as meninas entre 10-17 anos, 50.6% do sexo feminino e a maioria coabita numa família nuclear (77,4%). Na coleta de dados utilizou-se a versão portuguesa da escala Kidscreen-52(1) e questões de caracterização sociodemográfica. Os dados foram coletados no período de janeiro a julho de 2018 e o tratamento estatístico foi realizado utilizando o Statistical Package for the Social Sciences® (SPSS - versão 24.0). Resultados Os adolescentes têm uma perceção positiva da sua qualidade de vida relacionada com a saúde, com diferença estatística para a idade, teste Anova (F=31,980; p =0.000), para o ano de escolaridade, (F=15,293; p=0.000) e Coabitação (F=11,491; p=0.010). Conclusão Os rapazes apresentam uma melhor percepção sobre a qualidade de vida, assim como os adolescentes mais jovens e os que coabitam com os pais (mãe e pai).

Resumen Objetivo Identificar las variables sociodemográficas (sexo, edad, escolaridad y cohabitación) que influyen en la percepción de calidad de vida relacionada con la salud de los adolescentes. Métodos Estudio descriptivo correlacional de naturaleza cuantitativa, en un muestreo no probabilístico por conveniencia, constituido por 567 adolescentes que cursan de 5° a 9° año de primaria en un Agrupamiento de Escuelas del centro de Portugal. Los participantes tenían edad promedio de 12,4 años (Dp=1,59), los varones de 9 a 16 años y las mujeres de 10 a 17 años, 50,6% de sexo femenino y la mayoría cohabita en una familia nuclear (77,4%). En la recolección de datos se utilizó la versión portuguesa de la escala Kidscreen-52(1) y cuestiones de caracterización sociodemográfica. Los datos se recolectaron de enero a julio de 2018 y el tratamiento estadístico se realizó utilizando el Statistical Package for the Social Sciences® (SPSS - versión 24.0). Resultados Los adolescentes tienen una percepción positiva de su calidad de vida relacionada con la salud, con diferencia estadística por edad, test Anova (F=31,980; p =0.000), por año de escolaridad, (F=15,293; p=0.000) y cohabitación (F=11,491; p=0.010). Conclusión Los varones presentan una mejor percepción sobre la calidad de vida, así como los adolescentes más jóvenes y los que cohabitan con los padres (madre y padre).

Abstract Objective To determine the sociodemographic variables (gender, age, level of formal education and cohabitation) that have influenced the perception of health-related quality of life of adolescents. Methods This was a descriptive, correlational and quantitative study including a non-probabilistic convenience sample of 567 adolescents. Of these, 50.6% were girls and attended 2nd and 3rd cycles of basic education in grouping of schools in central Portugal. The participants mean age was 12.4 years-old (SD = 1.59), boys age ranged from 9 to 16 years-old and girls from 10 to 17, most of them lived within a nuclear family (77.4%). Data were collected from January to June 2018 using a Portuguese version of Kidscreen-52(1) scale along with a questionnaire of sociodemographic characterization. The IBM SPSS Statistics for Windows (Version 24.0. Armonk, NY: IBM Corp) was used for statistical analyses. Results Adolescents have a positive perception of their quality of life regarding health. A statistical difference related with age, One-way ANOVA test (F = 31.980; p = 0.000), school year (F = 15.293; p = 0.000) and cohabitation (F = 11.491; p = 0.010). Conclusion Boys present a higher perception of quality of life, as well as younger adolescents and those who live with their parents (mother and father).

Perception of health professionals about neonatal palliative care / La percepción de los profesionales de la salud sobre los cuidados paliativos neonatales / Perceção dos profissionais de saúde sobre os cuidados paliativos neonatais

ABSTRACT Objective: To identify the perception of health professionals about neonatal palliative care. Method: A phenomenological qualitative study, a non-probabilistic sample, of 15 health professionals from a neonatal intensive care unit in northern Portugal. Content analysis was performed. Results: Despite their lack of training in palliative care, the health professionals showed concern for the dignity, quality of life and comfort of the newborn and family. They expressed emotional and relational difficulties in following the trajectories of serious illness and death and in the ethical decisions regarding the end-of-life. Conclusion: It is emphasized that professionals are sensitive to pain and suffering and reveal dedicated and committed in the care of the newborn and family. They are available to train and embrace the current challenges posed by the constitution of pediatric palliative care teams and to help achieve an organizational culture that advances in such care.

RESUMEN Objetivo: Identificar la percepción de los profesionales del equipa de la salud sobre los cuidados paliativos neonatales. Método: Estudio cualitativo fenomenológico, muestra no probabilística de 15 profesionales de la salud de una unidad neonatal del norte de Portugal. Se realizó análisis de contenido. Resultados: A pesar de la falta de formación en cuidados paliativos, los profesionales revelaron preocupación por la dignidad, calidad de vida y confort del recién nacido y su familia. Expresaron dificultades emocionales y relacionales para acompañar las trayectorias de la enfermedad severa y de la muerte y para lidiar con la decisión ética. Conclusión: Debemos destacar que los profesionales son sensibles al dolor, sufrimiento y se muestran dedicados y comprometidos en el cuidado del recién nacido y la familia. Están disponibles para participar en formación y abrazar los desafíos actuales que pasan por la constitución de equipos de cuidados paliativos pediátricos y por lograr una cultura organizacional que permita el progreso de esos cuidados.

RESUMO Objetivo: Identificar a percepção dos profissionais da equipa de saúde sobre os cuidados paliativos neonatais. Método: Estudo qualitativo fenomenológico, amostra não probabilística de 15 profissionais da equipa de saúde de uma unidade de cuidados intensivos neonatal, do norte de Portugal. Realizou-se análise de conteúdo. Resultados: Apesar da falta de formação em cuidados paliativos, os profissionais revelaram preocupação com a dignidade, qualidade de vida e conforto do recém-nascido e família. Expressaram dificuldades emocionais e relacionais no acompanhar as trajetórias de doença grave e morte e a nível da decisão ética no final de vida. Conclusão: Salientamos que os profissionais estão sensíveis à dor e sofrimento e mostram-se dedicados e comprometidos no cuidar do recém-nascido e família. Mostram-se disponíveis para fazer formação e abraçar os desafios atuais que passam pela constituição de equipas de cuidados paliativos pediátricos e o alcançar de uma cultura organizacional que progrida nesses cuidados.

Perception of health professionals about neonatal palliative care.

OBJECTIVE: To identify the perception of health professionals about neonatal palliative care. METHOD: A phenomenological qualitative study, a non-probabilistic sample, of 15 health professionals from a neonatal intensive care unit in northern Portugal. Content analysis was performed. RESULTS: Despite their lack of training in palliative care, the health professionals showed concern for the dignity, quality of life and comfort of the newborn and family. They expressed emotional and relational difficulties in following the trajectories of serious illness and death and in the ethical decisions regarding the end-of-life. CONCLUSION: It is emphasized that professionals are sensitive to pain and suffering and reveal dedicated and committed in the care of the newborn and family. They are available to train and embrace the current challenges posed by the constitution of pediatric palliative care teams and to help achieve an organizational culture that advances in such care.

O ruído em neonatologia: perceção dos profissionais de saúde / Noise in neonatology: perception of health professionals / El ruido en neonatología: percepción de los profesionales de la salud

Enquadramento: É reconhecido o impacto negativo do ruído no recém-nascido em unidades de neonatologia, bem como nos pais e profissionais de saúde, sendo importante a sensibilização para a redução e controlo deste agente stressor. Objetivos: Identificar a perceção dos profissionais de saúde sobre o ruído em neonatologia. Metodologia: Estudo quali-quantitativo e descritivo. Amostra não probabilística com 52 profissionais de saúde. Utilizou-se um questionário ad-hoc construído para o efeito. Resultados: Os profissionais, na sua maioria, consideram a unidade de neonatologia ruidosa, incómoda no desempenho de funções e consideram existir efeitos adversos do ruído, apesar de apresentarem poucos conhecimentos sobre os valores de decibéis recomendados para uma unidade neonatal. Conclusão: A perceção dos profissionais de saúde sobre o ruído indica a necessidade de implementação de um programa de redução de ruído. Considerou-se pertinente a formação e envolvimento da equipa, de forma a serem elementos ativos e mobilizadores na adoção de medidas que promovam um ambiente acusticamente mais saudável para o recém-nascido e bem-estar dos pais e dos profissionais de saúde.

Background: The negative impact of noise in the newborn in neonatology units, as well as in the parents and health professionals, is known, so it is essential to raise awareness of the reduction and control of this stressor agent. Objectives: To identify the perception of health professionals about noise in neonatology. Methodology: Qualitative-quantitative and descriptive study. A non-probabilistic sample of 52 health professionals. An ad-hoc questionnaire designed for this purpose was used. Results: The majority of professionals considers neonatology units noisy and uncomfortable in performing functions and believes that noise has adverse effects, although there is little knowledge about the decibel values recommended for the neonatal unit. Conclusion: The perception of health professionals about noise indicates the need to implement a noise reduction program. We consider the training and involvement of the team relevant, so professionals can be active and inciting in the adoption of measures that promote an acoustically healthy environment for the newborn and the well-being of parents and health professionals.

Marco contextual: Se reconoce el impacto negativo del ruido en el recién nacido en unidades de neonatología, así como en los padres y en los profesionales de la salud, por lo que es importante la sensibilización para reducir y controlar este factor de estrés. Objetivos: Identificar la percepción de los profesionales de la salud sobre el ruido en neonatología. Metodología: Estudio cuali-cuantitativo y descriptivo. La muestra fue no probabilística con 52 profesionales de la salud. Se utilizó un cuestionario ad-hoc construido para tal efecto. Resultados: La mayoría de los profesionales consideran la unidad de neonatología ruidosa, incómoda en el desempeño de funciones y consideran que existen efectos adversos del ruido, a pesar de que presentan pocos conocimientos sobre los valores de decibelios recomendados para una unidad neonatal. Conclusión: La percepción de los profesionales de la salud sobre el ruido indica la necesidad de implementar un programa de reducción del ruido. Se consideró pertinente formar e implicar al equipo, de forma que sean elementos activos y movilizadores en la adopción de medidas que promuevan un ambiente acústicamente más sano para el recién nacido y para el bienestar de los padres y de los profesionales de la salud.

Perspetiva dos pais sobre as perturbações do sono das crianças em idade pré-escolar / Parents' perspective on sleep disorders in pre-school children / Perspectiva de los padres sobre los trastornos del sueño de los niños en edad prescolar

CONTEXTO: O sono tem um papel determinante no desenvolvimento infantil e quando é perturbado assume um impacto social e na saúde das crianças e pais. OBJETIVO(S): Identificar as perturbações do sono percebidas pelos pais das crianças em idade pré-escolar. METODOLOGIA: Estudo quantitativo, descritivo e correlacional. Amostra não probabilística com 642 pais de crianças. As crianças frequentam o ensino pré-escolar dos concelhos de Albergaria-a-Velha (64,2%) e Águeda (35,8), têm idade média de 4,55 (±0,93) anos e 51,7% são do sexo feminino. O instrumento incluiu um questionário de caracterização sociodemográfica e estilos de vida e o Questionário de Hábitos de Sono das Crianças (CSHQ-PT). RESULTADOS: Apurámos que 82,4% das crianças apresentam perturbação do sono (Global) sendo 43,3% do sexo feminino e com idades de 5-6 anos. A Resistência em ir para a cama é classificada como intermédia para 41% das crianças. Em 40,2% o Início do sono é adequado (demora até 20 minutos) e a Duração do sono é adequada para 45,3%. A Ansiedade associada ao sono e Parassonias apresentam valores semelhantes nos três níveis de classificação. Manifestam Despertares noturnos muito frequentes 38,8%. A maioria (74,3%) apresenta reduzida Perturbação respiratória do sono. Um terço das crianças tem Sonolência diurna elevada. CONCLUSÕES: Os dados revelam a necessidade de dotar os enfermeiros de competências para detetar as alterações no sono e desenvolver programas estruturados de empowerment parental para melhorar os hábitos e higiene do sono das crianças.

BACKGROUND: Sleep has a determining role in child development and when it is disturbed, has a social and an health impact on children and parents. AIM: Identify the sleep disturbances perceived by pre-school children’s parents. METHODS: Quantitative, descriptive and correlational study. Non-probabilistic sample with 642 children’s parents. Children attend pre-school education in Albergaria-a-Velha (64.2%) and Águeda (35.8), mean age 4.55 (±0.93) years and 51.7% are female. The instrument included a sociodemographic characterization and lifestyle questionnaire and the Children's Sleep Habits Questionnaire. RESULTS: We found that 82.4% of the children presented Global sleep disturbance, being 43.3% female and 5-6 years old. The Resistance to go to bed is classified as intermediate for 41% of the children. In 40.2% the Onset of sleep is adequate (it takes up to 20 minutes) and Sleep duration is adequate for 45.3%. The Anxiety associated with sleep and Parasomnias feature similar values in the three levels of classification. Manifest very frequent Nocturnal awakenings 38.8%. The majority (74.3%) presents reduced respiratory Sleep Disturbance. A third of children have high daytime sleepiness. CONCLUSIONS: Outcomes reveal the need to provide nurses with skills to detect changes in sleep and develop structured programs of parental empowerment to improve children's sleep habits.

CONTEXTO: El sueño tiene un papel determinante en el desarrollo infantil y cuando es perturbado asume un impacto social y en la salud de los niños y padres. OBJETIVO(S): Identificar las perturbaciones del sueño percibidas por los padres de los niños en edad preescolar. METODOLOGÍA: Estudio cuantitativo, descriptivo y correlacional. Muestra no probabilística con 642 padres de niños. Los niños asisten a la enseñanza preescolar de los municipios de Albergaria-a-Velha (64,2%) y Águeda (35,8), tienen una edad media de 4,55 (± 0,93) años y el 51,7% son del sexo femenino. El instrumento incluyó un cuestionario de caracterización sociodemográfica y estilos de vida y el Cuestionario de Hábitos de Sueño de los Niños (CSHQ-PT). RESULTADOS: En el 82,4% de los niños presentan Alteración Global del sueño siendo 43,3% del sexo femenino y con edades de 5-6 años. La Resistencia en ir a la cama se clasifica como intermedia para el 41%. En el 40,2% el Inicio del sueño es adecuado (tarda hasta 20 minutos) e la Duración del sueño es adecuada para el 45,3%. La Ansiedad asociada al sueño y Parassonias presentan valores similares en los tres niveles de clasificación. Manifiestan Despertares nocturnos muy frecuentes 38,8%. La mayoría (74,3%) presenta reducida Trastorno respiratorio del sueño. Un tercio de los niños tiene Somnolencia diurna elevada. CONCLUSIONES: Los datos revelan la necesidad de dotar a los enfermeros de competencias para detectar los cambios en el sueño y desarrollar programas estructurados de empowerment parental para mejorar los hábitos del sueño de los niños.

Nurses' clinical communication skills

BACKGROUND: Providing nursing care involves an interpersonal relationship between the nurse and the patient which is created through communication. The importance of clinical communication skills is a current priority when it comes to health care workers' education and training and has been attracting more and more attention. As a consequence clinical communication skills are now present in more and more academic programmes. OBJECTIVES: To assess nurses' clinical communication skills; to identify the variables that might influence the clinical communication skills; to analyse nurses' perspective regarding the training in the clinical communication field. MATERIAL AND METHODS: Quantitative, non-experimental, descriptive and correlational and cross-sectional study. We used the questionnaire to collect socio-demographic and professional data, and the Clinical Communication Skills Scale based on the Kalamazoo Consensus Statement (KCS)1,2 and which had already been used in Portugal.3 The sample was formed by 275 practitioner nurses who have been working in health care institutions located in the center of Portugal. RESULTS: The Scale we used presents 5 factors that explain 64.33% of the total variation: To involve the patient; To facilitate dialogue; To understand concerns; To communicate in an assertive way; To carry out the interview. The majority of the nurses consider that the training they had in the communication skills field during their nursing course was good or very good, however we could see that 23.3% think it was mediocre. Almost all of them (98.9%) agree that there should be a better and more specific training in the field of clinical communication skills as far, as nurses as concerned. Nurses who had training in this area, older nurses, those who work directly with patients and those who have been working for a longer period of time show better communication skills. CONCLUSION: Although they think that the training they has was good, we could confirm that there was a deficit in nurses' clinical communication skills and that nurses themselves refer they need more training in this area. Data point out to a more significant investment in clinical communication as far as nurses' training is concerned and they suggest the promotion of lifelong learning opportunities in this area

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Nursing tutors’ perception of clinical supervision Skills

INTRODUCTION: The evolution of science and technology, changes within the healthcare organizations and new healthcare emerging philosophies require an active participation from healthcare professionals in helping in their peers' training. The supervision process is therefore more and more important. OBJECTIVES: To identify specialist nursing instructors' perception of the clinical supervisor skills in child-health area and paediatrics. MATERIAL AND METHODS: Qualitative-descriptive and phenomenological study composed by a sample of ten nursing tutors in the Dr. Nélio Mendonça Hospital's Paediatrics Department. We used a semi-structured interview and recordings of the conversations. We performed a content analysis on the corpus of all the interviews, once we had defined subcategories and indicators. RESULTS: The category "clinical supervisor skills" emerged from our study and the subcategories which were the most commonly referred were "personal characteristics with a 38% record unit" and "professional skills" (25.7%). As far as the relevant aspects in the child-health area and paediatrics are concerned, personal and professional skills stood out once again, with a 40.4% rate each. The main facilitating factor in the supervision process was the fact that it is a structured process (21.6%), and the inhibition factor was the deficit that exists in interpersonal relationships (21.7%). Globally, there were more record units associated with inhibition factors. CONCLUSION: Knowing what supervisors' insights in such a specific area as child-healthcare and paediatrics are, we think that this study can be a contribution to improve the quality of the supervision process in nursing. A joint effort between supervisor and supervised nurse will be needed to improve the processes that link institutions and their actors, processes where knowledge, experiences and professional objectives are commonly shared

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OC42 - What do parents know about fever?

UNLABELLED: Theme: Parenting/parenthood. INTRODUCTION: Due to lack of information, the fever in the child brings anxiety and fear to their parents. OBJECTIVES: To identify parents' knowledge towards the child with fever and the sources of information they have used. METHODS: Cross-sectional, descriptive-correlational study. Convenience not probabilistic sample of 360 parents with children in child health surveillance consultation, in central Portugal. Data collection was performed by a questionnaire about fever in children. RESULTS: Knowledge of the fever was found to be weak among parents aged * 38 years (36.2%) with a partner (77.0%), living in rural areas (69.3%) and having completed the ninth grade (53.9%). Parents up to 37 years (68.2%) with a partner (89.0%), living in urban area (53.0%) and having higher education (43.3%) showed good knowledge. The main sources of information were the doctor (65.8%) and nurses (50.6%). CONCLUSION: Nurses need to invest in training parents more on this subject.

Perspective of health professionals on hand hygiene.

OBJECTIVE: To identify the practices reported by health professionals on hand hygiene; To determine how the practices of hand hygiene are related to socio-demographic and professional variables and variables in the context of practice. MATERIAL AND METHODS: A descriptive-correlational and cross-sectional study conducted in a hospital in central Portugal, in May and June, 2012. 71 health professionals participated, with 23.9% physicians, 64.8% nurses and 11.3% operating assistants, in paediatrics, neonatology and paediatric emergencies. The majority was female (91.5%) and 32.4% are between the ages of 31 and 40 years. A questionnaire developed from DGS (General Health Directorate) recommendations was applied with questions on socio-demographic and professional characteristics as well as on the context of practice. RESULTS: The professionals are motivated to perform hand hygiene (98.6%). In self-assessment, they practice hand hygiene appropriately, however the results revealed that 43.7% of subjects reported little knowledge concerning the interference of ornaments on the practice of hand hygiene, 38% of the sample reported the steps of the hand washing technique improperly, and approximately 43% of the sample does not practice hygiene at the correct times. The majority of the participants who use a proper technique are nurses, with significant differences with regards to doctors and operating assistants (P=.001). CONCLUSIONS: Most have knowledge about the practice of hand hygiene; however, some professional groups need to improve their practice of proper technique and the correct time to do so. Approximately a third did not attend specific training, leading us to reflect on the need to invest in training.

Nurses' perceptions of advance directives.

OBJECTIVE: To identify nurses perceptions of Advance Directives (AD) and to analyse the influence of experience with AD on their perception. MATERIAL AND METHODS: Quantitative, descriptive, correlational study conducted in a hospital in central Portugal with a sample of 139 nurses, aged 20-60 and in which 78.4% are women and 74% are under 40 years of age. A questionnaire was applied on nurses' perceptions of AD, their socio-demographic characteristics, and professional experiences with AD. RESULTS: Nurses with 26-30 years of experience have a more critical position with regards to AD (P=.03). Approximately 95% of nurses have no experience of situations where they were given the opportunity for the patient to decide using the AD, nor did they experience situations where the patient has been informed of this right. Most nurses (72.7%) expressed their readiness to reflect with the patient to preparing the AD document and 45.3% would only do so, if the patient or the family requested it. CONCLUSION: Nurses have little experience with AD. They are available to respect the patient's will but did not feel able to address the issue on their own initiative. Most agree that the AD can "fail" if the patient does not reevaluate it periodically. Reflection and debate on the ethical issues surrounding AD should be promoted: promoting patient autonomy, care in vulnerable situations, team decisions and conscientious objection.

Perspective of health professionals on hand higiene

OBJECTIVE: To identify the practices reported by health professionals on hand hygiene; To determine how the practices of hand hygiene are related to socio-demographic and professional variables and variables in the context of practice. MATERIAL AND METHODS: A descriptive-correlational and cross-sectional study conducted in a hospital in central Portugal, in May and June, 2012. 71 health professionals participated, with 23.9% physicians, 64.8% nurses and 11.3% operating assistants, in paediatrics, neonatology and paediatric emergencies. The majority was female (91.5%) and 32.4% are between the ages of 31 and 40 years. A questionnaire developed from DGS (General Health Directorate) recommendations was applied with questions on socio-demographic and professional characteristics as well as on the context of practice. RESULTS: The professionals are motivated to perform hand hygiene (98.6%). In self-assessment, they practice hand hygiene appropriately, however the results revealed that 43.7% of subjects reported little knowledge concerning the interference of ornaments on the practice of hand hygiene, 38% of the sample reported the steps of the hand washing technique improperly, and approximately 43% of the sample does not practice hygiene at the correct times. The majority of the participants who use a proper technique are nurses, with significant differences with regards to doctors and operating assistants (P = .001). CONCLUSIONS: Most have knowledge about the practice of hand hygiene; however, some professional groups need to improve their practice of proper technique and the correct time to do so. Approximately a third did not attend specific training, leading us to reflect on the need to invest in training

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Nurses’ perceptions of advance directives

OBJECTIVE: To identify nurses perceptions of Advance Directives (AD) and to analyse the influence of experience with AD on their perception. MATERIAL AND METHODS: Quantitative, descriptive, correlational study conducted in a hospital in central Portugal with a sample of 139 nurses, aged 20-60 and in which 78.4% are women and 74% are under 40 years of age. A questionnaire was applied on nurses' perceptions of AD, their socio-demographic characteristics, and professional experiences with AD. RESULTS: Nurses with 26-30 years of experience have a more critical position with regards to AD (P = .03). Approximately 95% of nurses have no experience of situations where they were given the opportunity for the patient to decide using the AD, nor did they experience situations where the patient has been informed of this right. Most nurses (72.7%) expressed their readiness to reflect with the patient to preparing the AD document and 45.3% would only do so, if the patient or the family requested it. CONCLUSION: Nurses have little experience with AD. They are available to respect the patient's will but did not feel able to address the issue on their own initiative. Most agree that the AD can "fail" if the patient does not reevaluate it periodically. Reflection and debate on the ethical issues surrounding AD should be promoted: promoting patient autonomy, care in vulnerable situations, team decisions and conscientious objection

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