VIGILÂNCIA DO DESENVOLVIMENTO INFANTIL: ANÁLISE DA SITUAÇÃO BRASILEIRA

Continuing education on child development in primary care: healthcare workers' perspectives

OBJECTIVE

To analyze the contributions of a continuing education with Primary Health Care professionals that promotes child development.

METHOD

A continuing education intervention, utilizing a qualitative approach, was conducted among healthcare workers at a Primary Health Care facility in a low-income neighborhood in the city of Recife. The intervention consisted of eight workshops conducted between July and October 2019, with the participation of fifteen healthcare workers. All data from the focus groups were recorded, transcribed, and analyzed thematically using Bronfenbrenner's bioecological model as the theoretical framework.

RESULTS

Through the continuing education intervention, healthcare professionals were able to reflect on their work processes and personal lives and propose actions to improve child development.

CONCLUSION

The study findings highlight the significant impact of such interventions in changing perceptions and professional practices related to child development. Overall, this research provides valuable insights into the effectiveness of continuing education interventions for promoting healthy child development in primary care settings.

Studies on the Child Handbook in Brazil: a scoping review

OBJECTIVE

To systematically identify and map studies involving the Caderneta da Criança (Child Handbook - CH) in Brazil.

METHODS

A scoping review using the methodology proposed by the Joanna Briggs Institute. The databases PubMed, Biblioteca Virtual em Saúde (BVS), Biblioteca Digital Brasileira de Teses e Dissertações, Periódicos Capes and Google Scholar were consulted. Primary and secondary studies that mentioned the use of CH were included, without restrictions regarding design, year of publication or population, published in Portuguese, English or Spanish and gray literature (theses and dissertations).

RESULTS

A total of 129 studies were included, mostly descriptive, published as scientific papers. The Northeast region, the population of caregivers of children and the Primary Care scenario were observed in most studies; 47% of the studies used the CH as a source of data, the majority on vaccination. Despite the different criteria to define adequacy of completing the CH, the studies identified weaknesses in filling out all of its items, except for immunization. The utilization and/or completion of the CH were linked to various factors, including the availability of the CH, characteristics of the children (such as sex, age, prematurity and well-child appointments), attributes of the family members and caregivers (such as age, education, income, parity, work status, prenatal care, reading, note-taking and bringing CH to appointments) and features of the professionals (such as workplace, medical specialty, communication style, knowledge about the CH, requesting, guiding and note-taking).

CONCLUSIONS

The results reinforce the need to better understand which factors affect the distribution of the CH in the population, as well as pointing to the need for understanding its use and completion by the different care points. The need for intervention studies to improve the implementation of this tool and to include training on the use of the CH in the context of continuing health education becomes evident.

Childcare appointment at the Family Health Strategy in municipalities in the inland region of the State of Paraíba, Brazil

This article aims to evaluate the childcare appointments by health professionals working at the Family Health Strategy in municipalities in the State of Paraíba, compare the performance by health team type (The Mais Médicos Program or conventional), and analyze the association of client satisfaction with the developed actions. This cross-sectional study evaluated the structural conditions of health units, the work process of health professionals, and client satisfaction, observing childcare appointments in 22 health teams. Poor employment relationships and professionals' knowledge about child growth curves were highlighted in the structure. In the 175 appointments observed, we detected neglect in completing the Child Health Booklet (CHB), obtaining data on food consumption, and guidance practices. Only 36% of the appointments were classified with adequate duration. There was greater satisfaction for appointments developed in health teams of the Mais Médicos Program, with longer duration and better performance in guidance practices. The implementation of childcare appointments reveals significant gaps that can influence maternal satisfaction.

A puericultura no SUS: o cuidado da criança na perspectiva da atenção integral à saúde

RESUMO O termo puericultura é atribuído ao pediatra, mas tem sido utilizado pela Estratégia Saúde da Família. Uma breve história da infância e da evolução do seu cuidado até a criação do Sistema Único de Saúde auxilia na compreensão de que, a rigor, puericultura sempre significou cuidado da criança. Este ensaio teve por objetivo compreender a história da puericultura e contribuir para atualizar o seu significado e sua importância para o cuidado da primeira infância no âmbito da Atenção Básica à saúde, com base em revisão narrativa sobre cuidado da criança e puericultura na literatura científica e em documentos do Ministério da Saúde. A puericultura tem se atualizado com a evolução das ações para o cuidado da criança. Começou de forma individualizada, pela caridade e filantropia, e, na atualidade, ampliou-se, operando em rede, coordenada pela Atenção Básica. O termo puericultura é resgatado como cuidado da criança e inserido na rede por meio de políticas públicas. O cuidado deve ser oferecido na perspectiva da atenção integral à saúde, onde a criança estiver, atendendo às suas necessidades, incluindo as de crianças com deficiências permanentes. Esses debates precisam estar inseridos na formação do pediatra e podem contribuir para o enfrentamento da fragmentação do cuidado.

A Caderneta da Criança e a terapia ocupacional na atenção básica à saúde

RESUMO A Caderneta da Criança (CC) é um instrumento essencial para a vigilância do desenvolvimento infantil, temática presente nos currículos dos Cursos de Terapia Ocupacional (TO), profissão que tem na infância uma importante área de atuação. Porém, poucos estudos descrevem ações da profissão na atenção primária à saúde da criança. Esta pesquisa objetivou descrever e analisar as ações e as atividades de estudantes de TO participantes do Projeto Multicampi Saúde da Criança à clientela de mães e crianças, pautadas na CC no contexto da atenção básica. É quantitativa, descritiva e retrospectiva, com dados extraídos de 37 diários de campo. As ações mais encontradas foram consultas de vigilância do desenvolvimento (27,4%), orientação (23,6%), educação em saúde e visita domiciliar (12,3% cada). Mapeamento dos serviços, Programa Saúde na Escola, grupos terapêuticos, apoio matricial e reuniões de equipe aparecem com menor expressividade. Os dados corroboram pesquisas que descrevem ações desenvolvidas por terapeutas ocupacionais da atenção básica e indicam que a CC proporcionou uma gama importante de ações nesse contexto. Observa-se ainda a importância do terapeuta ocupacional na equipe multiprofissional de atenção à saúde da criança e a relevância do Projeto Multicampi Saúde da Criança no percurso formativo do discente.

Practice of Early Childhood Developmental Milestone Assessment and Its Determinants Among Health Professionals Working at Public Hospitals in Addis Ababa, Ethiopia: A Cross-Sectional Study

Background

Early childhood developmental assessment refers to the continual process of observing, gathering, recording, and interpreting information to make developmental and instructional decisions and measure young children’s performance over time. Significant changes in the physical and neuropsychomotor developmental milestones take place in the first 2 years of life. Children younger than 3 years of age (36 months) who are at risk of having developmental delays may be eligible for early intervention treatment services. The study aimed to assess practice in early childhood developmental assessment and its determinants among health professionals working in public hospitals in Addis Ababa, Ethiopia.

Methods

This facility-based descriptive cross-sectional study was conducted from September to April 2018, with a total sample size of 268 health professionals from six public hospitals in Addis Ababa, Ethiopia. The data were entered into EpiData software version 4.2, and analyzed by SPSS version 23 software for bivariate and multivariable logistic regression analysis. Significant associations were taken as p<0.05 and the strength of associations was expressed using odds ratios.

Results

The practice of early childhood developmental milestone assessment was found to be 27.8%. Being a general practitioner (AOR=23.826, 95% CI: 6.77–83.9, p=0.000) or health officer (AOR=11.02, 95% CI: 2.1–58.812, p=0.005), and work experience greater than 11 years (AOR=20.897, 95% CI: 1.5–291.49, p=0.024) were significantly associated with good practice of early childhood developmental milestone assessment.

Conclusion

Practice of early childhood developmental milestone assessment remains poor. Training and sharing experiences among different professions, and assigning professionals with the highest levels of work experience in the service could improve the practice levels.

Child developmental monitoring: implementation through the family health strategy nurse / Vigilância do desenvolvimento infantil: implementação pelo enfermeiro da estratégia saúde da família

Objetivo: Analisar como ocorre a implementação da vigilância do desenvolvimento infantil no processo de cuidado de enfermeiros da Estratégia Saúde da Família. Método: Pesquisa de abordagem qualitativa, realizada com 11 enfermeiros atuantes na Estratégia Saúde da Família de dois municípios do Curimataú Paraibano. Os dados foram coletados de novembro a dezembro de 2018, por entrevista semiestruturada e tratados conforme análise temática. Resultados: Foi evidenciado o tema “Vigilância do Desenvolvimento Infantil e a implementação pelo enfermeiro na Estratégia Saúde da Família” abordando quais instrumentos utilizados e registros realizados para a vigilância do desenvolvimento; aspectos considerados na avaliação da criança e promoção do desenvolvimento infantil. Conclusão: Percebe-se a necessidade de instituições de ensino superior na área de saúde e gestores enxergarem a problemática e investirem na formação e qualificação profissional, no intuito de empoderar os enfermeiros para a vigilância do desenvolvimento infantil na atenção primária, de forma sistemática e integral.

The Diagnostic Accuracy of Delayed Development in Adolescents

INTRODUCTION

The early identification of developmental delay in adolescents by health professionals is relevant for a good prognosis. However, the clinical indicators of development delay are unclear in nursing science.

PURPOSE

To analyze the clinical indicators of delayed development in school adolescents.

METHODS

A diagnostic accuracy study that investigated delayed development among 385 adolescents in public schools between July and September of 2017. The accuracy measures were analyzed using a latent class analysis based on sensitivity and specificity values.

FINDINGS

The delayed development is present in 18.26% of school adolescents. The best accuracy values were as follows: low self-esteem (0.9838), dissatisfaction with own image (0.8400), impaired daily activities (0.9815), internalization behavior (0.8304), outsourcing behavior (0.6367), eating disorders (1.0000), emotional insecurity (0.7093), dependent behavior (0.9836), and altered sexual maturation (0.6085).

CONCLUSION

Thus, this set of nine clinical indicators can be used by nurse practitioners to confirm delayed development in school adolescents.

IMPLICATIONS FOR NURSING PRACTICE

This research contributes by providing accurate clinical indicators of delayed development in adolescents. Thus, nurses should recognize delayed development in adolescents through accurate clinical indicators and propose nursing interventions that have positive health results.

Prevalence and socioeconomic determinants of development delay among children in Ceará, Brazil: A population-based study

Objective

To assess the prevalence of child development delay and to identify socioeconomic determinants.

Study design

We conducted a population-based cross-sectional study of children 2 to 72 months of age residing in the state of Ceará, Brazil. In total, 3200 households were randomly selected for participation in the study and had child development assessed with the Ages and Stages Questionnaire (ASQ) version 3. Development delay was defined as a score of less than -2 standard deviations below the median of the Brazilian ASQ standard. We present population-level prevalence of delay in five development domains and assess socioeconomic determinants.

Results

A total of 3566 children completed the ASQ development assessment of which 9.2% (95% CI: 8.1–10.5) had at least one domain with development delay. The prevalence of delay increased with age in all domains and males were at higher risk for communication, gross motor and personal-social development delays as compared to females (p-values <0.05). We found robust associations of indicators of socioeconomic status with risk of development delay; increasing monthly income and higher social class were associated with reduced risk of delay across all domains (28,2% in the poorest and 21,2% in richest for any delay, p-values <0.05 for all domains). In addition, children in poor households that participated in conditional cash transfer (CCT) programs appeared to have reduced risk of delay as compared to children from households that were eligible, but did not participate, in CCT programs.

Conclusions

There is a relatively high population-level prevalence of development delay in at least one domain among children 0–6 years of age in Ceará, Brazil. Integrated child development, social support, and poverty reduction interventions may reduce the population-level prevalence of development delay in Ceará and similar settings.