Child vaccination in animated infographic: technology for permanent education about the nursing process

OBJECTIVE

To develop and validate an animated infographic about the nursing process in childhood vaccination.

METHOD

Methodological study for the development and validation of educational technology, an animated infographic, on childhood vaccination. First, contents from the Ministry of Health that should compose the infographic were selected. Then, a script was prepared and a storyboard used to guide the production of the animated infographic. Once finalized, the technology went through the content and appearance validation process with nursing experts in the study area.

RESULTS

Sixty-nine screens of storyboard were done and the infographic lasted five minutes and 52 seconds. Forty-five nurses were selected and, of these, 21 agreed to participate in the study. The infographic was evaluated according to its objectives, structure, presentation, and relevance, resulting in an overall CVI of 97%.

CONCLUSION

The animated infographic produced was validated by experts and, once adapted following the judges' suggestions, it became a valid educational tool to be used by students and nursing professionals.

Parental stress during pregnancy and maternity

OBJECTIVE

To identify factors related to parental stress of women during pregnancy and the child's first month of life.

METHOD

Prospective longitudinal study in two stages. Analysis of home interviews with 121 participants, Gestational Stress Scale, and Parental Stress Scale. Fisher's exact test, Spearman's correlation, and linear and logistic multivariate regression were applied, with p < 0.05.

RESULTS

Most of the participants were between 18 and 35 years old, had 11 to 13 years of education, had no paid work, had a partner, usually the child's father, planned pregnancy, were multiparous, and underwent prenatal care. During pregnancy, 67.8% had stress. In the first month after the child's birth, most had low parental stress (52.1%). High parental stress correlated with some gestational stress. Planning pregnancy decreased parental stress.

CONCLUSION

Gestational and parental stress in the child's first month of life were correlated and pregnancy planning was a factor that reduced stress levels. Timely actions to reduce parental stress are essential for parenting and the child's overall health.

Clusters of risk for the occurrence of leprosy and disabilities in children under 15 years of age in Cuiabá: a geospatial study

OBJECTIVE

This study aimed to analyze the spatial distribution of leprosy and disabilities in children under 15 years of age in Cuiabá.

METHODS

Ecological study carried out in the city of Cuiabá, Mato Grosso, Brazil. The study population consisted of leprosy cases in children under 15 years old notified in the Notifiable Diseases Information System, between 2008 and 2018. Based on residential addresses, cases were georeferenced. In the analysis of the spatial distribution of the cases, the estimation of the Kernel density was used and, later, the statistics of spatial, spatio-temporal and Spatial Variation in Temporal Trends were applied.

RESULTS

514 cases of leprosy were reported in children under 15 years of age in Cuiabá, with a percentage of 10.1% of cases with degree of physical disability 1 and 2.3% with degree of physical disability 2 at the time of diagnosis. With the techniques of spatial and spatio-temporal scanning, clusters of risk for leprosy were identified in the North, West, East and South regions of Cuiabá, and with the technique of Spatial Variation in Temporal Trends, a cluster was identified in the West region of Cuiabá.

CONCLUSION

In Cuiabá, cases of leprosy in children under 15 years of age with disabilities were distributed throughout the urban area of the city, with the highest density of cases in the North and West regions, followed by the East region. The clusters with the highest Relative Risk were identified in the East and West regions, characterized by having low and medium income levels.

Mães adolescentes, autocuidado e cuidado infantil: validação de conteúdo de um calendário histórico de eventos

RESUMO Objetivo: Validar o conteúdo da ferramenta Event History Calendar Mãe Adolescente: fortalecendo o autocuidado e o cuidado da criança. Método: Estudo metodológico com a técnica Delphi, realizado em duas rodadas, envolvendo 37 especialistas de enfermagem. Na coleta de dados, de dezembro/2019 a agosto/2020, foi utilizado um questionário semiestruturado composto por 47 itens relacionados às duas dimensões da ferramenta: Autocuidado e Cuidado da criança. O Índice de Validade de Conteúdo ≥ 0,80 foi utilizado para avaliar a concordância entre os especialistas. Elementos qualitativos foram analisados quanto à clareza e abrangência do conteúdo. Resultados: Na primeira rodada, 46 itens apresentaram Índice de Validade de Conteúdo ≥ 0,80. Os elementos qualitativos apontaram necessidade de maior clareza para o público adolescente. Após as alterações, a ferramenta apresentou 30 itens. Na segunda rodada, os 30 itens avaliados alcançaram Índice de Validade de Conteúdo ≥ 0,80. As considerações qualitativas foram traduzidas em modificações no conteúdo e sequência na versão final da ferramenta. Conclusão: A ferramenta validada obteve avaliação adequada dos itens de cada dimensão, relacionados ao autocuidado da mãe adolescente e cuidado da criança, com alto grau de compreensibilidade.

Estresse parental na gestação e maternidade

RESUMO Objetivo: Identificar fatores relacionados ao estresse parental de mulheres na gestação e primeiro mês de vida da criança. Método: Estudo longitudinal prospectivo em duas etapas. Análise de entrevistas em domicílio com 121 participantes, Escala de Estresse Gestacional e de Estresse Parental. Aplicados teste exato de Fisher, correlação de Spearman e regressão multivariada linear e logística, com p < 0,05. Resultados: A maior parcela das participantes tinha entre 18 e 35 anos, 11 a 13 anos de estudo, sem trabalho remunerado, com companheiro, geralmente o pai da criança, gestação planejada, multípara e realização do pré-natal. Na gestação, 67,8% apresentaram estresse. No primeiro mês após o nascimento do filho, a maioria teve baixo estresse parental (52,1%). Estresse parental alto apresentou correlação com algum estresse gestacional. Planejar a gestação diminuiu o estresse parental. Conclusão: Estresse gestacional e parental no primeiro mês de vida da criança foram correlacionados e o planejamento da gestação constituiu fator de diminuição dos níveis de estresse. Ações oportunas para reduzir o estresse parental são fundamentais para a parentalidade e saúde integral da criança.

Adolescent mothers, self-care and childcare: content validation of an Event History Calendar

OBJECTIVE

To validate the content of the tool Event History Calendar Adolescent Mother: strengthening self-care and child care.

METHOD

Methodological study using the Delphi technique, conducted in two rounds, involving 37 nursing specialists. In data collection, from December/2019 to August/2020, a semi-structured questionnaire composed of 47 items related to the two dimensions of the tool: Self-care and Child Care was used. The Content Validity Index ≥ 0.80 was used to assess agreement among the experts. Qualitative elements were analyzed for clarity and comprehensiveness of content.

RESULTS

In the first round, 46 items showed Content Validity Index ≥ 0.80. The qualitative elements pointed out more clarity for the adolescent audience. After the changes, the tool presented 30 items. In the second round, the 30 items evaluated achieved Content Validity Index ≥ 0.80. The qualitative considerations were translated into modifications in the content and sequence in the final version of the tool.

CONCLUSION

The validated tool obtained adequate evaluation of the items of each dimension, related to adolescent mother self-care and child care, with a high degree of comprehensibility.

Clusters of risk for the occurrence of leprosy and disabilities in children under 15 years of age in Cuiabá: a geospatial study

ABSTRACT Objective This study aimed to analyze the spatial distribution of leprosy and disabilities in children under 15 years of age in Cuiabá. Methods Ecological study carried out in the city of Cuiabá, Mato Grosso, Brazil. The study population consisted of leprosy cases in children under 15 years old notified in the Notifiable Diseases Information System, between 2008 and 2018. Based on residential addresses, cases were georeferenced. In the analysis of the spatial distribution of the cases, the estimation of the Kernel density was used and, later, the statistics of spatial, spatio-temporal and Spatial Variation in Temporal Trends were applied. Results 514 cases of leprosy were reported in children under 15 years of age in Cuiabá, with a percentage of 10.1% of cases with degree of physical disability 1 and 2.3% with degree of physical disability 2 at the time of diagnosis. With the techniques of spatial and spatio-temporal scanning, clusters of risk for leprosy were identified in the North, West, East and South regions of Cuiabá, and with the technique of Spatial Variation in Temporal Trends, a cluster was identified in the West region of Cuiabá. Conclusion In Cuiabá, cases of leprosy in children under 15 years of age with disabilities were distributed throughout the urban area of the city, with the highest density of cases in the North and West regions, followed by the East region. The clusters with the highest Relative Risk were identified in the East and West regions, characterized by having low and medium income levels

Quality of follow-up of preterm infants in the Primary Health Care network: "Qualipreterm" guide

OBJECTIVES

to develop the first version of an assessment guide for the quality of follow-up of preterm infants in Primary Health Care.

METHODS

a descriptive methodological study, which developed a guide to assess follow-up quality of preterm infants in Primary Care. Steps of conceptual establishment, construction of items and answers, organization of domains and structuring of the guide were carried out.

RESULTS

the guide was organized in five domains that included: Hospital discharge planning and care plan organization; Home follow-up during visits and teleservice; Infant health monitoring to promote health and prevent injuries; Integration between health services, education and specialized monitoring; Family support and support for care. It is proposed to assess the domains in inadequate, regular, good and excellent.

FINAL CONSIDERATIONS

the first version of the guide suggests assessment elements aimed at the recommendations of good practices for preterm infants' health in the Primary Health Care network.

Matching between maternal knowledge about infant development and care for children under one year old

OBJECTIVE

to analyze maternal knowledge about infant development and its matching to the care offered to children during their first year of life.

METHOD

a longitudinal and prospective study, in the stages of pregnancy and of the child's 12th/13th month of life. Interviews were applied to 121 women in a Brazilian city, based on 21 items selected from the Knowledge of Infant Development Inventory, related to the first year of life. Calculation of rates of correct answers was used, as well as regression by Ordinary Least Squares and White's standard error.

RESULTS

the participants who answered correctly more aspects have more years of study, are older and present high family incomes. When the "having a partner or not" variable was considered, the correct answers presented a discrete fluctuation. Regarding the themes, there were more correct answers to aspects about health, safety and infant development milestones. Primiparous mothers were more likely to wean, overprotect and have children using electronic devices, and less likely to seek information about child care.

CONCLUSION

there was matching between some maternal knowledge and execution of child care. The connection between them is relevant to indicate in detail the unknowns and uncertainties and to improve positive knowledge, contributing to promoting early childhood development.

Correspondencia entre el conocimiento materno sobre el desarrollo infantil y el cuidado de los niños menores de un año

Resumen Objetivo: analizar el conocimiento materno sobre el desarrollo infantil y su correspondencia con el cuidado que se le brinda al niño en el primer año de vida. Método: estudio longitudinal, prospectivo, en las etapas de gestación y de los 12/13 meses del niño. Se les realizaron entrevistas a 121 mujeres de un municipio brasileño, basadas en 21 ítems seleccionados del Inventario de Conocimiento sobre Desarrollo Infantil, relacionados con el primer año de vida. Se utilizó el cálculo de las tasas de aciertos, la regresión de Mínimos Cuadrados Ordinarios y el error estándar de White. Resultados: las participantes que tuvieron una mayor cantidad de aciertos tienen más escolaridad, más edad e ingreso familiar alto. Los aciertos vinculados a la variable “tener pareja o no” mostraron una ligera oscilación. En cuanto a los temas, se registraron más aciertos en los ítems sobre salud, seguridad e hitos del desarrollo infantil. Las madres primíparas presentaron mayor probabilidad de destete, sobreprotección y de que el niño estuviera en contacto con dispositivos electrónicos, y menor probabilidad de buscar información sobre el cuidado infantil. Conclusión: hubo correspondencia entre algunos conocimientos maternos y los cuidados que le brindaron al niño. La conexión entre ellos es importante para indicar detalladamente las incógnitas y las dudas y mejorar el conocimiento positivo, que contribuye a promover el desarrollo infantil temprano.

Telesimulation about home visits and child care: facilitators, barriers and perception of Nursing students

OBJECTIVE

to evaluate the facilitators, barriers and perceptions of Nursing students in learning about home visiting and child care through Telesimulation during the COVID-19 pandemic.

METHOD

a qualitative study to evaluate Telesimulation via computers, grounded on Kolb's theoretical model. A semi-structured questionnaire and the Student Satisfaction and Self-Confidence in Learning Scale were applied, with descriptive analysis and qualitative thematic analysis on the perceptions of 41 Nursing students.

RESULTS

the contextualized Telesimulation provided learning opportunities in dimensions of the pedagogical strategy, telesimulated scenario, communication and specificities of child care in home visits. It was considered a safe and dynamic activity that helped knowledge consolidation and reflective attitudes, proximity to reality, and develop interaction, observation and types of approaches. There were restrictions due to Internet connection failures. A large percentage of the students indicated good satisfaction and self-confidence level with learning in the scale applied.

CONCLUSION

the real clinical situation with remote immersion allowed observation, decision-making, reflection and elaboration of conclusions, inherent to the experiential learning cycle. The set of elements of this Telesimulation created an environment that stimulated the interest of Nursing students for other learning stages, suggesting a space that strengthens knowledge and maintains dialogue with face-to-face practices.

Telessimulação sobre visita domiciliar e cuidado infantil: facilidades, barreiras e percepções de estudantes de enfermagem

Resumo Objetivo: avaliar as facilidades, barreiras e percepções de estudantes de enfermagem na aprendizagem sobre visita domiciliar e cuidado infantil por telessimulação na pandemia da COVID-19. Método: estudo qualitativo avaliativo de telessimulação por computador, fundamentado no modelo teórico de Kolb. Foram aplicados um questionário semiestruturado e a Escala de Satisfação de Estudantes e Autoconfiança na Aprendizagem, com análise descritiva e análise qualitativa temática sobre percepções de 41 graduandos de enfermagem. Resultados: a telessimulação contextualizada proporcionou oportunidades de aprendizagem em dimensões da estratégia pedagógica, cenário telessimulado, comunicação e especificidades do cuidado infantil em visita domiciliar. Atividade segura e dinâmica, auxiliou a solidificar conhecimentos e atitudes reflexivas, aproximação à realidade, desenvolvimento da interação, observação e tipos de abordagens. Houve restrições por falhas de conexão. Grande parte dos estudantes indicou níveis bons de satisfação e autoconfiança com a aprendizagem na escala aplicada. Conclusão: a situação clínica real com imersão remota permitiu observação, tomada de decisão, reflexão e elaboração de conclusões inerentes ao ciclo de aprendizagem experiencial. O conjunto de elementos desta telessimulação criou um ambiente que estimulou o interesse dos estudantes de enfermagem para outras etapas de aprendizagem, sugerindo um espaço que fortalece conhecimentos e que guarda interlocução com as práticas presenciais.

Qualidade do seguimento do bebê prematuro na rede de Atenção Primária à Saúde: guia “Qualiprematuro”

RESUMO Objetivos: desenvolver a primeira versão de um guia avaliativo da qualidade do seguimento do bebê prematuro na Atenção Primária à Saúde. Métodos: estudo descritivo metodológico, que desenvolveu um guia para avaliar a qualidade do seguimento do bebê prematuro na Atenção Primária. Realizadas etapas de estabelecimento conceitual, construção dos itens e respostas, organização de domínios e estruturação do guia. Resultados: o guia foi organizado em cinco domínios que contemplou: Planejamento da alta hospitalar e organização do plano de cuidados; Seguimento domiciliar em visita e teleatendimento; Seguimento da saúde infantil para promover saúde e prevenir agravos; Integração entre serviços de saúde, educação e acompanhamento especializado; Apoio e suporte familiar para o cuidado. Propõe-se avaliar os domínios em inadequado, regular, bom e excelente. Considerações Finais: a primeira versão do guia sugere elementos de avaliação direcionados às recomendações de boas práticas para a saúde do prematuro na rede de Atenção Primária à Saúde.

Evaluation of respiratory complications in a cohort of preterm infants who did not receive palivizumab monoclonal antibodies

ABSTRACT Objectives: to analyze the occurrence of respiratory complications over the first year of life in preterm infants who did not receive palivizumab monoclonal antibodies. Methods: analytical retrospective cohort study with preterm infants born between 2012 and 2016 in Uberlândia, state of Minas Gerais, Brazil. Data collection occurred from January to November 2018, by consulting hospital and primary healthcare medical records. Data were processed with the Poisson regression model, with p<0.05. Results: of a total of 5,213 preterm births, 504 (9.7%) met the inclusion criteria. The preterm infants in this subset were assisted 2,899 times in primary care, which resulted in 1,098 (37.5%) medical diagnoses, of which 803 (78.5%) involved the respiratory tract. Preterm babies fed on formula milk at hospital discharge had more diagnoses of respiratory diseases. Maternal age (p=0.039), respiratory diagnosis at hospital discharge (p=0.028), and number of sporadic appointments (p<0.001) showed a significant association with bronchiolitis; number of sporadic appointments showed a significant association with occurrence of respiratory diseases; and breastfeeding had a protective effect against the development of bronchiolitis. Conclusions: preterm infants who did not receive palivizumab showed a high percentage of respiratory diseases, and breastfeeding helped protect them against bronchiolitis. It is recommended that these preterm babies be monitored in primary health care.

Correspondência entre conhecimentos maternos sobre desenvolvimento infantil e cuidados de crianças menores de um ano

Resumo Objetivo: analisar os conhecimentos maternos sobre o desenvolvimento infantil e sua correspondência aos cuidados ofertados à criança no primeiro ano de vida. Método: estudo longitudinal, prospectivo, nas etapas da gestação e 12º/13º mês da criança. Foram aplicadas entrevistas a 121 mulheres de um município brasileiro, baseadas em 21 itens selecionados do Inventário de Conhecimento sobre o Desenvolvimento Infantil, relativos ao primeiro ano de vida. Utilizou-se o cálculo de taxas de acertos, regressão por Mínimos Quadrados Ordinários e erro padrão de White. Resultados: as participantes que acertaram mais aspectos possuem mais anos de estudo, mais idade e renda familiar elevada. Os acertos quando considerada a variável “ter ou não companheiro/a” apresentaram discreta oscilação. Quanto às temáticas, acertaram mais aspectos sobre saúde, segurança e marcos do desenvolvimento infantil. Mães primíparas apresentaram maior probabilidade de desmame, superproteção e da criança ter contato com aparelhos eletrônicos, e menor probabilidade de buscar informações sobre cuidados infantis. Conclusão: houve correspondência entre alguns conhecimentos maternos e a execução dos cuidados da criança. A conexão entre eles é relevante para indicar detalhadamente os desconhecimentos e as incertezas e aprimorar os saberes positivos, contribuindo para promover o desenvolvimento na primeira infância.

Telesimulación en visitas domiciliarias y cuidado infantil: facilidades, barreras y percepciones de estudiantes de enfermería

Resumen Objetivo: evaluar las facilidades, barreras y percepciones de estudiantes de enfermería en el aprendizaje sobre visita domiciliaria y cuidado infantil por telesimulación en la pandemia de COVID-19. Método: estudio cualitativo que evalúa la telesimulación por computadora, basado en el modelo teórico de Kolb. Se aplicó un cuestionario semiestructurado y la Escala de Satisfacción de los Estudiantes y Autoconfianza en el Aprendizaje, con análisis descriptivo y análisis temático cualitativo sobre las percepciones de 41 estudiantes de enfermería. Resultados: la telesimulación contextualizada brindó oportunidades de aprendizaje en los aspectos estrategia pedagógica, escenario telesimulado, comunicación y especificidades del cuidado infantil en visitas domiciliarias. Es una actividad segura y dinámica, que contribuyó a consolidar conocimientos y actitudes reflexivas, permitió un acercamiento a la realidad, el desarrollo de la interacción, observación y tipos de acercamientos. Hubo restricciones por fallas en la conexión. La mayoría de los estudiantes indicaron buenos niveles de satisfacción y confianza en sí mismos con el aprendizaje en la escala aplicada. Conclusión: la situación clínica real con participación a distancia permitió la observación, toma de decisiones, reflexión y elaboración de conclusiones inherentes al ciclo de aprendizaje experiencial. El conjunto de elementos de esta telesimulación creó un ambiente que estimuló el interés de los estudiantes de enfermería por otras etapas de aprendizaje, por lo que se considera un espacio que fortalece el conocimiento y dialoga con las prácticas presenciales.

Health surveillance and development of children with congenital Zika Virus syndrome: an integrative literature review

Objective:

To identify scientific knowledge about the attention to health surveillance and development of Brazilian children under the age of three years involving the Congenital Zika virus (ZIKV) Syndrome.

Data sources:

This is an integrative literature review of primary studies with Brazilian children under three years of age from 2015 to 2019. The searches were carried out in the databases Latin American and Caribbean Literature in Health Sciences (LILACS), US National Library of Medicine (PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL), SCOPUS and Web of Science. It was carried out by crossing the keywords in English (child, child development and Zika virus) and in Portuguese (criança, desenvolvimento infantil e Zika vírus), with the combination of the Boolean operator “AND”.

Data synthesis:

The knowledge produced is related to the specific health and development problems of children affected by the Congenital ZIKV Syndrome, with clinical characteristics, care demands, multiprofessional performance, health monitoring and surveillance needs.

Conclusions:

This integrative review synthesized scientific knowledge by adding aspects that reinforce the relevance of appropriate approaches to assess and care for children, linked to the engagement of caregivers, the need to document, evaluate and track the situations of children in early childhood and long-term, management coordination of care and its challenges in the context of primary health care.

The influence of the quality in daycare environments on children’s motor development between six to 15 months old

Abstract Objectives: to analyze the influence of the quality in the environment on children’s motor development between six to 15 months old attending early childhood education centers. Methods: a cross-sectional and analytical study addressing children’s motor development between six to 15 months old, both sexes, enrolled in nursery (0-12 months) and preschoolers (12-24 months). The Affordances in the Home Environment for Motor Development-Infant Scale and Alberta Infant Motor Scale were used in the Brazilian versions Results: the sample was comprised of 104 children and 30 early childhood education centers: presenting a mean age of 9.15 months, 88% attended full-time and 12% part-time schooling (mornings or afternoons). One center was classified with a low Affordances, 26 were considered Sufficient, and three were Adequate. Of the participating children, 40% presented typical motor development. The higher levels of Affordances suggest better motor development, and lower levels of suspected delayed motor development. Conclusion: the environments of early childhood education centers influence children’s motor performance, especially daily activities and the use of toys. The lower the Affordances level, more likely children are suspected of delayed motor development.

Factors related to duration of hospitalization and death in premature newborns

OBJECTIVE

To analyze factors related to prolonged hospitalization and death in premature newborns in a border region.

METHOD

Cross-sectional study, with retrospective data collection, which analyzed 951 medical records of premature newborns hospitalized between 2013 and 2017. The independent variables were maternal age, nationality, prenatal appointments, maternal intercurrences, gestational age, weight at birth, Apgar, complications; the dependent variables were days of hospitalization, discharge, death, and transference. The tests Pearson Chi-squared and Fisher's Exact were employed.

RESULTS

Premature birth amounted to 10.3%; out of these, 43.3% were hospitalized. The prevalence of mortality was 21.3%. Few prenatal appointments, maternal intercurrences, low fifth minute Apgar, and the baby's health complications increased days of hospitalization. Lower weight and gestational age, low Apgar and complications with the baby increased death.

CONCLUSION

Understanding hospitalization aspects enabled the identification of factors that lead to complications to the premature newborn, which are relevant to efforts to overcome unfavorable outcomes and face challenges posed by the sequels throughout life. The integration between countries and their borders is a notorious condition to accelerate care processes and promote better outcomes.

Follow-up care for premature children: the repercussions of the COVID-19 pandemic

OBJECTIVE

to analyze elements of the follow-up care provided to premature children amidst the COVID-19 pandemic.

METHOD

qualitative study from the perspective of philosophical hermeneutics, interpreting experiences with childcare provided at home. Twelve mothers and 14 children aged two years old were interviewed online via a text messaging application. Data were analyzed by interpreting meanings.

RESULTS

weaknesses stood out in the follow-up care provided to children such as gaps of communication, lack of guidance and delayed immunizations, while care intended to meet health demands was interrupted. Vulnerability aspects affecting child development included: social isolation measures that impeded the children from socializing with their peers, increased screen time, the manifestation of demanding behaviors and irritation and the mothers experiencing an overload of responsibilities. The elements that strengthened maternal care included the mothers being attentive to contagion, enjoying greater experience and satisfaction with the maternal role, spending more time with their children, and recognizing respiratory signs and symptoms, especially fever.

CONCLUSION

follow-up care provided to children in stressful situations implies implementing practices that support the wellbeing of children and families, decreasing the likelihood of children being exposed to development deficits, and detecting signs and symptoms timely. The use of nursing call centers can break the invisibility of longitudinal needs and promote health education actions at home.

Strengthening Self-Care and Child Care of Adolescent Mothers Through an Event History Calendar

PURPOSE

To identify events and experiences of adolescent mothers relevant to their own care and the care of their children so as to support the elaboration of a future Event History Calendar (EHC) tool.

DESIGN AND METHODS

Qualitative study was conducted based on the Grounded Theory, from the constructivist perspective. Data were collected through in-depth interviews with 11 Brazilian adolescent mothers. Initial and focused coding was applied in the data analysis.

RESULTS

The results present events that demarcate the adolescent mothers' perspectives of child care. Self-care and child care are related to everyday learning, ways of coping, strengthening of various support sources, mastery of gaps in health care, and sensory events.

CONCLUSIONS

The different events for adolescents are related to the transience of life, strategies of the moment, and the process of support for pregnancy-motherhood, which is dependent on a network of people and institutions that provide cooperation and participation in the reengagement of the adolescents while encouraging quality of life and development. The events identified can contribute to a list of relevant elements to structure a tool using EHC to guide the clinical practice of nurses so as to strengthen the adolescent's self-care and child care.

PRACTICE IMPLICATIONS

In the context of fragility in the communicative process between adolescent mothers and nurses, the strategy of an EHC can contribute to the expansion of nursing care, aid in developing new coping strategies addressing vulnerabilities, recognize multidimensional needs, strengthen the potentialities and confidence of mothers, and encourage involvement, advocacy and empowerment.

Using geo-spatial analysis for assessing the risk of hospital admissions due to community-acquired pneumonia in under-5 children and its association with socially vulnerable areas (Brazil)

Background

The concentration of under-5 child morbidity and mortality due to pneumonia in developing countries reflects the social inequities. This study aimed to map and assess the spatial risk for hospitalization due to Community-Acquired Pneumonia in children under 5 years of age and its association with vulnerable areas.

Methods

Ecological study in the city of Ribeirão Preto, state of São Paulo, Brazil. The study population consisted of hospitalized under-5 children, diagnosed with community-acquired pneumonia, in Ribeirão Preto-São Paulo-Brazil, from 2012 to 2013. Data were collected in different databases, by a trained team, between March 2012 and August 2013 and from the 2010 Demographic Census of the Brazilian Institute of Geography and Statistics. The 956 urban census tracts were considered as the units of analysis. The incidence of cases per 10,000 inhabitants was calculated by census tracts during the study period. For the identification of the spatial risk clusters, the Kernel density estimator and the Getis-Ord Gi* technique were performed. Generalized additive models were used to verify the association between areas with social vulnerability and the occurrence of childhood pneumonia.

Results

The study included 265 children under the age of five, hospitalized due to community-acquired pneumonia. A concentration of cases was identified in the regions with greater social vulnerability (low income, poor housing conditions and homelessness), as well as a lower occurrence of cases in the most developed and economically privileged area of the city. The majority of the children lived in territories served by traditional primary healthcare units, in which the health surveillance and family and community focus are limited. It is important to highlight that the tracts with the highest degrees of vulnerability, such as those identified as high vulnerability (urban) and very high vulnerability (subnormal urban clusters).

Conclusions

The results contribute to the comprehension of the social factors involved in child hospitalization due to pneumonia, based on the analysis of the spatial distribution. This approach revealed a strategic tool for diagnosing the disparities as well presenting evidences for the planning in health and strength health care system in achieving equity, welfare and social protection of children.

Supplementary Information

Supplementary information accompanies this paper at 10.1186/s12887-020-02398-x.

COMPLEMENTARY FEEDING INDICATORS FOR CHILDREN AGED 6 TO 23 MONTHS ACCORDING TO BREASTFEEDING STATUS

Objective:

To verify if there are differences among the complementary feeding indicators of children aged 6-23 months according to the breastfeeding status.

Methods:

A cross-sectional study was carried out with 1,355 children aged 6-23 months in 2012 to evaluate five indicators proposed by the World Health Organization (WHO) and modified in accordance with Brazilian’s recommendations “Ten steps to a healthy feeding: a feeding guide for children under two years old”. The indicators used were: I. Introduction of solid, semi-solid or soft foods; II. Minimum dietary diversity; III. Minimum meal frequency; IV. Minimum acceptable diet, and V. Consumption of iron-rich foods. To verify differences between the complementary feeding indicators according to breastfeeding status, the F-statistic was used, with p≤0.05 meaning significant.

Results:

Indicators I, II, and V were similar among breastfed and non-breastfed children; however, indicators III and IV presented a higher proportion of adequacy for non-breastfed children, with 94.9% (CI95% 93.2-96.2) versus 40.3% (CI95% 33.2-47.9) for indicator III, and 57.3% (CI95% 53.2-61.2) versus 23.1% (CI95% 17.4-30.1) for indicator IV.

Conclusions:

Non-breastfed children have better complementary feeding status, but the indicator III takes into account non-breast milk as a meal for non-breastfed children, which increased the number of dairy meals and influenced indicator IV (calculated from indicators II and III).

Care opportunities for premature infants: home visits and telephone support

OBJECTIVE

to analyze opportunities for orientations to promote the care of premature infants during home visits and telephone support.

METHOD

a qualitative study from the perspective of philosophical hermeneutics conducted with 18 mothers of premature infants discharged from hospital. Hospital contact and interviews were carried out, 15 and 45 days after discharge and at the infants' six months of life, with data analysis by interpretation of meanings from 25 home visits and 56 telephone support contacts.

RESULTS

the following two thematic units emerged: Needs for contact and guidance: the place for home visits and opportunities for resolving doubts by telephone support, indicating aspects that suggest weakening child health, discontinuity in follow-up and vulnerability in specialized follow-ups. Home visits and telephone support favored the concern of health needs, doubts about basic care and problem solving, as ways to prevent damage and promote child health.

CONCLUSION

home visits and telephone support emerge as collaborative practices of care and detection of latent conditions, which can be reduced or interrupted with prompt return of guidance, suggesting opportune strategies to increase follow-up, linkage and access to the health services.

Maternal-child nursing care for adolescent mothers: health education

OBJECTIVES

to develop an educational intervention through a game that addresses aspects related to adolescent motherhood and child care.

METHODS

this is an action research based on diagnosis, intervention and apprehension stages.

RESULTS

the situational diagnosis was based on a literature review on adolescent motherhood and child care. In the intervention stage, the educational game's first version was elaborated. In the third stage constituted by apprehension, the game was submitted to assessment of interdisciplinary experts. Suggestions of experts were adopted and the game had its second version.

FINAL CONSIDERATIONS

the educational intervention in the present study appears a care technology that adds knowledge and practices to the work of nurses in Primary Health Care, focusing on adolescent women and children health care.

Nurse to adolescent health communication process: approach to Event History Calendar

OBJECTIVES

comprehend the Event History Calendar components that are relevant for the nurse to adolescent communicative process, in the context of Primary Health Care.

METHODS

reflective study, based on the Event History Calendar approach, in the relational, communicative, and educational dimensions.

RESULTS

best practices for adolescent health promotion are vital and constitute a challenge to nurses. The Event History Calendar is a potential tool for research and care practices to comprehend the needs of adolescents, with reminder of key personal events, culturally and socially specific. The comprehension of retrospective data referring to activities, behaviors, experiences and transitions of life, in certain periods of time, enables dialogue and new understandings about the history of adolescents.

FINAL CONSIDERATIONS

the Event History Calendar provides nursing professionals with an expansion of their practice in educational, relational, and communicative dimensions, as well as to instruct care planning and management.

The vulnerabilities of premature children: home and institutional contexts

ABSTRACT Objective: To analyze situations in which premature children are vulnerable in home care, in the first six months after hospital discharge. Method: Qualitative study, from the perspective of philosophical hermeneutics, carried out in a Brazilian city on the border. In-depth interviews were conducted, with a data analysis considering the method of interpretation of meanings. 18 mothers of premature children discharged from a hospital unit participated. 25 home visits and 56 calls were made. Results: The reports from the mothers express situations of vulnerability, concerns, needs for care, singularities of the development of the premature baby, and repercussions of institutional routines in home care. Final considerations: There are vulnerable circumstances in prematurity that reaffirm interconnected individual, social, and institutional dimensions. It is important to highlight that the institutional dimension involves the responsibility of health professionals not to increase individual and social vulnerabilities, but to promote care and seek to reduce situations that generate risks, uncertainties, concerns, and damages.

CADERNETA DE SAÚDE DA CRIANÇA: COORDENAÇÃO DO CUIDADO E ACESSO À SAÚDE

Objetivo: analisar fatores associados ao preenchimento da caderneta de saúde da criança parafomentar a coordenação do cuidado e acesso à saúde.Método: estudo quantitativo, realizado entre janeiro e junho de 2016, em município paulista.Entrevistadas 284 mães e observadas as cadernetas de seus filhos; considerados significativosresultados com p< 0,05.Resultados: identificou-se baixo preenchimento para pré-natal (5%), dados do recém-nascido(40%), exames de triagem neonatal (10%) e alta hospitalar (6%). Escolaridade materna (p=0,006)foi fator associado ao correto preenchimento de dados do recém-nascido.Conclusão: a caderneta não tem sido fonte de dados para seguimento da atenção ao recém-nascidono município investigado. Favorecer continuidade da atenção após o nascimento e a execução deregistros adequados potencializa a coordenação do cuidado. O preenchimento desse instrumento,incorporado às práticas dos serviços e dos profissionais de saúde em todos os pontos da rede deatenção à criança, traz contribuições ao acesso à saúde.

DYSFUNCTIONS IN THE SOCIO EMOTIONAL DEVELOPMENT OF INFANTS AND ITS RELATED FACTORS: AN INTEGRATIVE REVIEW

ABSTRACT Objective: to synthesize factors related to dysfunctions in the socioemotional development of infants. Method: integrative review carried out between April and August 2016 with defined criteria for inclusion and exclusion of studies, search strategies, extraction and synthesis of data. The exposure factors underwent categorical thematic analysis and systematization according to the levels of the context (Microsystem, Mesosystem, Exosystem and Macrosystem) of the Bioecological Model of Human Development. Results: in the context of the Microsystem and Mesosystem, the factors found were: limitations in care; adversities in family relationships and in the social support and illness situation of the caregivers that influence the proximal processes. In the Exosystem and the Macrosystem, they were: social vulnerabilities of caregivers and fragilities of public policies that determine the material and social conditions of the family. Conclusion: the synthesis of evidence on exposure factors favors the construction of measurement scales of the contextual elements related to the social emotional development of young children. Beyond the milestones, present or not, in the evaluation of a child, these technologies can be predictive, with great potential of anticipation of the factors of exposure and prevention of developmental dysfunctions.

CHILDREN WITH DIABETES MELLITUS TYPE 1: VULNERABILITY, CARE AND ACCESS TO HEALTH

ABSTRACT Objective: to investigate the trajectory and follow-up of the health of children with diabetes mellitus type 1 in regard to the attention given by the different public health services and the relationships between the services, the child and their families, from the perspective of mothers and caregivers. Method: qualitative study with inductive thematic analysis, based on the theoretical references of vulnerability and health care networks, from in-depth interviews with 56 mothers or caregivers, in two Brazilian public health services. Results: reports marked by sufferings, challenges and notes show the centrality in the disease, fragile access, little resolution, insecurity in urgent and emergency situations and superficial bond with insufficient support to the family, and fragmentation. The specialized care is characterized by trust, the bond and the efforts to prevent the use of other health services. Conclusion: families and children are exposed to vulnerable circumstances in the longitudinal follow-up, with consequent distancing of network care. Thus, they indicate the need to expand the integration of care, intersectoral actions, social participation and coordination of care networks, in search of greater access and inclusion. Therefore, there are implications with political and financial efforts to advance access to comprehensive care and reduce vulnerabilities.

Validation of vulnerability markers of dysfunctions in the socioemotional development of infants

OBJECTIVES

to validate the vulnerability markers of dysfunctions in the socioemotional development of infants.

METHODS

study with a sequential exploratory mixed-method design. The vulnerability markers elaborated in the qualitative phase were analyzed by experts in the quantitative phase using the Delphi technique with a minimum consensus of 70%. Seventeen judges answered the questionnaire in the first round of analysis and 11 answered in the second round.

RESULTS

in the first round, two markers did not reach minimum consensus: the presence of instability in family relationships (66%) and delinquency and/or drug abuse by parents/caregivers (65%). In the second round, all markers were validated, with more than 90% agreement in most of the attributes, and reached the minimum consensus of 73%.

CONCLUSION

the eight vulnerability markers reached the minimum consensus for validation, and a relevant instrument for infant care can be developed after assessing the reliability and clinically validating these markers.

Nursing strategies for child health surveillance

OBJECTIVE

to appreciate the strategies promoted by nurses in the context of child health surveillance relevant to early childhood development.

METHOD

this is a qualitative study with an inductive thematic analysis of the data, based on the conceptual principles of child health surveillance, and developed through semi-structured interviews with Brazilian nurses working with families in primary health care.

RESULTS

the nurses' strategies in favor of child health surveillance focus on actions that anticipate harm with continuous follow-up and monitoring of health indicators. The process of child growth and development is the basis for responses and benefits to health, connection with the daily lives of families, active search, articulations between professionals and services, access to comprehensive care, and intrinsic actions between promotion, prevention and health follow-up.

CONCLUSION

child health surveillance actions developed by nurses with families involve knowledge sharing, favor the resolution of problems, increase child health indicators, and strengthen the relationship between health and children's rights, which support the promotion of development in early childhood.

AÇÕES E ARTICULAÇÕES DO ENFERMEIRO NO CUIDADO DA CRIANÇA NA ATENÇÃO BÁSICA

RESUMO Objetivo: compreender como se configura a assistência de enfermagem a crianças menores de cinco anos em Unidades de Saúde da Família, com foco na integralidade do cuidado. Método: pesquisa de abordagem qualitativa. Os dados foram coletados mediante entrevista semiestruturada com 26 enfermeiras, em um município paulista, entre junho de 2013 e janeiro de 2014, e submetidos a análise de conteúdo, modalidade temática. Resultados: construídas duas categorias. Na primeira, "A prática do cuidado da criança: contribuições da enfermagem", algumas ações foram elencadas para alcance do cuidado integral, e valorizou-se a compreensão da criança como sujeito singular no contexto familiar e comunitário. A categoria "Redes de apoio: tecendo ações e articulações para o acesso e a integralidade do cuidado da criança" revelou a consulta de enfermagem como instrumento de valor às enfermeiras, para as quais a disponibilidade de outros setores e serviços de saúde para atender a criança em suas necessidades viabiliza um cuidado integral. Ressaltou-se ainda a importância do acesso a ações que buscam melhorar a qualidade de vida das crianças e reduzir potenciais riscos para seu crescimento e desenvolvimento. Conclusão: como contribuição, tem-se que as ações das enfermeiras sinalizam caminhos para a integralidade do cuidado, corroborando políticas públicas atuais. Faz-se premente que tais ações sejam valorizadas e transmitidas a cenários de cuidado que ainda carecem de assistir a criança e sua família integralmente e, assim, cumprir compromissos apontados nas agendas destinadas a esta clientela.

Intervenção educativa com mães jovens: aquisição de saberes sobre cuidados da criança

Resumo Objetivo: Identificar os saberes das mães jovens sobre o cuidado cotidiano da criança a partir de intervenção educativa, em busca de subsídios ao cuidado integral à saúde. Métodos: Estudo descritivo e de intervenção, desenvolvido com 20 mães entre 16 e 25 anos de idade com filhos menores de três anos, pertencentes à área de abrangência de uma unidade de saúde da família. A intervenção educativa foi baseada em cinco dinâmicas grupais e lúdicas, com avaliação por meio de pré e pós teste, abordando temas sobre nutrição, higiene, prevenção de acidentes domésticos, manejo da criança doente em casa e o desenvolvimento nos três primeiros anos de vida das crianças, antes, imediatamente depois da intervenção e cinco meses após a intervenção. Resultados: Com intervenção educativa intragrupo, no pré teste, os saberes das mães variaram entre os índices bom e ótimo, e houve uma parcela com classificações regulares e insuficientes em alguns temas. No pós-teste realizado imediatamente após a intervenção, os saberes foram classificados entre bom e ótimo, enquanto que no teste pós-intervenção, aplicado cinco meses após a educação em saúde, os índices regular e insuficiente voltam a se apresentar. Conclusão: A aquisição de saberes das mães aponta que a intervenção educativa por meio de jogos configura uma estratégia satisfatória na educação em saúde sobre o cuidado à saúde da criança. Contudo, os resultados sugerem a importância da continuidade das ações educativas em diversos momentos e contextos para garantir a sustentabilidade dos saberes e práticas, contribuindo para a integralidade do cuidado à saúde.

RECONHECIMENTO EM AXEL HONNETH: CONTRIBUIÇÕES À PESQUISA EM SAÚDE

RESUMO Objetivo: sistematizar as potencialidades e desafios da Teoria do Reconhecimento, de Axel Honneth, e refletir sobre eles como subsídio às pesquisas em saúde. Método: trata-se de artigo de reflexão que toma o potencial da incorporação da categoria reconhecimento na propositura honnethiana para pesquisa, compreensão, exercício e gestão do cuidado em saúde. Resultados: o processo de reconhecimento favorece a exploração e a compreensão das relações de poder e respeito, sobretudo em termos do conflito a elas circunscrito. Dessa forma, indica subsídios para diagnósticos e núcleos estruturantes para a superação de práticas opressivas e desiguais, com desdobramentos para lidar com situações de insegurança, fragilidades na autoestima e vulnerabilidades nas interações entre os sujeitos, que configuram desafios contemporâneos. Conclusão: na exploração científica do cuidado, gestão e políticas públicas em saúde, este referencial teórico pode auxiliar na visibilidade do contexto e seus nós críticos, para favorecer a autonomia e a dignidade humana, relevantes para as relações interpessoais nos processos de cuidado, com contribuições profícuas à qualificação da atenção à saúde.

Children with type 1 Diabetes Mellitus: access to special immunobiological and child care

OBJECTIVES

Identifying the use of child care situations, the vaccination situation and the reasons for non-vaccination, and characterizing whether mothers/guardians demonstrate notions about the right to special vaccines for children with type 1 Diabetes Mellitus.

METHOD

A descriptive, cross-sectional study with analysis of quantitative data based on interviews with mothers/guardians, particularly regarding access to childcare and vaccination against influenza and pneumococcal 23-valent (PPSV).

RESULTS

47 mothers/guardians participated in the study. The participants reported using more specialized services to follow child health, and only a few used the child care of the basic health care regularly. There were incomplete vaccination schedules, delayed annual follow-ups, missing vaccination cards at the consultations, misinformation about the special character of the vaccination, as well as emphasis on the need of presenting a specific form to obtain the vaccination, resulting in discontinuation of health actions and missed opportunities for vaccination.

CONCLUSION

Fragilities in child care and immunization actions require an increase of primary health care and of the care network, based on knowledge and the right to health in order to expand the evidence-based practice, access and comprehensiveness.

Atenção primária à criança com diabetes mellitus tipo 1: perspectiva de cuidadores

Resumo Objetivo: Avaliar e comparar a qualidade da atenção primária ofertada às crianças com diabetes mellitus tipo 1 entre os tipos de serviços públicos de atenção à saúde na experiência dos seus principais cuidadores. Métodos: Estudo transversal, fundamentado em avaliação em saúde, a partir de entrevistas com 55 cuidadores de crianças com diabetes mellitus tipo 1, com base no instrumento de avaliação Primary Care Assessment Tool-versão criança. Resultados: Grande parte dos atributos da atenção primária à saúde apresentou escores considerados insatisfatórios, inclusive os escores Geral e Essencial. Foi encontrado maior vínculo com o serviço especializado (ambulatórios de endocrinologia pediátrica). Apesar dos escores Geral e Essencial não terem alcançado valores satisfatórios, os serviços especializados apresentaram melhores resultados que os serviços de atenção primária à saúde, mostrando, na percepção dos usuários, diferenças relevantes entre os serviços. Os serviços especializados foram percebidos como fontes regulares de atenção e melhores fornecedores de práticas de atenção primária à saúde. Tal apontamento pode estar relacionado ao maior contato dos participantes com os profissionais dos serviços especializados e prontidão desses serviços na atenção às crianças com diabetes mellitus tipo 1, sugerindo fragilidades nos serviços de atenção primária à saúde. Conclusão: A atenção à saúde das crianças com diabetes mellitus tipo 1 no município estudado apresenta pouca presença e extensão dos atributos da atenção primária, com ações fragmentadas e desarticuladas, levam a prejuízos na integração e ampliação dos cuidados em rede.

MILK CONSUMPTION IN INFANTS UNDER ONE YEAR OF AGE AND VARIABLES ASSOCIATED WITH NON-MATERNAL MILK CONSUMPTION

OBJECTIVE

To verify the type of milk consumed by children under one year of age and identify variables associated with non-maternal milk consumption (formula or cow milk).

METHODS

Cross-sectional study developed during the 2012 National Vaccination Campaign against Poliomyelitis. The companions of 935 children under one year of age answered a structured questionnaire on the child's diet in the last 24 hours. The estimates are presented by points, with 95%CI. F-statistics were used to check for differences in the proportion of the types of milk consumption according to the children's age range (<6 months and 6-11 months) and the association between non-maternal milk consumption and the study variables.

RESULTS

The consumption of maternal milk and child formula was higher for children under six months of age - corresponding to 82.8% (95%CI 78.5-86.3) and 70.4% (95%CI 61.4-78.0), respectively -, whereas the consumption of cow milk was higher among children between 6 and 11 months of age - 74.2% (95%CI 66.5-80.6) -, with differences in the consumption proportions (p<0.0001). The variables associated with higher cow milk consumption were lower maternal education (p<0.0001), the fact that the mother does not have a paid occupation (p=0.0015), child doctor's appointment in the public health network (p<0.0001) and participation in the Child's Milk Program (p<0.0001).

CONCLUSIONS

The infants received cow's milk early (before the first year of life), especially children from families with lower socioeconomic levels and children who took part in a specific social program for milk distribuition.

Role of Primary Health Care in child hospitalization due to pneumonia: a case-control study

Objective:

to evaluate the association of primary health care and other potential factors in relation to hospitalization due to pneumonia, among children aged under five years.

Method:

epidemiological study with a case-control, hospital-based design, which included 345 cases and 345 controls, matched according to gender, age and hospital. Data were collected using a pre-coded questionnaire and the Primary Care Assessment Tool, analyzed by means of multivariate logistic regression, following the assumptions of a hierarchical approach.

Results:

the protective factors were: family income >US$216.12 (OR=0.68), weight gain during pregnancy ≥10 kg (OR=0.68), quality of Primary Health Care (OR for scores >3.41=0.57; OR for scores >3.17 and ≤3.41=0.50), gastro-esophageal reflux (OR=0.55), overweight (OR=0.37) and birth interval ≥48 months (OR=0.28). The risk factors included: parity (2 childbirths: OR=4.60; ≥3 childbirths: OR=3.25), out-of-date vaccination (OR=2.81), undernutrition (OR=2.53), history of wheezing (≥3 episodes OR=2.37; 1 episode: OR=2.13), attendance at daycare center (OR=1.67), and use of medicines over the past month (OR=1.67).

Conclusion:

primary health care and its child health care practices, such as nutritional monitoring, immunization, care to prevalent illnesses, prenatal care and family planning need to be prioritized to avoid child hospitalization due to pneumonia.

Nursing care in early childhood: contributions from intersubjective recognition

OBJECTIVE

to understand the elements composing intersubjective recognition that are relevant for nursing care in early childhood in favor of comprehensive child development.

METHOD

reflexive study based on the Honnethian concept of intersubjective recognition in the dimensions of affection, defense of rights, and social esteem.

RESULTS

nursing knowledge and practices, permeated by the intersubjective recognition in the mentioned dimensions, contribute to the dynamism of interpersonal relations, the production of co-responsibility, and shared construction of health care in early childhood, with benefits to comprehensive development.

CONCLUSION

a successful coordination of the three intersubjective dimensions enables the expansion of the understanding on childhood and nursing care in child health in the field of human development promotion, covering affection, defense of rights, and social esteem in the established relationships with future positive individual and social possibilities.

Cuidado cotidiano da criança: necessidades e vulnerabilidades na perspectiva de mães adolescentes

Este estudo objetivou analisar os cuidados às crianças na perspectiva de mães adolescentes, em busca da identificação de vulnerabilidades e necessidades no âmbito do cuidado de enfermagem. Trata-se de pesquisa exploratória com análise qualitativa temática indutiva dos dados, a partir de entrevistas gravadas com 20 mães adolescentes de crianças entre seis meses e menores de dois anos de idade, cadastradas e acompanhadas por equipes de Saúde da Família do município de Passos, Minas Gerais, Brasil. Os relatos maternos expressam aspectos sobre o cuidado cotidiano da criança, a atenção às suas necessidades, o enfrentamento de dificuldades e o reconhecimento de situações vulneráveis. O cuidado materno na adolescência apresentou-se como uma experiência singular, com relatos maternos que apontam aspectos a serem mais explorados pelos profissionais de saúde, em especial pela enfermagem, em busca de oferta de apoio e incremento da confiança materna.

Acesso e cuidado do recém-nascido em um programa de atenção à saúde

Estudo transversal que objetivou descrever o acesso e a integralidade do atendimento de crianças menores de um ano de idade, nascidas entre janeiro de 2010 a dezembro de 2012 em um município brasileiro, a partir de um programa de atenção ao recém-nascido. Das 24.560 crianças, 55,0% são usuárias do Sistema Único de Saúde; 10,1% das crianças apresentaram baixo peso ao nascer; 6.332 (46,9%) crianças receberam vacina BCG no dia da consulta de enfermagem; 13.590 (79,5%) crianças realizaram triagem neonatal com menos de sete dias de vida; 17.035 (69,4%) crianças foram vacinadas contra Hepatite B ao nascimento; dentre os usuários SUS, 68% das crianças compareceram à consulta de enfermagem na primeira semana de vida e 37,8% à consulta médica após 10 dias de vida. O estudo apresenta informações sobre o cuidado, após o nascimento, do recém-nascido na rede básica de saúde, como potencial instrumento para coordenar a assistência prestada a esta clientela.

Proposal of indicators to evaluate complementary feeding based on World Health Organization indicators

This study compares complementary feeding World Health Organization (WHO) indicators with those built in accordance with Brazilian recommendations (Ten Steps to Healthy Feeding). A cross-sectional study was carried out during the National Immunization Campaign against Poliomyelitis in Guarapuava-Paraná, Brazil, in 2012. Feeding data from 1,355 children aged 6-23 months were obtained through the 24 h diet recall. Based on five indicators, the proportion of adequacy was evaluated: introduction of solid, semi-solid, or soft foods; minimum dietary diversity; meal frequency; acceptable diet; and consumption of iron-rich foods. Complementary feeding showed adequacy higher than 85% in most WHO indicators, while review by the Ten Steps assessment method showed a less favorable circumstance and a high intake of unhealthy foods. WHO indicators may not reflect the complementary feeding conditions of children in countries with low malnutrition rates and an increased prevalence of overweight/obesity. The use of indicators according to the Ten Steps can be useful to identify problems and redirect actions aimed at promoting complementary feeding.

NURSES' KNOWLEDGE IN CHILD HEALTH PRIMARY CARE PRIMARY

ABSTRACT The study aimed to characterize nurses' needs for scientific knowledge that supports nursing care in clinical practice of child health primary care. An exploratory and qualitative study was undertaken, grounded in health care and longitudinality of nursing care for children, based on interviews with 35 nurses from family health services with thematic analysis of the data. The results indicate the need to use child evaluation, family guidance, clinical protocols, care management and partnership among health professionals, which imply a range of knowledge, in order to trigger effective and problem-solving care actions. Practice based on professional knowledge and the subjects' needs can enhance care, with benefits for children, families and the institutional organization. It is vital for nurses to take responsibility for their own practice, continuously examining ways to deliver care for and remain up to date.

BREASTFEEDING AND ACUTE DIARRHEA AMONG CHILDREN ENROLLED IN THE FAMILY HEALTH STRATEGY

This study's objectives were to identify the prevalence of breastfeeding in children younger than 12 months of age enrolled in the Family Health Strategy and identify cases of reported acute diarrhea, associating them with breastfeeding categories and factors that interfere in the practice of breastfeeding. This descriptive and cross-sectional study, based on statistical analysis, was conducted with 854 children living in a municipality in Northeastern Brazil. The prevalence of exclusive breastfeeding among children under six months of age was 32%. Exclusively breastfed children under the age of six months were less likely to experience diarrhea compared to mixed-breastfeeding children. Children using pacifiers, bottles or consuming water were less likely to be breastfed, while those consuming porridge were more likely to experience diarrhea. Strategies to promote, protect and support breastfeeding require continuous improvement, especially in regard to factors leading to early weaning, in order to achieve better indicators and improve prevention of acute diarrhea and promote child health.

HOME VISIT: CARE TECHNOLOGY USED BY NURSES TO ADVOCATE FOR CHILD'S HEALTH

This study aimed to identify elements of care designed to protect children during home visits, from narratives of nurses, from the perspective of care and advocacy for the right to health of children. This is an exploratory study using qualitative thematic analysis, based on conceptual aspects of care and the right to health, from interviews with 14 nurses working in the Family Health Strategy. The narratives about the actions of nurses in home visits show protective measures of child health, organized into themes: observation and intervention for child care at home; arrest of situations of rights violation; child vulnerabilities with parental users of alcohol and other drugs. The home visit proved to be a fundamental tool for clinical practice in primary health care, constituting a privileged space for the nursing care of the child, and a family context for child health advocacy.