Childcare Consultations Research Articles

A IMPORTÂNCIA DO ALEITAMENTO MATERNO PARA ESTREITAR O VÍNCULO AFETIVO ENTRE MÃE E FILHO

Breastfeeding plays a crucial role in strengthening the bond between mother and child. In addition to providing vital nutrition in the first months and years of a child's life, breastfeeding also promotes a healthy, affectionate relationship. Exclusive practice in the first months is the best form of nutrition, intensifying the emotional bond and contributing to healthy development. Adequate guidance on breastfeeding techniques during the prenatal and postpartum period is essential to ensure the effectiveness of this process. Furthermore, breastfeeding offers benefits for both the baby and the mother, helping with postpartum recovery and protecting against diseases such as breast cancer. However, challenges persist in promoting breastfeeding, with rates below recommendations in some regions due to social and cultural factors. It is essential that health policies and professionals offer support and education to mothers, regardless of their ethnic origin or financial situation. Childcare consultations play a crucial role in monitoring a child's growth and promoting child health. Therefore, the active involvement of health professionals, public policies and society in general is necessary to create an environment favorable to breastfeeding. Breastfeeding is essential for promoting healthy relationships between mothers and children, contributing to the physical and emotional health of both.

Knowledge and practice of primary care nurses about autism spectrum disorder

Objective: To evaluate the knowledge and practice of nurses from primary health care units about autism spectrum disorder. Method: Cross-sectional, quantitative study with 42 primary care nurses from Teresina, Piauí. A questionnaire on professional characteristics and knowledge was used. Simple frequency analyses and associations between variables were performed, adopting a maximum likelihood test with p‹0.05. Results: There was a predominance of nurses aged 23 to 72 years, female (95.2%) and with more than ten years of experience (78.6%). Most (95.2%) reported insufficient knowledge during the graduation, 88.1% assisted or suspected of children with characteristics of autism spectrum disorder in childcare consultations, 85.7% did not know screening instruments and none received training from the service. Medium level of knowledge (66.7%) prevailed, but with deficits in content on characteristics and etiology. There was a statistically significant association between level of knowledge and age group (p=0.033). Conclusion: There is a need for appropriate undergraduate training and continuing education for professionals.

Epidemiologia da violência obstétrica: uma revisão narrativa do contexto brasileiro

Abstract The aim of this review is to present the state of the art regarding obstetric violence in Brazil. The most commonly used terms are “obstetric violence,” “disrespect and abuse,” and “mistreatment”. Concerning measurement, the most widely used instrument is based on the definition of “mistreatment,” still in its early stages of evaluation and lacking adaptation to Brazil. The prevalence of obstetric violence varies widely in national studies due to methodological factors and the type of postpartum women considered. Regarding risk factors, adolescent or women over 35, non-white, with low education levels, users of the public health system (SUS), those who had vaginal birth or abortion, are at higher risk. Hierarchical relationships between the healthcare team and the family are also relevant, as well as inadequate hospital structures, bed shortages, and insufficient healthcare professionals, which contribute to obstetric violence. The consequences of this violence include an increased risk of postpartum depression and PTSD, reduced likelihood of attending postpartum and childcare consultations, and difficulties in exclusive breastfeeding. Interventions to mitigate obstetric violence should consider women’s empowerment, healthcare professionals’ training, monitoring obstetric violence, and legal support.

Epidemiology of obstetric violence: a narrative review of the Brazilian context.

The aim of this review is to present the state of the art regarding obstetric violence in Brazil. The most commonly used terms are "obstetric violence," "disrespect and abuse," and "mistreatment". Concerning measurement, the most widely used instrument is based on the definition of "mistreatment," still in its early stages of evaluation and lacking adaptation to Brazil. The prevalence of obstetric violence varies widely in national studies due to methodological factors and the type of postpartum women considered. Regarding risk factors, adolescent or women over 35, non-white, with low education levels, users of the public health system (SUS), those who had vaginal birth or abortion, are at higher risk. Hierarchical relationships between the healthcare team and the family are also relevant, as well as inadequate hospital structures, bed shortages, and insufficient healthcare professionals, which contribute to obstetric violence. The consequences of this violence include an increased risk of postpartum depression and PTSD, reduced likelihood of attending postpartum and childcare consultations, and difficulties in exclusive breastfeeding. Interventions to mitigate obstetric violence should consider women's empowerment, healthcare professionals' training, monitoring obstetric violence, and legal support.

Nursing assistance in childcare consultation for child development assessment

Nursing assistance in childcare consultation for child development assessment

Exclusive breastfeeding. Factors that influence its abandonment

A descriptive study was carried out with the objective of identifying some factors associated with the abandonment of breastfeeding in a clinic in the health area of Puerto Padre, Cuba during the year 2022. The working universe was constituted by 170 infants under six months of age, the sample was constituted by 141 infants. For the elaboration of the project, the mothers or guardians of the infants were surveyed, and the clinical history was verified by childcare consultations using the variables time of exclusive breastfeeding, factors associated with the mother for the abandonment of breastfeeding, factors associated with the child for the abandonment of breastfeeding. Most of the children abandoned breastfeeding between three and four months of age. In relation to the factors associated with the mother for the abandonment of breastfeeding, it was found that the knowledge of the mothers related to breastfeeding is inadequate, most of them have an adequate level of schooling, the number of serious maternal diseases is not significant, predominantly mastitis and the age group of adolescents. In relation to the factors associated with the child, it was found that term birth predominated and most of the children were exclusively breastfed, and the number of children with oropharyngeal malformations was not significant

Income and immunity: The consequences of a pre- and neo-natal income shock on childhood infection risk

ObjectivesThe experiences and conditions that children are exposed to in utero and early infancy impact their health in adulthood. Understanding the channels through which these effects emerge is important, because this may help us to anticipate which children are at highest risk of adverse effects, and provide early interventions to help. In this paper, we test a new channel linking perinatal experiences to later-life health: immunity.
 MethodWe use administrative birth records, linked with hospital admissions episodes and primary care consultations for children in the Northern Territory of Australia. This data forms part of the Child and Youth Development Partnership data linkage project. We analyse the impact of a shock to household income in Aboriginal communities, resulting from a change in government transfer policy. We estimate the impact of exposure to this shock in utero or in the first 3 months of life, relative to exposure later in childhood, to isolate the impact of an income shock during this key developmental period.
 ResultsWe find that children who were exposed to the shock in utero or in their first three months of life were at higher risk of severe infection requiring hospital admission. They spend, on average, 4.5 more days in hospital from birth to their 6th birthday (a 45 percent increase). Most of this impact is concentrated in admissions for infection. Only a small share of the effect can be explained by the immediate impact of the policy on birthweight.
 ConclusionOur findings are consistent with the explanation that an income shock worsens nutrition, and that worse nutrition during key developmental stages can permanently weaken children’s immune systems. This finding speaks to the importance of attention to key phases in childhood development, when designing policies that affect households’ financial resources. Furthermore, we find birthweight is a poor predictor of childhood hospital admission. However, use of longitudinal administrative data helps us to identify alternative markers of new-born health that are better predictors.

INTERVENÇÃO EDUCATIVA COM ENFERMEIROS SOBRE CONSULTA DE PUERICULTURA: UM ESTUDO DE MÉTODO MISTO

ABSTRACT Objective: to determine the effect and influence of an educational intervention on childcare consultation on nurses’ knowledge and practice. Method: a mixed research method was adopted, with a sequential explanatory design, characterized by a stage with a quantitative approach, developed in a quasi-experimental study, with 30 nurses, followed by a qualitative one, carried out by in-depth interview, with 11 nurses working in the Family Health Units of João Pessoa, Paraíba, Brazil. In quantitative analysis, descriptive statistics and proportion test were used, and in qualitative analysis, thematic analysis was used. Results: the effect of the educational intervention was statistically significant in the consultation dimensions: consultation frequency; child nutrition; physical examination; growth assessment; development assessment; and health education. In the qualitative stage, the influence of the intervention in expanding knowledge and changing some nurses’ practices in the aforementioned dimensions was understood, with agreement between the data found. Conclusion: the positive effect of the educational intervention on nurses’ knowledge and practice in childcare consultations was evident, enabling them to reflect on the content covered and promote changes in their daily lives.

Impactos da pandemia da COVID-19 no programa mãe coruja da VII região de saúde de Pernambuco

Resumo Objectives: to analyze the impacts caused by the COVID-19 pandemic on the Mother Owl Program of the VII Health Region of Pernambuco. Methods: descriptive, cross-sectional and quantitative study, carried out at the VII Regional Health Management, in Salgueiro-PE. Data were collected from the Mother Owl Information System, from August to November 2021, being related to women and children registered from 2019 to March 2021. Adopting a time frame for before and during the pandemic, the Student’s t and chi-square tests in the analysis of continuous and categorical variables, respectively. Results: data from 581 women and 412 children were analyzed. Before the pandemic, there was a higher average number of prenatal consultations (p<0.001) and greater completeness in the children’s race data (p<0.001). During the pandemic, there was a lower frequency of breastfeeding in the first hour of life (p<0.001) and of filling in the data regarding maternal education (p<0.001). In addition, no more than 7 childcare consultations were performed (p<0.001). Conclusions: the assistance of women and children was impacted, mainly with the drop in prenatal and childcare consultations, showing that COVID-19 had a negative impact on the health of people monitored by the Program and on the quality of information inserted in the system.

VIDEOCLIPE PARA APRENDIZAGEM DA FISIOLOGIA DA LACTAÇÃO: AVALIAÇÃO PELA REDE DE APOIO FAMILIAR ÀS LACTANTES

ABSTRACT Objective: to evaluate the adequacy of using a care-educational technology with video clips for learning the physiology of lactation by the family support network for breastfeeding women. Method: a methodological study guided by the Knowledge Translation in Action Model. The collection procedure was carried out from July to September 2022 in the city of Santa Cruz do Sul, state of Rio Grande do Sul, Brazil. After the childcare consultation, each puerperal woman indicated one or more members of her support network to participate in the research. In face-to-face interviews, 52 participants answered the following instruments: Assistive Technology Assessment and Face Validation of Educational Technologies in Health. Normality of the variables was verified using the Kolmogorov-Smirnov test. The quantitative variables with normal distribution were described by mean and standard deviation. Face Validity Index and Cronbach's Alpha were calculated. Results: the video clip was evaluated as adequate (1.75) in all attributes: Interactivity (1.75), Objectivity (2.00), Relevance and efficacy (2.00) and Clarity (2.00). Face validity was excellent (0.969). Both instruments obtained Cronbach's Alpha values of 0.883 and 0.852, respectively, indicating reliability in this population. Conclusion: the video clip for learning the physiology of lactation is suitable for use by the family support network for breastfeeding mothers.

PUERICULTURA E SEGUIMENTO DE CRIANÇAS EXPOSTAS À SÍFILIS OU NOTIFICADAS COM A SÍFILIS CONGÊNITA

ABSTRACT Objective: to analyze childcare and follow-up of children exposed to or notified with congenital syphilis in Primary Health Care. Method: a descriptive study carried out in Fortaleza, Ceará, whose population was made up of children exposed to syphilis or notified with congenital syphilis in 2017 and 2018. The data were collected from notification forms and the children's medical records. Sociodemographic variables of the mother and childcare were analyzed. For this purpose, the Statistical Package for the Social Sciences (SPSS), version 22, was used. Results: a total of 715 children took part in the study. The mothers' age varied from 14 to 42 years old, 436 (61%) had Complete Elementary School, 276 (38.6%) had a steady or occasional partner, 97 (13.6%) had a paid job and 23 (3.2%) used drugs. A total of 712 (99.6%) attended prenatal care and 134 (18.7%) were treated for syphilis. In relation to the children, 50 (7.0%) attended only one childcare consultation and a considerable loss was observed in follow-up over the months. Ten (1.4%) completed all eight consultations recommended by the Ministry of Health. No child underwent the Venereal Disease Research Laboratory at one, three, six, 12 and 18 months. Conclusion: childcare and follow-up of children exposed to syphilis or notified with congenital syphilis do not meet the guidelines recommended by the Ministry of Health. There is a significant follow-up loss among the children.

Content validation of a questionnaire to assess the knowledge of pediatricians, family, and community physicians on obesity.

The aim of this study was to validate the content of a questionnaire in order to assess the attitudes and practices in childcare consultations, knowledge on overweight and obesity, their risk factors, and barriers in addressing the issue by pediatricians and family physicians. The Delphi technique was used, with the objective of reaching a consensus on a certain subject, through experts' opinions. The content validity index (CVI) of each item, axis, and questionnaire was calculated. The inter-rater reliability was calculated using an agreement coefficient suitable for the answer distribution such as Gwet's AC2 with ordinal weight. A total of 63 experts were invited to assess and give their opinion on the questionnaire. In all, 52 accepted the invitation and analyzed the instrument. After two rounds, the questionnaire reached the proper CVI for the study and was considered complete, with its final version having 40 questions, a final index of 95%, and an inter-rate reliability of 0.905. This instrument, developed to assess attitudes and practices, knowledge, and barriers found in addressing the obesity by primary care physicians, obtained a CVI greater than 0.8 and an excellent agreement coefficient of the 52 judges. Therefore, its content can be considered validated.

Educational action to monitor children's growth and development based on the theory of meaningful learning.

Evaluating the effect of an educational program on the knowledge of Primary Health Care nurses regarding the surveillance of growth and development during childcare appointments. A before-after intervention study with 30 nurses. The nurses' knowledge and practice assessment were done using a tool that had been developed and validated. The educational activity was carried out, linking child growth and development indicators with public policies for early childhood and nurses' practices. David Ausubel's Significant Learning Theory was used as a teaching-learning strategy. The same instrument was reapplied after one month. Descriptive statistics were used in the analysis and the proportion test, Wilcoxon test and Item Response Theory with the Rasch model were applied. The nurses checked more items right in the instrument after the intervention; there was an increase in the scores of correct answers and a decrease in the item response difficulty index in the knowledge and practice section, post-intervention. The educational activity had a positive effect, affecting changes in nurses' knowledge and practice, which enabled childcare consultations to become more qualified.

Relação entre reação de hipersensibilidade e a dose zero da vacina tríplice viral: um relato de caso

Introduction: The measles outbreak registered in Brazil in 2018, forced the alteration of preventive actions for the disease, leading to the addition of the zero dose of the Triple Viral vaccine for children from 6 months of age to 11 months and 29 days. The zero dose precedes the first dose, but does not exclude its mandatory nature. Studies that address the harms and benefits of the extra early dose are scarce. This study aimed to point out the pros and cons of zero dose management in light of the report of an adverse hypersensitivity reaction to this dose of the Triple Viral vaccine. Case report: Male patient, 6 months old, attended the childcare consultation to investigate a possible hypersensitivity reaction after administration of the zero dose of the Triple Viral vaccine. On physical examination, he showed good general condition, development compatible with age and generalized hypersensitivity. Discussion: It addresses the importance of the Triple Viral Vaccine and raises the question of few studies about the consequences of the new vaccine protocol, which recommends the administration of zero dose in children under one year old, in the face of the measles outbreak. Conclusion: The Triple Viral vaccine is an efficient mechanism to fight measles. The benefits outweigh the adverse effects of the vaccine, however, further studies are needed in order to understand the real consequences of administering the zero dose to children under one year of age.

Relação entre reação de hipersensibilidade e a dose zero da vacina tríplice viral: um relato de caso

INTRODUCTION: The measles outbreak registered in Brazil in 2018, forced the alteration of preventive actions for the disease, leading to the addition of the zero dose of the Triple Viral vaccine for children from 6 months of age to 11 months and 29 days. The zero dose precedes the first dose, but does not exclude its mandatory nature. Studies that address the harms and benefits of the extra early dose are scarce. This study aimed to point out the pros and cons of zero dose management in light of the report of an adverse hypersensitivity reaction to this dose of the Triple Viral vaccine. CASE REPORT: Male patient, 6 months old, attended the childcare consultation to investigate a possible hypersensitivity reaction after administration of the zero dose of the Triple Viral vaccine. On physical examination, he showed good general condition, development compatible with age and generalized hypersensitivity. DISCUSSION: It addresses the importance of the Triple Viral Vaccine and raises the question of few studies about the consequences of the new vaccine protocol, which recommends the administration of zero dose in children under one year old, in the face of the measles outbreak. CONCLUSION: The Triple Viral vaccine is an efficient mechanism to fight measles. The benefits outweigh the adverse effects of the vaccine, however, further studies are needed in order to understand the real consequences of administering the zero dose to children under one year of age.

Importance of Early Recognition of Arterial Hypertension in Children and Adolescents

Arterial hypertension is considered an epidemic, remaining as the main cause of death and global disability. As high blood pressure in childhood is highly predictive of high blood pressure in adulthood, there has been a growing interest in the early recognition of this condition in the pediatric population, through outpatient screening in children over three years of age. Objective: to emphasize the importance of routine monitoring of blood pressure measurement in children and adolescents in childcare consultations. Methodology: This is a literature review of published articles, searched through the PubMed, Virtual Health Library and Google Scholar databases. Results: 12 scientific articles were selected as the data source for the present study, seven in English and five in Portuguese. Conclusion: the measurement of blood pressure in all consultations with children is important. If the disease is identified, treatment must be instituted, which will vary between non-pharmacological and pharmacological therapies, which should be introduced for all pediatric patients with blood pressure values above the acceptable percentile for age. In this sense, it is pertinent that nurses acquire and develop skills that make it possible to implement strategies for the prevention of hypertension, as well as the early identification of children and adolescents at risk of arterial hypertension.

Análise da prevalência do consumo de açúcar em consultas de puericultura

Abstract Objectives: to analyze the prevalence of sugar consumption and associated factors in childcare consultations. Methods: cross-sectional study with 599 children > six months to < 24 months of age, assisted by the Family Health Units. Outcomes: daily consumption of sweetened beverages, sweets/candies, recorded in the Food and Nutrition Surveillance System; independent variables: sociodemographic data. Multiple logistic regression test was applied. Results: 62.10% of the children consume sugary drinks and 42.23%, sweets/candies. Consuming sugary drinks was associated with the age of 12-17 months and 29 days (OR=2.525; CI95%=1.68-3.78) and 18-17 months and 29 days (OR=2.90; CI95%=1.90-4.43); children living with more than four people at home (OR=1.59; CI95%=1.11-2.26), aged 12-17 months and 29 days (OR=2.05; CI95%=1.34-3.13) and 18-23 months and 29 days (OR=2.51; CI95%=1.62-3.87) were more likely to consume sweets/candies than younger children. Maternal aspects, such as age (OR=0.66; CI95%=0.46-0.93), marital status (OR=1.67; CI95%=1.06-2.6), schooling (OR=2.14; CI95%=1.12-4.08), and presence of government assistance (OR=2.03; CI95%=1.41-2.93), were conditions associated with the consumption of sweets. Conclusions: the prevalence of sugar in children’s diet was high and was associated with sociodemographic aspects. Health education actions should be carried out in childcare, in order to promote healthy food, minimizing the consumption of sugar.

Nursing assistance in child care in Brazil: an integrative literature review / Assistência de enfermagem na puericultura no Brasil: uma revisão integrativa da literatura

INTRODUCTION: Childcare begins with nursing after prenatal care when the nurse accompanies the pregnant woman and performs actions and guidance on the care of the baby. OBJECTIVE: To describe the importance of the nurse's assistance in the child care consultation. METHODOLOGY: This is an integrative review of the literature. The inclusion criteria were: original articles, in the period of 2013-2017; in the Portuguese language. RESULTS: The studies revealed that through reception, bonding, qualified listening and prior scheduling it is possible to guarantee the quality of care and a better adherence of this family to the childcare program. CONCLUSION: It is concluded that the role of nursing in childcare begins from its gestation, through guidelines for the care that this pregnant woman will have with her baby at birth, neonatal screening, such as the test of the foot, test of the ear, tongue test, eye and little heart test, immunization surveillance, body hygiene, guidance on breastfeeding and the child's first meals and follow-up of growth and development.

Child sexual abuse: identify signs and symptoms in childcare consultation and minimize psychosocial trauma

Child sexual abuse: identify signs and symptoms in childcare consultation and minimize psychosocial trauma

Patient volume and quality of primary care in Ethiopia: findings from the routine health information system and the 2014 Service Provision Assessment survey

BackgroundSeveral studies have reported inadequate levels of quality of care in the Ethiopian health system. Facility characteristics associated with better quality remain unclear. Understanding associations between patient volumes and quality of care could help organize service delivery and potentially improve patient outcomes.MethodsUsing data from the routine health management information system (HMIS) and the 2014 Ethiopian Service Provision Assessment survey + we assessed associations between daily total outpatient volumes and quality of services. Quality of care at the facility level was estimated as the average of five measures of provider knowledge (clinical vignettes on malaria and tuberculosis) and competence (observations of family planning, antenatal care and sick child care consultations). We used linear regression models adjusted for several facility-level confounders and region fixed effects with log-transformed patient volume fitted as a linear spline. We repeated analyses for the association between volume of antenatal care visits and quality.ResultsOur analysis included 424 facilities including 270 health centers, 45 primary hospitals and 109 general hospitals in Ethiopia. Quality was low across all facilities ranging from only 18 to 56% with a mean score of 38%. Outpatient volume varied from less than one patient per day to 581. We found a small but statistically significant association between volume and quality which appeared non-linear, with an inverted U-shape. Among facilities seeing less than 90.6 outpatients per day, quality increased with greater patient volumes. Among facilities seeing 90.6 or more outpatients per day, quality decreased with greater patient volumes. We found a similar association between volume and quality of antenatal care visits.ConclusionsHealth care utilization and quality must be improved throughout the health system in Ethiopia. Our results are suggestive of a potential U-shape association between volume and quality of primary care services. Understanding the links between volume of patients and quality of care may provide insights for organizing service delivery in Ethiopia and similar contexts.