Edilaine Giovanini Rossetto

Prevalência de aleitamento materno e fatores associados no município de Londrina-PR

Objective: To describe breastfeeding prevalence and associated factors, in the municipality of Londrina, PR, Brazil. Methods: This quantitative, descriptive study included interviews of 770 companions of children younger than 12 months of age during an anti-polio vaccination campaign in August 2008. Results: A total of 72.5% of the children were breastfed in the first hour after birth; 33.8% were exclusively breastfed from zero to six months of age, 53.7% until the fourth month and 7.8% until the sixth month; 51.5% were in continued breastfeeding between 9 and 12 months of age. The women who breastfed the most were 35 years old or older, had a bachelor’s degree, had more than one child and were on maternity leave. Conclusion: Breastfeeding rates increased in the city, however, analyzing health services actions is needed to improve these rates.Objective: To describe breastfeeding prevalence and associated factors, in the municipality of Londrina, PR, Brazil. Methods: This quantitative, descriptive study included interviews of 770 companions of children younger than 12 months of age during an anti-polio vaccination campaign in August 2008. Results: A total of 72.5% of the children were breastfed in the first hour after birth; 33.8% were exclusively breastfed from zero to six months of age, 53.7% until the fourth month and 7.8% until the sixth month; 51.5% were in continued breastfeeding between 9 and 12 months of age. The women who breastfed the most were 35 years old or older, had a bachelor’s degree, had more than one child and were on maternity leave. Conclusion: Breastfeeding rates increased in the city, however, analyzing health services actions is needed to improve these rates.

Manejo da dor pós-operatória na visão dos pais da criança hospitalizada

Considerando os efeitos deleterios da dor pos-operatoria na crianca e seu direito a receber alivio, sentiu-se a necessidade de estudar esse tema. Pesquisa qualitativa desenvolvida na unidade pediatrica de um hospital publico de Londrina - Parana, visando investigar a percepcao dos pais quanto ao manejo da dor pos-operatoria pela equipe de enfermagem e seu envolvimento neste processo. Foram entrevistados 10 familiares que acompanhavam criancas submetidas a cirurgias. Os dados foram agrupados em dois temas: caracterizacao do manejo da dor pos-operatoria e estrategias adotadas para o alivio da dor pos-operatoria. A terapia farmacologica foi mencionada como principal metodo utilizado pela equipe para analgesia. Quanto a atuacao dos pais, referiram o uso de estrategias nao farmacologicas como: distracao, brinquedos, entre outros. O tratamento farmacologico e supervalorizado pelos profissionais e pelos pais. Tecnicas nao farmacologicas sao extremamente uteis, porem, e necessario incentivar os pais a participar ativamente no manejo da dor pos-operatoria de seus filhos.

Prevalence of breastfeeding and associated factors in the municipality of Londrina (PR, Brazil)

Objective: To describe breastfeeding prevalence and associated factors, in the municipality of Londrina, PR, Brazil. Methods: This quantitative, descriptive study included interviews of 770 companions of children younger than 12 months of age during an anti-polio vaccination campaign in August 2008. Results: A total of 72.5% of the children were breastfed in the first hour after birth; 33.8% were exclusively breastfed from zero to six months of age, 53.7% until the fourth month and 7.8% until the sixth month; 51.5% were in continued breastfeeding between 9 and 12 months of age. The women who breastfed the most were 35 years old or older, had a bachelor’s degree, had more than one child and were on maternity leave. Conclusion: Breastfeeding rates increased in the city, however, analyzing health services actions is needed to improve these rates.Objective: To describe breastfeeding prevalence and associated factors, in the municipality of Londrina, PR, Brazil. Methods: This quantitative, descriptive study included interviews of 770 companions of children younger than 12 months of age during an anti-polio vaccination campaign in August 2008. Results: A total of 72.5% of the children were breastfed in the first hour after birth; 33.8% were exclusively breastfed from zero to six months of age, 53.7% until the fourth month and 7.8% until the sixth month; 51.5% were in continued breastfeeding between 9 and 12 months of age. The women who breastfed the most were 35 years old or older, had a bachelor’s degree, had more than one child and were on maternity leave. Conclusion: Breastfeeding rates increased in the city, however, analyzing health services actions is needed to improve these rates.

INCIDÊNCIA DE REINTERNAÇÃO DE PREMATUROS COM MUITO BAIXO PESO NASCIDOS EM UM HOSPITAL UNIVERSITÁRIO

Resumen Este estudio investigó la incidencia de rehospitalización y los factores asociados a prematuros nacidos con muy bajo peso en un hospital universitario. Es un estudio descriptivocuantitativo con los neonatos menores de 1500g nacidos en 2006 y que recibieron alta hasta diciembre de ese año. Todos fueron acompañados hasta los seis meses de vida. Se colectaron los datos en fichas de atención ambulatorio de los prematuros y contacto telefónico con las madres. De los 53 bebés estudiados, un 30,2% fue reinternado, un 7,5% murió y un 56,3% de las reinternaciones ocurrió debido a afecciones respiratorias. De los reinternados, un 68,7% permaneció más de 60 días en la Unidad de Cuidados Intensivos Neonatal; un 68,7% estaba desmamado en la reinternación; un 37,5% no estaba en acompañamiento ambulatorio. Sólo un 19,8% de los que seguían en acompañamiento fue reinternado. La incidencia de reinternación presentó una asociación estadística con el municipio de origen (p=0,007). Palabras Clave: Readmisión del Paciente. Prematuro. Factores de Riesgo 1Enfermeira Neonatologista. Enfermeira do Hospital Universitário de MaringáPR. Brasil. E-mail: leticiamariha@yahoo.com.br,2Enfermeira. Residente em Enfermagem Neonatal da Universidade Estadual de Londrina – PR (UEL). Brasil. E-mail: kayna411@yahoo.com.br,3Enfermeira. Mestre em Enfermagem Fundamental pela USP de São Paulo e docente assistente do Depar tamento de Enfermagem da UEL. Brasil. E-mail: ediluiz@sercomtel.com.br,4 Enfermeira. Mestre em Enfermagem Fundamental pela USP de São Paulo e docente assistente do Depar tamento de Enfermagem da UEL. Brasil. E-mail: sarahuel@sercomtel.com.br,5Enfermeira Neonatologista. Enfermeira do Hospital Araucária de LondrinaPR. Brasil. E-mail: talitabengozi@yahoo.com.br PESQUISA RESEARCH INVESTIGACIÓN This study investigated the incidence and factors related to premature readmission of very low weight in a neonatal unit in a university hospital. This is a descriptive quantitative study of newborns with low weight babies who were discharged until December 2006 and were up to 6 months of life. Data were obtained from sheets of care of premature infants and telephone contact with mothers. Of the 53 babies studied, 30.2% were readmitted, 7.5% were to death, 56.3% of readmissions were for respiratory disorders. From the readmitted, 68.8% stayed more than 60 days in the Neonatal Intensive Care Unit, 62.5% were weaned on readmission, 37.5% From the readmitted were not in ambulatory monitoring while only 19.8% of those who followed were monitoring readmitted. The incidence of readmission may be related to the city borned.Este estudio investigo la incidencia de rehospitalizacion y los factores asociados a prematuros nacidos con muy bajo peso en un hospital universitario. Es un estudio descriptivo-cuantitativo con los neonatos menores de 1500g nacidos en 2006 y que recibieron alta hasta diciembre de ese ano. Todos fueron acompanados hasta los seis meses de vida. Se colectaron los datos en fichas de atencion ambulatorio de los prematuros y contacto telefonico con las madres. De los 53 bebes estudiados, un 30,2% fue reinternado, un 7,5% murio y un 56,3% de las reinternaciones ocurrio debido a afecciones respiratorias. De los reinternados, un 68,7% permanecio mas de 60 dias en la Unidad de Cuidados Intensivos Neonatal; un 68,7% estaba desmamado en la reinternacion; un 37,5% no estaba en acompanamiento ambulatorio. Solo un 19,8% de los que seguian en acompanamiento fue reinternado. La incidencia de reinternacion presento una asociacion estadistica con el municipio de origen (p=0,007).

The prevalence of breastfeeding in prematures with very low birth weight – a systematic review

Due to the difficulty in establishing breast feeding among mothers of premature babies, several studies have been carried out to find out the frequency of this practice. National and international indexes are little known, particularly those related to extremely underweight premature babies. The objective of this study was to do a systematic bibliographic review on the prevalence/ duration of breast feeding among mothers of very low birth weight infants. Six data bases were consulted to search for articles on the subject published from 1997 onwards. From the 78 articles related to the topic, 9 dealt with the prevalence and/or duration of breast feeding among mothers of premature babies born weighing less than 1500 grams. Data were summarized in a table containing detailed information on each research. Some issues came up as essential to the subject of breast feeding among mothers of premature babies such as the concept of breast feeding adopted, the sample, the place and year of the study, the design of the study and the time of data collection. As breast feeding is closely related to cultural and social values from each region and country and the mother’s decision, it is difficult to compare prevalence from different contexts/worlds. However, some interventions in the studied population were efficient, showing that breast feeding is necessary, difficult and highly demanding yet possible through simple and intentionally systematized actions.

Skin lesions of newborns in a neonatal unit: observational study

Aim: Identify the incidence and prevalence of skin lesions in hospitalized neonates and characterize the identified lesions. Method: Longitudinal, observational and quantitative. Daily studies on 40 newborns in a neonatal unit, during the physical examination, during September and October 2011. Data analyzed through descriptive and inferential statistics. Results and Discussion: The study identified 195 lesions with an average of five lesions per newborn; incidence was 16%; prevalence was 58% and; average hospitalization period was 37.2 days. Diaper-caused dermatitis was the most common lesion, which progressed to moniliasis complications at a lower rate than previously found in other studies. The findings show statistical significance between the use of anti-fungals for diaper-caused dermatitis and treatment time. Conclusion: The need for preventive lesion treatment, which can improve the quality of life and growth for newborns.

Transcultural adaptation and validation of the instrument nurse parent support tool to the portuguese language

Objetivo: Realizar a adaptacao transcultural e validacao do instrumento Nurse Parent Support Tool (NPST) para a lingua portuguesa. Metodologia: apos aprovacao do comite de etica em pesquisa e o consentimento da autora, seguiu-se metodologia internacionalmente aceita: adaptacao transcultural, retro-traducao, avaliacao por juizes, pre-teste e analise de propriedades psicometricas. Resultados: As adaptacoes realizadas pelos juizes resultaram na versao final equivalente a versao original e retro-traduzida; alem de validada em carater de conteudo. A consistencia interna apresentou-se altamente satisfatoria. Conclusao: o instrumento adaptado e validado e um parâmetro reprodutivel a ser utilizado na avaliacao do apoio da equipe de enfermagem aos pais de bebes internados em Unidade Neonatal.

Heparina para desobstrução de cateter venoso central de inserção periférica no recém-nascido: estudo in vitro

Objective: To compare the efficacy of two concentrations of heparin to clear the lumen of in vitro clotted neonatal peripherally inserted central catheters (PICCs). Methods: This is an in vitro, experimental quantitative study of 76 neonatal 2.0-Fr PICCs coagulated in vitro. The catheters were divided into two groups of 38 PICCs each. In both groups an infusion of low molecular weight heparin was administered with a dose of 25IU/mL for Group 1 and 50IU/mL for Group 2. The negative pressure technique was applied to the catheters of both groups at 5, 15 and 30min and at 4h to test their permeability. Kaplan-Meier survival analysis was used to verify the outcome of the groups according to time intervals. Results: The comparison between both groups in the first 5min showed that more catheters from Group 2 were cleared compared to Group 1 (57.9 vs. 21.1%, respectively). Kaplan-Meier survival analysis showed that less time was needed to clear catheters treated with 50IU/mL of heparin (p<0.001). Conclusions: The use of low molecular weight heparin at a concentration of 50IU/mL was more effective in restoring the permeability of neonatal PICCs occluded in vitro by a clot, and the use of this concentration is within the safety margin indicated by scientific literature.

Aleitamento materno exclusivo em prematuros de hospitais Amigo da Criança: estudo comparativo

Aim: to compare the prevalence of exclusive breastfeeding (EBF) and to verify the factors associated with its interruption in premature infants hospitalized at Baby-Friendly hospitals. Method: this is a comparative study performed with 107 premature infants admitted to the neonatal unit of two hospitals in Parana. Data were obtained through interviews with mothers and analysis of infant records at hospital discharge and 15 days after delivery. Results: the prevalence of EBF was 29.2% in the University Hospital and 15.3% in the Philanthropic Hospital. At hospital discharge, associations with clinical characteristics of infants predominated, and 15 days after discharge there was a greater association with the socio-demographic characteristics of the parents. Conclusion: the prevalence of EBF, which was shown to be low at the time of hospital discharge in both hospitals, decreased after discharge, reinforcing the need for other strategies, in addition to those provided at Baby-Friendly hospitals, for the promotion and support of EBF in preterm infants .

Using the knowledge translation framework to change practical care of central catheters in a Brazilian neonatal unit

INTRODUCTION The use of central catheters in intensive care is essential, but exposes the patient to the risk of a bloodstream infection. Although there is evidence to improve the care for these patients, there is a gap between knowledge and healthcare practices. This study was designed to describe the bundle implementation for central catheters in light of the knowledge translation (KT) conceptual framework in a neonatal unit and assess its impact on care practices with catheters. METHODOLOGY A time-series quasi-experimental study design was conducted in a Brazilian neonatal unit, through 289 non-participant observations of professional practices before and after the implementation of the bundles. RESULTS The deployment of two bundles was guided through the steps of a careful selection of adopting KT evidence and context-related and investment factors in the facilitation process. The implementation of the bundles was planned by a group manager, mediated by a facilitator, and guided by targets established by professionals. The biggest impact was on the maintenance of catheters; seven of eleven practices improved significantly (p < 0.01). The insertion of catheters showed lesser impact of change, with high adequacy ratios before implementation, but also presented satisfactory adherence to recommendations. CONCLUSIONS This is the first Brazilian study using the KT conceptual framework to develop, implement, and evaluate the impact of central line bundles in a neonatal care environment, detailing the implementation process. It highlights the importance of accountability and staff involvement in all stages of the study.