Flávia Helena Pereira Padovani

Sintomas depressivos e ansiosos em mães de recém-nascidos com e sem malformações

OBJETIVO: comparar as condicoes emocionais de maes cujos filhos nascem com malformacoes visiveis (Grupo M) com as das maes de criancas eutroficas (Grupo E) logo apos o nascimento. METODO: foram avaliados os sintomas de ansiedade e depressao de 22 maes de cada grupo por meio do Inventario de Depressao de Beck (BDI) e do Inventario de Ansiedade Traco-Estado (IDATE). Foram excluidas as maes portadoras de deficiencia sensorial incapacitante, HIV, disturbios psiquiatricos e sindromes geneticas. Os dados foram complementados com consultas a prontuarios medicos da crianca e da mae. Para analise comparativa entre as medianas dos grupos foi utilizado o teste nao-parametrico U de Mann-Whitney; para amostras independentes e para os escores indicativos de sintomas clinicos, o teste exato de Fisher e o teste do χ2. RESULTADOS: houve diferencas significativas nas medianas dos escores das tres subescalas (ansiedade-traco, ansiedade-estado e disforia/depressao) entre os dois grupos de maes. Houve uma porcentagem significativamente maior de maes do Grupo M com escores indicativos de sinais clinicos para depressao ou ansiedade no pos-parto imediato e, para ambos os quadros, quando comparadas com maes do Grupo E. Os resultados podem ser decorrentes de tracos de personalidade materna, visto que os indices de ansiedade-traco eram significativamente maiores nas maes de criancas malformadas, mas especialmente pelo estado da crianca, seu encaminhamento para a UTI e sua condicao de vida futura. CONCLUSOES: a porcentagem de maes de recem-nascidos com malformacoes visiveis que apresentou escores indicativos de sinais clinicos para ansiedade, depressao e ambos sugerem a necessidade de suporte, individual ou em grupo.

Fatores de risco para o desenvolvimento de criancas atendidas em Unidades de Saude da Familia, ao final do primeiro ano de vida: aspectos sociodemograficos e de saude mental materna

The scope of this article is to evaluate risk and protection factors for the development of 1-year-olds assisted at family health care units. It is a cross-sectional study involving 65 children of approximately 1 year of age and their mothers attended at two family health care units. The development was assessed using a developmental screening test (Denver II). The mothers filled out the SRQ-20 questionnaire to identify common mental disorder (CMD) indicators. After data collection, descriptive and inferential statistical analysis was performed. Global development was at risk in 43.1% of the children evaluated, and the most affected areas were language and fine motor development; 44.6% of mothers had results indicative of CMD when the child was 1 year of age. In bivariate analysis, reported depression, smoking, infections in pregnancy, CMD after birth and working outside the home were significantly associated with the childrens development. After full statistical analysis, CMD was revealed as being a risk factor, and working away from home as being a protection factor. In order to increase the chances of success of programs targeted for children at health care units and avoiding the risk of impaired development, it is important to focus on two aspects: childrens stimulation and maternal mental health.The scope of this article is to evaluate risk and protection factors for the development of 1-year-olds assisted at family health care units. It is a cross-sectional study involving 65 children of approximately 1 year of age and their mothers attended at two family health care units. The development was assessed using a developmental screening test (Denver II). The mothers filled out the SRQ-20 questionnaire to identify common mental disorder (CMD) indicators. After data collection, descriptive and inferential statistical analysis was performed. Global development was at risk in 43.1% of the children evaluated, and the most affected areas were language and fine motor development; 44.6% of mothers had results indicative of CMD when the child was 1 year of age. In bivariate analysis, reported depression, smoking, infections in pregnancy, CMD after birth and working outside the home were significantly associated with the childrens development. After full statistical analysis, CMD was revealed as being a risk factor, and working away from home as being a protection factor. In order to increase the chances of success of programs targeted for children at health care units and avoiding the risk of impaired development, it is important to focus on two aspects: childrens stimulation and maternal mental health.

Stress materno e hospitalização infantil pré-cirúrgica

Abstract The aim of this study was to evaluate the level of stress in mothers accompanying children hospitalized to have elective surgi cal proceduresperformed, relating it to demographic variables of the child and previous experience in this context. Fifty-four mothers accompanyingchildren hospitalized to have elective surgery performed participated in the study. The instruments used were the Lipp Stress SymptomsInventory for adults, and a questionnaire drawn up for the study to survey the children’s variables. The results pointed out tht 82% of thesample presented stress, with the stage of resistance and psychological symptoms prevailing. A statistically significant relationship wasobserved between the presence of maternal stress and the fact that the child had no previous experience of surgery (p=0.052). O n the otherhand, no statistically significant differences were observed between the presence of maternal stress and the child’s age and ge nder. It wasconcluded that the impact of surgical procedures affects the child and family, which must be taken into consideration so that i nterventionscan be proposed for pre-operative preparation.Uniterms

Salivary cortisol levels: the importance of clown doctors to reduce stress

This study was designed to correlate entertainment of clown-doctors (CD) activities on hospitalized children and aphysiological bio-marker. For this purpose we collected saliva samples and verified children satisfaction with these activities by using a visual analog scale (VAS). Children from 6 to 7 years-old, with diagnosis of any acute pathology, interned in the Pediatric Ward of the Botucatu Medical School Hospital (São Paulo, Brazil) were interviewed. Two groups were taken into consideration: lunchCD and dinnerCD. The following protocol was applied in each group (lunch and dinner): collection of the first saliva sample and presentation of VAS prior to CD activities, followed by collection of a second saliva sample and another VAS assessment after CD activities. The salivary cortisol was reduced in both groups comparing the first saliva sample. The satisfaction of the intervention was evident for lunchCD. The CD intervention is effective in decreasing an important physiological biomarker of stress factor, cortisol, in hospitalized children, been effective for the healing process.

Estratégias de enfrentamento em crianças em situação pré-cirúrgica: relação com idade, sexo, experiência com cirurgia e estresse

This studys aim was to verify coping strategies among children aged between 7 and 12 years old who will be experiencing surgery and the potential relationship of coping strategies with sociodemographic variables, stress in children and in companions, and the childs prior experience with surgery. A total of 58 children hospitalized and waiting for elective surgeries responded to the Assessment Instrument of Coping to Hospitalization and an instrument to assess stress. The companion received a sociodemographic questionnaire and the Lipp Stress Symptom Inventory. Problem-solving strategies and distraction were the most frequent strategies used, while social withdrawal and opposition were the least frequent. Girls and children of stressful parents used emotion regulation strategies with significantly more frequency. Likewise, greater cognitive restructuring was observed in older children and those with prior experience with surgeries. The results show the need to consider the studied variables when developing pre-operative preparation programs.

Mental Health, Mother-Child Interaction and Development at the End of the First Year of Life

La salud mental materna puede afectar la calidad de la interaccion madre-hijo y el desarrollo infantil. Este estudio evaluo la relacion entre interaccion madre-hijo y el desarrollo neuropsicomotor de ninos con edad de un ano, considerando la salud mental materna. Fueron evaluados 65 ninos de un ano, usuarios de Unidades de Salud de la Familia, mediante una prueba de deteccion del riesgo. Las madres fueron entrevistadas y respondieron a instrumento de rastreo psiquiatrico. Se evaluo la interaccion mediante un protocolo de interaccion diadica. 43,1% de los ninos presento riesgo de desarrollo. Aunque 44,6% de las madres presento malestar psicologico, su salud mental no se asocio con los comportamientos presentados en la interaccion. Sin embargo, comportamientos interactivos de la madre y del nino se asociaron con retraso en el desarrollo. La estimulacion cognitiva fue la unica variable predictiva de retrasos. Los datos contribuyen para la comprension del papel de la interaccion y el desarrollo infantil.

Saúde Mental, Interação Mãe-Criança e Desenvolvimento ao Final do Primeiro Ano de Vida

La salud mental materna puede afectar la calidad de la interaccion madre-hijo y el desarrollo infantil. Este estudio evaluo la relacion entre interaccion madre-hijo y el desarrollo neuropsicomotor de ninos con edad de un ano, considerando la salud mental materna. Fueron evaluados 65 ninos de un ano, usuarios de Unidades de Salud de la Familia, mediante una prueba de deteccion del riesgo. Las madres fueron entrevistadas y respondieron a instrumento de rastreo psiquiatrico. Se evaluo la interaccion mediante un protocolo de interaccion diadica. 43,1% de los ninos presento riesgo de desarrollo. Aunque 44,6% de las madres presento malestar psicologico, su salud mental no se asocio con los comportamientos presentados en la interaccion. Sin embargo, comportamientos interactivos de la madre y del nino se asociaron con retraso en el desarrollo. La estimulacion cognitiva fue la unica variable predictiva de retrasos. Los datos contribuyen para la comprension del papel de la interaccion y el desarrollo infantil.

Risk factors for impaired development in children attended at family health units at the end of the first year of life: socio-demographic aspects and maternal mental health

The scope of this article is to evaluate risk and protection factors for the development of 1-year-olds assisted at family health care units. It is a cross-sectional study involving 65 children of approximately 1 year of age and their mothers attended at two family health care units. The development was assessed using a developmental screening test (Denver II). The mothers filled out the SRQ-20 questionnaire to identify common mental disorder (CMD) indicators. After data collection, descriptive and inferential statistical analysis was performed. Global development was at risk in 43.1% of the children evaluated, and the most affected areas were language and fine motor development; 44.6% of mothers had results indicative of CMD when the child was 1 year of age. In bivariate analysis, reported depression, smoking, infections in pregnancy, CMD after birth and working outside the home were significantly associated with the childrens development. After full statistical analysis, CMD was revealed as being a risk factor, and working away from home as being a protection factor. In order to increase the chances of success of programs targeted for children at health care units and avoiding the risk of impaired development, it is important to focus on two aspects: childrens stimulation and maternal mental health.The scope of this article is to evaluate risk and protection factors for the development of 1-year-olds assisted at family health care units. It is a cross-sectional study involving 65 children of approximately 1 year of age and their mothers attended at two family health care units. The development was assessed using a developmental screening test (Denver II). The mothers filled out the SRQ-20 questionnaire to identify common mental disorder (CMD) indicators. After data collection, descriptive and inferential statistical analysis was performed. Global development was at risk in 43.1% of the children evaluated, and the most affected areas were language and fine motor development; 44.6% of mothers had results indicative of CMD when the child was 1 year of age. In bivariate analysis, reported depression, smoking, infections in pregnancy, CMD after birth and working outside the home were significantly associated with the childrens development. After full statistical analysis, CMD was revealed as being a risk factor, and working away from home as being a protection factor. In order to increase the chances of success of programs targeted for children at health care units and avoiding the risk of impaired development, it is important to focus on two aspects: childrens stimulation and maternal mental health.

Calidad de Vida en Niños Prematuros: Factores de Riesgo y Protección

Considerando-se o aumento significativo nos indices de sobrevida de criancas nascidas prematuras, objetivou-se avaliar sua qualidade de vida em idade escolar e identificar possiveis fatores de risco e protecao. 57 criancas de 5 a 8 anos, nascidas prematuras, responderam a um teste cognitivo e os pais avaliaram seu comportamento e qualidade de vida. A maioria das criancas apresentou nivel intelectual medio ou superior. Apesar do leve prejuizo na qualidade de vida, observou-se alta prevalencia de problemas de comportamento nas criancas maiores. Identificou-se sexo masculino e problemas comportamentais como fatores de risco para qualidade de vida, sinalizando para a necessidade de servicos de acompanhamento antes do ingresso da crianca nascida prematura na escola, visando facilitar sua adaptacao.Given the significant increase in survival rates of prematurely born children, this study assessed their quality of life at school age and identified potential risk and protective factors. We included 57 children with premature birth aged 5 to 8 years. Participants completed a cognitive test, and their parents assessed their behavior and quality of life. Most children presented an average or high intellectual level. Despite the mildly compromised quality of life, we observed a high prevalence of behavioral problems in older children. Male participants and behavioral problems were identified as risk factors for lower quality of life; this finding indicates the need to implement systematic monitoring services to facilitate adaptation of premature born children when entering in the school.

Qualidade de Vida em Crianças Nascidas Prematuras: Fatores de Risco e Proteção

Considerando-se o aumento significativo nos indices de sobrevida de criancas nascidas prematuras, objetivou-se avaliar sua qualidade de vida em idade escolar e identificar possiveis fatores de risco e protecao. 57 criancas de 5 a 8 anos, nascidas prematuras, responderam a um teste cognitivo e os pais avaliaram seu comportamento e qualidade de vida. A maioria das criancas apresentou nivel intelectual medio ou superior. Apesar do leve prejuizo na qualidade de vida, observou-se alta prevalencia de problemas de comportamento nas criancas maiores. Identificou-se sexo masculino e problemas comportamentais como fatores de risco para qualidade de vida, sinalizando para a necessidade de servicos de acompanhamento antes do ingresso da crianca nascida prematura na escola, visando facilitar sua adaptacao.Given the significant increase in survival rates of prematurely born children, this study assessed their quality of life at school age and identified potential risk and protective factors. We included 57 children with premature birth aged 5 to 8 years. Participants completed a cognitive test, and their parents assessed their behavior and quality of life. Most children presented an average or high intellectual level. Despite the mildly compromised quality of life, we observed a high prevalence of behavioral problems in older children. Male participants and behavioral problems were identified as risk factors for lower quality of life; this finding indicates the need to implement systematic monitoring services to facilitate adaptation of premature born children when entering in the school.