Luciane Soares de Lima

Fatores que interferem na transição alimentar de crianças entre cinco e oito meses: investigação em Serviço de Puericultura do Recife, Brasil

OBJECTIVES: to identify five- and eight-month old breast-feeding infants fed according to Health Ministry recommendations, cared for by the Instituto Materno Infantil Professor Fernando Figueira - IMIP Childcare Service; to ascertain the major problems faced by mothers in the process of weaning children; to identify the type of guidance given to mothers on how to initiate the food transition. METHODS: a descriptive, cross-sectional study was carried out involving 101 mothers/children aged between five- and eight-months who had initiated food transition between April and August 2003. The mothers were asked to participate in the study prior to a consultation with a physician, according to criteria for inclusion and exclusion. The children were classified in compliance with the norms established by the Ministry of Health regarding the food transition. RESULTS: it was found that 79.2% of the children did not meet the Ministry of Healths norms for food transition. The reasons for not complying with the norms mentioned by mothers were as follows: refusal on the part of the child (23.5%); interference of grandmothers (19%); practicality of preparation/provision of porridge compared with solid food (17.7%). As for the type of guidance, 97.4% claimed to have received spoken and written guidance at work. In the case of the sample studied, nurses and grandmothers had played a major role in providing guidance on the food transition, 77% and 16%, respectively. CONCLUSION: only 20.8% of the children displayed an adequate feeding standard complying with the norms of the Ministry of Health. The mother, who is the one usually responsible for child care, was influenced by family members, especially the grandmother, and by society at large. It was also found that the majority (97.4%) of the mothers received written as well as spoken guidance.

Capacidade funcional de idosos com doenças crônicas residentes em Instituições de Longa Permanência

The study aimed to describe the functional performance and the presence of chronic diseases in 164 elderly residents in long-stay institutions in Recife-PE, Brazil .A socio-demographic questionnaire, the Functional Independence Measurement, Lawtons scale and the Mini-Mental test were applied. Analysis of variance was used to assess differences in performance. The elders were predominantly single, women, and with low educational level. Among the reasons for admission stood out: abandonment, fragile health and living in the streets. It was found a high percentage of chronic diseases; 70% of elders were dependent for activities of daily living; and all were dependent for instrumental activities. Dementia was the disease that most affected functionality, followed by the osteoarticulares diseases and mental disorder. It was highlighted, among the impaired activities, the use of stairs and the sphincter control, with eating as the best performance. It was found that the institutionalized elderly showed functional impairment and social vulnerability.El objetivo de este estudio fue describir el desempeno funcional y la presencia de enfermedades cronicas en 164 ancianos de Instituciones de Larga Permanencia, en Recife-PE, Brasil. Fueron aplicados un cuestionario socio-demografico, la Medida de Independencia Funcional, la escala de Lawton y el Mini-mental. El analisis de varianza fue utilizado para valuar las diferencias de los resultados. Los ancianos eran predominantemente solteros, mujeres y con baja escolaridad. Entre los motivos de admision se destacaron: abandono, salud fragil y vivencia en la calle. Se encontro alto porcentual de enfermedades cronicas; 70% eran dependientes para las actividades de la vida diaria, y todos dependientes para las actividades instrumentales. La demencia fue la enfermedad que mas afecto la funcionalidad, seguida de las complicaciones osteoarticulares y del trastorno mental. Entre las actividades comprometidas se destaca el uso de escaleras y el control de esfinteres. La alimentacion fue la actividad de mejor desempeno. Se verifico que los ancianos institucionalizados presentaron comprometimiento funcional y situacion de vulnerabilidad social.

Associação entre controle ambiental domiciliar e exacerbação da asma em crianças e adolescentes do município de Camaragibe, Pernambuco

BACKGROUND: Hypersensitivity to dust mites, mold and pet dander found in the home is common among patients with asthma. Home environmental control to reduce exposure to allergens is one of various therapeutic measures that can be taken. OBJECTIVES: To determine the prevalence of adequate home environmental control among a study population monitored by the Family Health Program and to identify any possible correlation with the exacerbation of asthma among children between the ages of 5 and 14 in the city of Camaragibe, located in the state of Pernambuco, Brazil. METHOD: A transversal study was carried out involving 210 mothers/guardians of children, to whom International Study of Asthma and Allergies in Children questionnaires were administered in order to characterize the exacerbation of asthma attacks. The Environment Assessment Guide of Allergic Patients was used to assess the bedrooms and living rooms in the home. RESULTS: Among the 210 asthmatic children and adolescents evaluated in 2001, adequate home environmental control was observed in 141 (67.1%), and no correlation was observed between the degree of environmental control and fewer (< 3) asthma attacks (p = 0.39). Regarding the rooms where the asthmatic patients sleep, inappropriate furnishings were found in the homes of 93 patients (44.3%), including rag curtains in 84 cases (40.2%). Passive smoking was reported in 77 cases (36.7%). CONCLUSION: The level of home environmental control was satisfactory in the great majority of the residences, which may have contributed to the fact that no correlation was found between home environmental control and lower frequency of acute asthma attacks among the population studied.

Culture Circles in adolescent empowerment for the prevention of violence

An action research based on Paulo Freires Culture Circles was developed to implement a health education intervention involving adolescents, in collective knowledge construction about strategies for the prevention of violence. The data collection in the Culture Circles involved 11 adolescents and included observation and field diary, photographic records and recording. The educational action aroused a critical socio-political and cultural position in the adolescents towards the situations of vulnerability to violence, including the guarantee of human rights, justice and the combat of inequities; changes in the social relations, combat against discrimination and intolerance; expansion of access and reorientation of health services through intersectoral public policies. The intervention empowered the group of adolescents for the prevention of violence and permitted the inclusion of health professionals in the school context, from an interdisciplinary perspective, contributing to the establishment of social support and protection networks.

Therapeutic play to prepare children for invasive procedures: a systematic review,

OBJECTIVE To analyze the available evidence regarding the efficacy of using therapeutic play on behavior and anxiety in children undergoing invasive procedures. DATA SOURCE The systematic review search was performed in the MEDLINE, LILACS, CENTRAL and CINAHL databases. There was no limitation on the year or language. SYNTHESIS OF DATA The literature search found 1892 articles and selected 22 for full reading. Eight articles were excluded, as they did not address the objectives assessed in this review. Twelve studies, representing 14 articles, were included. The studies were conducted between 1983 and 2015, five in Brazil, one in the United States, five in China, one in Lebanon, one in Taiwan, and one in Iran. Most studies showed that intervention with therapeutic play promotes reduction in the level of anxiety and promotes collaborative behavior and acceptance of the invasive procedure. CONCLUSIONS Evidence related to the use of therapeutic play on anxiety and behavior of children undergoing invasive procedures is still questionable. The absence, in most studies, of the creation of a random sequence to assign the subjects to either the control or the experimental group, as well as allocation concealment, are factors that contribute to these questions. Another issue that characterizes an important source of bias is the absence of blinded evaluators. It is necessary to perform further studies that will take into account greater methodological stringency.Objective To analyze the available evidence regarding the efficacy of using therapeutic play on behavior and anxiety in children undergoing invasive procedures.

Intervenção educativa sobre violência com adolescentes: possibilidade para a enfermagem no contexto escolar

Objective: This study aimed to perform an educational intervention with adolescents on violence in schools context, using the Culture Circles. Methods: Action-research, with qualitative approach conducted in October 2011. Data collection include: participative observation with daily field notes, photographic recording and filming and production of the puppet theater group. Participants were 12 adolescents from a public school in Recife-PE. The analysis was performed by triangulating data in dialogue with the literature. Results: Problematization provided by Circle of Culture allowed the teenagers reveal the many manifestation facets of violence through situations of physical and verbal aggression among school members, threats against teachers and violence against property, even those symbolic practices involving forms of Bullying. Conclusion: The health education intervention has opened possibilities for nurse inclusion in the school setting in order to strengthen networking for the work to prevent violence.Este estudo objetivou realizar uma intervencao educativa com adolescentes sobre a violencia no contexto escolar, utilizando a metodologia de Circulos de Cultura. Metodos: Pesquisa-acao, de abordagem qualitativa, realizada em outubro de 2011. A coleta de dados incluiu: observacao participante com diario de campo, registro fotografico e filmagem, e, como producao do grupo, teatro de fantoches. Participaram 12 adolescentes de uma escola publica do Recife-PE. Para analise, recorreu-se a triangulacao de dados em dialogo com a literatura. Resultados: A problematizacao proporcionada pelo Circulo de Cultura permitiu aos adolescentes desvelar as diversas faces de manifestacao da violencia, mediante situacoes de agressao fisica e verbal entre os membros escolares, ameacas contra o professor e violencia contra o patrimonio, ate aquelas formas simbolicas envolvendo praticas de constrangimento. Conclusao: A intervencao de educacao em saude abriu possibilidades para insercao da(o) enfermeira(o) no cenario escolar a fim de fortalecer articulacoes em rede para o trabalho de prevencao a violencia.

Validação de material educativo para alta hospitalar de pacientes com prescrição de oxigenoterapia domiciliar prolongada

Objective: The aim of this study was to validate the content and understandability of the instrument of written communication, complementary educational material to hospital discharge for patients with prolonged home oxygen prescription. Methods: This is a descriptive study, in which a quantitative approach was used. In this study we developed an educational material in the form of folder regarding the use of oxygen, which was analyzed by five nurses, who suggested modifications. After completion of the folder changes, it was given to patients receiving Prolonged Home Oxygentherapy (PHO). Results: The assessment that patients had regarding the educational material was positive, as 100% of respondents rated themselves between good and excellent (or scores between 7 and 10). Conclusion: The role and function of nurses as health educators is confirmed since they need to use verbal and written communication to the healthcare process.

Qualidade de vida na asma brônquica: a concordância das percepções das crianças, adolescentes e seus pais

Objective: To evaluate the perception of the quality of life of asthmatic children and adolescents and their parents, investigating the agreement rates in each domain using the Pediatric Asthma Quality of Life Questionnaire - Adapted (PAQLQ-A). Methods: Cross-sectional study conducted at two outpatient clinics of a university reference center for asthmatic children and adolescents in Recife, Brazil. After meeting the ethical requirements, health-related quality of life data were collected using the version of the PAQLQ adapted and translated into Portuguese. The questionnaire was answered by 126 patients (70 children and 56 adolescents) and their parents. Agreement was analyzed by the Kappa statistic test using the computer program SPSS, version 13.0, software. Results: Agreement between children and parents’ answers varied from “unsatisfactory” to “poor”. The worst agreement rate was found in the domain symptoms, especially regarding the item “wheezing”, and in the domain emotions, regarding the item “feel bothered”. Agreement between adolescents and their parents’ answers varied from “unsatisfactory” to “fair”, with the worst agreement rate in the domain activities, especially in the item “feel bothered by not being able to be with other people”, and the best agreement rate was found in the domain emotions, in the item “feel uncomfortable.” Conclusions: The PAQLQ-A was not well understood by the studied population and agreement regarding the perception of the quality of life of asthmatic children and adolescents between patients and their parents was poor. Appropriate instruments adapted to regional characteristics or even revalidation of international instruments considering regional diversity should be developed.

Do pacifiers increase the risk of nosocomial diarrhoea? A cohort study.

Design Prospective cohort study. Setting Teaching paediatric hospital—Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Northeast Brazil. Participants 378 of 536 infants admitted in paediatric wards from April to October 2009 were daily assessed during hospital stay until the first episode of nosocomial diarrhoea (ND), death or discharge. Infants with community-acquired diarrhoea, respiratory or haemodynamic instability and who stayed in hospital for <24 h were excluded. Primary and secondary outcome measures Incidence and risk factors for ND and rates of pacifier faecal contamination. Results 33 ND episodes occurred in 378 infants, with a cumulative incidence of 8.7% and density of 11.25/1000 patients-day. ND occurred in 8.2% (16/194) of pacifier users compared with 9.2% (17/184) in non-users (adjusted OR=0.88, 95% CI 0.43 to 1.80). In multivariate logistic regression analysis, duration of oxygen use (OR=1.61; 95% CI 1.18 to 2.20) and days of antimicrobial use (OR=1.62, 95% CI 1.34 to 1.94) were associated with higher risk of ND, whereas being breast fed (OR=0.40, 95% CI 0.17 to 0.93) and each day of hospital stay (OR=0.65, 95% CI 0.53 to 0.80) were protective factors. Faecal coliforms were isolated in 16% (27/169) of tested pacifiers, 77.8% of which had more than 100 000 CFU/ml. The probability of a child remaining free of an episode of diarrhoea up to the seventh day of hospitalisation in the ward was 91.2% (95% CI 87.7% to 94.9%). The log-rank test showed no statistical difference between pacifier users and non-users. Conclusions ND is a frequent healthcare-associated infection in paediatric wards, but the use of pacifiers during the stay in hospital does not seem to affect the incidence of ND in infants in many settings where the burden of diarrhoea is still high.

Repercussão de uma intervenção educativa com agentes comunitários de saúde nas condições ambientais de domicílios de crianças asmáticas

OBJECTIVE: To determine the impact that an educational intervention employing problem-solving strategies for the environmental control of aeroallergens has on environmental conditions in the households of children with asthma. The intervention was carried out by community health agents. METHODS: This was a prospective intervention study. The community health agents visited 95 households in which there were children (2-10 years of age) who had recurrent episodes of wheezing and dyspnea. All of the households investigated were in the city of Iguatu, Brazil. The educational interventions involved focus groups and community health agents. The focus groups were asked to brainstorm the educational measures to be implemented, in order to devise problem-solving strategies. After the intervention, 84 households were revisited and reevaluated. RESULTS: After the intervention, there was a significant decrease in the use of brooms for cleaning the floor (p = 0.02), in the use of coal-burning stoves (p = 0.001), and in the number of stuffed toys (p = 0.05). There was also a significant post-intervention improvement in the environmental control of aeroallergens in the bedrooms of the children (p = 0.003). Conclusions: The educational intervention applied in this study proved to be an important tool for the target population, improving environmental conditions in the households of children with asthma