Magda Andrade Rezende

Avaliação de habilidades de linguagem e pessoal-sociais pelo Teste de Denver II em instituições de educação infantil

Supervision and promotion of development are important care given to children enrolled in day-care centers and pre-schools. International and national organisms have systematized strategies to supervise child development but in Brazilian day-care centers this action is not well performed. OBJECTIVE: To assess, after a two-year follow-up, personal and social language abilities in a cohort of children enrolled in three day-care centers, in the city of Sao Paulo. METHODS: The sample group consisted of 30 children from 0 to 4 years, of a homogeneous socioeconomic level according to the tool of evaluation of urban poverty level. According to this tool all the families were in the upper level of the assessment. To evaluate the child development was used the Denver II, applied at two different moments, in the first year of follow-up of the cohort and once in the second year. RESULTS: In the personal and social areas, a significant improvement difference was observed from the 1st to the 2nd evaluation. In the language area no differences could be observed among the three evaluations, although age had a significant role as 3-year old children presented the worst results. Regarding sex, no significant differences were observed in the performance of the two areas. CONCLUSION: It is possible that performance in the personal and social areas has been improved by the day-care center conditions, what didn´t happen in area of language. Regarding this area, it could be affected by the adult/child ratio as with children older than 3 years, but further researches are needed inclusive continuity to this cohort.Supervisao e promocao do desenvolvimento infantil sao cuidados necessarios as criancas que frequentam creches e pre-escolas. Organizacoes de saude internacionais e nacionais tem sistematizado estrategias para tal, porem nas instituicoes brasileiras estas acoes sao pouco realizadas. OBJETIVO: Avaliar, pelo segundo ano consecutivo, habilidades das areas de linguagem e pessoal-social de uma coorte de criancas que frequentam 3 creches da cidade de Sao Paulo. METODO: O grupo amostral foi constituido por 30 criancas de 0 a 4 anos, de nivel socio-economico homogeneo segundo instrumento para avaliacao de nivel de pobreza urbana. Segundo este instrumento todas as familias estavam na faixa superior de classificacao. Para avaliacao do desenvolvimento foi usado o Teste de Triagem de Desenvolvimento de Denver II, empregado em dois momentos distintos no primeiro ano de acompanhamento da coorte, e uma vez no segundo ano. RESULTADOS: Na area pessoal-social a melhora foi significante da 1a para a 2a avaliacao, o que nao ocorreu na area de linguagem, ao longo das 3 avaliacoes. No entanto, a partir dos 3 anos de idade as criancas passaram a obter resultados piores. Quanto aos sexos nao houve diferencas significantes nos desempenhos nas duas areas. CONCLUSAO: E possivel que as habilidades das criancas na area pessoal-social tenham sido incrementadas pelas condicoes das instituicoes, o que nao ocorreu na de linguagem. Nao se pode afirmar a causa destes acontecimentos, embora seja intrigante a proporcao adulto/crianca que diminui apos as criancas completarem 3 anos de idade, mas outras pesquisas sao necessarias, inclusive a continuidade desta coorte.

O processo de comunicação na promoção do aleitamento materno

La lactancia materna es un comportamiento humano complejo que contribuye con la reduccion de la mortalidad y morbilidad infantil. Las investigaciones desarrolladas acerca de la experiencia vivida por las madres demuestran que amamantar, muchas veces, es una actividad dolorosa, sea psiquica o fisicamente. El personal de salud necesita estar capacitado para relacionarse con las madres y esto incluye tener habilidades de comunicacion. Las autoras presentan el proceso de comunicacion cuyo eje de abordaje este centrado en la persona. La utilizacion de esta comunicacion constituye un cuidado efectivo hacia la mujer.La lactancia materna es un comportamiento humano complejo que contribuye con la reduccion de la mortalidad y morbilidad infantil. Las investigaciones desarrolladas acerca de la experiencia vivida por las madres demuestran que amamantar, muchas veces, es una actividad dolorosa, sea psiquica o fisicamente. El personal de salud necesita estar capacitado para relacionarse con las madres y esto incluye tener habilidades de comunicacion. Las autoras presentan el proceso de comunicacion cuyo eje de abordaje este centrado en la persona. La utilizacion de esta comunicacion constituye un cuidado efectivo hacia la mujer.

Follow-up of the child's motor abilities in day-care centers and pre-schools

The aim was to describe the results of a developmental screening test in a cohort of 30 children attending 3 day-care centers in the city of Sao Paulo and develop hypotheses about these results. Thirty children were evaluated three times, during two years, by using the DDST. In the gross motor area the results improved (Tests of the Signs, 1st to the 3rd evaluation, p= 0.038*). There was a relationship between the age of the child (2 to 3 years) and worst results (Fishers Exact test, p= 0.013*). In the fine motor area the results improved (Tests of the Signs, 1st to the 2nd evaluation, p= 0.031*). So, the development of motor abilities improved after the children started attending the day-care centers. We must undertake more researches in order to attribute the specific influences of each area: day-care center and/or family.The aim was to describe the results of a developmental screening test in a cohort of 30 children attending 3 day-care centers in the city of São Paulo and develop hypotheses about these results. Thirty children were evaluated three times, during two years, by using the DDST. In the gross motor area the results improved (Tests of the Signs, 1st to the 3rd evaluation, p= 0.038*). There was a relationship between the age of the child (2 to 3 years) and worst results (Fishers Exact test, p= 0.013*). In the fine motor area the results improved (Tests of the Signs, 1st to the 2nd evaluation, p= 0.031*). So, the development of motor abilities improved after the children started attending the day-care centers. We must undertake more researches in order to attribute the specific influences of each area: day-care center and/or family.

A enfermeira e a equipe de enfermagem: segundo mães acompanhantes

Estudo realizado na unidade de internacao pediatrica de Hospital Escola do municipio de Sao Paulo, durante o segundo semestre de 2000. Trata-se de pesquisa qualitativa cujo objetivo foi (1) compreender se maes acompanhantes identificavam a enfermeira, bem como os outros componentes da equipe de enfermagem (tecnica e auxiliares), e (2) conhecer suas percepcoes acerca dos cuidados prestados pela equipe de enfermagem. Foram entrevistadas, individualmente, 8 maes acompanhantes das criancas internadas. Os discursos foram submetidos a analise tematica de conteudo. Obteve-se duas categorias: identificacao da enfermeira/equipe de enfermagem pelas maes acompanhantes e percepcao das maes acompanhantes acerca da equipe de enfermagem. Na primeira categoria constatou-se dificuldade na identificacao dos componentes da equipe de enfermagem. Na segunda, constatou-se que a atividade de enfermagem e percebida como subordinada a area medica. Eventualmente as maes tem dificuldade para distinguir o que e realizado pela enfermeira ou pelos outros componentes da equipe, mas todos os cuidados sao avaliados como muito bons. Alem disso, a enfermeira e percebida como aquela que resolve qualquer problema. Enfermagem e percebida pelas maes acompanhantes como atividade mediada pela representacao de maternidade. Conclui-se que o cuidado realizado por esta equipe, apesar de ser visto como muito bom, ainda precisa ser apresentado as maes como profissional e autonomo, a fim de se superar a visao estereotipada de enfermagem.This study was carried out at the Pediatrics Unit in a School Hospital of the city of São Paulo during the second semester of 2000. This is a qualitative research with the following objectives: (1) to understand how mothers with a child in hospital identify the nurse as well as other components of the nursing Staff (technicians and assistants) and (2) to learn about their perceptions about the care provided by the nursing staff. Eight mothers with a child hospitalized were individually interviewed. Speeches were submitted to a thematic analysis of the content. Two categories were observed: Identification of the nurse/nursing staff by mothers with a child in hospital and the perception of these mothers about the nursing staff. In the first category, the difficulty to identify the components of the nursing staff was observed. In the second, it was observed that the nursing activity is seen as subordinated to the medical area. Eventually, mothers have difficulty to distinguish what is performed by the nurse or by the other members of the staff but the entire nursing care is evaluated as very good. Besides, the nurse is considered as the one who solves the problem. Nursing is seen by these mothers as an activity mediated by the representation of motherhood. The care performed by this staff in spite of being considered as very good, still needs to be presented to mothers as professionals and self-employed in order to change a stereotyped view of nursing.

Aspectos éticos e estratégias para a participação voluntária da criança em pesquisa

Ethical issues about research with human beings have been addressed in health literature since decades. In spite of this, it is necessary to enhance actions to face many challenges, like the ones related to investigation of childhood. This paper presents and discusses ethical issues in research with children. It describes some strategies to perform with children, considering their developmental process and individual characteristics, in order to guarantee their voluntary participation in research.Ethical issues about research with human beings have been addressed in health literature since decades. In spite of this, it is necessary to enhance actions to face many challenges, like the ones related to investigation of childhood. This paper presents and discusses ethical issues in research with children. It describes some strategies to perform with children, considering their developmental process and individual characteristics, in order to guarantee their voluntary participation in research.

Ethical issues and strategies for the voluntary participation of children in research

Ethical issues about research with human beings have been addressed in health literature since decades. In spite of this, it is necessary to enhance actions to face many challenges, like the ones related to investigation of childhood. This paper presents and discusses ethical issues in research with children. It describes some strategies to perform with children, considering their developmental process and individual characteristics, in order to guarantee their voluntary participation in research.Ethical issues about research with human beings have been addressed in health literature since decades. In spite of this, it is necessary to enhance actions to face many challenges, like the ones related to investigation of childhood. This paper presents and discusses ethical issues in research with children. It describes some strategies to perform with children, considering their developmental process and individual characteristics, in order to guarantee their voluntary participation in research.

Acompanhamento das habilidades motoras de crianças que freqüentam creches e pré-escolas

The aim was to describe the results of a developmental screening test in a cohort of 30 children attending 3 day-care centers in the city of Sao Paulo and develop hypotheses about these results. Thirty children were evaluated three times, during two years, by using the DDST. In the gross motor area the results improved (Tests of the Signs, 1st to the 3rd evaluation, p= 0.038*). There was a relationship between the age of the child (2 to 3 years) and worst results (Fishers Exact test, p= 0.013*). In the fine motor area the results improved (Tests of the Signs, 1st to the 2nd evaluation, p= 0.031*). So, the development of motor abilities improved after the children started attending the day-care centers. We must undertake more researches in order to attribute the specific influences of each area: day-care center and/or family.The aim was to describe the results of a developmental screening test in a cohort of 30 children attending 3 day-care centers in the city of São Paulo and develop hypotheses about these results. Thirty children were evaluated three times, during two years, by using the DDST. In the gross motor area the results improved (Tests of the Signs, 1st to the 3rd evaluation, p= 0.038*). There was a relationship between the age of the child (2 to 3 years) and worst results (Fishers Exact test, p= 0.013*). In the fine motor area the results improved (Tests of the Signs, 1st to the 2nd evaluation, p= 0.031*). So, the development of motor abilities improved after the children started attending the day-care centers. We must undertake more researches in order to attribute the specific influences of each area: day-care center and/or family.

Amamentação: uma necessária mudança de enfoque

: During many years, the objective of the scientific production on breast-feeding has been the product: milk. However, researches during the 90.s, performed by nurses, have shown that this focus is iatrogenic: milk becoming more important than people (the mothers in this case) and that the fortresses must be seen as persons who are breastfeeding (or trying to do so). The breast-feeding process can be very painful, also causing premature weaning. The author proposes, in view of these considerations, care that is centered on the person of the fortress. It must also be remembered that the fortress needs adequate social-ambient surroundings to achieve breast-feeding and it is societys duty to provide them.Durante muitos anos o objetivo da producao cientifica sobre amamentacao tem sido o produto: o leite. No entanto, pesquisas da decada de 90, realizadas por enfermeiras, vem mostrando que este enfoque nao e adequado e que as nutrizes precisam ser vistas como pessoas que estao amamentando (ou tentando faze-lo). O processo de amamentar pode ser muito sofrido causando, inclusive, desmame precoce. Tendo em vista tais interpretacoes, propoe-se um cuidado centrado na pessoa da nutriz. Deve-se lembrar tambem que a nutriz precisa de circunstância socio-ambientais adequadas para conseguir amamentar e e dever da sociedade prove-las.During many years, the objective of the scientifc production on breast-feeding has been the product: milk. However, researches during the 90.s, performed by nurses, have shown that this focus is iatrogenic: milk becoming more important than people (the mothers in this case) and that the fortresses must be seen as persons who are breastfeeding (or trying to do so). The breast-feeding process can be very painful, also causing premature weaning. The author proposes, in view of these considerations, care that is centered on the person of the fortress. It must also be remembered that the fortress needs adequate social-ambient surroundings to achieve breast-feeding and it is societys duty to provide them.

ALEITAMENTO NATURAL E RELACTAÇÃO — ATUAÇÃO DA ENFERMEIRA

: The role of the nurse both in breastfeeding and in relactation is presented according to Leavells and Clarks levels of prevention. The authors describe the subject the mother should be taught during pregnancy and after delivery; they emphasize the preparation of the breasts for breastfeeding, the measures to be taken in periods of crisis and of hypogalactia, the procedures for promotion of relactation.

O trabalho sob a ótica das manipuladoras de alimentos de uma unidade hospitalar

OBJETIVO: Analisar as percepcoes acerca da atividade profissional de um grupo de manipuladores de alimentos de um hospital publico. METODOS: A pesquisa, de cunho qualitativo, foi realizada em um servico de nutricao e dietetica de um hospital publico de ensino da Cidade de Sao Paulo. Desenvolveu-se a partir de corpus obtido por tecnica do grupo focal realizada com 15 funcionarias, sendo 8 vinculadas ao lactario e 7 a cozinha dietetica. Os depoimentos foram gravados, transcritos e analisados sob o ponto de vista do conteudo e das representacoes sociais. Posteriormente, a validacao da analise foi realizada com as participantes. A caracterizacao socioeconomica foi realizada com uso de um formulario auto-aplicavel. RESULTADOS: O trabalho e percebido como crucial para a sobrevivencia, porem de grande responsabilidade social, alem de implicar em rotina exaustiva. Alem disso, constitui instância que possibilita apoio e relacionamento entre as trabalhadoras, embora nao lhes proporcione o status que julgam merecer. O trabalho e representado como instância simultânea de sofrimento e apoio; embora importante, tanto para elas mesmas, quanto para o grupo social. Ao mesmo tempo, chefias e os superiores se mostram alheios a todas as dificuldades. CONCLUSAO: Por consequencia, percebe-se que ha necessidade de mudancas na organizacao do trabalho, a fim de reduzir os fatores que ocasionam cansaco, descontentamentos e desânimo nas manipuladoras. Faz-se necessario maior investimento, por parte da chefia do servico, na adocao de estrategias gerenciais mais descentralizadas e participativas, respeitando, na medida do possivel, as opinioes e diferencas individuais, bem como investindo em treinamentos periodicos dos trabalhadores.