Utilização de dispositivos digitais, funcionamento familiar e desenvolvimento da linguagem em crianças de idade pré-escolar: um estudo transversal / Use of digital devices, family functioning, and language development in preschool children: a cross-sectional study

RESUMO Objetivo Este estudo teve como objetivo analisar a relação entre a utilização de dispositivos digitais, o funcionamento familiar e o desenvolvimento da linguagem em crianças de idade pré-escolar. Método Estudo transversal, descritivo-correlacional com uma amostra de 93 díades pais-crianças. As crianças tinham uma média etária de 57,01 ± 9,95 meses, sendo a maioria do gênero feminino. Os instrumentos de recolha de dados incluíram um questionário sobre o uso de dispositivos digitais, a versão portuguesa da Escala de Avaliação da Flexibilidade e Coesão Familiar - Versão IV (FACES-IV) e o Teste de Linguagem - Avaliação de Linguagem Pré-Escolar (TL-ALPE). Resultados As respostas demonstram uma maior tendência para a utilização do smartphone, tablet e televisão entre 0 e 3 horas por dia nas crianças. Com a aplicação da FACES-IV e do TL-ALPE, verificou-se que a maioria das famílias participantes eram do tipo equilibrado e que a maioria das crianças apresenta um normal desenvolvimento da linguagem. Observaram-se relações estatisticamente significativas entre a FACES-IV e o TL-ALPE; a FACES-IV e a utilização de dispositivos digitais; a utilização de dispositivos digitais e o TL-ALPE. Verificou-se que crianças com um funcionamento familiar mais equilibrado pontuam mais alto nas provas do TL-ALPE e que o tempo de uso de dispositivos digitais pode comprometer o desenvolvimento da linguagem. Conclusão Destaca-se o impacto da utilização dos dispositivos digitais e o papel do funcionamento familiar no desenvolvimento da linguagem da criança, sugerindo que uma utilização moderada de dispositivos digitais e um funcionamento familiar equilibrado são fatores facilitadores de um bom desenvolvimento da linguagem.

ABSTRACT Purpose This study aimed to analyse the relationship between the use of digital devices, family function, and language development in preschool children. Methods This cross-sectional, descriptive-correlational study included a sample of 93 parent-child dyads. The children were of an average age of 57.01 ± 9.95 months, and the majority were female. The data collection instruments included a questionnaire on the use of digital devices, the Portuguese version of the Family Flexibility and Cohesion Evaluation Scale - Version IV (FACES-IV), and a Preschool Language Test (TL-ALPE). Results The findings showed a greater tendency of children to use smartphones, tablets, and television for 0-3 hours daily. The analysis of the responses on the FACES-IV and TL-ALPE instruments showed that most of the participating families were of the balanced type and that most children had normal language development. Statistically significant relationships were found between the FACES-IV subscales and TL-ALPE subtests, FACES-IV subscales and the use of digital devices, and the use of digital devices and TL-ALPE subtests. Notably, children in more balanced family functioning scored higher on TL-ALPE tests, and the time spent using digital devices may compromise language development. Conclusion This study highlights the impact of digital device use and the role of family functioning on children's language development, suggesting that moderate digital device use and balanced family functioning are facilitating factors for good language development.

Percepción de enfermedad, características de personalidad y dinámica familiar en niños y adolescentes afectados por VIH asistentes a instituciones prestadoras de servicios de salud / Illness perception, personality characteristics and family dynamic in children and teenagers affected by HIV, attended in institutions providing health services

Resumen Objetivo: Describir la percepción de enfermedad, características de personalidad y la dinámica familiar de niños y adolescentes afectados por VIH, teniendo en cuenta sus características sociodemográficas y la revelación o no del diagnóstico. Método: Es un estudio de tipo cualitativo, con diseño de teoría fundamentada. La muestra estuvo conformada por 14 niños y adolescentes afectados por VIH y diagnosticados desde su nacimiento, entre 6 y 15 años de edad. El muestreo fue no probabilístico intencional o con fines especiales. Se utilizó el test de Machover, el test de la familia y un cuestionario de preguntas abiertas y cerradas sobre percepción de enfermedad. Resultados: Se encontró que los participantes que no tienen conocimiento sobre su diagnóstico, a diferencia de los que han pasado por un proceso de revelación, poseen una autoimagen perturbada con tendencias a baja autoestima y autoconcepto pobre. A su vez, las conversaciones y los dibujos realizados por ellos sugieren sensación y tendencia a la soledad, inseguridad, deterioro a nivel de las relaciones familiares e interpersonales, evidenciando la existencia de una percepción de enfermedad negativa, que puede incidir en su desarrollo personal y social corroborando lo encontrado por Instone (2000), Trejos, Reyes, Bahamón y Alarcón (2014), Pérez Quiroz, et al. (2013) y Ehrenzweig (2005). Conclusiones: El presente estudio reconoce la importancia de llevar a cabo procesos adecuados de revelación del diagnóstico para el VIH en niños y adolescentes, permitiendo la mejora de su calidad de vida en pro de su desarrollo biopsicosocial teniendo en cuenta la normalización del ajuste psicológico y mantenimiento del cumplimiento terapéutico, atendiendo a las directrices internacionales sobre el tema de la revelación.

Abstract Objective: This paper aims to describe the perception of illness, personality characteristics and a family dynamic of children and adolescents affected by HIV, considering their social-demographic characteristics and the disclosure or non-disclosure of the diagnosis. Method: A qualitative study, with a grounded theory design was conducted. For data collection, 14 children and adolescents affected by HIV diagnosed from birth, between 6 and 15 years of age were sampled. This sampling was intentional non-probabilistic or special purposes. The Machover test, the family test and a questionnaire asking open and closed questions to describe illness perception were used. Results: As a result, it was evident that participants who have no knowledge of their diagnosis, unlike those who have gone through a disclosure process, have a disturbed self-image with tendencies to low self-esteem and poor self-concept. Likewise, conversations and drawings made by them showing tendency to loneliness, insecurity, and deterioration of family and interpersonal relationships, assuming a perception of negative illness, which can affect their personal and social development. Confirming Instone (2000) findings, Trejos, Reyes, Bahamón and Alarcon (2014), Pérez Quiroz, et al. (2013) and Ehrenzweig (2005). Conclusion: This study recognizes the importance of carrying out adequate diagnostic processes for children and adolescents affected with HIV, allowing the improvement of their quality of life and also, benefiting their psychosocial development, taking into account the normalization of psychological adjustment and preservation of therapeutic adherence. In accordance with international guidelines of HIV disclosure.

Unidos em torno da mesa: a dinâmica familiar na obesidade / United around the table: the family dynamics in obesity

A partir da Abordagem Sistêmica da Família, é apresentado o estudo de caso de um paciente com obesidade grave que está se preparando para realizar a cirurgia de redução de estômago em um hospital público de Brasília-DF. A coleta dos dados foi realizada em duas visitas domiciliares para construção do genograma familiar, colagem feita pela família e realização de duas tarefas. O estudo demonstra a forte ligação entre alimentação e pertencimento familiar, além de reforçar aspectos da dinâmica familiar de sistemas com membros obesos descritos na literatura, como: fronteiras internas difusas e externas rígidas; poucas atividades de lazer; ênfase à lealdade familiar; obesidade vista como único problema familiar e evitação de conflitos. Por fim, as autoras sugerem a ampliação à inclusão da terapia familiar no pré e pós-operatório de pacientes com obesidade grave.

From the perspective of the Family Systems Approach, a case study of a patient with severe obesity being prepared to perform surgery to reduce stomach in a public hospital in Brasilia-DF is presented. Data collection was performed in two home visits to construction of the genogram, family collage made by family and carry out two tasks. The study demonstrates the strong link between food and family membership, and strengthen aspects of family dynamics of systems with obese members of the literature, such as diffuse internal borders and external rigid, few leisure activities, emphasis on family loyalty; obesity seen as single family problem avoidance conflict. Finally, the authors suggest to expand the inclusion of family therapy in the preoperative and postoperative patients with severe obesity.

Terapia narrativa en la co-construcción de la experiencia y el afrontamiento familiar en torno a la impresión diagnóstica de TDAH / Narrative therapy in the co-construction of experience and family coping when facing an ADHD diagnosis

Este trabajo de investigación/intervención pretendió comprender la organización de la experiencia y el afrontamiento familiar en torno a la impresión diagnóstica de Trastorno por Déficit de Atención e Hiperactividad-TDAH, desde las narrativas construidas por el sistema en un contexto terapéutico. El diseño comprendió cuatro momentos y doce escenarios de intervención. Los resultados mostraron cómo las familias construyen narrativas dominantes de los síntomas manifiestos del niño desde las distinciones, prejuicios y creencias; y tienden a evidenciar coalición entre el niño y el cuidador, y culpabilización mutua entre los padres.

This investigation/intervention work sought to understand the organizationof the experience and family coping in families dealing with a diagnosticimpression of Attention Deficit and Hyperactivity Disorder (ADHD) fromthe narratives built by the system in a therapeutic context. The designunderstood four moments and twelve intervention scenarios. The resultsshowed as the families they build narrative dominant of the boy’s apparentsymptoms from the distinctions, prejudices and beliefs, and they spread to evidence coalition between the child and the person in charge of the childand the guiltiness between parents.

Grado de correlación en la percepción de la dinámica familiar entre ambos padres de preescolares que acuden a Guarderías del DIF Jalisco / Correlation of the family dinamic score between fathers and mothers of preschool children attending the integral development of the family system (DIF) of Guadalajara, Jalisco (Mexico)

Introducción. Objetivo: identificar la correlación entre la calificación de dinámica familiar de papá y mamá de preescolares que acuden a Guarderías del Sistema Nacional del Desarrollo Integral de la Familia Jalisco. Material y métodos. Estudio transversal analítico. Se incluyeron 138 encuestas de dinámica familiar aplicadas a ambos padres. Se utilizó un instrumento de medición con 8 áreas: I. Dinámica de pareja; II. Formación de identidad; III. Comunicación, expresión, solidaridad; IV. Estructura de autoridad; V. Manejo del conflicto y agresividad;VI. Disciplina y método; VII. Sistema de Valores; VIII.Aislamiento e integración sociocultural. Resultados. No hubo diferencia en la calificación entre ambos padres ni entre los promedios de las 8 áreas. Hubo una correlación significativa entre ambos padres (r = 0.759, P <0.001). El área I tuvo mayor correlación con las demás áreas (P <0.005). La correlación entre las diferentes áreas de papá y mamá fue significativo. Destacaron por ausencia de correlación: área III de papá vs área II y VIII de mamá; área IV de papá vs área I, II,VII y VIII de mamá. Conclusión. La elevada correlación de cada díada papá-mamá sobre su dinámica familiar, de sus áreas recíprocas y entre las áreas de cada cónyuge da gran consistencia al instrumento de evaluación.

Introduction. Objective: to test the correlation of the family dynamic score between fathers and mothers of preschool children attending the Integral Development of the Family System (DIF) of Guadalajara City. Material and methods. In a cross sectional study design 140 family dynamic surveys were included. Eight areas of the dynamic of the family of both parents were explored: I. Dynamic of the couple; II. Formation of identity; III. Communication, expression and solidarity; IV. Structure of the authority;V. Management of the conflict and aggressiveness;VI. Discipline and method;VII. System of values;VIII. Socio cultural integration and isolation. Results. There were not differences between fathers and mothers in the eight explored areas.The score of fathers and mothers had a significant correlation (r =0.759). Area I had the higher correlation with the rest of the areas (P <0.005).The correlation among different areas of father and mother were also significant. It was no correlation of area III of fathers vs area II and VIII of mothers; area IV of fathers vs area I, II,VII and VIII of mothers. Conclusion. The strong correlation of the family dynamic score of each couple and among the majority of reciprocal areas gives a high consistency to the instrument of evaluation.

Influencia de la dinámica familiar y otros factores asociados al déficit en el estado nutricio de preescolares en guarderías del sistema Desarrollo Integral de la Familia (DIF) Jalisco / Influence of associated factors on the nutritional status of preschool children attending a day care center system

Introducción. Objetivo: identificar la influencia de factores asociados al estado nutricio de preescolares en Guarderías del sistema de Desarrollo Integral de la Familia, Jalisco. Material y métodos. En estudio transversal analítico se incluyeron 140 preescolares de 15-71 meses estimando el déficit en indicadores antropométricos a -1 y -2 desviaciones estándar (DE). Se obtuvieron variables socioeconómicas, demográficas y educacionales. Se calificó la dinámica familiar de los padres, explorando: la dinámica de pareja; identidad; comunicación y expresión; autoridad; conflicto; disciplina; valores; aislamiento. Con la razón de momios (RM) se estimó el riesgo de desnutrición y en modelo de regresión se exploraron factores que explicaran la variación en déficit antropométrico y dinámica familiar. Resultados. Asociados a déficit peso/talla: menor escolaridad del padre (RM 2.96); menor puntuación en la dinámica familiar (madre) (RM 2.72); ocupación de madre (RM 2.27) y mayor tabaquismo del padre (RM 2.50). A déficit talla/edad mayor número de miembros en familia (RM 2.16) y menor puntuación en la dinámica familiar (madre) (RM 8.6). Ingreso familiar mensual y escolaridad del padre explicaron la variación en el índice peso/talla (P <0.025). Conclusión. La disfunción de la dinámica familiar, menor ingreso económico, y mayor número de miembros fueron factores de riesgo del estado nutricio. Menor ingreso familiar y escolaridad del padre influyeron en la percepción de ambos padres sobre su dinámica familiar.

Introduction. Objective: to identify the influence of associated factors to the nutritional status of preschool children attending a day care center system in the City of Guadalajara (Mexico). Material and methods. In a cross sectional study design 140 preschool children of 15-71 months of age were included. Deficit of -1 and -2 standard deviation (SD) of the anthropometrical indicators were also estimated. The family dynamic score of both parents was obtained exploring 8 parameters: I. Dynamics of the couple; II. Identity; III. Communication, expression and solidarity; IV. Authority; V. Conflict management; VI. Discipline and method; VII. System of values; VIII. Integration and isolation. The risk of malnutrition was also estimated. In a multiple regression model independent factors were included explaining the variation on anthropometric deficit and family dynamics. Results. Associated factors for weigh/height deficit: father's education (odds ratio [OR] 2.27); family dynamics score (mother) (OR 2.72); mother's occupation (OR 2.27) and cigarette consumption of fathers (OR 2.50). For height/age deficit: members in the family (OR 2.16) and family dynamics score (mother) (OR 8.6). Family monthly income and education of fathers explained the variation in the weight/height index (P <0.025). Conclusion. Dysfunction of the family dynamics, low income, number of members in the family, were risk factors for the nutritional status. Low income and education of fathers influenced the perception of both parents about their family dynamics.

Correlation between Personality, Family Dynamic Environment and Suicidal attempt among Korean Adolescents Population / 간호학회지

PURPOSE: The purpose of this study was to identify the rate of suicidal attempts, investigate difference of rate of suicidal attempts between students and delinquents, and examine correlation between personality, family dynamics, environment, and suicidal attempts among Korean adolescents. METHOD: Data were collected through questionnaire surveys. Internal consistencies for this questionnaire ranged from 0.63 to 0.88. The subject used in this study consisted of 922(delinquent : 367, student : 555), using the proportional stratified random sampling method. Statistical methods employed were Chi-square and t-test. RESULTS: 1) The rate of suicidal attempts were 10.8%, and the highest peak age of suicidal attempt was 17-18 year old (16.9%).2) Delinquents(19.6%) showed a higher rate of suicidal attempts than students (5.1%). Among the students, girls (43.3%) showed a higher rate of suicidal attempt than boys (19.1%). Whereas, boys (80.9%) showed a higher rate of suicidal attempt than girls (56.7%) among delinquents.3) Those who attempt suicide have more familial problem such as incest, psychosis, depression, attempted suicide, committed suicide, and alcoholism in their family. They also have more dysfunctional family dynamics, environment, and maladaptive personalities than non-attempters. CONCLUSIONS: Suicide and suicidal behaviors are multifaceted events. For suicide prevention, independent assessments of variables such as familial problems, personality, family dynamics, and environment must be considered.

The Influence of a Family Dynamic Environment, Personality, and Smoking on Delinquent Behavior Among Korean Adolescents / 간호학회지

PURPOSE: The purpose of this study was to determine the important factors on juvenile delinquency and to examine relationships between sex, age, the family environment, the personality of adolescents, smoking, and juvenile delinquency. Methods: Data collection was done through questionnaire surveys. The subjects for this study consisted of 1,948 adolescents delinquents : 784, students : 1,164 in Korea, using proportional stratified random sampling method. Statistical methods employed were chi-square, t-test and path analysis. Results: The results of this study were as follows : 1. The delinquent adolescents were reared in a more dysfunctional family environment, and had a higher maladaptive personality than the other student adolescents. 2. The delinquent adolescents showed the larger amount of smoking than the student adolescents. The cause of increased smoking tendency among delinquents simply were 'for social relation', 'for diversion', 'for nicotine addiction', whereas 'for tension relieving' among non-delinquent adolescents. 3. The most powerful contributors on delinquent behavior were antisocial personality tendencies, smoking, sex, strength of parent- child relationships, and the age of the adolescents in this order. Conclusions: Our cross-sectional findings indicate that smoking was one of the most powerful contributing variables to delinquent behavior, but family environment, personality, sex and age of adolescents were also proved to be strong exogenous variables to smoking in adolescents.

Development of Instrument for Assessing Family Dynamic Environmental Function Related to Juvenile Delinquency / 신경정신의학

OBJECTIVE: The importance of the family dynamic environment in the development and maintenance of delinquent behavior among adolescents is expanded by evidence that the childs problem behavior within the family generalizes to the delinquent behavior with peers in schools. Therefore, this study was done to develop an instrument for assessing family dynamic environment functioning related to juvenile delinquency. METHODS: This study was a methodological research for developing a family dynamic environment scale related to juvenile delinquency. Through the relevant literature review and individual interview using open-ended questions with adolescents in school, outpatient basis and juvenile corrective institution, the authors developed pre-questionnaire with 50 items for measuring family dynamic environment functioning. Statistical methods employed were Cronbach's alpha and factor analysis for testing reliability and validity of this questionnaire and t-test for mean difference between students and delinquent adolescents, using SAS program. Subjects of this study consisted of 2,177 adolescents including 1,206 students and 971 delinquent adolescents selected by proportional stratified random sampling method. RESULTS: 1) Five stable factors were extracted and these contributed 50.3% of the variance in the total score. All 42 items loaded above .35 on each factor. 2) Factor I was named as family psychological climate (17 items), factor II as parent-child relationship (7 items), factor III as paternal parenting attitude (6 items), factor IV as family stability (7 items), and factor V as maternal parenting attitude (5 items). 3) Comparison of these 5 factors between student adolescents and delinquent adolescents showed that there was a significant difference in factor I [t=4.28 (student), -4.29 (delinquent), p=.0000], factor II [t=-8.61 (student), -8.86 (delinquent), p=.0001], factor III [t=-2.52 (student), -2.50 (delinquent), p=.0118], factor IV [t=-13.59 (student), -13.66 (delinquent), p=.0000], factor V [t=-4.18 (student), -4.16 (delinquent), p=.0000], and total score [t=-6.20 (student), -6.21 (delinquent), p=.0000]. 4) Cronbach's alpha coefficiency for internal consistency was .947 for total 42 items and .922, .807,. .815, .777 and .709 for each 5 factors of family dynamic environment factors related to delinquent behavior. CONCLUSIONS: The authors concluded that this scale has a high validity and reliability for measuring family dynamic environment of the Korean adolescents. While high validity and reliability are essential parts for measuring instrument, other characteristics such as efficiency, simplicity, objectivity, comprehensibility, and others may also be important factors. Therefore, further study is needed for develop an ideal measuring instrument.