The use of toys by nursing as a therapeutic resource in the care of hospitalized children / El uso del juguete por la enfermería como recurso terapéutico en la atención al niño hospitalizado / O uso do brinquedo pela enfermagem como recurso terapêutico na assistência à criança hospitalizada

ABSTRACT Objectives: to describe the use of toys by nursing during the care of children in the inpatient unit; to analyze the factors that influence the use of therapeutic toys by nursing in the care of hospitalized children. Methods: qualitative research, conducted in a pediatric hospital in Rio de Janeiro between July and August 2019. Semi-structured interview and thematic analysis were used as methodological procedure. Results: the 12 nurses and 7 nursing technicians revealed minimizing fear, relieving tension, and creating a bond between the child and the professional as the main benefits; they use as resources: children's toys, hospital materials, cartoons, and children's videos. The high demand for work, deficit of human resources, and appropriate ludic materials are factors that interfere with the use of toys as a therapeutic resource. Final Considerations: although the participants recognize the importance of the toy as a therapeutic resource, there is no systematization of its use in pediatric practice.

RESUMEN Objetivos: describir uso del juguete por la enfermería durante la atención al niño en unidad de internación; analizar los factores que influencian la utilización del juguete terapéutico por la enfermería en la atención al niño hospitalizado. Métodos: investigación cualitativa, realizada en un hospital pediátrico de Rio de Janeiro entre julio y agosto de 2019. Procedimiento metodológico fue la entrevista semiestructurada y análisis temático. Resultados: los 12 enfermeros y 7 técnicos de enfermería revelan como principales beneficios minimizar miedo, aliviar tensión y construir vínculo entre niño y profesional; utilizan como recursos: juguetes del niño, materiales hospitalarios, dibujos animados y videos infantiles. La alta demanda de trabajo y el déficit de recursos humanos y materiales lúdicos apropiados son factores que interferen en el uso del juguete como recurso terapéutico. Consideraciones Finales: aunque los participantes reconozcan la importancia del juguete mientras recurso terapéutico, no hay sistematización de su utilización en la práctica pediátrica.

RESUMO Objetivos: descrever o uso do brinquedo pela enfermagem durante a assistência à criança na unidade de internação; analisar os fatores que influenciam a utilização do brinquedo terapêutico pela enfermagem no cuidado da criança hospitalizada. Métodos: pesquisa qualitativa, realizada em um hospital pediátrico do Rio de Janeiro entre julho e agosto de 2019. O procedimento metodológico foi a entrevista semiestruturada e análise temática. Resultados: os 12 enfermeiros e 7 técnicos de enfermagem revelam como principais benefícios minimizar o medo, aliviar a tensão e criar vínculo entre criança e profissional e; utilizam como recursos: brinquedos da criança, materiais hospitalares, desenhos animados e vídeos infantis. A alta demanda de trabalho e o déficit de recursos humanos e materiais lúdicos apropriados são fatores que interferem no uso do brinquedo como recurso terapêutico. Considerações Finais: embora os participantes reconheçam a importância do brinquedo enquanto recurso terapêutico, não há sistematização de sua utilização na prática pediátrica.

The use of toys by nursing as a therapeutic resource in the care of hospitalized children / El uso del juguete por la enfermería como recurso terapéutico en la atención al niño hospitalizado / O uso do brinquedo pela enfermagem como recurso terapêutico na assistência à criança hospitalizada

ABSTRACT Objectives: to describe the use of toys by nursing during the care of children in the inpatient unit; to analyze the factors that influence the use of therapeutic toys by nursing in the care of hospitalized children. Methods: qualitative research, conducted in a pediatric hospital in Rio de Janeiro between July and August 2019. Semi-structured interview and thematic analysis were used as methodological procedure. Results: the 12 nurses and 7 nursing technicians revealed minimizing fear, relieving tension, and creating a bond between the child and the professional as the main benefits; they use as resources: children's toys, hospital materials, cartoons, and children's videos. The high demand for work, deficit of human resources, and appropriate ludic materials are factors that interfere with the use of toys as a therapeutic resource. Final Considerations: although the participants recognize the importance of the toy as a therapeutic resource, there is no systematization of its use in pediatric practice.

RESUMEN Objetivos: describir uso del juguete por la enfermería durante la atención al niño en unidad de internación; analizar los factores que influencian la utilización del juguete terapéutico por la enfermería en la atención al niño hospitalizado. Métodos: investigación cualitativa, realizada en un hospital pediátrico de Rio de Janeiro entre julio y agosto de 2019. Procedimiento metodológico fue la entrevista semiestructurada y análisis temático. Resultados: los 12 enfermeros y 7 técnicos de enfermería revelan como principales beneficios minimizar miedo, aliviar tensión y construir vínculo entre niño y profesional; utilizan como recursos: juguetes del niño, materiales hospitalarios, dibujos animados y videos infantiles. La alta demanda de trabajo y el déficit de recursos humanos y materiales lúdicos apropiados son factores que interferen en el uso del juguete como recurso terapéutico. Consideraciones Finales: aunque los participantes reconozcan la importancia del juguete mientras recurso terapéutico, no hay sistematización de su utilización en la práctica pediátrica.

RESUMO Objetivos: descrever o uso do brinquedo pela enfermagem durante a assistência à criança na unidade de internação; analisar os fatores que influenciam a utilização do brinquedo terapêutico pela enfermagem no cuidado da criança hospitalizada. Métodos: pesquisa qualitativa, realizada em um hospital pediátrico do Rio de Janeiro entre julho e agosto de 2019. O procedimento metodológico foi a entrevista semiestruturada e análise temática. Resultados: os 12 enfermeiros e 7 técnicos de enfermagem revelam como principais benefícios minimizar o medo, aliviar a tensão e criar vínculo entre criança e profissional e; utilizam como recursos: brinquedos da criança, materiais hospitalares, desenhos animados e vídeos infantis. A alta demanda de trabalho e o déficit de recursos humanos e materiais lúdicos apropriados são fatores que interferem no uso do brinquedo como recurso terapêutico. Considerações Finais: embora os participantes reconheçam a importância do brinquedo enquanto recurso terapêutico, não há sistematização de sua utilização na prática pediátrica.

Distribution and drug resistance of pathogenic bacteria in lower respiratory tract of 276 hospitalized children / 公共卫生与预防医学

Objective To analyze the epidemiological characteristics and drug resistance of pathogenic bacteria in 276 hospitalized children with lower respiratory tract infection to facilitate prevention and treatment. Methods Among of 276 hospitalized children with lower respiratory tract infection from January 2019 to December 2021 were analyzed. Data on the distribution of pathogenic bacteria were collected and analyzed. At the same time, the information on drug resistance was collected, and the potential relationship between pathogen distribution and drug resistance was briefly analyzed and discussed. Results A total of 532 strains of pathogenic bacteria were detected in the blood samples from 276 patients in this study. There were 207 strains of Gram-positive bacteria, including 104 strains of Staphylococcus aureus, 96 strains of Staphylococcus epidermidis and 7 strains of others. Gram negative bacteria (325 strains) were 172 strains of Klebsiella and 153 strains of Escherichia coli. The distribution of pathogenic bacteria in different gender and age groups (under 5 years old, 5-10 years old, and over 10 -14 years old) was calculated separately. The results showed that the distribution of pathogenic bacteria in female children under 5 years old (n=49 cases) was different from the total population: the infection of Gram-positive bacteria was higher than that of Gram-negative bacteria, and the proportion of Staphylococcus epidermidis was the highest (P<0.05). The distribution characteristics of children of other ages and sexes were consistent with the total distribution characteristics. The resistance rate of Gram-positive bacteria to penicillin, erythromycin and clarithromycin was high, while the resistance rate of Gram-negative bacteria to ampicillin, cefazolin and cefuroxime was high. The distribution characteristics were the same in children of different sex and age. Conclusion The pathogenic bacteria in children with lower respiratory tract infection in pediatric ward are mainly Gram-negative bacteria, and the main pathogenic bacteria have a high resistance rate to common drugs. The distribution of pathogenic bacteria in female children under 5 years old is unique: the infection of Gram-positive bacteria is higher than that of Gram-negative bacteria, and the proportion of Staphylococcus epidermidis is the highest, which deserves attention. The clinical drug sensitivity test can be used as an important reference for the treatment of drugs to guide the rational selection of antibiotics.

Práxis lúdica no atendimento educacional hospitalar: revisão de literatura de teses e dissertações / Playful praxis in hospital education care: literature review of theses and dissertations

O objetivo do estudo foi identificar processos educativos decorrentes da práxis lúdica no contexto do atendimento educacional hospitalar (AEH) desde uma revisão de literatura. A metodologia foi a utilização de levantamento na Biblioteca Digital Brasileira de Teses e Dissertações ­ BDTD, no período de 2017 a 2021. Foram selecionadas e analisadas três dissertações. A análise permitiu a identificação dos seguintes processos educativos: ressignificação, enfrentamento da hospitalização, solidariedade, afetividade, motivação e sensibilidade. A práxis lúdica no AEH contribui no desenvolvimento educacional das crianças, assim como, no fazer docente do/a educador/a no contexto hospitalar. Os processos educativos identificados estão interligados numa perspectiva de transformação da realidade de hospitalização marcada pelo adoecimento, reafirmando a relevância desse atendimento.

The aim of this literature review was to identify the educational processes resulting from ludic praxis in the context of hospital educational care (HEC). The search of articles from 2017 to 2021, at Brazilian Digital Library of Theses and Dissertations resulted in three dissertations selected for analysis. The educational processes identified were: resignification, facing hospitalization, solidarity, affectivity, motivation and sensitivity. Findings showed that the ludic praxis in the HEC contribute to children educational development in this setting and to teaching activity of hospital educators. All the educational processes identified in the HEC are interconnected in a perspective of transformation of the hospitalization reality marked by illness, addressing the need for more research seeking to unravel educational processes that permeate the social practice of the HEC, reaffirming its relevance.

Development and validation of caregivers′knowledge-attitude-practice scale on safety precautions of children′s falling from bed in hospital / 中国实用护理杂志

Objective:To develop a scale of caregivers′ knowledge, attitude and practice (KAP) on safety precautions of children′s falling from bed in hospital, and test its reliability and validity.Methods:Based on the theory of KAP, the item pool was constructed by literature review and expert consultation. A convenient sampling method was used to investigate 380 caregivers of children admitted to Shanghai Children′s Medical Center, School of Medicine, Shanghai Jiao Tong University in May 2021. The reliability and validity of the scale was tested. Critical ratio method and correlation analysis method were used for item analysis of the scale. Validity analysis was conducted by detecting content validity and construct validity; reliability analysis was conducted by detecting internal consistency reliability and split-half reliability.Results:The formal scale finally developed comprised 17 items in 3 dimensions on knowledge, attitude and practice. The Cronbach′s α coefficient and split-half reliability of the overall scale were 0.739 and 0.841. The content validity of the scale was 0.991, and the content validity of each item was 0.890-1.000. Exploratory factor analysis has extracted 3 common factors, and the cumulative variance contribution rate was 60.57%.Conclusion:The scale of caregivers′ KAP on safety precautions of children′s falling from bed in hospital has good reliability and validity, and can be used as a tool to evaluate the knowledge, willingness or behavior of caregivers' participation in preventing falls.

Prevalencia de desnutrición en niños al ingreso hospitalario en 9 países latinoamericanos y análisis de sus factores asociados

RESUMEN Introducción: La desnutrición continúa siendo una causa frecuente de aumento de la morbimortalidad, especialmente en pacientes hospitalizados. Objetivo: Evaluar la tasa de desnutrición infantil observada al ingreso hospitalario en nueve países latinoamericanos y estimar el impacto de diversas condicionantes que pueden incidir en su desarrollo. Materiales y Métodos: Estudio descriptivo, transversal de niños de ambos sexos, de 0 a 18 años de edad, hospitalizados en nueve países latinoamericanos (Argentina, Chile, Cuba, Guatemala, México, Panamá, Paraguay, Uruguay y Venezuela). La información se obtuvo mediante encuesta y antropometría efectuada durante las primeras 48 horas de ingresados. Para la evaluación nutricional se evaluó el peso y la talla de los niños de acuerdo a los estándares de la Organización Mundial de la Salud (OMS). El análisis estadístico se realizó en el programa SPSS versión 24. Resultados: Del total de 5.366 pacientes, 45,2% eran mujeres y 46,5% menores de 2 años. Un 50,2% eran eutróficos, un 15,4% presentaba riesgo de desnutrir o desnutrición leve, un 12,5% desnutrición, un 14,2% sobrepeso o riesgo de obesidad, y un 7,7% obesidad. El 20,5% eran de talla baja. Los niños con 4 o más hospitalizaciones previas tuvieron mayor riesgo de presentar malnutrición por déficit (OR = 1,7). Las patologías cardiológicas presentaron un OR = 1,8 de presentar malnutrición por déficit. Conclusiones: La prevalencia de desnutrición en niños al ingreso hospitalario es moderada y se relaciona especialmente a patología cardiológica y a los antecedentes de varias hospitalizaciones previas.

ABSTRACT Introduction: Malnutrition continues to be a frequent cause of increased morbidity and mortality, especially in hospitalized patients. Objective: To evaluate the observed infant malnutrition rate at hospital admission in nine Latin American countries and to estimate the impact of various conditions that may affect their development. Materials and Methods: This was a descriptive, cross-sectional study of children of both sexes, from 0 to 18 years of age, hospitalized in nine Latin American countries (Argentina, Chile, Cuba, Guatemala, Mexico, Panama, Paraguay, Uruguay and Venezuela). The information was obtained through a survey and anthropometry carried out during the first 48 hours after admission. For the nutritional evaluation, the weight and height of the children were evaluated according to the standards of the World Health Organization (WHO). Statistical analysis was performed using SPSS version 24. Results: Of the total of 5,366 patients, 45.2% were female and 46.5% were under 2 years of age. 50.2% were eutrophic, 15.4% had a risk of malnutrition or mild malnutrition, 12.5% malnutrition, 14.2% overweight or at risk of obesity, and 7.7% were obese. 20.5% were short. Children with 4 or more previous hospitalizations had a higher risk of presenting deficiency malnutrition (OR = 1.7). Patients with cardiological pathologies presented an OR = 1.8 of presenting deficiency malnutrition. Conclusions: The prevalence of malnutrition in children at hospital admission is moderate and is especially related to cardiac pathology and a history of several previous hospitalizations.

Evaluación nutricional de niños menores de cinco años de edad durante la estancia hospitalaria en un Servicio de Salud de referencia / Nutritional evolution in children under the age of 5 during hospital stay in a reference health care service

Introducción: La desnutrición en niños hospitalizados es una causa frecuente de morbi mortalidad. La prevalencia de desnutrición hospitalaria pediátrica en América Latina es del 11 % en promedio (rango de 6 a 35 %). Objetivos: Evaluar la evolución nutricional de los niños menores de cinco años de edad, internados en la Cátedra y Servicio de Pediatría del Hospital de Clínicas, FCM UNA, al ingreso versus al egreso hospitalario durante el periodo 2016. Materiales y métodos: Diseño observacional, descriptivo, retrospectivo. Variables: edad, sexo, procedencia, peso al nacer, edad gestacional, peso al ingreso y al alta, talla, duración lactancia materna exclusiva, inicio de alimentación complementaria, escolaridad y ocupación materna, patología de base, diagnóstico de ingreso, días de internación, alimentación enteral y/o parenteral, días de ayuno, evolución. Tamaño muestral: 361 niños menores de cinco años de edad. Se evaluó el estado nutricional según estándares de la Organización Mundial de la Salud (OMS), a través del Programa ANTHRO v3.2.2. Estadística: medidas paramétricas y no paramétricas. T student. Significancia: p < 0,05. Resultados: Ingresaron 361 niños, 51,5% Masculino, Edad media: 15 meses (1-59 meses) Grupos: 56 % lactantes menores, 21% lactantes mayores y 23% preescolares, 87% de procedencia urbana. El. 26,6% presentó algún grado de desnutrición y 10,5 % desnutrición crónica. El 40 % de los pacientes presentaba alguna comorbilidad. La desnutrición durante la estancia hospitalaria fue del 8,2%. La asociación de uso de alimentación enteral y ganancia de peso fue significativa (p< 0,05). Ningún niño presentó kwashiorkor. Ningún óbito fue registrado. Conclusión: La prevalencia de desnutrición durante la hospitalización en niños menores de cinco años de edad es del 8,2 % en un hospital de referencia, menor al promedio en hospitales de América Latina.

Introduction: Malnutrition in hospitalized children is a frequent morbidity and mortality cause. The prevalence of in-hospital malnutrition in pediatric patients in Latin America has a mean rate of 11% (ranging from 6% to 35%). Objectives: Evaluate the nutritional evolution in children under the age of 5 admitted to the Service of Clinics Pediatrics, FCM-UNA, assessing their first Vs. last day of hospitalization during the 2016 period. Materials and methods: The design of the study was observational descriptive, longitudinal in time. Variables: age, gender, place of origin, birth weight, gestational age, weight at first and last day of hospitalization, beginning of complementary feeding, mother schooling years, mother occupation, previous diseases, admittance diagnose, complications, days of hospitalization, enteral or parenteral feeding, days of fasting, evolution. Sample size: 361 patients under the age of 5 years. Nutritional status was evaluated using z values for Weight/Age, Weight/Height, Height /Age (WHO 2006, ANTHRO Software). Statistical aspects: parametric and nonparametric tests. Student's t-test significant at p<0,05. Results: 361 children were admitted. 51.5% males, mean age of 15 months (1-59 months). Were 56% infants, 21% toddlers and 23% pre-schoolers, 87% from a urban background., 26.6% had some degree of malnutrition and 10.5% suffered from chronic malnutrition; 40,% of patients presented some comorbidity. Malnutrition during hospital stay: 8.2%. Association of enteral feeding and weight gain was significant (p<0,05). None developed Kwashiorkor. No deceased cases were found. Conclusion: The prevalence of malnutrition during hospitalization in children under the age of five years was 8.2% in a reference hospital, below the average among hospitals in Latin America.

O adoecimento, o tratamento e a relação paciente-médico-cuidador segundo a criança hospitalizada / Illness, treatment and the patient-doctor-caregiver relationship according to the hospitalized child

Este estudo buscou descrever como a criança enferma compreende seu adoecimento, tratamento e relação paciente-médico-cuidador em internação pediátrica. Participaram seis crianças hospitalizadas, de oito a 11 anos, que responderam à entrevista semiestruturada e Procedimento Desenho-Estória com Tema (PDE-T), sendo o material gravado, transcrito e submetido à análise qualitativa. O conteúdo revelou o impacto emocional e social do adoecimento e experiência de internação, vista como restritiva e punitiva, mas também como espaço de brincar e se relacionar com os pares. As crianças mostraram pouca participação na relação paciente-médico-cuidador, reconheceram seus médicos como atuantes no tratamento e a mãe, principal cuidadora, como mediadora dessa relação e fonte de apoio psicológico. A partir dos resultados, assinala-se a importância de intervenções psicossociais e multidisciplinares que auxiliem as crianças em suas demandas e favoreçam sua postura ativa nessa relação triádica, tão significativa no processo de cuidado em saúde da criança.

This study aimed to describe how the sick child understands hi illness, treatment and the patient-doctor-caregiver relationship in pediatric hospitalization. Six hospitalized children from eight to 11 years participated, who answered the semi-structured interview and the Desenho-Estória com Tema (PDE-T) procedure, and the material was recorded, transcribed and submitted to qualitative analysis. The content revealed the emotional and social impact of illness and hospitalization experience, seen as restrictive and punitive, but also as a space for playing and relating to peers. The children showed little participation in the patient-doctor-caregiver relationship, acknowledged their doctors' active role in their treatment and their mothers', main caregiver, as a mediator of this relationship and source of psychological support. From the results, is highlighted the importance of psychosocial and multidisciplinary interventions that help children in their demands and favor their active stance in this triadic relationship, so significant in the child's care process.

O enfermeiro e a criança: a prática do brincar e do brinquedo terapêutico durante a hospitalização / The nurse and the child: therapeutic toy and the practice of playing during hospitalization

Objetivou-se identificar o conhecimento dos enfermeiros quanto à prática do brincar e do Brinquedo Terapêutico na hospitalização da criança. Estudo descritivo com abordagem qualitativa, realizado com 10 enfermeiros que atuam em um hospital público infantil no Norte de Santa Catarina, por meio de uma entrevista semiestruturada, no ano de 2018. Os dados foram analisados conforme o método da análise temática. Emergiram quatro categorias temáticas: o brincar e o enfermeiro; o brincar como parte do tratamento; o brincar em um ambiente favorável; a abordagem do enfermeiro e o uso do brinquedo/Brinquedo Terapêutico. Os resultados mostram que os enfermeiros reconhecem a importância do brincar durante a hospitalização da criança, considerado uma forma de aproximação com o infante. Verifica-se também o desconhecimento dos enfermeiros em relação à tecnologia do uso do Brinquedo Terapêutico durante a hospitalização como uma ferramenta de cuidados da enfermagem. Ressalta-se a importância da abordagem deste conteúdo nos cursos de graduação em enfermagem, especialização e residência em enfermagem pediátrica e a realização de cursos de capacitação para os profissionais da prática assistencial (AU)

The objective of this study was to identify nurses' knowledge regarding the practice of playing and Therapeutic Toy in the hospitalization of children. Descriptive study with qualitative approach, conducted with ten nurses who work in a public children's hospital in northern Santa Catarina through a semi-structured interview, in 2018. The data were analyzed according to the thematic analysis method. Four thematic categories emerged: play and the nurse; play as part of treatment; play in a favorable environment; the nurse's approach and the use of the toy/Therapeutic Toy. The results show that nurses recognize the importance of playing during the child's hospitalization, considered a way of approaching the infant. Nurses' lack of knowledge regarding the technology of the use of the Therapeutic Toy during hospitalization as a nursing care tool is also verified. We emphasize the importance of addressing this content in undergraduate nursing, specialization and residency courses in pediatric nursing and conducting training courses for healthcare professionals (AU)

Programa de Promoción y Educación para la Salud Bucal, Destinado a Niños y Adolescentes Hospitalizados / Oral Health Education and Promotion Program for Hospitalized Children and Adolescents

La enfermedad sistémica es uno de los riesgos asociados al desarrollo de enfermedades bucales. Este programa fue orientado a promover la salud bucal de niños y adolescentes internados en la clínica de la cátedra de Pediatría del Hospital de Clínicas "José de San Martín". Se realizó un estudio descriptivo transversal sobre una muestra de 1140 individuos registrados entre los años 2008 y 2018. El objetivo fue analizar las variables que afectan su salud bucal. Para ello, cursantes de la Carrera de especialización en Odontopediatría de la UBA implementaron semanalmente un Programa de Promoción y Educación para la salud bucal, destinado a niños internados y sus acompañantes. Para el registro de caries se utilizó el Índice de Necesidad de Tratamiento comunitario (INTc), se analizó la dieta, el riesgo social y la presencia o no de cepillo dental. Se realizó prueba de Chi cuadrado para la comparación de las variables cualitativas, cálculo de medias, rangos, porcentajes y desvíos. Como resultado se observaron diferencias significativas del INTc en los pacientes con dieta cariogénica entre los distintos grupos de edad. El coeficiente asociado a la dieta es aproximadamente 5 veces mayor que el asociado al uso de cepillo. El INTc evidenció una media en preescolares de 2.45 con DS 2.47, en escolares de 4.59 con DS de 3.33 y en adolescentes fue de 4.02 con DS de 3.15. En conclusión, la salud bucal no está separada de la salud general, por lo que se destaca la necesidad de incorporar al odontólogo dentro del grupo interdisciplinario que atiende a niños hospitalizados. La dieta cariogénica fue la covariables con mayor efecto y luego el uso de cepillo dental (AU)

Informações transmitidas às famílias das crianças na emergência na perspectiva da Enfermagem / Nursing professionals' performance regarding the transmission of information to the relatives of children admitted to emergency care units / Información transmitida a las familias de los niños en la emergencia desde la perspectiva de la Enfermería

Objetivo: Analisar a atuação da enfermagem na transmissão das informações às famílias das crianças na emergência. Métodos: Pesquisa qualitativa. Os participantes foram 16 membros da equipe de enfermagem do setor de emergência de um hospital pediátrico público do Rio de Janeiro. O procedimento para a coleta dados foi à entrevista não diretiva em grupo, e os depoimentos foram submetidos à analise temática, à luz da Política Nacional de Humanização. Resultados: As informações transmitidas ao familiar/acompanhante foram relacionadas ao ambiente, normas e rotinas hospitalares, higiene corporal, procedimentos invasivos, e medicamentos. Três momentos distintos para a transmissão de informações foram identificados: admissão da criança, permanência na unidade e alta. Conclusão: A equipe de enfermagem reconhece o direito à informação das famílias das crianças e atua em todos os momentos da assistência à criança no setor de emergência. Acredita-se que a capacitação dos enfermeiros é fundamental para promover transformações na atuação da enfermagem

Objective: This paper analyzes the nursing professionals' performance regarding the transmission of information to the relatives of children admitted to emergency care units. Methods: This qualitative research was performed with 16 members of a nursing team working in an emergency unit of a public pediatric hospital in Rio de Janeiro city, Rio de Janeiro State, Brazil. Data collection was accomplished by using non-directive group interviews, and the statements were submitted to thematic analysis in the light of the Brazilian National Humanization Policy. Results: The information transmitted to the family member/companion was related to the environment, norms and routines, body hygiene, invasive procedures, and medications. Three distinct moments related to the transmission of information were identified: child's admission, stay and discharge within the unit. Conclusion: The nursing team recognized that the children's relatives have the right to information and provided continuous emergency care in the emergency unit. Training nursing professionals is fundamental to improve their performance

Objetivo: Analizar la actuación de la enfermería en la transmisión de informaciones a las familias de niños en la emergencia. Método: Investigación cualitativa. Participaron 16 miembros del equipo de enfermería del sector de emergencia de un hospital pediátrico público en Rio de Janeiro. Datos recolectados por entrevista no directiva en grupo; testimonios sometidos al análisis temático, a la luz de la Política Nacional de Humanización. Resultados: Las informaciones transmitidas a la familia/acompañante se relacionaron con el ambiente, normas y rutinas hospitalarias, higiene corporal, procedimientos invasivos y medicamentos. Emergieron tres categorías: admisión del niño; permanencia en la unidad y; alta. Conclusión: El equipo de enfermería reconoce el derecho a la información a la familia/acompañante y actúa en los momentos de asistencia al niño en emergencia. Se cree que la capacitación de enfermeros es fundamental para promover transformaciones en la actuación de la enfermería

Experiências familiares durante a hospitalização infantil: uma revisão integrativa / Family experiences during child hospitalization: an integrative review / Experiencias familiares durante la hospitalización infantil: una revisión integrativa

Objetivo: Desvelar o que vem sendo produzido pela enfermagem sobre as experiências enfrentadas pelos familiares de crianças hospitalizadas. Método: Revisão integrativa a partir da busca nas bases PubMed, LILACS e na biblioteca Virtual SciELO, utilizando os descritores: hospitalized child, family, nursing, durante o mês de janeiro de 2018. Selecionaram-se estudos publicados entre 2011 e 2017, nos idiomas inglês, português e espanhol. Após a análise dos dados, foram selecionados 31 estudos; Resultados: Elaborou-se as categorias: adaptação da rotina familiar; afastamento do restante da família e dos filhos sadios; desajuste diante da estrutura física e falta de conforto hospitalar; procedimentos médicos, enfermagem e normas/rotinas rígidas. Conclusão: A hospitalização de uma criança interfere significativamente na vida dos familiares, afetando seu relacionamento familiar, sua saúde física e mental e a manutenção de sua rede social

Objective: The study's purpose has been to unveil what has been produced by nursing professionals concerning the experiences faced by hospitalized children family members. Methods: It is an integrative literature review, which was performed in January 2018 based on the search in the PubMed, LILACS and SciELO databases, using the descriptors: hospitalized child, family, nursing. The selected studies were published from 2011 to 2017 in English, Portuguese, and Spanish languages. After data analysis, 31 studies were selected. Results: The following categories were elaborated: adaptation of the family routine, withdrawing away from the rest of the family and healthy children; maladaptation due to physical structure and lack of hospital comfort; medical procedures, nursing and strict rules/routines. Conclusion: Children hospitalization impacts significantly on their family life, affecting their family relationships, their physical and mental health, and the maintenance of their social network

Objetivo: Desvelar lo que viene siendo producido por la enfermería sobre las experiencias enfrentadas por los familiares de niños hospitalizados. Método: Revisión integrativa a partir de la búsqueda en las bases PubMed, LILACS y en la biblioteca Virtual SciELO, utilizando los descriptores: hospitalized child, family, health, durante el mes de enero de 2018. Se seleccionaron estudios publicados entre 2011 y 2017, en los idiomas Inglés, portugués y español. Después del análisis de los datos, se seleccionaron 31 estudios; Resultados: Se elaboraron las categorías: adaptación de la rutina familiar; alejamiento del resto de la familia y de los hijos sanos; desajuste ante la estructura física y falta de confort hospitalario; procedimientos médicos, enfermería y normas / rutinas rígidas. Conclusión: La hospitalización de un niño interfiere significativamente en la vida de los familiares, afectando su relación familiar, su salud física y mental y el mantenimiento de su red social

The effects of influenza-like illness definitions on influenza surveillance in hospitalized children / 中华疾病控制杂志

Objective To evaluate clinical factors associated with laboratory-confirmed influenza infection and probe into the effects of different influenza-like illness(ILI) definitions on influenza surveillance in hospitalized children. Methods The influenza surveillance on the hospitalized children with acute respiratory infection was carried out in Soochow university affiliated children’s hospital from October 2017 to May 2018. The definition of influenza-like illness(ILI), which proposed by world health organization (WHO), the European center for disease prevention and control (ECDC) and ministry of public health of China, was analyzed to determine the area under receiver operating characteristic curve (ROC), sensibility, specificity, and the positive and negative predictive values of the ILI definition using the laboratory evidence of influenza virus infection as golden criteria. Logistic regression model was employed to explore the risk factors of the laboratory confirmed influenza infection among the hospitalized children. Results Of the enrolled 1 459 hospitalized children, 204(14.0%) were lab-confirmed influenza cases. The ECDC definition had the highest sensitivity (91.7%, 95% CI: 87.9%-95.5%) but the lowest specificity (44.6%, 95% CI: 41.9%-47.4%). The WHO definition had the lowest specificity (70.6%, 95% CI: 64.3%-76.8%). China’s definition was the most discriminant definition with relatively high sensitivity (91.2%, 95% CI: 87.3%-95.1%) and specificity (51.5%, 95% CI: 48.8%-54.3%), and its positive area under curve value (71.2%, 95% CI: 67.9%-74.5%) was the highest. Multivariate analysis model showed that the detection rate of influenza virus in children with fever (≥38 ℃) was higher than that in children without fever (OR=7.03, 95% CI:3.89-12.70). Conclusions It is suggested to adopt China’s ILI definition to get better output during influenza surveillance among hospitalized children.

Analysis on distribution and epidemic characteristics of common pathogens of pneumonia among hospitalized children，Suzhou，2011－2018 / 中华疾病控制杂志

@#Objective To understand the distribution and epidemic characteristics of common pathogens of pneumonia among hospitalized children in Suzhou． Methods Nasopharyngeal secretions were collected from hospitalized children with clinical pneumonia admitted to the respiratory department of Children＇s Hospital Affiliated to Suzhou University from April 2011 to March 2018 to detect common viral and bacterial pathogens of children＇s pneumonia． Ｒesults The total positive rate of pathogens was 75. 6% in the 4 765 clinical pneumonia cases. The positive rate of bacterial pathogens was 57. 4%. Streptococcus pneumoniae ( SP) was the highest，followed by Haemophilus influenzae ( H. i) ; The positive rate of viral pathogens was 44. 1%. Ｒespiratory syncytial virus ( ＲSV) was the highest，followed by Bocavirus ( BoV) . The mixed infection rate of bacteria and virus was 25. 9%，and the most common types were ＲSV and SP，BoV and Streptococcus viride ( SV) ． Conclusions SP，H．i，ＲSV and BoV are the main pathogens of clinical pneumonia in children． There are statistical differences in different age groups and seasons of hospitalized children＇s pneumonia in Suzhou． The mixed infection rate of bacteria and virus is high．

Quedas entre crianças e adolescentes internados em hospitais: revisão integrativa de literatura Empatia em saúde: revisão integrativa / Caídas entre niños y adolescentes internos en hospitales: revisión integradora de literatura / Falls among children and teenagers in hospitals: an integrative literature review

Objetivo: investigar as taxas, as características, os fatores associados e as medidas preventivas relacionadas às quedas entre crianças e adolescentes em hospitais. Método: revisão integrativa de literatura realizada nas bases Scientific Electronic Library Online, Biblioteca Virtual em Saúde, National Library of Medicine e Google Scholar. Resultados: dez estudos atenderam aos critérios estabelecidos. As taxas variaram de 0.6 a 1.7 quedas por 1000 pacientes/dia. Grande parte das quedas ocorrem entre crianças do sexo masculino; com idade inferior a 9 anos. A maioria desses incidentes ocorrem na presença de um adulto. São fatores de risco para a ocorrência de quedas: idade da criança (p<0.01); tempo de internação (p<0.05); hiperatividade (p<0.01); distúrbios hematológicos (p<0.05); quedas anteriores (p<0.01); dimensionamento da enfermagem (p<0.00); escolaridade do cuidador (p<0.01) e o fato de o mesmo ser tabagista (p<0.01). As medidas preventivas adotadas foram: uso de berço e camas adequados para a idade, avaliação do risco de quedas, intervenções educacionais e uso de identificadores de alerta. Conclusão: A grande variação nas taxas de quedas entre os estudos sugere diferentes modos de organização do cuidado. A ocorrência de quedas no ambiente hospitalar entre crianças pode estar relacionada a fatores intrínsecos do paciente, do cuidador, ambientais e de organização do cuidado.

Objective: to investigate rates, characteristics, associated factors and preventive measures related to falls among children and adolescents in hospitals. Method: integrative literature review on the Scientific Electronic Library Online, Virtual Health Library, National Library of Medicine and Google Scholar. Results: ten studies met the established criteria. Rates ranged from 0.6 to 1.7 falls per 1000 patients / day. Most falls occur among male children; under the age of nine years old. Most of these incidents occur in the presence of an adult. Risk factors for falls are: age of the child (p <0.01); length of hospital stay (p <0.05); hyperactivity (p <0.01); hematological disorders (p <0.05); previous falls (p <0.01); nursing design (p <0.00); (p <0.01) and the fact that it was smoker (p <0.01). The preventive measures adopted were: use of cots and adequate beds for the age, evaluation of the risk of falls, educational interventions and use of alert identifiers. Conclusion: The large variation in falls rates between studies suggests different modes of care organization. The occurrence of falls in the hospital environment among children may be related to intrinsic patient, caregiver, environmental and care organization factors

Objetivo: investigar las tasas, las características, los factores asociados y las medidas preventivas relacionadas con las caídas entre niños y adolescentes en hospitales. Método: revisión integrativa de literatura realizada en las bases Scientific Electronic Library Online, Biblioteca Virtual en Salud, National Library of Medicine y Google Scholar. Resultados: diez estudios atendieron a los criterios establecidos. Las tasas variaron de 0.6 a 1.7 caídas por 1000 pacientes / día. Gran parte de las caídas ocurren entre los varones; con una edad inferior a 9 años. La mayoría de estos incidentes ocurren en presencia de un adulto. Son factores de riesgo para la ocurrencia de caídas: edad del niño (p <0.01); tiempo de internación (p <0.05); hiperactividad (p <0.01); trastornos hematológicos (p <0.05); caídas anteriores (p <0.01); el tamaño de la enfermería (p <0.00); escolaridad del cuidador (p <0.01) y el hecho de que el mismo sea tabacal (p <0.01). Las medidas preventivas adoptadas fueron: uso de cuna y camas adecuadas para la edad, evaluación del riesgo de caídas, intervenciones educativas y uso de identificadores de alerta. Conclusión: La gran variación en las tasas de caídas entre los estudios sugiere diferentes modos de organización del cuidado. La ocurrencia de caídas en el ambiente hospitalario entre niños puede estar relacionada a factores intrínsecos del paciente, del cuidador, ambientales y de organización del cuidado.

Molecular prevalence and clinical characteristics of human metapneumovirus and human bocavirus in 333 hospitalized children with community-acquired pneumonia / 中华实验和临床病毒学杂志

Objective@#To study the molecular prevalence and clinical characteristics of human metapneumovirus and human bocavirus in hospitalized children with community-acquired pneumonia.@*Methods@#Total 333 throat swabs and clinical information of patients were collected between 2017 and 2018 at Department of Pediatrics of No.2 Clinical Teaching Hospital, Chengde Medical University. The IgM of adenovirus (AdV), respiratory syncytial virus (RSV), influenza virus-A/B (Influ-A/B), parainuenza viruses (PIVs)were tested by detection kit, and the positive samples of human metapneumovirus (hMPV), human bocavirus (HBoV), AdV, RSV and human coronavirus (HCoV) were detected by RT-PCR or PCR.@*Results@#43 cases, 19 cases, 3 cases and 2 cases were positive for Influ-B, PIV, RSV and AdV IgM, respectively. Total 80 cases were infected with hMPV (71 cases were single infection, 8 cases were double infection, and 1 case was triple infection), 22 cases were infected with HBoV (14 cases were single infection, 7 cases were double infection, and 1 case was triple infection), 6 cases were infected with AdV (4 cases were single infection, 1 case was double infection, and 1 case was triple infection), only 1 case was single infected with RSV or HCoV, respectively. 39 cases (11.7%) and 41 cases (12.3%) were distributed at <5 years group and ≥5 years group, respectively. 45.0%(18/40)in severe cases and 27.99%(82/293)in mild cases were positive for hMPV, HBoV, AdV, RSV and HCoV, the ratio of viral positive case was significant higher in severe cases than mild cases (P=0.042). The age (P=0.000), peak of fever (P=0.035), duration of hospitalization (P=0.000), neutrophils (P=0.000) and lymphocytes (P=0.000) were significant difference in severe cases compared with mild cases.@*Conclusions@#Multiple respiratory viruses can cause community-acquired pneumonia and more attention should be pay to the surveillance of hMPV and HBoV.

Off-label use of antibiotics in hospitalised children in a tertiary care teaching hospital

Background: Children constitute one-third of the population and they suffer from a variety of infectious diseases and are commonly prescribed antibiotics. Most of the antibiotics lack sufficient information on safety and efficacy in children and are thus prescribed off-label. This study was envisaged to assess the off-label use of antibiotics in hospitalized children.Methods: Total 120 patients were included in the study. Off-label use was determined on the basis of product literature and National Formulary of India. Descriptive statistics was used to present the data i.e. percentage; proportions, frequency, mean and standard deviation using Microsoft excel worksheet.Results: A total of 791 drugs from different classes were prescribed to 120 patients with a mean of 6.6±2.68 drugs described per patient during their stay in the hospital. 100 out of 120 (83%) patients were prescribed at least one antibiotic during their stay in the hospital. Out of the 204 antibiotics prescribed, 43(21%) were prescribed off-label. Antibiotic dose was the most common reason followed by age (1month-1 year more than 2-6 years of age) and frequency in off-label use.Conclusions: Antibiotics are commonly prescribed to children with substantial off-label use. The same must be seriously addressed by the policy makers and stakeholders in order to promote their rational use.

Percepção de crianças hospitalizadas acerca do tratamento oncológico / The viewpoint of hospitalized children with regards to oncological treatment / La percepción de los niños hospitalizados sobre el tratamiento del cáncer

Objetivo: compreender a percepção de crianças, na faixa etária de seis a doze anos, acerca do tratamento em uma unidade oncológica pediátrica de Petrolina/Pernambuco. Método: pesquisa descritiva, com abordagem qualitativa, realizada em um hospital público, localizado no interior do estado de Pernambuco. Participaram cinco (05) crianças, na faixa etária de seis a doze anos, por meio da entrevista semiestruturada. A análise ocorreu tendo como referência a análise temática de conteúdo proposta por Bardin. Resultados: emergiram categorias que revelam a necessidade do processo terapêutico, as alterações da autoimagem e os procedimentos invasivos como importantes fontes de sofrimento para a criança e o familiar acompanhante; os aspectos negativos e positivos da experiência hospitalar; e os motivos pelos quais as crianças aderiam à terapêutica e enfrentavam a doença. Conclusão: estratégias devem ser priorizadas no sentido de estabelecer comunicação com a criança e a família, incluindo aspectos como o protocolo terapêutico, a rotina da unidade, os procedimentos invasivos, as modificações estéticas, dentre outros; organizar a unidade, considerando a rotina da criança e do familiar acompanhante; e os incentivar para a superação de dificuldades e para a adesão ao tratamento

Objective: To understand the perception of children, aged six to twelve, about the treatment in a pediatric oncology unit of Petrolina/ Pernambuco. Method: descriptive research with qualitative approach, performed in a public hospital, located in the state of Pernambuco. Attended by five (05) children, aged six to twelve years, through semi-structured interviews. The analysis took place with reference to the thematic content analysis proposed by Bardin. Results: categories emerged which show the need of the therapeutic process, changes in self-image and invasive procedures as important sources of suffering for the child and the accompanying family member; the negative and positive aspects of hospital experience; and the reasons why children adhere to therapy and faced the disease. Conclusion: strategies should be prioritized in order to establish communication with the child and family, including aspects such as the therapeutic protocol, unit routine, invasive procedures, a esthetic changes, among others; organize the unit, considering the routine of children and accompanying family member; and encourage them to overcome difficulties and adherence to treatment

Objetivo: Conocer la percepción de los niños, de seis a doce años de edad, sobre el tratamiento en una unidad de oncología pediátrica de Petrolina/Pernambuco. Método: estudio descriptivo con enfoque cualitativo, realizado en un hospital público, situado en el estado de Pernambuco. Con la asistencia de cinco (05) niños, de seis a doce años, a través de entrevistas semi-estructuradas. El análisis se llevó a cabo en relación con el análisis de contenido temático propuesto por Bardin. Resultados: categorías emergieron que muestran la necesidad Del proceso terapéutico, los cambios en la autoimagen y procedimientos invasivos como una importante fuente de sufrimiento para el niño y el miembro de La familia que acompaña; los aspectos negativos y positivos de la experiencia em el hospital; y las razones por las cuales los niños se adhieren a la terapia y se enfrentaron a la enfermedad. Conclusión: Las estrategias deben ser priorizadas para establecer la comunicación con el niño y su familia, incluyendo aspectos tales como el protocolo terapéutico, rutina unidad, procedimientos invasivos, los cambios estéticos, entre otros; organizar la unidad, teniendo en cuenta La rutina de los niños y miembro de la familia que acompaña; y alentarlos a superar las dificultades y la adherencia AL tratamiento

Current status of nutritional support for hospitalized children: a nationwide hospital-based survey in South Korea

BACKGROUND/OBJECTIVES: The prevalence of malnutrition among hospitalized children ranges between 12% and 24%. Although the consequences of hospital malnutrition are enormous, it is often unrecognized and untreated. The aim of this study was to identify the current status of in-hospital nutrition support for children in South Korea by carrying out a nationwide hospital-based survey. SUBJECTS/METHODS: Out of 345 general and tertiary hospitals in South Korea, a total of 53 institutes with pediatric gastroenterologists and more than 10 pediatric inpatients were selected. A questionnaire was developed by the nutrition committee of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition. The questionnaires were sent to pediatric gastroenterologists in each hospital. Survey was performed by e-mails. RESULTS: Forty hospitals (75.5%) responded to the survey; 23 of them were tertiary hospitals, and 17 of them were general hospitals. Only 21 hospitals (52.5%) had all the required nutritional support personnel (including pediatrician, nutritionist, pharmacist, and nurse) assigned to pediatric patients. Routine nutritional screening was performed in 22 (55.0%) hospitals on admission, which was lower than that in adult patients (65.8%). Nutritional screening tools varied among hospitals; 33 of 40 (82.5%) hospitals used their own screening tools. The most frequently used nutritional assessment parameters were weight, height, hemoglobin, and serum albumin levels. In our nationwide hospital-based survey, the most frequently reported main barriers of nutritional support in hospitals were lack of manpower and excessive workload, followed by insufficient knowledge and experience. CONCLUSIONS: Although this nationwide hospital-based survey targeted general and tertiary hospitals with pediatric gastroenterologists, manpower and medical resources for nutritional support were still insufficient for hospitalized children, and nutritional screening was not routinely performed in many hospitals. More attention to hospital malnutrition and additional national policies for nutritional support in hospitals are required to ensure appropriate nutritional management of hospitalized pediatric patients.

Adenovirus detection in 25 602 hospitalized children with respiratory tract infection / 重庆医学

Objective To investigate the characteristics of adenovirus infection in hospitalized children with respiratory tract infection in Shenzhen.Methods Nasopharyngeal swabs obtained from 25 602 children hospitalized with respiratory tract infections in Shenzhen Children's Hospital during 2014 to 2016,were tested for adenovirus with direct immunofluorescence assay.The detection rate of adenovirus and diagnosis in hospitalized children with respiratory tract infection were analyzed.Results The total adenovirus detection rate was 2.97 ％ in 25 602 samples,with a male to female ratio of 2.04:1,no significantly difference in detection rate in male (3.12％) and female (2.70％).Accounted for 724 (95.14％) of the total adenovirus positive detection children below six years old,and 409(53.75％) children were detected below two years old.There was a distinct seasonality;the detection rate was higher in summer and winter (x2 =36.631,P＜0.01).In 761 hospitalized patients of ADV positive,431 were pneumonia,109 were bronchitis,74 were tonsillitis,14 were conjunctivitis pharynx and 133 were acute upper respiratory infection.Conclusion Our study demonstrates that respiratory adenovirus infection is an important cause of hospitalization in children below the age of 6 years in Shenzhen,China.The detection rate was higher in summer and winter than spring and autumn.Most adenovirus positive children were diagnosed by pneumonia,bronchitis and acute upper respiratory tract infection.