Translation, cross-cultural adaptation and validity study of the "Play Nicely Program: The Healthy Discipline Handbook" for use in Brazil.

OBJECTIVE: to describe the translation, cross-cultural adaptation and validity process of the "Play Nicely Program: The Healthy Discipline Handbook" for use in Brazil. METHODS: a methodological study that followed the translation, back-translation, expert committee assessment, and pre-test steps. The Content Validity Index (CVI) was calculated for both the judge population and the pre-test population. Four translators, seven expert judges in the field of child health and thirty participants in the pre-test, including parents, teachers and healthcare professionals, participated in the study. RESULTS: in experts' analysis (98.4%), a value of 100% of adequate assessments was obtained, and in the target population's analysis (89.5%), there were 100% of adequate assessments. In both analyses, suggested adaptations were made. CONCLUSIOS: cross-cultural adaptation and content validity into Brazilian Portuguese of the "Play Nicely Program: The Healthy Discipline Handbook" were considered adequate for application in the target population.

School reintegration of children and adolescents with chronic illness from the mothers' perspective: A qualitative study.

INTRODUCTION: The diagnosis of chronic illness in childhood implies frequent hospitalizations and, consequently, the interruption of school attendance. This study aimed to understand the process of school reintegration of children and adolescents with chronic illness from the mothers' perspective. METHOD: A qualitative descriptive-exploratory study was conducted with mothers who experienced the process of school reintegration of their child or adolescent, aged between 8 and 17 years old, and diagnosed with chronic illness. The participants were recruited by convenience and interviewed at the paediatric unit of a children's hospital. Data collection was interrupted when the data set was sufficient to answer the research question. The interviews were analysed using inductive thematic analysis. The study was approved by the research ethics committee. RESULTS: Eleven interviews were conducted, 10 with mothers and one with a grandmother, who played the maternal role. Participants' age ranged between 33 and 58 years old. A theme was developed-"School reintegration under the maternal vigilance"-which encompasses four subthemes: (1) What matters? My child's health comes first; (2) How to keep in touch with the school? (3) Back to the school: Are we ready? (4) Sharing vigilance: reality and expectations. The themes highlighted a cyclical, dynamic, and subjective school reintegration process, constantly permeated by maternal vigilance. CONCLUSION: A new understanding about school reintegration was evidenced, from the perspective of mothers of children and adolescents with different chronic illnesses. Mothers and children experience a nonlinear and recurrent process of leaving and returning to school, surrounded by a lack of communication and continuity in school activities. The results of this study may assist health professionals in planning care focused on the needs of the school reintegration of this population.

Translation, cross-cultural adaptation and validity study of the "Play Nicely Program: The Healthy Discipline Handbook" for use in Brazil / Traducción, adaptación transcultural y estudio de validación del "Play Nicely Program: The Healthy Discipline Handbook" / Tradução, adaptação transcultural e estudo de validação do "Play Nicely Program: The Healthy Discipline Handbook"

ABSTRACT Objective: to describe the translation, cross-cultural adaptation and validity process of the "Play Nicely Program: The Healthy Discipline Handbook" for use in Brazil. Methods: a methodological study that followed the translation, back-translation, expert committee assessment, and pre-test steps. The Content Validity Index (CVI) was calculated for both the judge population and the pre-test population. Four translators, seven expert judges in the field of child health and thirty participants in the pre-test, including parents, teachers and healthcare professionals, participated in the study. Results: in experts' analysis (98.4%), a value of 100% of adequate assessments was obtained, and in the target population's analysis (89.5%), there were 100% of adequate assessments. In both analyses, suggested adaptations were made. Conclusios: cross-cultural adaptation and content validity into Brazilian Portuguese of the "Play Nicely Program: The Healthy Discipline Handbook" were considered adequate for application in the target population.

RESUMEN Objetivo: desarrollar el proceso de traducción, adaptación transcultural y validación del "Play Nicely Program: The Healthy Discipline Handbook" para uso en Brasil. Métodos: estudio metodológico, siguiendo las etapas de traducción, retrotraducción, evaluación por el comité de jueces y preprueba. Se calculó el Índice de Validez de Contenido (IVC) tanto para la población de jueces como para la población previa a la prueba. Población de estudio: cuatro traductores, siete jueces expertos en el área de salud infantil y treinta participantes en la preprueba con padres, docentes y profesionales de la salud. Resultados: en el análisis de los especialistas (98,4%), se obtuvo un valor de 100% de valoraciones adecuadas y, en el análisis de la población objetivo (89,5%), Se totalizó el 100% de las evaluaciones adecuadas. En ambos análisis, se realizaron adaptaciones sugeridas. Conclusiones: la adaptación transcultural y la validación de contenido para el portugués brasileño del "Play Nicely Program: The Healthy Discipline Handbook" se consideraron adecuadas para su aplicación en la población objetivo.

RESUMO Objetivo: desenvolver o processo de tradução, adaptação transcultural e validação do "Play Nicely Program: The Healthy Discipline Handbook" para uso no Brasil. Métodos: estudo metodológico, seguindo as etapas de tradução, retrotradução, avaliação do comitê de juízes e pré-teste. Foi calculado o Índice de Validade de Conteúdo (IVC) tanto para a população de juízes quanto para a população do pré-teste. População do estudo: quatro tradutores, sete juízes especialistas na área de saúde da criança e trinta participantes no pré-teste com pais, professores e profissionais da saúde. Resultados: na análise dos especialistas (98,4%), obteve-se valor de 100% de avaliações adequadas e, na análise da população-alvo (89,5%), totalizaram-se 100% de avaliações adequadas. Em ambas análises, foram realizadas adaptações sugeridas. Conclusão: a adaptação transcultural e a validação de conteúdo para o português do Brasil do "Play Nicely Program: The Healthy Discipline Handbook" foram consideradas adequadas para a aplicação na população-alvo.

Parental psychosocial needs in Brazilian paediatric intensive care units.

BACKGROUND: Having children admitted in the intensive care unit is a demanding experience for parents. They encounter several difficulties during this process, and it is important to properly identify their psychosocial needs for the health team to address appropriately. OBJECTIVE: The aim of the study is to identify the psychosocial needs encountered by parents of children in pediatric intensive care units in Brazil. METHODS: A descriptive study with a qualitative approach was used to increase understanding of psychosocial experiences of parents. Individual semi-structured interviews were conducted with 11 parents of hospitalized children in pediatric intensive care units in Brazil. Thematic analysis was used to analyze the data. The university ethics review committee approved the research protocol. All parents were informed on study details and provided written consent prior to the interview. RESULTS: Four themes were constructed: 1) Support from family and peers; 2) Support from the healthcare team; 3) Parental role; and 4) Emotional recovery. Parents expressed diverse psychosocial needs based on family and peer social support, child's clinical condition, as well as the structure, norms, and routines of health care teams during hospitalization. CONCLUSIONS: The findings highlight the importance of nursing assessment of psychosocial experiences encountered by parents of children in pediatric intensive care units, which will guide planning of individualized interventions and to increase family-centered care in pediatric intensive care units.

Understanding the spirituality of parents following stillbirth: A qualitative meta-synthesis.

This meta-synthesis aims to synthesize qualitative evidence from primary studies to better understand the experience of the spirituality of parents and its relationship to adapting following stillbirth. Five electronic databases were systematically searched and the quality of 21 eligible studies was critically appraised. A thematic synthesis revealed two analytical themes: (1) Spiritual suffering following stillbirth; (2) Moving through spirituality to adapt to the loss, each encompassing four descriptive themes. The findings can inform a more culturally and spiritually sensitive approach to care, taking into account the parents' beliefs, folk customs, religion, values, and spiritual needs.

The Experiences of Bereaved Parents After the Loss of a Child to Cancer: A Qualitative Metasynthesis.

This study aims to synthesize qualitative evidence about the bereavement experience of parents following the death of a child due to cancer. A qualitative metasynthesis was conducted from searching five databases. The search identified 650 articles that were independently assessed by two reviewers. Thirty-one articles were selected for full-text reading and assessed for eligibility; a total of 14 articles were included in the final sample and submitted to quality appraisal. The software NVivo® was used to organize the data and support the thematic analysis procedures. Two analytical themes were constructed: (1) losing a child and facing a rupture in identity and sense of life and (2) surviving grief and reengaging in life. The grief process was dynamic, continuous, and begun before the death of the child. Fathers and mothers reacted differently to the loss and experience of grief. The loss of a child definitively changed the parents' life and caused identity crisis and loss of life's purpose. During the process of survival, parents constructed new meanings that helped them cope with grief; they used strategies that allowed them to recover their sense of purpose in life. Synthesizing the experience of bereaved parents is essential to improve the support families of children with advanced cancer receive to better cope with their suffering and loss, before and after the child's death.

The experience of health-related quality of life in extended and permanent cancer survivors: A qualitative systematic review.

OBJECTIVE: This qualitative systematic review aims to synthesize qualitative evidence from primary studies on experiencing health-related quality of life (HRQoL) in extended and permanent cancer survivors. METHODS: A systematic literature search was performed in PubMed, CINAHL, LILACS, PsycINFO, Scopus, and Web of Science. It followed guidelines from the statement in the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ). A quality appraisal of each study was undertaken using the Critical Appraisal Skills Programme. Data synthesis was conducted according to the thematic synthesis approach. Confidence in each review finding was assessed using the Confidence in the Evidence from Reviews of Qualitative research (Grade-CERQual). RESULTS: Twenty-four studies from nine countries were selected for the final sample. Analysis of the studies' results allowed for the construction of nine descriptive themes that were interpreted into three analytical themes: "The body as a representation of HRQoL," "Living through and beyond cancer: the re-signification of HRQoL," and "Employing resources to improve HRQoL." According to the CERQual approach, moderate confidence estimations were achieved for the results. CONCLUSIONS: The themes reflect that the HRQoL experience is re-signified by survivors from the privilege of being alive. This process happens with the support of social resources, family, hope, and spirituality. Based on the findings, it is suggested that health staff should be able to recognize the impact that cancer survival has on HRQoL and develop a care plan that addresses needs to sustain health in these survivors.

Informações aos pais durante o tratamento do câncer infantil: um estudo descritivo / Information to parents during childhood cancer treatment: a descriptive study

OBJETIVO: Este estudo teve como objetivo explorar a perspectiva de pais de crianças com câncer na busca de informações em diferentes momentos do tratamento. MÉTODO: Estudo descritivo, qualitativo. Realizaram-se entrevistas semiestruturadas com 22 pais em dois hospitais públicos de São Paulo, Brasil. Os dados foram analisados segundo os procedimentos da análise de conteúdo indutiva. RESULTADOS: Não foi observado um padrão na busca por informações na trajetória da doença, mas necessidades diferentes quanto ao tipo de informação, à medida que a criança ou adolescente avança dentro do plano terapêutico. As principais fontes de informação apontadas foram: os médicos, outros profissionais de saúde que não o enfermeiro e a internet. O médico ainda é a referência como fonte de informação. O enfermeiro apresentou um papel bem modesto em relação às suas possibilidades de atuação enquanto educador e provedor de informações. Pais e mães evidenciaram a necessidade de informações claras e individualizadas. CONCLUSÕES: Espera-se que os profissionais envolvidos no cuidado dessa clientela estejam dispostos a fornecer informações e adotar estratégias para simplificar as informações fornecidas, a fim de preparar os pais para o processo de tomada de decisão durante o tratamento

OBJETIVO: Este estudio tuvo como objetivo explorar la perspectiva de los padres de niños con cáncer en la búsqueda de información en diferentes momentos del tratamiento. MÉTODO: Estudio descriptivo, con enfoque cualitativo. Las entrevistas semiestructuradas fueran desarrolladas con 22 padres en dos hospitales públicos de Sao Paulo, Brasil. Los datos se analizaron mediante análisis de contenido inductiva. RESULTADOS: No se observó un estándar en la búsqueda de información en el curso de la enfermedad, pero diferentes requisitos en cuanto al tipo de información según el avance del niño o adolescente en el plan de tratamiento. Las principales fuentes de información fueron: médicos, otros profesionales de salud que no enfermeras y Internet. El médico sigue siendo la referencia como fuente de información. La enfermera tiene papel muy modesto en relación con sus posibilidades de actuación como proveedora de información. Los padres pusieron de relieve la necesidad de una información clara e individualizada. Se espera de los profesionales implicados en la atención a esta clientela la disposición a proporcionar la información y la adopción de estrategias para simplificar la información proporcionada con el fin de preparar los padres para cuidar y para el proceso de toma de decisiones durante el tratamiento

OBJECTIVE: The study aimed to explore the perspective of parents of children with cancer when searching for information at different points in the treatment. METHOD: This is a descriptive study with qualitative data analysis. Semistructured interviews were conducted with 22 parents at two public hospitals in the city of São Paulo, Brazil. The data were analyzed using inductive content analysis. RESULTS: We did not observe a pattern in the search for information during the disease trajectory, but different needs regarding the type of information as the child or adolescent advances within the therapeutic plan. The primary sources of information were: doctors, other health professionals than nurses and the internet. The doctor remains the reference as a source of information. Nurses presented a very modest role concerning their possibilities to serve as educators and information providers. Parents stressed the need for precise and individualized information. CONCLUSIONS: The professionals involved in the care for this population are expected to be ready to provide information and to adopt strategies to simplify the information given to enable these families for care and for the decision-making process during treatment

Terapia medicamentosa no domicílio: experiências de mães de crianças e adolescentes com anemia falciforme / Terapia medicamentosa en domicilio: experiencias de madres de niños y adolescentes con anemia de células falciformes / Home-based medication therapy: experiences of mothers of children and adolescents with sickle cell anemia

RESUMO Objetivo: descrever as experiências de mães de crianças e adolescentes com anemia falciforme acerca da terapia medicamentosa no domicílio. Método: estudo descritivo, com análise qualitativa dos dados, realizado em setembro de 2016. Foram entrevistadas oito mães de crianças e adolescentes, em tratamento para doença falciforme, em Unidade de Internação e Ambulatório de Pediatria de um hospital terciário da capital paulista. Os dados foram organizados, codificados e apresentados em categorias, conforme procedimentos preconizados para análise de conteúdo. Resultados: as mães apresentaram desconhecimento acerca dos cuidados durante a administração dos medicamentos no domicílio, bem como de eventuais efeitos adversos, mecanismo de ação e benefícios das medicações utilizadas. Conclusão: confirmou-se a necessidade da atuação do enfermeiro na orientação das mães para a administração segura e correta dos fármacos no domicílio, a fim de reduzir complicações relacionadas com absorção do medicamento, supressão terapêutica e exposição indevida dos cuidadores à droga.

RESUMEN Objetivo: describir las experiencias de madres de niños y adolescentes con anemia de células falciformes acerca de la terapia medicamentosa en domicilio. Método: estudio descriptivo, con análisis cualitativo de los datos, desarrollado en septiembre del 2016. Fueron entrevistadas ocho madres de niños y adolescentes sometidos a tratamiento para enfermedad de células falciformes en Unidad de Internación y Ambulatorio de Pediatría de un hospital terciario de la capital del estado de São Paulo. Los datos fueron organizados, codificados y presentados en categorías, según los procedimientos recomendados para análisis de contenido. Resultados: las madres mostraron desconocimiento acerca de los cuidados durante la administración de los medicamentos en domicilio, y también de eventuales efectos adversos, mecanismo de acción y beneficios de las medicaciones utilizadas. Conclusión: se confirmó la necesidad de actuación del enfermero en la orientación de las madres para la administración segura y correcta de los fármacos en domicilio, con objeto de reducir complicaciones relacionadas a la absorción del medicamento, supresión terapéutica y exposición indebida de los cuidadores a la droga.

ABSTRACT Objective: describe the experiences of mothers of children and adolescents with sickle cell anemia with regard to home-based medication therapy. Method: descriptive study with qualitative data analysis, developed in September 2016. Eight mothers of children and adolescents under treatment for sickle cell disease were interviewed at the Pediatric Inpatient and Outpatient Service of a tertiary hospital in the state capital of São Paulo. The data were organized, coded and presented in categories, following content analysis procedures. Results: the mothers presented lack of knowledge on care during home-based medication administration, as well as on possible adverse effects, the action mechanism and benefits of the medication used. Conclusion: nurses need to act in advising the mothers for safe and correct drug administration at home, with a view to reducing complications related to the absorption of the drug, therapeutic suppression and caregivers' undue exposure to the drug.

Care provided by the father to the child with cancer under the influence of masculinities: qualitative meta-synthesis / Cuidado paterno del hijo con cáncer bajo la influencia de las masculinidades: metasíntesis cualitativa / Cuidado paterno ao filho com câncer sob influência das masculinidades: metassíntese qualitativa

ABSTRACT Objective: To synthesize and interpret findings and conclusions of qualitative research addressing the experience of the father in the care of the child with cancer. Method: Meta-synthesis of 16 qualitative studies from six databases, analyzed through taxonomic analysis. Results: Child and adolescent cancer have several repercussions on the daily life of the father, especially related to the stigma around the disease, the fear of the unknown and the social and family role. Faced with the illness and the need to care for the child, the father seeks to recover normality in the family and transitions between hegemonic masculine behaviors and practices culturally recognized as female. Final Considerations: The complex experience of the father, influenced by masculinities, was evidenced. The limitations regard the restricted understanding of the contextual specificities of the experiences, due to the limited characteristics of the parents and children described in the studies. The knowledge produced is useful to promote involvement of fathers in the care of the child, as well as to strengthen and assist him in this task.

RESUMEN Objetivo: Sintetizar e interpretar resultados y conclusiones de investigaciones cualitativas sobre la experiencia del padre en el cuidado del hijo con cáncer. Método: Metasíntesis de 16 estudios cualitativos recogidos en seis bases de datos y examinados mediante análisis taxonómica. Resultados: El cáncer infantojuvenil repercute considerablemente en la vida cotidiana del padre, sobre todo con relación al estigma de la enfermedad, al miedo a lo desconocido y al papel social y familiar. Ante la enfermedad y la necesidad de cuidar del hijo, el padre busca rescatar la normalidad en la familia y transita entre comportamientos hegemónicamente masculinos y prácticas reconocidas culturalmente como femeninas. Consideraciones finales: Se puso en evidencia la compleja experiencia paterna influenciada por las masculinidades. Las limitaciones se refieren a la estricta comprensión de las especificidades contextuales de las experiencias por las escasas características de los padres e hijos descritos en los estudios. El conocimiento producido puede llegar a ser útil para promover el compromiso paterno en el cuidado del hijo, así como fortalecerlo y ayudarlo en esta tarea.

RESUMO Objetivo: Sintetizar e interpretar resultados e conclusões de pesquisas qualitativas sobre a experiência do pai no cuidado do filho com câncer. Método: Metassíntese de 16 estudos qualitativos capturados em seis bases de dados e analisados por meio da análise taxonômica. Resultados: O câncer infantojuvenil impõe inúmeras repercussões ao cotidiano do pai, sobretudo relacionadas ao estigma da doença, ao medo do desconhecido e ao papel social e familiar. Diante da doença e da necessidade de cuidado do filho, o pai busca resgatar a normalidade na família e transita entre comportamentos hegemonicamente masculinizantes e práticas reconhecidas culturalmente como femininas. Considerações finais: Evidenciou-se a complexa experiência paterna influenciada pelas masculinidades. As limitações referem-se à restrita compreensão das especificidades contextuais das experiências, pelas escassas características dos pais e filhos descritas nos estudos. O conhecimento produzido revela-se útil para promover o engajamento paterno no cuidado do filho, bem como fortalecê-lo e auxiliá-lo nesta tarefa.

Care provided by the father to the child with cancer under the influence of masculinities: qualitative meta-synthesis.

OBJECTIVE: To synthesize and interpret findings and conclusions of qualitative research addressing the experience of the father in the care of the child with cancer. METHOD: Meta-synthesis of 16 qualitative studies from six databases, analyzed through taxonomic analysis. RESULTS: Child and adolescent cancer have several repercussions on the daily life of the father, especially related to the stigma around the disease, the fear of the unknown and the social and family role. Faced with the illness and the need to care for the child, the father seeks to recover normality in the family and transitions between hegemonic masculine behaviors and practices culturally recognized as female. FINAL CONSIDERATIONS: The complex experience of the father, influenced by masculinities, was evidenced. The limitations regard the restricted understanding of the contextual specificities of the experiences, due to the limited characteristics of the parents and children described in the studies. The knowledge produced is useful to promote involvement of fathers in the care of the child, as well as to strengthen and assist him in this task.

Rede e apoio social as familias de criancas com paralisia cerebral / Red y apoyo social a las familias de niños con parálisis cerebral / Network and social support to families of children with cerebral palsy

Este estudo objetivou analisar a estrutura e composição das famílias com crianças com paralisia cerebral e identificar a existência de apoio e rede social que elas dispõem. Métodos: Trata-se de uma pesquisa descritiva, qualitativa, desenvolvida em um hospital universitário em Londrina-PR. Os dados foram coletados com dez famílias, no hospital e em domicílio, no período de outubro de 2011 a março de 2012, por meio de diário de campo, genograma, ecomapa e entrevista semiestruturada. Foram analisados mediante o Método de Interpretação dos Sentidos. Resultados: As famílias foram, na maioria,do tipo nuclear. Sua rede social foi composta pela família materna, profissionais de saúde e instituições religiosas, destacando a ausência dos profissionais da Estratégia Saúde da Família. Receberam apoio emocional, instrumental, informacional e cognitivo, os quais não foram suficientes e geraram sentimentos negativos. Conclusão: Cabe ao enfermeiro detectar as fragilidades na rede e auxiliar as famílias na busca e obtenção do suporte necessário. .

Objetivo:Analizar la estructura y la composición de familias con niños con parálisis cerebral e identificar la existencia de apoyo y de red social.Métodos:Estudio descriptivo, cualitativo, desarrollado en un hospital universitario en Londrina/PR. Los datos fueron recogidos con diez familias, de octubre/2011 a marzo/2012, a través de diario de campo, genograma, ecomapa y encuesta semiestructurada y analizados mediante el Método de Interpretación de los Sentidos.Resultados:Las familias eran, en su mayoría, del tipo nuclear. Su red social fue compuesta por la familia materna, profesionales de salud e instituciones religiosas, destacando la ausencia de los profesionales de la Estrategia Salud de la Familia. Las familias recibieron apoyo emocional, instrumental, informacional y cognitivo, los cuales fueron insuficientes y resultaron en sentimientos negativos.Conclusión:Cabe al enfermero detectar los puntos débiles en la red y auxiliar a las familias en la búsqueda y obtención del soporte necesario.

Congenital anomalies: hospitalization in a pediatric unit.

OBJECTIVE: To analyze the profile of children with congenital anomalies admitted to a pediatric unit. METHODS: This is a quantitative and retrospective research. The sample consisted of records of children aged from 0 to 12 years old who were hospitalized in the pediatric unit of the University Hospital of Londrina, Paraná, Southern Brazil, from 2007 to 2009. Data were collected by chart review processed in the Epi-Info® program, and they were submitted to descriptive statistical analysis. RESULTS: There were 282 first admissions of children with congenital anomalies. Of these, 130 (46.0%) required readmission totaling therefore 412 hospitalizations. The mean stay was three days. There was a male predominance, and the age range was from three to seven years old. The most frequent congenital anomalies were in the genital and urinary systems (19.6%), followed by cleft lip and palate (17.3%), and those of the circulatory system (16.2%). There were 269 surgical procedures to correct there anomalies. CONCLUSIONS: This study underscores the epidemiological importance of congenital malformations, highlighting the need to prevent and control the triggering factors.

Anomalias congênitas: internações em unidade pediátrica / Congenital anomalies: hospitalization in a pediatric unit / Anomalías congénitas: internaciones en unidad pediátrica

OBJETIVO: Analisar o perfil das crianças com anomalias congênitas em unidade pediátrica. MÉTODOS: Trata-se de uma pesquisa quantitativa e retrospectiva. A amostra constituiu-se dos prontuários de crianças de 0 a 12 anos que foram internadas na unidade pediátrica de um hospital escola público em Londrina, Paraná, de 2007 a 2009. Os dados foram obtidos por busca ativa aos registros processados no programa Epi-Info®, e submetidos à análise estatística descritiva. RESULTADOS: Ocorreram 282 primeiras internações de crianças com anomalias congênitas. Destas, 130 (46,0%) necessitaram de reinternações e totalizaram, portanto, 412. A média de internação foi de três dias. Houve predomínio do sexo masculino e faixa etária de três a sete anos. Entre as anomalias prevaleceram aquelas do aparelho geniturinário (19,6%), seguidas pelas fendas labiais e palatinas (17,3%) e pelo aparelho circulatório (16,2%). Foram realizados 269 procedimentos cirúrgicos para corrigir as anomalias. CONCLUSÕES: Este estudo reafirma a importância epidemiológica das anomalias congênitas, apontando para a necessidade de prevenir e controlar os fatores desencadeadores.

OBJECTIVE:To analyze the profile of children with congenital anomalies admitted to a pediatric unit. METHODS: This is a quantitative and retrospective research. The sample consisted of records of children aged from 0 to 12 years old who were hospitalized in the pediatric unit of the University Hospital of Londrina, Paraná, Southern Brazil, from 2007 to 2009. Data were collected by chart review processed in the Epi-Info® program, and they were submitted to descriptive statistical analysis. RESULTS: There were 282 first admissions of children with congenital anomalies. Of these, 130 (46.0%) required readmission totaling therefore 412 hospitalizations. The mean stay was three days. There was a male predominance, and the age range was from three to seven years old. The most frequent congenital anomalies were in the genital and urinary systems (19.6%), followed by cleft lip and palate (17.3%), and those of the circulatory system (16.2%). There were 269 surgical procedures to correct there anomalies. CONCLUSIONS: This study underscores the epidemiological importance of congenital malformations, highlighting the need to prevent and control the triggering factors.

OBJETIVO: Analizar el perfil de niños con anomalías congénitas en unidad pediátrica. MÉTODOS: Se trata de investigación cuantitativa y retrospectiva. La muestra se constituye de prontuarios de niños de cero a 12 años de edad, internadas en la unidad pediátrica de un hospital escuela público en Londrina (Paraná, Brasil), en el periodo de 2007 a 2009. Los datos fueron obtenidos por búsqueda activa a los prontuarios, procesados en el programa Epi-Info®, y sometidos al análisis estadístico descriptivo. RESULTADOS: Ocurrieron 282 primeras internaciones de niños con anomalías congénitas. De estas, 130 (46%) necesitaron de reinternaciones, totalizando, por lo tanto, 412 internaciones. El promedio de internación fue de tres días. Hubo predominio del sexo masculino y franja de edad de 3 a 7 años. Entre las anomalías, predominaron las del sistema genitourinario (19,6%), hendiduras labiales y palatinas (17,3%) y sistema circulatorio (16,2%). Se realizaron 269 procedimientos quirúrgicos para corrección de las anomalías. CONCLUSIÓN: Este estudio reafirma la importancia epidemiológica de las anomalías congénitas, señalando la necesidad de prevención y control de los factores desencadenadores.

Bexiga neurogênica e o cateterismo vesical intermitente / Neurogenic bladder and intermittent catheterization / Vejiga neurógena y sondaje intermitente

Objetivo: relatar os benefícios do cateterismo vesical intermitente e da técnica limpa. Método: foi realizado um levantamento bibliográfico via internet nas bases de dados Lilacs, Medline, Pubmed, Science Direct e banco de teses da CAPES. As palavras-chave utilizadas foram: cateterismo urinário e cateterismo urinário/história, sendo o período selecionado de 1945 a 2009. Resultados: o cateterismo vesical intermitente é indicado para as patologias que levam a dificuldades no esvaziamento vesical, principalmente para pacientes portadores de disfunção vesico-esfincteriana. Tem sido utilizado desde a primeira Guerra Mundial, porém mais empregado após a segunda Guerra Mundial. O cateterismo vesical intermitente se assemelha a função vesical normal, já que permite o esvaziamento cíclico da bexiga, evitando a superdistensão e a perda de suas características de reservatório, além de diminuir as taxas de infecção urinária e prevenir a deteriorização do trato urinário superior e inferior. Além disso, a técnica limpa permite que o próprio paciente a execute, proporcionando o retorno às suas atividades profissionais, culturais e de lazer. Conclusão: cabe aos profissionais de saúde, em especial ao enfermeiro, as orientações e o treinamento dos pacientes.(AU)

Objective: to report the benefits of intermittent catheterization and clean technique. Method: it was performed a literature review on internet in Lilacs, Medline, Pubmed, Science Direct and CAPES theses database. The key-words used were: urinary catheters and urinary catheters/history, and the selected period from 1945 to 2009. Results: the intermittent catheterization is indicated for the conditions that lead to difficulties in voiding, especially for patients with bladder-sphincter dysfunction. It has been used since the First World War, but most used after the Second World War. Intermittent bladder catheterization is similar to normal bladder function, as it allows the cyclic emptying of the bladder, avoiding excessive distension and loss of reservoir characteristics, In addition to lower tract infection rates and prevent upper and lower urinary tract deterioration. The clean technique allows to the patient perform it, offering the return to its professional, cultural and leisure activities. Conclusion: it fits for health professionals, especially the nurse, the guidance and training of patients.(AU)

Objetivo: comunicar los beneficios de la cateterización intermitente y la técnica de limpieza. Método: se realizó una literatura a través de la Internet en la Lilacs, Medline, PubMed, Science Direct y tesis de base de datos de la CAPES. Las palabras clave utilizadas fueron: el uso de sondas y catéteres urinarios / historia, y el período seleccionado desde 1945 hasta 2009. Resultados: la cateterización intermitente es indicado para las condiciones que llevan a dificultades en la micción, especialmente para los pacientes con disfunción del esfínter de la vejiga. Se ha utilizado desde la Primera Guerra Mundial, pero la mayoría de utilizarse después de la Segunda Guerra Mundial. Sondaje vesical intermitente es similar a la función normal de la vejiga, ya que permite la superdistensão cíclica vaciado de la vejiga, y evitar la pérdida de las características del yacimiento, y puede reducir las tasas de infección urinaria y evitar el deterioro del tracto urinario superior e inferior. Por otra parte, la técnica de limpieza permite que el paciente siga, proporcionando un retorno a sus actividades profesionales, culturales y de ocio. Conclusión: es para los profesionales de la salud, especialmente la enfermera, la orientación y la formación de los pacientes.(AU)