The Influence of Parental Sleep and Experiences Related to COVID-19 on Sleep in Children and Adolescents between 2020 and 2021 in Brazil.

The study aimed to evaluate the influence of parental sleep and experiences related to COVID-19 on sleep changes in children and adolescents in the period between 2020 and 2021 in Brazil and further compare the sleep of adults with and without children. This is a longitudinal web-survey study. Participants were invited to respond to a questionnaire regarding sleep characteristics, mental health issues, and work/lifestyle modifications in two waves of the pandemic (April-July 2020 and 2021). A total of 1172 adults answered both questionnaires, and 281 were dyads (parent-child/adolescent). Parent and non-parent adult responders had similar sociodemographic data, with a predominance of the female sex and self-declared white skin color prevailing along with higher levels of education in both groups. The prevalence of sleep problems in adults varied from 20.6% to 30.2% in the parent group and from 16.9% to 30.1% in non-parents. The prevalence of sleep problems in children and adolescents raised from 2020 to 2021 (respectively, 48% and 49.5%) but differences were not statistically significant. The multivariate logistic model showed in both years that changes in children's/adolescents' sleep was related to parents working at home, infected family/friends, time of exposure to COVID-19, and daytime sleep dysfunction. Our data showed that parental sleep and experiences related to COVID-19 influenced sleep changes in children and adolescents. Parents had a significant difference in daytime sleepiness compared to the group without children.

Effects of the COVID-19 pandemic on sleep quality in children and adolescents: A systematic review and meta-analysis.

We synthesise the literature on the potential influence of the COVID-19 pandemic on sleep quality in children and adolescents. The search identified studies that examined the relationship between sleep quality and disorders during the COVID-19 pandemic. It began in May 2021 and has had two updates with the last in January 2022. The databases used were LILACS, PubMed, and EMBASE. Random effects models were performed to explore heterogeneity between studies. Data were presented as continuous variables (mean value and standard deviation) to perform a meta-analysis. Twenty-nine studies from 16 countries were identified: Nine had children and eight had adolescents. The overall quality of the studies ranged from high (27.6%) to medium (65.5%) and low (6.9%). Eight studies were eligible for meta-analysis. There was an increase in sleep duration during the pandemic when compared with the previous period 0.33 (95%CI -0.07; 0.60) (p < 0.001) and late bedtime 0.78 (95%CI -0.33; 1.22) (p < 0.001). A trend toward reduced sleep efficiency was also detected 0.54 (95%CI -0.75; -0.33) p = 0.20. Parents' reports of increased use of screen media/electronic devices were associated with worse sleep quality. The results suggest an influence of the pandemic on sleep characteristics such as increased sleep duration, late bedtimes, and poor sleep quality. These alterations were related to changes in family routines during this period.

COVID-19 Pandemic and Autism Spectrum Disorder, Consequences to Children and Adolescents - a Systematic Review.

In this systematic review, we aimed to identify the impact of the COVID-19 pandemic on children/adolescents with a diagnosis of autism spectrum disorder (ASD). The protocol was registered on PROSPERO CRD42021255848. Articles were selected from PubMed, Embase, and LILACS according to these characteristics: patients from zero to 18 years old, exposed to the COVID-19 pandemic, impact on social communication/interaction and restricted/repetitive behavior domains. The Newcastle-Ottawa Scale was used to assess methodological quality and the risk of bias. Of the 351 articles initially identified, 26 were finally included with information on 8,610 patients. Although the studies were heterogeneous, they indicated that the pandemic-related issues experienced by patients with ASD were mostly manifested in their behavior and sleep patterns. Supplementary Information: The online version contains supplementary material available at 10.1007/s40489-022-00344-4.

Sleep quality among parents and their children during COVID-19 pandemic

Abstract Objective: To evaluate sleep characteristics of parents and their children during the COVID-19 pandemic and predictors for sleep disturbances. Methods: Cross-sectional web-based study using an online survey made available for dyads of parents and their children during the 7th week of quarantine in southern Brazil. Parents' and adolescents' sleep were characterized using the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale. For children aged 0-3 years parents completed the Brief Infant Sleep Questionnaire, for those aged 4-12 years the Sleep Disturbance Scale for Children. Parents also informed, subjectively, their perception about sleep habits during social distancing. Multiple regression was run to predict sleep disturbances in adults using independent variables: sex, income, education, children age, and children with sleep disturbances. Results: Data from 577 dyads showed sleep alterations in 69,8% of adults, in 58,6% of children aged 0-3 years, 33,9% in the 4-12 years range (with a predominance of disorders of initiating or maintaining sleep), and 56,6% in adolescents. Sex (female) and children with sleep disturbances were significant predictors of a sleep problem in parents (p < 0.005). Subjective perception revealed complaints related to emotional concerns such as anxiety and fear in adults and due to alterations in routine in children and adolescents. Conclusion: The present study's data showed an increased rate of sleep problems among families during quarantine both measured by validated instruments and also based on personal perception.

Prevalence and factors associated with no intention to exclusively breastfeed for the first 6 months of life

Abstract Objective: To investigate the prevalence and factors associated with no intention to exclusively breastfeed for the first 6 months of life in a sample of women in the first 24 h postpartum during the hospital stay. Methods: Cross-sectional study with data from screening phase of a birth cohort. The proportion of mothers who did not intend to breastfeed exclusively for 6 months (primary outcome) derived from a negative response to the question "Would you be willing to try to breastfeed exclusively for the first 6 months?", in an interview conducted by previously trained interviewers. Crude and adjusted prevalence ratios (PR) with 95% confidence intervals were obtained by Poisson regression with robust variance. Results: A total of 2964 postpartum women were interviewed. The overall prevalence of mothers who did not intend to breastfeed exclusively for 6 months was 17.8% (16.4-19.1%). After adjusting for maternal age and type of pregnancy (singleton or multiple), no intention to exclusively breastfeed was higher in mothers with a monthly household income < 3 minimum wages (PR, 1.64; 1.35-1.98) and in those who intended to smoke 4-7 days/week after delivery (PR, 1.42; 1.11-1.83). The presence of significant newborn morbidity (PR, 0.32; 0.19-0.54) and intention to breastfeed up to 12 months (PR, 0.46; 0.38-0.55) had a protective effect against not intending to breastfeed exclusively for 6 months. Conclusions: Approximately 1 in every 5 mothers did not intend to breastfeed exclusively for 6 months. Strategies aimed at promoting exclusive breastfeeding should focus attention on mothers from lower economic strata and smokers.

Conhecimento da equipe de enfermagem na prevenção de lesão por pressão no ambiente hospitalar / Knowledge of the nursing tean in the prevention of pressure injury in the hospita environment / Conocimiento del equipo de enfermería em la prevención de lesiones por presión em el ambiente hospitalario

Objetivo: Analisar o conhecimento da equipe de enfermagem quanto às medidas de prevenção de lesão por pressão. Método: Estudo tipo censo, de abordagem quantitativa, do tipo transversal, desenvolvida com profissionais da enfermagem dedois hospitais da região do Vale do Paranhana/RS. Amostra de 132 profissionais de enfermagem, sendo 112 técnicos de enfermagem e 20 enfermeiros. Foi aplicado o teste Pieper-Zulkowski -Teste de Conhecimento sobre Lesão por Pressão (PZ-TCLP). Todas as análises e processamento dos dados foram realizados no programa SPSS 18,0. O nível de significância adotado foi de 5% (p<0,05). Resultados: Houve predominância do nível técnico (84,8%) e sexo feminino (81,1%). Com relaçãoao teste, os participantes obtiveram 78,5% e 96,2% de acertos nas perguntas sobre o conhecimento da avaliação das lesões por pressão, 26,6% e 100,0% nos itens referentes à classificação da lesão por pressão. Sobre prevenção das lesões por pressão, os profissionais tiveram mais oscilação entre 3,8% e 100,0%. Conclusão: Observa-se que os profissionais aplicam métodos que não se utilizam mais como medidas preventivas, reforçando a importância da constante atualização dos profissionais, para melhorar a qualidade da assistência ao paciente.

Objective:To analyze the knowledge of the nursing team regarding pressure injury prevention measures. Method:Census-type study, quantitative approach, cross-sectional, developed with nursing professionals from two hospitals in the region of Vale do Paranhana/RS. Sample of 132 nursing professionals, being 112 nursing technicians and 20 nurses. The Pieper-Zulkowski test -Pressure Injury Knowledge Test (PZ-TCLP) was applied. All analyses and data processing were performed using the SPSS 18.0 program. The significance level adopted was 5% (p<0.05). Results:There was a predominance of the technical level (84.8%) and female sex (81.1%). Regarding the test, the participants obtained 78.5%and 96.2% of correct answers in the questions about knowledge of pressure injuries assessment, 26.6% and 100.0% in the items referring to the classification of pressure injuries. Regarding the prevention of pressure injuries, professionals had more oscillation between 3.8% and 100.0%. Conclusion:It is observed that professionals apply methods that are no longer used as preventive measures, reinforcing the importance of constant updating of professionals, to improve the quality of patient care.

Objetivo: Analizar el conocimiento del equipo de enfermería sobre las medidas de prevención de lesiones por presión. Método:Estudio cuantitativo, de tipo censal, con abordaje transversal, desarrollado con profesionales de enfermería de dos hospitales de la región Vale do Paranhana/RS. Muestra de 132 profesionales de enfermería, 112 técnicos de enfermería y 20 enfermeros. Se aplicó el test de Pieper-Zulkowski -Pressure Injury Knowledge Test (PZ-TCLP). Todo el análisis y procesamiento de datos se realizó con el programa SPSS 18.0. El nivel de significación adoptado fue del 5% (p<0,05). Resultados:Predominó el nivel técnico (84,8%) y el sexo femenino (81,1%). En cuanto a la prueba, los participantes obtuvieron 78,5% y 96,2% de respuestas correctas en las preguntas sobre conocimiento de evaluación de lesiones por presión, 26,6% y 100,0% en los ítems referentes a la clasificación de lesiones por presión. En cuanto a la prevención de lesiones por presión, los profesionales mostraron una mayor oscilación entre el 3,8% y el 100,0%. Conclusión:Se observa que los profesionales aplican métodos que ya no se utilizan como medidas preventivas, reforzando la importancia de la actualización constante de los profesionales para mejorar la calidad de la atención al paciente.

Prevalence and factors associated with no intention to exclusively breastfeed for the first 6 months of life.

OBJECTIVE: To investigate the prevalence and factors associated with no intention to exclusively breastfeed for the first 6 months of life in a sample of women in the first 24 h postpartum during the hospital stay. METHODS: Cross-sectional study with data from screening phase of a birth cohort. The proportion of mothers who did not intend to breastfeed exclusively for 6 months (primary outcome) derived from a negative response to the question "Would you be willing to try to breastfeed exclusively for the first 6 months?", in an interview conducted by previously trained interviewers. Crude and adjusted prevalence ratios (PR) with 95% confidence intervals were obtained by Poisson regression with robust variance. RESULTS: A total of 2964 postpartum women were interviewed. The overall prevalence of mothers who did not intend to breastfeed exclusively for 6 months was 17.8% (16.4-19.1%). After adjusting for maternal age and type of pregnancy (singleton or multiple), no intention to exclusively breastfeed was higher in mothers with a monthly household income < 3 minimum wages (PR, 1.64; 1.35-1.98) and in those who intended to smoke 4-7 days/week after delivery (PR, 1.42; 1.11-1.83). The presence of significant newborn morbidity (PR, 0.32; 0.19-0.54) and intention to breastfeed up to 12 months (PR, 0.46; 0.38-0.55) had a protective effect against not intending to breastfeed exclusively for 6 months. CONCLUSIONS: Approximately 1 in every 5 mothers did not intend to breastfeed exclusively for 6 months. Strategies aimed at promoting exclusive breastfeeding should focus attention on mothers from lower economic strata and smokers.

Sleep quality among parents and their children during COVID-19 pandemic.

OBJECTIVE: To evaluate sleep characteristics of parents and their children during the COVID-19 pandemic and predictors for sleep disturbances. METHODS: Cross-sectional web-based study using an online survey made available for dyads of parents and their children during the 7th week of quarantine in southern Brazil. Parents' and adolescents' sleep were characterized using the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale. For children aged 0-3 years parents completed the Brief Infant Sleep Questionnaire, for those aged 4-12 years the Sleep Disturbance Scale for Children. Parents also informed, subjectively, their perception about sleep habits during social distancing. Multiple regression was run to predict sleep disturbances in adults using independent variables: sex, income, education, children age, and children with sleep disturbances. RESULTS: Data from 577 dyads showed sleep alterations in 69,8% of adults, in 58,6% of children aged 0-3 years, 33,9% in the 4-12 years range (with a predominance of disorders of initiating or maintaining sleep), and 56,6% in adolescents. Sex (female) and children with sleep disturbances were significant predictors of a sleep problem in parents (p < 0.005). Subjective perception revealed complaints related to emotional concerns such as anxiety and fear in adults and due to alterations in routine in children and adolescents. CONCLUSION: The present study's data showed an increased rate of sleep problems among families during quarantine both measured by validated instruments and also based on personal perception.

Ações empreendedoras em enfermagem: desafios de enfermeiras em posição estratégica de liderança / Acciones emprendedoras en enfermería: desafíos de enfermeras en posición estratégica de liderazgo / Being an entrepreneur in nursing: challenges to nurses in a strategic leadership position

Resumo Objetivo: Conhecer os desafios ao desenvolvimento de ações empreendedoras na perspectiva de enfermeiras em posição estratégica de liderança. Métodos: Estudo de abordagem qualitativa, descritivo e exploratório. Participaram 12 mulheres, enfermeiras, em posição estratégica de liderança, em diferentes organizações e serviços de saúde de um município do Sul do Brasil. Foi aplicada a entrevista semiestruturada como técnica de coleta, no período de setembro a novembro de 2017. A análise de conteúdo temática se deu seguindo as etapas de pré-análise, exploração do material, tratamento dos resultados e interpretação. Resultados: Foi desvelado que as enfermeiras em posição estratégica de liderança visualizam desafios importantes no desenvolvimento de ações empreendedoras, representados pelas estruturas descritas nas categorias temáticas: Movimentos da ação empreendedora por enfermeiras em posição estratégica de liderança; Empreender em posição estratégica de liderança: situações (i)mobilizadoras; O aprender a empreender: desafios de uma responsabilidade avançada. Conclusão: No contexto do estudo, a posição ocupada pelas enfermeiras representa oportunidade ímpar na disseminação de uma cultura empreendedora em diversos cenários de atuação profissional, pelo seu potencial estratégico na condução de pessoas e processos, bem como no estímulo ao desenvolvimento de ações empreendedoras no gerenciamento do cuidado e na gestão de serviços de saúde e enfermagem. O estudo desperta para a necessidade de buscar caminhos e possibilidades que permitam gerenciar os paradoxos que permeiam a condição nem sempre favorável do ser mulher enfermeira em cargo estratégico de liderança nas instituições de saúde e de ensino.

Resumen Objetivo: Conocer los desafíos al desarrollo de acciones emprendedoras según la perspectiva de enfermeras en posición estratégica de liderazgo. Métodos: Estudio de abordaje cualitativo, descriptivo y exploratorio. Participaron 12 mujeres, enfermeras, en posición estratégica de liderazgo, en diferentes organizaciones y servicios de salud de un municipio del sur de Brasil. Se aplicó la entrevista semiestructurada como técnica de recolección, en el período de septiembre a noviembre de 2017. El análisis de contenido temático se dio siguiendo las etapas de pre-análisis, exploración del material, tratamiento de los resultados e interpretación. Resultados: Se desveló que las enfermeras en posición estratégica de liderazgo visualizan desafíos importantes en el desarrollo de acciones emprendedoras, representados por las estructuras descritas en las categorías temáticas: Movimientos de la acción emprendedora por enfermeras en posición estratégica de liderazgo; emprender en posición estratégica de liderazgo: situaciones (i) movilizadoras; el aprender a emprender: desafíos de una responsabilidad avanzada. Conclusión: En el contexto del estudio, la posición ocupada por las enfermeras representa una oportunidad impar en la diseminación de una cultura emprendedora en diversos escenarios de actuación profesional, por su potencial estratégico en la conducción de personas y procesos, así como en el estímulo al desarrollo de acciones emprendedoras en la gestión del cuidado y en la gestión de servicios de salud y enfermería. El estudio apunta a la necesidad de buscar caminos y posibilidades que permitan gestionar las paradojas que permean la condición no siempre favorable del ser mujer enfermera, en cargo estratégico de liderazgo, en las instituciones de salud y de enseñanza.

Abstract Objective: To identify challenges to the development of entrepreneurial behaviors, from the perspective of nurses in a strategic position of leadership. Methods: This was a qualitative, descriptive, and exploratory study. Participants were twelve female nurses, working in a strategic leadership position in different health organizations and services of a municipality in southern Brazil. A semi-structured interview was administered between September and November of 2017. Analysis of the thematic content was conducted using the steps of pre-analysis, material exploration, treatment of results, and interpretation. Results: It was revealed that nurses in a strategic leadership position presented important challenges in the development of entrepreneurial behaviors, represented by the structures described in the thematic categories: movements of entrepreneurial actions by nurses in strategic positions of leadership; being an entrepreneur in a strategic leadership position: (im)mobilizing situations; learning to be an entrepreneur: challenges of advanced responsibility. Conclusion: In the context of the study, the position occupied by nurses represents an unparalleled opportunity for the dissemination of an entrepreneurial culture in diverse professional settings, both in terms of strategic potential for management of people and processes, as well as in stimulating the development of entrepreneurial actions in care management, and management of health and nursing services. The study awakens the need to search for means and possibilities to allow for management of the paradoxes that permeate the reality of being a female nurse in a strategic position of leadership in healthcare and teaching institutions, which is not always a favorable situation.

Análise contextual da atenção à saúde do trabalhador em consultas de enfermagem / Contextual analysis of health care worker in nursing consultations

Ensaio crítico-reflexivo que objetivou analisar os contextos associados à atenção à saúde do trabalhador emconsultas de enfermagem, com base no referencial metodológico de Análise Contextual proposto por Hinds, Chaves e Cypress,o qual pressupõe quatro níveis contextuais que se interligam: contexto imediato, específico, geral e metacontexto. Para tal,10 publicações oriundas de Revisão Integrativa em fontes secundárias da Biblioteca Virtual em Saúde instruem o estudo.Constatou-se que a atenção ao trabalhador nas consultas de enfermagem é influenciada por barreiras comunicacionais quedificultam o entendimento acerca das relações entre as manifestações de adoecimento e trabalho. Somam-se, ainda, os aspectossocioculturais e psicológicos envolvidos na relação enfermeiro-trabalhador, bem como a atuação em enfermagem focada nomodelo biomédico. Faz-se necessário valorizar a escuta clínica em enfermagem na atenção ao trabalhador, especialmente pormeio da consulta de enfermagem, pois muitos casos de trabalhadores em sofrimento psíquico relacionado ao trabalho não estãosendo identificados no cotidiano dos serviços de saúde.