Family Functioning of Adolescents with Congenital Cardiopathy in a Sample from Public Schools in Porto Alegre - RS

Abstract Background The impact of chronic diseases on the patient and the family ranges from minimal to severe distress. Family functioning has been often investigated as a psychosocial measure having an essential role for social adjustment in chronic diseases. Objectives To compare family functioning among families of adolescents with congenital heart disease (CHD) and healthy controls (H) in relation to cohesion, adaptability, and family risk. Method Cross-sectional exposed-control study with 2 groups of adolescents (12 -18 years). The exposed group included adolescents with congenital heart disease (CHD), from a specialized public health system hospital (SUS), and adolescents from 7 public schools, considered healthy, composed the control group. In the hospital, the data collection was individual, before the medical consultation. In schools, the collection took place in groups. Adolescents and parents responded to the FACES III scale. The following statistical tests were used: Pearson's chi-square, Fisher's test, T-test for independent samples, Poisson multivariate regression analysis with 95% reliability, significance established at 5% and a statistical power at 99% (ß = 0.01). Results A total of 161 (41.6%) adolescents with CHD and 226 (58.4%) healthy adolescents participated. There was greater family cohesion among adolescents with CHD, with a higher frequency of connected families, while among healthy adolescents, there are more families of the disengaged type. Regarding adaptability, a higher proportion of families of the chaotic type were found among healthy adolescents compared to adolescents with CHD. A higher frequency of high-risk families was identified among healthy adolescents (16.8%). Conclusion The families of the adolescents with CHD have a more balanced functioning and low risk when compared to the families of healthy adolescents; with greater cohesion between the members and greater adaptability. Congenital heart disease was not an independent factor for high-risk family. (Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0).

Knowledge and food practices questionnaire: construction and validation

Abstract Objectives: To develop and validate an instrument about nutritional knowledge and feeding practices to be used in children aged 7-11 years, based on the latest Brazilian Food Guide. Methods: Review on the subject; instrument creation; content validity with two groups of judges: first, nutritionists and, after adjustments, a multidisciplinary group (content validity index [CVI]); FACE validity; reproducibility analysis (intraclass correlation coefficient [ICC], level of agreement, and kappa [k]); internal consistency analysis (Cronbach's alpha[α]) and construct validity (Kaiser-Meyer-Olkin and exploratory factorial analysis). The sample was calculated, considering at least ten subjects for each question of the questionnaire. Results: There was a final sample of 453 children (53.6% girls), with a mean age of 9.45 years (SD = 1.44). The content validity showed a CVI ≥ 0.80 for relevance in 62.3% of the items for nutritionists' group and 100% of the items for the multidisciplinary group, clarity (49.4%, 91.8%), and pertinence (58.8%, 98.4%), respectively. The test-retest showed a level of agreement of 84.3% and k = 0.740 for the Knowledge dimension and ICC = 0.754 for the Food Practices dimension. The internal consistency showed α = 0.589 for the Knowledge dimension and α = 0.618 for the Food Practices dimension. For the construct validity, Kaiser-Meyer-Olkin was 0.724 and exploratory factorial analysis showed a variance of 47.01 with varimax rotation and defined five factors for the Practices Dimension. Conclusion: The Food Knowledge and Practices Questionnaire (Questionário de Conhecimento e Práticas Alimentares [QCPA]) instrument showed validity and reliability to assess nutritional knowledge and food practices in children aged 7-11 years.

Knowledge and food practices questionnaire: construction and validation.

OBJECTIVES: To develop and validate an instrument about nutritional knowledge and feeding practices to be used in children aged 7-11 years, based on the latest Brazilian Food Guide. METHODS: Review on the subject; instrument creation; content validity with two groups of judges: first, nutritionists and, after adjustments, a multidisciplinary group (content validity index [CVI]); FACE validity; reproducibility analysis (intraclass correlation coefficient [ICC], level of agreement, and kappa [k]); internal consistency analysis (Cronbach's alpha[α]) and construct validity (Kaiser-Meyer-Olkin and exploratory factorial analysis). The sample was calculated, considering at least ten subjects for each question of the questionnaire. RESULTS: There was a final sample of 453 children (53.6% girls), with a mean age of 9.45 years (SD = 1.44). The content validity showed a CVI ≥ 0.80 for relevance in 62.3% of the items for nutritionists' group and 100% of the items for the multidisciplinary group, clarity (49.4%, 91.8%), and pertinence (58.8%, 98.4%), respectively. The test-retest showed a level of agreement of 84.3% and k = 0.740 for the Knowledge dimension and ICC = 0.754 for the Food Practices dimension. The internal consistency showed α = 0.589 for the Knowledge dimension and α = 0.618 for the Food Practices dimension. For the construct validity, Kaiser-Meyer-Olkin was 0.724 and exploratory factorial analysis showed a variance of 47.01 with varimax rotation and defined five factors for the Practices Dimension. CONCLUSION: The Food Knowledge and Practices Questionnaire (Questionário de Conhecimento e Práticas Alimentares [QCPA]) instrument showed validity and reliability to assess nutritional knowledge and food practices in children aged 7-11 years.

Nursing Guidelines on Cardiac Surgery and Parents' Anxiety: Randomized Clinical Trial.

OBJECTIVE: The preparation of parents of children who should undergo cardiac surgery requires special treatment such as the explanations about the event. This study aims to compare the effects of standardized nursing guidelines with routine institutional orientation on the anxiety of parents of children undergoing cardiac surgery. METHODS: Randomized clinical trial. The sample consisted of parents of children who underwent cardiac surgery from December 2010 to April 2011. Twenty-two parents were randomized to the intervention group (IG) and received the standard nursing guidelines and 22 participated in the control group (CG) and received the routine guidelines from the institution. Anxiety was assessed by the State-Trait Anxiety Inventory (STAI) applied in the preoperative period, between 12 and 20 hours before surgery and before receiving standard or institutional guidelines and 48 hours after surgery. The analysis of variance (ANOVA) for repeated measures was performed to evaluate the differences between the variations in STAI scores between the groups during the studied period. The level of significance was 0.05. RESULTS: There were no significant differences in baseline anxiety scores between groups with regard to trait anxiety as well as state anxiety: STAI-trait (CG 42.6±4.9 vs. IG 41.4±6.0, P=0.48); STAI-state (CG 42.3±5.7 vs. IG 45.6±8.3, P=0.18). Likewise, the variation in score after 48 hours was similar between groups (STAI-trait P=0.77; STAI-state P=0.61). CONCLUSION: There were no significant differences in the parents' anxiety levels when comparing the two types of guidelines: the standard nursing and the institutional orientation.

Nursing guidelines on cardiac surgery and parents anxiety: randomized clinical trial

Abstract Objective: The preparation of parents of children who should undergo cardiac surgery requires special treatment such as the explanations about the event. This study aims to compare the effects of standardized nursing guidelines with routine institutional orientation on the anxiety of parents of children undergoing cardiac surgery. Methods: Randomized clinical trial. The sample consisted of parents of children who underwent cardiac surgery from December 2010 to April 2011. Twenty-two parents were randomized to the intervention group (IG) and received the standard nursing guidelines and 22 participated in the control group (CG) and received the routine guidelines from the institution. Anxiety was assessed by the State-Trait Anxiety Inventory (STAI) applied in the preoperative period, between 12 and 20 hours before surgery and before receiving standard or institutional guidelines and 48 hours after surgery. The analysis of variance (ANOVA) for repeated measures was performed to evaluate the differences between the variations in STAI scores between the groups during the studied period. The level of significance was 0.05. Results: There were no significant differences in baseline anxiety scores between groups with regard to trait anxiety as well as state anxiety: STAI-trait (CG 42.6±4.9 vs. IG 41.4±6.0, P=0.48); STAI-state (CG 42.3±5.7 vs. IG 45.6±8.3, P=0.18). Likewise, the variation in score after 48 hours was similar between groups (STAI-trait P=0.77; STAI-state P=0.61). Conclusion: There were no significant differences in the parents' anxiety levels when comparing the two types of guidelines: the standard nursing and the institutional orientation.

Adolescents' perception of parental feeding practices: Adaptation and validation of the Comprehensive Feeding Practices Questionnaire for Brazilian adolescents-The CFPQ-Teen.

BACKGROUND: Parental feeding practices may play a key role in dietary habits and nutritional status of adolescents, but research from adolescents' point of view on this topic is scarce. OBJECTIVE: To adapt and validate an instrument of parental feeding practices as perceived by adolescents in a Brazilian setting. METHODS: The Comprehensive Feeding Practices Questionnaire was translated into Portuguese and adapted to be answered by adolescents (ages 12 to 18). Content analysis and FACE validity to assess cultural equivalence was undertaken by experts in the adolescent nutritional and psychological fields. Pilot study was evaluated in 23 adolescents. The final version was administered to 41 students to assess instrument reproducibility (Intraclass Correlation Coefficient). Internal consistency (Cronbach's Alpha) and construct validity (Confirmatory Factor Analysis) were assessed in a third sample of 307 adolescents. RESULTS: Experts and adolescents considered content validity as appropriate. In reproducibility analysis (Intraclass Correlation Coefficient), 10 of the 12 factors were above 0.7. The factors "teaching about nutrition" and "food as reward" obtained values of 0.60 and 0.68, respectively. The Cronbach's Alpha of the whole scale was 0.83 and alphas for subscales ranged from 0.52 to 0.85; the factors "teaching about nutrition" and "food as a reward" had the lowest values (0.52). After removing these two factors, the Confirmatory Factor Analysis indicated that the structural model was appropriate. The final scale was made up of 10 factors with 43 questions. CONCLUSIONS: The Comprehensive Feeding Practices Questionnaire-Teen demonstrates validity and reliability, and is a suitable tool to evaluate the perceptions of adolescents regarding parental feeding practices.

Ocular Signs Related to Overweight and Arterial Hypertension in Children: A Systematic Review.

BACKGROUND: The ocular effects of obesity and hypertension need to be established and can be used as prognostic markers. OBJECTIVE: To estimate the prevalence of ophthalmological alterations in children and adolescents who are overweight and/or have SAH. METHODS: The database for this study included all observational studies (CS, cohort, case-control and "baseline" description of randomized clinical trials) with children and/or adolescents who were overweight, obese or had SAH and that measured ophthalmological alterations. RESULTS: Comparative studies with healthy children demonstrated positive association between body adiposity with retinal venular dilation, and SAH with retinal arteriolar narrowing. Different retinal fundus cameras and computer-assisted programs to evaluate the retinal vessels, variations in the methods of analysis, adjustments, populations, were the main arguments against formal meta-analysis. The heterogeneity was too high (I2 >90%, in fixed or randomized effects), and the lack of linearity, normal distribution and homoscedasticity did not recommend meta-regression. CONCLUSION: Obesity and SAH show associations with ophthalmological alterations, especially with retinal vessel diameter. Lack of standardization does not allow a quantitative evaluation.