This is a qualitative study aiming to analyze the healthcare model for children with chronic conditions in Primary Health Care. The study subjects were nurses, nurse technicians and auxiliary nurses working in 16 basic health units in the city of Belo Horizonte, Minas Gerais. Data were collected through semi-structured interviews and later analyzed from the critical perspective, seeking to identify the common themes in the empirical material. Data revealed how primary health care professionals identified and reached children with chronic conditions, as well as how they presented the care actions performed. However, the development of a model of care for children with chronic conditions in primary health that considers their specific health needs constitutes a challenge.

Background: Maternity care practices such as skin-to-skin care, rooming-in, and direct breastfeeding are recommended, but it is unclear if these practices increase the risk of clinically significant COVID-19 in newborns, and if disruption of these practices adversely affects breastfeeding. Methods: We performed a retrospective cohort study of 357 mothers and their infants <12 months who had confirmed or suspected COVID-19. Subjects came from an anonymous worldwide online survey between May 4 and September 30, 2020, who were recruited through social media, support groups, and health care providers. Using multivariable logistic regression, Fisher's exact test, and summary statistics, we assessed the association of skin-to-skin care, feeding, and rooming-in with SARS-CoV-2 outcomes, breastfeeding outcomes, and maternal distress. Results: Responses came from 31 countries. Among SARS-CoV-2+ mothers whose infection was £3 days of birth, 7.4% of their infants tested positive. We found a nonsignificant decrease in risk of hospitalization among neonates who roomed-in, directly breastfed, or experienced uninterrupted skin-to-skin care (p > 0.2 for each). Infants who did not directly breastfeed, experience skin-to-skin care, or who did not room-in within arms' reach, were significantly less likely to be exclusively breastfed in the first 3 months, adjusting for maternal symptoms (p £ 0.02 for each). Nearly 60% of mothers who experienced separation reported feeling ''very distressed,'' and 29% who tried to breastfeed were unable. Presence of maternal symptoms predicted infant transmission or symptoms (adjusted odds ratio = 4.50, 95% confidence interval = 1.52-13.26, p = 0.006). Conclusion: Disruption of evidence-based quality standards of maternity care is associated with harm and may be unnecessary.

Objetivo: caracterizar os atendimentos de primeira consulta realizados pelo enfermeiro a crian�as de risco, egressas da Unidade de Terapia Intensiva Neonatal de um hospital da regi�o metropolitana de Belo Horizonte, e definir os principais diagn�sticos de enfermagem e interven��es realizados nesse atendimento. M�todo: trata-se de um estudo transversal retrospectivo.Os dados foram coletados por meio dos prontu�rios da institui��o, no per�odo de setembro de 2013 a setembro de 2014. Resultados: os rec�m-nascidos com alta das Unidades de Terapia Intensiva Neonatal que regressaram para o seguimento ambulatorial foram, em sua maioria, do sexo feminino com 52 (52%). Em rela��o � idade gestacional, 44 (44%) nasceram com menos de 32 semanas e 29 (29%) com menos de 1500 gramas. Ap�s a quantifica��o dos dados, foram predominantes os diagn�sticos de amamenta��o eficaz (75%), risco de atraso no desenvolvimento (42%), padr�o de sono prejudicado (19%), desobstru��o ineficaz de vias a�reas (12%), risco de integridade da pele prejudicada (11%) e risco de infec��o (7%). Conclus�o: para garantir a continuidade do cuidado, estrat�gias devem ser implementadas junto com a fam�lia e, portanto, este estudo poder� contribuir para a explora��o de novos diagn�sticos e interven��es de enfermagem visando � vincula��o do n�vel ambulatorial com os servi�os de aten��o b�sica.

ABSTRACT:The aim of this qualitative study was to analyze family participation in care delivery to newborns in daily practice at a Neonatal Intensive Care Unit. The study was carried out at five hospitals in Belo Horizonte, Minas Gerais, Brazil. The study subjects were healthcare professionals taking care of newborns hospitalized at the Neonatal Intensive Care Unit and the relatives of these infants. Data were collected through participant observation and daily conversations and analyzed using Content Analysis. The data permitted capturing aspects of family participation in newborn care related to institutional organization, interaction with healthcare professionals and the care process. Different actions favoring mothers' participation in care delivery to their children were identified at the Neonatal Intensive Care Unit. Nevertheless, the study showed that these actions have not been incorporated into the daily activities at the institution, nor into healthcare professionals' practice. DESCRIPTORS: LA FAMILIA EN EL CUIDADO DEL RECIÉN NACIDO HOSPITALIZADO: POSIBILIDADES Y RETOS PARA LA CONSTRUCCIÓN DE LA INTEGRALIDAD RESUMEN:Estudio de enfoque cualitativo que tuvo por objetivo analizar la participación de la familia en el cuidado del recién nacido en la Unidad de Terapia Intensiva Neonatal. El estudio se llevó a cabo en cinco hospitales de Belo Horizonte, Minas Gerais, Brasil. Tuvo como sujetos los profesionales sanitarios en la Unidad de Terapia Intensiva Neonatal y los familiares del recién nacido. Los datos se recolectaron por observación participante y conversaciones del cotidiano y fueron analizados a través de la técnica de Análisis de Contenido. Los datos permitieron captar aspectos de la participación de la familia relacionados con la organización institucional, la interacción con los profesionales y la realización del cuidado. Se identificó la existencia de diferentes acciones que favorecen la participación de la madre en el cuidado del hijo en la Unidad de Terapia Intensiva Neonatal, aún así, estas no están incorporadas en el cotidiano institucional y en el quehacer de los profesionales sanitarios. DESCRIPTORES:Familia. Recién nacido. Unidades de Terapia Intensiva Neonatal. Relaciones profesional-familia. Atención integral de salud.

doi: 10.5216/ree.v12i3.7509A busca de um cuidado que contemple as dimensões biopsicossociais do recém-nascido, não limitadas às que garantem a sua sobrevida, tem sido promovida através de diferentes práticas que consideramos serem favorecedoras da integralidade. Neste estudo realizou-se uma revisão bibliográfica sistemática com o objetivo de identificar práticas cuidadoras que favorecem a integralidade do cuidado ao recém-nascido de alto risco. A busca foi realizada nas bases de dados BDENF, LILACS, MEDLINE, PAHO, WHOLIS e BVS INTEGRALIDADE, utilizando-se os indexadores Cuidados Integrais de Saúde, Neonatologia, Recém-nascido e Unidades de terapia intensiva neonatal, no período de 1988 a 2009. Foram selecionadas 17 publicações, em inglês, português e espanhol. Os resultados foram agrupados nas categorias: cuidado centrado no recém-nascido e na família, trabalho em equipe multiprofissional, participação da mãe e dos familiares no cuidado ao recém-nascido e continuidade da assistência. Concluiu-se que iniciativas são tomadas para possibilitar um cuidado integral mas que, para construção da integralidade da assistência ao neonato de risco, ainda existem dificuldades a serem superadas, principalmente em relação à ampliação do foco do cuidado e à reorganização do processo de trabalho em Unidade de Terapia Intensiva Neonatal.Descritores: Cuidados Integrais de Saúde; Neonatologia; Recém-nascido; Unidades de terapia intensiva neonatal.

Down syndrome (DS) is the most common genetic cause of intellectual disability worldwide. The purpose of this analysis was to determine the internal consistency reliability of eight language versions of the Family Management Measure (FaMM) and compare family management of DS across cultures. A total of 2,740 parents of individuals with DS from 11 countries completed the FaMM. The analysis provided evidence of internal consistency reliability exceeding .70 for four of six FaMM scales for the entire sample. Across countries, there was a pattern of positive family management. Cross-cultural comparisons revealed parents from Brazil, Spain, and the United States had the most positive family management and respondents from Ireland, Italy, Japan, and Korea had the least positive. The rankings were mixed for the four remaining countries. These findings provide evidence of overall strong internal consistency reliability of the FaMM. More cross-cultural research is needed to understand how social determinants of health influence family management in families of individuals with DS.

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Objective: To analyze problem-solving and coping strategies of parents of children with Down Syndrome in family adaptation. Method: This is a qualitative research that used the Resiliency Model of Family Stress, Adjustment, and Adaptation. Participants were mothers and/or fathers from 40 families of children aged 1 to 7 years diagnosed with DS. Directed content analysis was performed, supported by software and considering a code dictionary. Results: Problem-solving and coping proved to be a set of actions, behaviors, efforts, and communications that contributed to family adaptation and favored balance between the demands imposed by Down Syndrome and the acquisition of resources by the family. Conclusion: In the first moment, which corresponds to the time of news or diagnosis of the syndrome and the first days after birth, internal and external resources, which represent coping, are developed to accept and refocus ideas and feelings towards Down Syndrome. Over time these resources have an effect and cause changes in family functioning patterns and in the relationship of these families with the outside world, as they seek child development.