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      Effectiveness of an intervention with mothers to stimulate children under two years* Translated title: Efetividade de uma intervenção com mães para a estimulação de crianças menores de dois anos Translated title: Efectividad de una intervención con madres para la estimulación de niños menores de dos años

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          Abstract

          Objective:

          To analyze the effectiveness of an educational intervention with mothers to stimulate children under two years of age at risk for neuropsychomotor development.

          Method:

          Before-after intervention study, conducted with 52 mothers of children under two years old, enrolled in reference centers in early childhood education. Initially, maternal knowledge regarding child development and stimulation was assessed through a structured instrument. Then, workshops were held with the mothers and, after three months, maternal knowledge was revised, reapplying the data collection instrument. In the analysis, descriptive and inferential statistics were used, applying the McNemar and Wilcoxon tests and the Rasch Model from the Item Response Theory.

          Results:

          after the intervention, there was a significant increase in scores regarding the following aspects: knowledge of mothers about child development and stimulation from 5.77 ± 1.85 to 18.60 ± 1.94 (p <0.001); reduction of the maternal difficulty index in answering the instrument questions from 1.17 ± 0.57 to -1.98 ± 1.63 (p 0.01).

          Conclusion:

          the educational intervention contributed to the improvement of maternal knowledge regarding the development and forms of child stimulation, corroborating the importance of this action to advance the health of children at risk under maternal care at home.

          Translated abstract

          Objetivo:

          analisar a efetividade de uma intervenção educativa com mães para a estimulação de crianças menores de dois anos em situação de risco para o desenvolvimento neuropsicomotor.

          Método:

          estudo de intervenção do tipo antes-depois, realizado com 52 mães de crianças menores de dois anos e matriculadas em centros de referências em educação infantil. Inicialmente, foram avaliados os conhecimentos maternos quanto ao desenvolvimento e à estimulação infantil por meio de instrumento estruturado. Em seguida, realizou-se oficinas com as mães e, após três meses, os conhecimentos maternos foram reavaliados, reaplicando o instrumento de coleta de dados. Na análise, utilizou-se estatística descritiva e inferencial, sendo aplicados teste de McNemar, de Wilcoxon e o modelo de Rash da Teoria da Resposta ao Item.

          Resultados:

          após intervenção, houve aumento significativo dos escores quanto aos aspectos: conhecimento das mães sobre o desenvolvimento e estimulação infantil de 5,77 ± 1,85 para 18,60 ± 1,94 (p < 0,001); e redução do índice de dificuldade materna em responder as questões do instrumento de 1,17 ± 0,57 para −1,98 ± 1,63 (p < 0,01).

          Conclusão:

          a intervenção educativa contribuiu para a melhora dos conhecimentos maternos quanto ao desenvolvimento e às formas de estimulação infantil, corroborando a importância desta ação para o avanço da saúde da criança com risco sob os cuidados maternos no domicílio.

          Translated abstract

          Objetivo:

          analizar la efectividad de una intervención educativa con madres para la estimulación de niños menores de dos años en situación de riesgo, para el desarrollo neuropsicomotor.

          Método:

          estudio de intervención del tipo antes-después, que fue realizado con 52 madres de niños menores de dos años, inscriptos en centros de referencias en educación infantil. Inicialmente, fueron evaluados los conocimientos maternos cuanto al desarrollo y la estimulación infantil por medio de instrumento estructurado. Luego, fueron realizados talleres con las madres y, después de tres meses, los conocimientos maternos reevaluados, reaplicando el instrumento de recogida de datos. En el análisis, se utilizó estadística descriptiva e inferencial, siendo aplicadas pruebas McNemar, Wilcoxon y Modelo de Rash de la Teoría de la Respuesta al Ítem.

          Resultados:

          después de la intervención, hubo incremento significativo de los escores cuanto a los aspectos: conocimiento de las madres sobre el desarrollo y la estimulación infantil de 5,77±1,85 para 18,60±1,94 (p<0,001); reducción del índice de dificultad materna en responder las cuestiones del instrumento de 1,17 ± 0,57 para -1,98 ± 1,63 (p<0,01).

          Conclusión:

          la intervención educativa contribuyó para la mejora de los conocimientos maternos cuanto al desarrollo y a las formas de estimulación infantil, corroborando la importancia de esta acción para el avance de la salud del niño con riesgo bajo los cuidados maternos en el domicilio.

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          Most cited references30

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          Parental Adverse Childhood Experiences and Offspring Development at 2 Years of Age

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            Child development: analysis of a new concept1

            Objectives: to perform concept analysis of the term child development (CD) and submit it to review by experts. Method: analysis of concept according to the hybrid model, in three phases: theoretical phase, with literature review; field phase of qualitative research with professionals who care for children; and analytical phase, of articulation of data from previous steps, based on the bioecological theory of development. The new definition was analyzed by experts in a focus group. Project approved by the Research Ethics Committee. Results: we reviewed 256 articles, from 12 databases and books, and interviewed 10 professionals, identifying that: The CD concept has as antecedents aspects of pregnancy, factors of the child, factors of context, highlighting the relationships and child care, and social aspects; its consequences can be positive or negative, impacting on society; its attributes are behaviors and abilities of the child; its definitions are based on maturation, contextual perspectives or both. The new definition elaborated in concept analysis was validated by nine experts in focus group. It expresses the magnitude of the phenomenon and factors not presented in other definitions. Conclusion: the research produced a new definition of CD that can improve nursing classifications for the comprehensive care of the child.
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              Impact of a child stimulation intervention on early child development in rural Peru: a cluster randomised trial using a reciprocal control design

              Objective Stimulation in early childhood can alleviate adverse effects of poverty. In a community-randomised trial, we implemented 2 home-based interventions, each serving as an attention control for the other. One group received an integrated household intervention package (IHIP), whereas the other group received an early child development (ECD) intervention. The primary objective of the study was to evaluate the effect of IHIP on diarrhoea and respiratory infections, the details of which are described elsewhere. Here, we present the impact of the ECD intervention on early childhood development indicators. Methods In this non-blinded community-randomised trial, an ECD intervention, adapted from the Peruvian government's National Wawa Wasi ECD programme, was implemented in 25 rural Peruvian Andean communities. We enrolled 534 children aged 6–35 months, from 50 communities randomised 1:1 into ECD and IHIP communities. In ECD communities, trained fieldworkers instructed mothers every 3 weeks over the 12 months study, to stimulate and interact with their children and to use standard programme toys. IHIP communities received an improved stove and hygiene promotion. Using a nationally validated ECD evaluation instrument, all children were assessed at baseline and 12 months later for overall performance on age-specific developmental milestones which fall into 7 developmental domains. Findings At baseline, ECD-group and IHIP-group children performed similarly in all domains. After 12 months, data from 258 ECD-group and 251 IHIP-group children could be analysed. The proportion of children scoring above the mean in their specific age group was significantly higher in the ECD group in all domains (range: 12–23%-points higher than IHIP group). We observed the biggest difference in fine motor skills (62% vs 39% scores above the mean, OR: 2.6, 95% CI 1.7 to 3.9). Conclusions The home-based ECD intervention effectively improved child development overall across domains and separately by investigated domain. Home-based strategies could be a promising component of poverty alleviation programmes seeking to improve developmental outcomes among rural Peruvian children. Trial registration number ISRCTN28191222; results.
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                Author and article information

                Journal
                Rev Lat Am Enfermagem
                Rev Lat Am Enfermagem
                rlae
                Revista Latino-Americana de Enfermagem
                Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo
                0104-1169
                1518-8345
                28 October 2019
                2019
                : 27
                : e3216
                Affiliations
                [1 ]Universidade Federal da Paraíba, João Pessoa, PB, Brazil.
                Author notes
                Corresponding author: Isolda Maria Barros Torquato. E-mail: isoldaufcg@ 123456gmail.com
                Author information
                http://orcid.org/0000-0003-4242-5755
                http://orcid.org/0000-0002-4795-0279
                http://orcid.org/0000-0003-4237-0184
                http://orcid.org/0000-0001-8880-6786
                http://orcid.org/0000-0003-0296-9256
                http://orcid.org/0000-0002-4295-6698
                Article
                00390
                10.1590/1518-8345.3176.3216
                6818664
                31664417
                8b36c01c-d4a5-48de-89ad-facfac22930a
                Copyright © 2019 Revista Latino-Americana de Enfermagem

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 11 December 2018
                : 04 August 2019
                Categories
                Original Article

                child development,child day care centers,pediatric nursing,health education,mothers,early intervention,desenvolvimento infantil,creche,enfermagem pediátrica,educação em saúde,mães,intervenção precoce,desarrollo infantil,guardería,enfermería pediátrica,educación en salud,madres,intervención precoz

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