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      The family myth in nursing care for children in psychological distress* Translated title: El mito familiar en los cuidados de enfermería a niños con malestar psíquico Translated title: O mito familiar no cuidado de enfermagem à criança em sofrimento psíquico

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          ABSTRACT

          This is a theoretical study aimed at reflecting on the contribution of the concept of family myth to nursing care for children in psychological distress. It is methodologically structured around three topics: the importance of the family in caring for children; the perspective of family-centered nursing care for children in psychological distress; and the contribution of the understanding of family myth to nursing care for children in psychological distress. The following dialectic is considered: the family, considered by current literature to be a harmonious unit, also triggers family conflicts that can be the cause of psychological suffering. The concept of family myth emerges as a possible theoretical anchor for nursing care for children in psychological distress, as it allows nurses to consider the signifiers that mark the child’s psychological structure and construct their symptoms. Uncovering the place that the family assigns to the child enables nurses to help them construct and elaborate their own place as a subject in their subjectivity.

          RESUMO

          Trata-se de um estudo teórico com o objetivo de refletir sobre a contribuição do conceito de mito familiar para o cuidado de enfermagem à criança em sofrimento psíquico, sendo metodologicamente estruturado em três tópicos: importância da família no cuidado de crianças; perspectiva do cuidado de enfermagem centrado na família de crianças em sofrimento psíquico; e contribuição do entendimento de mito familiar para o cuidado de enfermagem à criança em sofrimento psíquico. Considera-se a dialética: a família, tida pela literatura atual como unidade harmônica, também desencadeia conflitos familiares que podem ser a causa de sofrimentos psíquicos. O conceito de mito familiar surge como possibilidade de ancoragem teórica ao cuidado de enfermagem à criança em sofrimento psíquico ao permitir que o enfermeiro considere os significantes que marcam a estruturação psíquica da criança e constroem seu sintoma. Desvendar o lugar que a família destina à criança viabiliza ao enfermeiro auxiliá-la a construir e elaborar um local próprio enquanto sujeito em sua subjetividade.

          RESUMEN

          Se trata de un estudio teórico dirigido a reflexionar sobre la contribución del concepto de mito familiar a los cuidados de enfermería a niños con sufrimiento psicológico. Metodológicamente se estructura en torno a tres temas: la importancia de la familia en el cuidado de los niños; la perspectiva de los cuidados de enfermería centrados en la familia para niños con sufrimiento psicológico; y la contribución de la comprensión del mito familiar a los cuidados de enfermería a niños con sufrimiento psicológico. Se plantea la dialéctica: la familia, considerada por la literatura actual como una unidad armoniosa, también desencadena conflictos familiares que pueden ser causa de sufrimiento psicológico. El concepto de mito familiar emerge como anclaje teórico para los cuidados de enfermería a los niños en malestar psicológico, ya que permite a las enfermeras considerar los significantes que marcan la estructura psicológica del niño y construyen sus síntomas. Desvelar el lugar que la familia asigna al niño permite a las enfermeras ayudarle a construir y elaborar su propio lugar como sujeto en su subjetividad.

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          Incidence Rates and Cumulative Incidences of the Full Spectrum of Diagnosed Mental Disorders in Childhood and Adolescence

          This nationwide cohort study estimates age- and sex-specific incidence rates and risks of being diagnosed with any mental disorder during childhood and adolescence using Danish population health registers. What are the age- and sex-specific incidence rates and cumulative incidences of the full spectrum of diagnosed mental disorders during childhood and adolescence? In this nationwide cohort study of 1.3 million individuals in Denmark, the risk (cumulative incidence) of being diagnosed with a mental disorder before 18 years of age was 14.63% in girls and 15.51% in boys. Distinct age- and sex-specific patterns of occurrence were found across mental disorders in children and adolescents. These findings suggest that precise estimates of rates and risks of all mental disorders during childhood and adolescence are essential for future planning of services and care and for etiological research. Knowledge about the epidemiology of mental disorders in children and adolescents is essential for research and planning of health services. Surveys can provide prevalence rates, whereas population-based registers are instrumental to obtain precise estimates of incidence rates and risks. To estimate age- and sex-specific incidence rates and risks of being diagnosed with any mental disorder during childhood and adolescence. This cohort study included all individuals born in Denmark from January 1, 1995, through December 31, 2016 (1.3 million), and followed up from birth until December 31, 2016, or the date of death, emigration, disappearance, or diagnosis of 1 of the mental disorders examined (14.4 million person-years of follow-up). Data were analyzed from September 14, 2018, through June 11, 2019. Age and sex. Incidence rates and cumulative incidences of all mental disorders according to the ICD-10 Classification of Mental and Behavioral Disorders: Diagnostic Criteria for Research, diagnosed before 18 years of age during the study period. A total of 99 926 individuals (15.01%; 95% CI, 14.98%-15.17%), including 41 350 girls (14.63%; 95% CI, 14.48%-14.77%) and 58 576 boys (15.51%; 95% CI, 15.18%-15.84%), were diagnosed with a mental disorder before 18 years of age. Anxiety disorder was the most common diagnosis in girls (7.85%; 95% CI, 7.74%-7.97%); attention-deficit/hyperactivity disorder (ADHD) was the most common in boys (5.90%; 95% CI, 5.76%-6.03%). Girls had a higher risk than boys of schizophrenia (0.76% [95% CI, 0.72%-0.80%] vs 0.48% [95% CI, 0.39%-0.59%]), obsessive-compulsive disorder (0.96% [95% CI, 0.92%-1.00%] vs 0.63% [95% CI, 0.56%-0.72%]), and mood disorders (2.54% [95% CI, 2.47%-2.61%] vs 1.10% [95% CI, 0.84%-1.21%]). Incidence peaked earlier in boys than girls in ADHD (8 vs 17 years of age), intellectual disability (5 vs 14 years of age), and other developmental disorders (5 vs 16 years of age). The overall risk of being diagnosed with a mental disorder before 6 years of age was 2.13% (95% CI, 2.11%-2.16%) and was higher in boys (2.78% [95% CI, 2.44%-3.15%]) than in girls (1.45% [95% CI, 1.42%-1.49%]). This nationwide population-based cohort study provides a first comprehensive assessment of the incidence and risks of mental disorders in childhood and adolescence. By 18 years of age, 15.01% of children and adolescents in this study were diagnosed with a mental disorder. The incidence of several neurodevelopmental disorders peaked in late adolescence in girls, suggesting possible delayed detection. The distinct signatures of the different mental disorders with respect to sex and age may have important implications for service planning and etiological research.
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              Política Nacional de Atenção Integral à Saúde da Criança: orientações para implementação

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                Author and article information

                Journal
                Rev Esc Enferm USP
                Rev Esc Enferm USP
                reeusp
                Revista da Escola de Enfermagem da USP
                Universidade de São Paulo, Escola de Enfermagem
                0080-6234
                1980-220X
                20 May 2024
                2024
                : 58
                : e20230414
                Affiliations
                [1 ]Universidade Estadual de Campinas, Faculdade de Enfermagem, Campinas, SP, Brazil.
                Author notes
                Corresponding author: Giulia Delfini Rua Tessália Vieira de Camargo, 126, Cidade Universitária, 13083-887 – Campinas, SP, Brazil giudelfini@ 123456gmail.com
                [*]

                Extracted from the the master’s thesis: “Care for children with mental disorders through Dramatic Therapeutic Play: an approach based on intersubjective relationships”, State University of Campinas, 2023.

                ASSOCIATE EDITOR: Ivone Evangelista Cabral

                Author information
                http://orcid.org/0000-0002-3030-6647
                http://orcid.org/0000-0003-4009-1042
                http://orcid.org/0000-0002-0478-707X
                Article
                00603
                10.1590/1980-220X-REEUSP-2023-0414en
                11104736
                38767847
                a758e725-0038-4695-b355-53bb91961167

                This is an open-access article distributed under the terms of the Creative Commons Attribution License.

                History
                : 20 December 2023
                : 04 April 2024
                Page count
                Figures: 00, Tables: 00, References: 27
                Categories
                Theoretical Study

                nursing care,child,mental health,family,psychoanalysis,cuidados de enfermería,niño,salud mental,familia,psicoanálisis,cuidados de enfermagem,criança,saúde mental,família,psicanálise

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