Experiencing pregnancy at an advanced maternal age in a private hospital

Objective: to describe the experiences of pregnant women at advanced maternal age assisted in a private hospital. Methods: a qualitative study, carried out with 17 women, by means of semi-structured interviews via telephone. The data was submitted to Thematic Content Analysis. Results: the participants were between 35 and 40 years old. Two categories emerged: Experiencing pregnancy as a couple and family: the preparation of the couple for pregnancy and childbirth (Pregnancy after 35 years old as an element of potentiality; Change in the family routine for the baby’s arrival) and Experiencing pregnancy and its changes: perceiving pregnancy as a healthy and calm experience (Change in emotional patterns related to the pregnancy process). Conclusion: experiencing pregnancy late in life was not a concern for women. Maturity and favorable socioeconomic conditions may have a protective influence on the course of healthy pregnancies in women attending the private health service.

O Brincar no Cotidiano Familiar de Crianças com Transtorno do Espectro Autista/The Play in Daily Life Family of Children with Autism Spectrum Disorder

Introdução: A literatura defende que o brincar tem grande importância para o desenvolvimento da criança e para suas relações com o mundo. Sabendo sobre os comprometimentos que o transtorno do espectro autista podem trazer para o desenvolvimento infantil e para a dinâmica familiar. Objetivo: Investigar como famílias de crianças autistas propiciam o brincar no seu cotidiano e o papel dos parentes nessa atividade. Método: A pesquisa foi conduzida com quatro famílias de crianças com autismo, de três a cinco anos, envolvendo suas mães, pais e um irmão mais velho. Foi utilizada metodologia qualitativa, baseada em narrativas dos pais e irmão. Resultados e Conclusão: Observou-se que cuidado e brincar se encontram dissociados, de modo que, na rotina familiar, cabe à mãe, o cuidado dos filhos, e fica ao encargo dos pais exercerem o papel de agentes lúdicos. O fato de algumas crianças terem irmãos demonstrou que estes podem auxiliar na organização de uma rotina mais lúdica e podem ser bons parceiros na dinâmica de brincar que se instala na casa. As famílias são parceiras no processo terapêutico ocupacional e auxiliam para que o brincar criativo possa estar presente nesse processo. Cabe aos terapeutas ocupacionais que trabalham na área da infância, um olhar mais atento à qualidade de vida das famílias das crianças atendidas.Palavras-chave: Autismo Infantil. Relações familiares. Brincadeiras. Terapia Ocupacional AbstractIntroduction: The literature illustrates the importance of playing with the child for their development and their relationship with the world. Knowing the impairment that the autistic spectrum disorder can cause to child’s development and to the family dynamics. Objective: to investigate how the families of autistic children enable playing in their child’s daily life and the relative’s contribution in this activity. Method: The research was conducted with four families that have autistic child ages three to five years old, involving their mother, father and an older sibling. For the collecting of data the qualitative methodology was used based on parents and sibling narrative. Results and Conlcusion: In the family routine it was observed that the care and play are decoupled. The child’s care is up to the mother and play is left to the father who fills the playful agent role. The fact of some children has a sibling showed that they can participate in the organization of a more playful routine. They can be good partners to set the playful dynamics in the house. Having a child with developmental disorder entails a number of difficulties for parents. The family is partner in the occupational therapy process. The family’s members helps because they can include the creative playing in this process. It is necessary for the occupational therapists working in the childhood's area pay more attention to a closer look at the families’ quality of life for the assisted children.Keywords: Autistic Disorder. Family Relations. Play and Playthings. Occupational Therapy ResumenIntroducción: La literatura sostiene que el juego es de gran importancia para el desarrollo de los niños y sus relaciones con el mundo. Conociendo las deficiencias que el trastorno del espectro autista puede traer al desarrollo infantil y la dinámica familiar. Objetivo: investigar cómo las familias de niños autistas brindan juego en su vida diaria y el papel de los familiares en esta actividad Metodo: La investigación se realizó con cuatro familias de niños con autismo de tres a cinco años, involucrando a sus madres, padres y un hermano mayor. Se utilizó metodología cualitativa basada en narrativas de padres y Hermanos. Resultados y Conclusión: Se observó que el cuidado y el juego están disociados, por lo que en la rutina familiar corresponde a la madre cuidar a los hijos y corresponde a los padres ejercer el rol de agentes lúdicos. El hecho de que algunos niños tengan hermanos demostró que pueden ayudar a organizar una rutina más lúdica y pueden ser buenos compañeros en las dinámicas de juego que se instalan en la casa. Las familias son socias en el proceso terapéutico ocupacional y ayudan a que el juego creativo pueda estar presente en este proceso. Depende de los terapeutas ocupacionales que trabajan en el área de la niñez examinar más de cerca la calidad de vida de las familias de los niños atendidos. Palabras clave: Autismo infantil. Relaciones Familiares. Juego. Terapia Ocupacional

The Impact of a Preterm Baby Arrival in a Family: A Descriptive Cross-Sectional Pilot Study

Background: The rate of premature births is increasing every day, with an estimated 15 million premature babies born worldwide each year. When a child is born prematurely, he or she is transferred to a Neonatal Intensive Care Unit (NICU), requiring special care on an ongoing basis. The admission of the newborn to these units can negatively affect the family routine as it generates changes and requires adaptation to new roles. Objectives: The objective of the present study was to understand the effect of the arrival of a premature baby on the family, based on the parents’ perception. Methods: A cross-sectional descriptive observational study conducted by means of a self-administered online ad-hoc questionnaire which collected information related to the situation of the relatives of premature infants in the region of Extremadura (Spain). The questionnaire consisted of a total of 35 questions, divided into three sections: ‘family environment’, ‘stay in hospital’ and ‘return home’. Results: Among the 53 responses obtained from fathers and mothers, 44 were from mothers. 53.6% of the respondents felt a delay in the acquisition of their parental role and 86.8% were afraid for their baby. During hospital stay, most of the parents had to modify their routines (94.3%), 69.8% suffered from sleep disturbances, 84.9% changed their eating habits and 88.5% referred to loss of time for themselves. Once at home, the time it took to recover their family normality ranged from 4 to 11 months, while 84.9% of respondents neglected their personal appearance and more than half had to give up or reduce their working hours. Conclusion: The arrival of a premature baby has a strong impact on the parents’ family environment, altering their daily routines and occupations both in hospital and at home. If preterm care programmes take into account these possible occupational imbalances, it will not only meet the needs of the parents but also provide family-centred care.

Qualitative Exploration of Mealtime Routines and Parental Stress of Children with Pediatric Feeding Disorders: Analysis of Occupational Performance

Pediatric feeding disorders (PFD) affect approximately 25-35% of children with typical development, 40-80% of children with developmental disabilities, and 90% of children with autism spectrum disorder (ASD). Feeding disorders affect families by disrupting mealtime routines, changing family dynamics, and increasing parental stress. Occupational therapy (OT) focuses on client-centered care that facilitates independence in meaningful occupations, including feeding and eating. OTs also play an essential role in assisting, training, and educating parents on effective mealtime strategies that can be implemented and carried over into the home environment. Few research studies show how parents manage behaviors and stress during mealtime routines, and little attention has been placed on how PFD can affect parental stress. This study reinforces the value of OT services that focus on family-based interventions and family-based training, considering rituals, routines, and environment to help decrease parental stress during mealtime routines. Data was collected during face-to-face interviews with parents of children diagnosed with PFD. The data gathered was used to identify and analyze how parents of children with PFD manage behaviors and stress during mealtimes. This study benefits families of children with PFD because it will provide additional resources and advocacy for parents. The benefit of having more resources available for parents regarding mealtime stress and mealtime behaviors is that parents will have more opportunities to find a strategy that will benefit the family routine and dynamic. This study will benefit OT practitioners because it will help guide OT family-based interventions reinforcing the importance of carry-over strategies for parents. Analysis of the data suggested that parents of children with PFD perceive mealtime behaviors as highly stressful. The analysis also showed that parents tend to ignore maladaptive mealtime behaviors during mealtime. However, when this was not successful, they would soothe the child or use punishment such as taking away electronic devices. To relieve stress, parents reported getting outdoors and talking to family or friends as the primary way of reducing stress. The findings from this qualitative study support the need for OTs to incorporate families’ unique habits, routines, and cultural and social norms into parent training to ensure the carry-over of strategies into the respective home environment.

Anthropomorphic symbolic images in the Ukrainian folk dancing culture

The purpose of the article is to define the semantics of the actional forms and compositional structures of circle dances and dancing pantomimes featuring the anthropomorphic images which are characteristic of the traditional annual calendar, rites of passage, and family routine ceremonialism laying the original background of the Ukrainian artwork. The methodology rests on the grounds of the complex approach and the application of analytical (art-critical, philosophical, cultural approaches to the field of study), historical (the Ukrainian choreography genesis study), cultural (examining functions performed by folk dancing culture in the spiritual life of the Ukrainian ethnos) and semiotic (analysis of dance signs structure and dancing symbols semantics) methods. Scientific novelty: the author has conducted a complex art critical research of the anthropomorphic images that became symbols in the Ukrainian national tradition with the determination of their in-depth semantic meaning and functional role in the national dancing art. Conclusions. Within the imagery richness of the Ukrainian folk choreography, there are a lot of sign-symbols, character-symbols represented in dance space patterns, and figures reproduced by performers’ plastic movements. The study of the structural-verbal and symbolic features of these choreographic patterns gives reasons to claim about their undoubted archaic roots in a play mode reflecting the unique variant of the transitional ritual (passage rite) related to an individual’s life, his status, and the external world.

Az otthoni tanulás sikerességét bejósló tényezők a Covid–19 okozta vészhelyzet miatt kialakított digitális munkarendben eltérő szocioökonómiai helyzetű családok esetében

Összefoglaló. A COVID–19-vírusjárvány miatt 2020 márciusától júniusáig bevezetett iskolai digitális munkarend az oktatási rendszer minden résztvevőjét számos új feladat elé állította. Feltételezzük, hogy különösen nagy kihívást jelenthetett a hátrányos helyzetű családok számára (Jakab 2020). Jelen tanulmányban egy kérdőíves kutatás eredményeit mutatjuk be, amelyben azt vizsgáltuk, hogy a szocioökonómiai státusz, a háztartási rendezettség, a családi rutin, valamint a gyermek tanulásba tett erőfeszítése közül mely tényezők jelzik előre az iskolai digitális munkarendben a tanulási sikerességet. A mintát középosztálybeli és hátrányos helyzetű, romatelepen élő, alsó tagozatos gyermeket nevelő felnőttek alkották. A hierarchikus lineáris regresszió eredményei azt mutatják, hogy a szocioökonómiai státusz önmagában nem szignifikáns prediktora a tanulási sikerességnek, azonban a tanulási erőfeszítés, a háztartási rendezettség és a családi rutin igen. A fenti eredmények – habár pusztán összefüggéseket és nem feltétlen kauzális kapcsolatokat mutatnak – alátámasztják, hogy hátrányos helyzetű gyermekek feltételezhetően sikeresen támogathatók a távoktatásban való eredményes részvételben egy, a fenti változókat célzó, intervencióval. Summary. Because of the COVID-19 pandemic, the education system switched to digital distant learning education from March to June 2020. These changes posed a number of new challenges to students, teachers and parents alike. We assume that disadvantaged families were in an even more vulnerable position (Jakab 2020). Thus, we aimed to conduct a study to examine whether and how certain factors, including socioeconomic status, household chaos, family routine, and children’s learning effort affected learning success during this period of homeschooling. The sample consisted of high/middle-class and disadvantaged (living in a Roma settlements) caregivers of 1st–4th grader children. Our results indicate that socioeconomic status alone was not a significant predictor of learning success, however, learning effort, household chaos, and family routine were found to be important predictors. These results – although purely correlational – might suggest that a targeted intervention can be expected to effectively help disadvantaged children adapt to and succeed in a digital distant learning education setting.

Risk factors for fine and gross motor development in preterm and term infants

ABSTRACT Purpose To investigate the association of sociodemographic, obstetrical and psychosocial factors with fine and gross motor developmental delay in preterm and term infants, in the age group of three months and one day to twelve months and twenty-nine days. Methods The term and preterm infants were evaluated by the Denver II Test for fine and gross motor skills, investigated in three phases: 165 infants in phase 1 (3 months and 1 day to 4 months and 29 days), 130 infants in stage 2 (8 months and 1 day to 9 months and 29 days) and 102 infants in phase 3 (11 months and 1 day to 12 months and 29 days). Sociodemographic, obstetrical and psychosocial data were obtained through an initial interview with family members and the psychic risk assessment through the Child Development Risk Indicators and PREAUT protocols. Statistical analysis was performed using the logistic regression model. Results Significant factors in the association with fine and gross motor delay were: maternal gestational and obstetric history (planned pregnancy, type of delivery, number of prenatal consultations, use of medication and gestational intercurrence), features and biological risks of the baby (gender, mechanical ventilation, feeding difficulty), sociodemographic factors (career and level of maternal schooling, number of children and people in the house) and psychosocial issues concerning to the family routine participation and presence of psychic risk. Conclusion There was a significant association between motor development delay of the infants, environmental and biological variables, with emphasis on psychic risk.

An Exploration of Mothers’ Beliefs, Expectations, and Behaviors Regarding Young African American Children’s Early School Experiences and Success

We explored mothers’ beliefs, expectations, and behaviors as these relate to early academic success, their roles as parents to young children, and the influence of other ecological factors. Eleven African American mothers of children in kindergarten through third grades were interviewed twice with daily journaling for 2 weeks. Utilizing both Bronfenbrenner’s ecological systems theory and Spencer’s phenomenological variant of ecological systems theory as our primary theoretical underpinnings, results were interpreted emphasizing contextual, cultural, and personal characteristics that may serve as protective or risk contributors during children’s education. As mothers defined their contributions to the early academic success of their children, related themes emerged from the data including the significance of parent involvement, family routine and cohesiveness, the availability of resources, and racial issues. Findings provide a contextualized cultural understanding of African American mothers’ beliefs and their potential influence on their children’s early school experiences and how these beliefs are enacted in structured and intentional ways.

T229. CAREGIVER BURDEN IN TREATMENT RESISTANT VERSUS NON-TREATMENT RESISTANT SCHIZOPHRENIA

Background About one-third of patients with schizophrenia are treatment-resistant (TRS). They cause a significative burden for their caregivers (1). Our objective is to compare caregiver burden in TRS versus non-TRS outpatients with schizophrenia. Methods Patients with diagnosis of schizophrenia (DSM-5), 18–50 years, both sexes, and a relative/caregiver, both sexes, aged 18 to 70 years, living in contact with the patient ≥30 hours/week. The use of clozapine for more than 6 months, in stable daily dosage was used as a proxy for TRS; non-TRS were patients using other antipsychotics, with stable dosage for at least 6 months. Psychopathology was evaluated with the CGI-Schizophrenia Scale (2). Family burden was assessed with the Family Burden Interview Schedule (FBIS-BR), objective and subjective total and subscores (3). Student’s t-test and chi-square test were used to compare TRS versus non-TRS patients and caregivers. Results TRS patients: n = 45; (31 male, 14 female); mean age: 37.11 ± 8.93 years; age at onset of illness 20.84 ± 6.20 years; duration of disease: 16.51 ± 9.14 years. CGI: positive: 3.96 ± 1.22; negative: 3.62 ± 1.17; depressive: 2.36 ± 0.98; cognitive: 3.76 ± 1.26; total: 13.66 ± 3.31. TRS Caregivers: n=45 (12 male, 33 female); mean age: 56.7 ± 11.04 years; in contact with the patient 82.53 ± 36.98 hours/week. Non-TRS patients: n= 15 (9 male, 6 female); mean age: 36.00 ± 12.49 years; age onset of illness 21.93 ± 9.73 years; duration of disease: 14.20 ± 13.66 years. CGI: positive: 2.40 ± 1.40; negative: 3.40 ± 1.24; depressive: 2.33 ± 1.11; cognitive: 3.20 ± 0.86; total: 11.33 ± 3.51. Non TRS Caregivers: n=15 (2 males, 13 female); mean age: 53.13 ± 13.61 years; in contact with the patient 106.13 ± 62.47 hours/week. Sociodemographic variables showed no significant differences were observed between TRS and non-TRS groups. CGI positive and total scores were significantly higher in TRS patients compared to non-TRS patients (p<0.001 and p<0.024 respectively). FBIS-BR Scores: TRS caregivers: The mean total score of the objective burden was 2.41 ± 0.66 and subjective burden was 2.00 ± 0.64. Assistance to the patient in daily life (objective) was 2.99 ± 0.55 and its subjective score was 1.56 ± 0.80. Supervision of patients’ problematic behaviors was 1.81 ± 0.61 and its subjective score was 1.00 ± 1.00. Impact on family routine was 2.43 ± 1.13 and worries about the patients’ present and future life (subjective) was 3.45 ± 0.70. Non TRS caregivers: The mean total score of the objective burden was 2.42 ± 0.58 and subjective burden was 2.18 ± 0.51. Assistance to the patient in daily life (objective) was 3.30 ± 0.80 and its subjective score was 1.91 ± 0.93. Supervision of patients’ problematic behaviors was 1.80 ± 0.51 and its subjective score was 0.94 ± 0.59. Impact on family routine was 2.16 ± 0.86 and worries about the patients’ present and future life (subjective) 3.68 ± 0.55. No significant differences were observed between the TRS and non-TRS caregivers’ groups. Discussion Contrary to our initial expectation (1), TRS and non-TRS caregivers showed similar burden, even though TRS patients had higher positive scores on the CGI. This lack of difference may be due to small number of patients in the non-TRS group; non-TRS patients might be refractory but did not receive clozapine yet. It is also possible that TRS caregivers adapt to the caring of these severe patients and learn to deal with the burden the disease.

Family dynamics and social network of families of children with special needs for complex/continuous cares

ABSTRACT: Objective: To describe the family dynamics and the social support network for families of children with special needs of multiple, complex and continuous care. Methods: A descriptive study of a qualitative approach, carried out in Maringá - PR, having as theoretical and methodological reference the Calgary Model of Family Assessment (CMFA). Data was collected through semi-structured audio-video interviews, carried out in the homes, together with 11 family caregivers of 13 children. Results: Data is presented in the following categories: structural, developmental and functional evaluation, which show the changes in the family routine and the needs for the adjustment of the roles of its members, in order to better implement the care at home. Conclusions: Using the CMFA made it possible to identify and understand the composition, fragilities and potentialities of the family, as well as the relationships among its members and rearrangements to better enable care at home. This information favors interventions congruent with the needs of these families.