Desenvolvimento neuromotor de crianças com necessidades especiais de saúde

Abstract

OLIVEIRA, Natália Rodrigues. Neuromotor development of children with special health needs. 2020. 138f Thesis [Doctorate in Nursing]. Universidade Federal do Ceará, Fortaleza, 2020. Assessment of the neuropsychomotor development is a health promotion strategy that aims to identify as early as possible changes and risks for child development delay, aiming at minimizing negative incomes and enhancing motor skills. The aim was to evaluate neuropsychomotor development of children with risk of delay in development and/or with special health care needs. Quantitative study, descriptive cross-sectional type performed in a treatment and early stimulation center in Fortaleza/CE, with data collect from June/2018 to January/2019. Sample consisted of 65 parents/principal caregivers and 65 children. It was eligible the child that was in periodic follow-up in the institution with age between 2 months and 16 days and 12 months and 15 days with risk for alteration in neuropsychomotor development, independently of gestational age, birth weight, congenital malformation and pathologies. It was excluded those that clinical condition couldn’t allow the evaluation, as grave infections, feverish conditions, use of sedatives, post-ictal moment, unable to tactile stimulation due to risk of seizure. Two instruments were applied: Harris Infant Neuromotor Test – HINT – Brazilian version, identification form. HINT application occurred during nursing consultation, medical consultation and stimulation sessions. Study approved by the Ethics and Research Committee of Federal University of Ceará under report number: 2.704.873. Most of the children (40) had chronological age above 7 months and 16 days; (23) had corrected age less than 7 months and 16 days, premature, male gender. The most prevalent risk factors were hospitalization in Neonatal Intensive Care Unit, use of oxygen, Respiratory Discomfort Syndrome, low weight; whereas the maternal ones were advanced age, hemorrhage and infection. Regarding the development classification of children: Abnormal (43.1%), Normal (30.8%), Advanced (16.9%), Suspicious (9.2%). The most prevalent diagnosis was prematurity 47 (72%) and 22 (46%) of premature babies presented abnormal classification by HINT. When final HINT scores were compared with maternal and perinatal variables, no difference was identified, except for Apgar 1º minute (p<0,034). In the association between maternal and perinatal variables and neuropsychomotor development classification, there was difference with chromosomal abnormality, auditory limitation, visual limitation. Risk factors that presented statistical significance with the final HINT score were seizures, hydrocephaly, visual limitation, intraventricular hemorrhage, use of ventilator. Perception of parents/principal caregivers about the child showed that 46.2% felt soft and cozy, 44.6% thought that they moved well, but was concerned; 44.6% that the child was slightly late for the age. All four questions about parent perception when associated to HINT classification showed p<0.05 (Likelihood ratio). It is concluded that the use of HINT allowed to classify the neuropsychomotor development of the children studied, showed relevance with emphasis on parent perception supporting actions centered in family which will contribute to child health promotion, having an impact on the infant morbidity and mortality decreasing them. Moreover, it was shown that HINT can be used on the care of children with special health care needs.