Educational action to monitor children’s growth and development based on the theory of meaningful learning

Vieira, Daniele de Souza; Brito, Paloma Karen Holanda; Bezerra, Iolanda Carlli da Silva; Soares, Anniely Rodrigues; Santos, Luciano Marques dos; Toso, Beatriz Rosana Gonçalves de Oliveira; Vaz, Elenice Maria Cecchetti; Collet, Neusa; Reichert, Altamira Pereira da Silva

doi:10.1590/1980-220X-REEUSP-2023-0200en

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 57 • 2023 • https://doi.org/10.1590/1980-220X-REEUSP-2023-0200en copy

Educational action to monitor children’s growth and development based on the theory of meaningful learning

Acción educativa para controlar el crecimiento y el desarrollo del niño basada en la teoría del aprendizaje significativo

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

Evaluating the effect of an educational program on the knowledge of Primary Health Care nurses regarding the surveillance of growth and development during childcare appointments.

Method:

A before-after intervention study with 30 nurses. The nurses’ knowledge and practice assessment were done using a tool that had been developed and validated. The educational activity was carried out, linking child growth and development indicators with public policies for early childhood and nurses’ practices. David Ausubel’s Significant Learning Theory was used as a teaching-learning strategy. The same instrument was reapplied after one month. Descriptive statistics were used in the analysis and the proportion test, Wilcoxon test and Item Response Theory with the Rasch model were applied.

Results:

The nurses checked more items right in the instrument after the intervention; there was an increase in the scores of correct answers and a decrease in the item response difficulty index in the knowledge and practice section, post-intervention.

Conclusion:

The educational activity had a positive effect, affecting changes in nurses’ knowledge and practice, which enabled childcare consultations to become more qualified.

DESCRIPTORS
Primary Health Care; Child Development; Education; Nursing; Public Health Surveillance

Items^‡ *p-value = significance level of the proportion test; †IRT = Item Response Theory; ‡The continuity of the questions can be consulted in supplementary material.	Pre test		Post test		p-value^* *p-value = significance level of the proportion test; †IRT = Item Response Theory; ‡The continuity of the questions can be consulted in supplementary material.	IRT^† *p-value = significance level of the proportion test; †IRT = Item Response Theory; ‡The continuity of the questions can be consulted in supplementary material.
	n	%	n	%		Pre test	Post test
	What is the ideal time for a home visit when a healthy newborn is discharged from the maternity hospital?	4	13,3	22		73,3	<0,001	2,07	–1,14
What is the minimum number of childcare visits recommended in the first year of life?	9	30,0	19	63,3	0,031	0,95	–0,63
The Ministry of Health recommends that appointments be made periodically and also according to the child’s needs. Choose the correct alternatives.	3	10,0	19	63,3	<0,001	2,42	–0,63
When assessing infant feeding, which of the following indirect indications can alert you to the fact that the child is not receiving enough breast milk.	13	43,3	21	70,0	0,115	0,30	–0,96
In relation to the introduction of food to children from the age of six months, analyze the following statements.	10	63,3	24	80,0	0,227	–0,62	–1,55
When should a complete physical examination of the child be carried out at the childcare appointment?	1	3,3	19	63,3	<0,001	3,63	–0,63
How should the physical examination of the child be carried out at the routine appointment?	4	13,3	18	60,0	0,001	2,07	–0,47
In relation to child growth monitoring, check T (True) and F (False).	11	36,7	10	33,3	0,999	0,61	–0,96
In the case of infants under one year of age with a low weight-for-age situation (below Score-2 on the chart), identified for the first time at the childcare visit, which of the behaviors would be appropriate.	18	60,0	21	70,0	0,581	–0,46	–1,14
The monitoring of preterm infants (<37 weeks gestational age) requires.	17	56,7	24	80,0	0,092	–0,3	–3,61
In relation to the monitoring of child development, mark T for True and F for False.	23	73,7	22	73,3	0,999	–1,33	–1,34
Among the risk factors listed, which one is not associated with neuropsychomotor developmental deficit (NPMD) in children?	28	93,3	29	96,7	0,999	–2,87	–3,62
From what age group is a child expected to sit without support?	23	73,7	23	76,7	0,999	–1,33	–2,87
How important is the mother’s/caregiver’s opinion in monitoring the child’s development?	29	96,7	29	96,7	0,999	–3,62	–2,07
What should you do at a childcare appointment when a child is developing adequately but has risk factors for developmental changes?	11	36,7	13	43,3	0,791	0,61	–2,87
In relation to the warning signs for children under 2 months of age, mark V for True and F for False.	26	86,7	28	93,3	0,625	–2,07	–1,14
What is the appropriate course of action when caring for a child in a situation compatible with violence?	25	83,3	26	86,7	0,999	–1,79	–0,63
How should continuity of care for children with special health needs (chronic illness, autism, hyperactivity, premature babies, etc.) be handled in the FHS?	23	76,7	28	93,3	0,125	–1,33	–0,63

Items^‡ *p-value = significance level of the proportion test; †IRT = Item Response Theory; ‡The continuity of the questions can be consulted in the supplementary material.	Pre test		Post test		p-value^* *p-value = significance level of the proportion test; †IRT = Item Response Theory; ‡The continuity of the questions can be consulted in the supplementary material.	IRT^† *p-value = significance level of the proportion test; †IRT = Item Response Theory; ‡The continuity of the questions can be consulted in the supplementary material.
	n	%	N	%		Pre test	Post test
	How often do you visit the newborn at home?	8	26,7	11		36,7	0,503	1,14	0,63
How often do you visit children under 1 year of age?	26	86,7	27	90,0	0,999	–2,08	–2,48
How often do you visit children between the 2nd and 3rd year of age?	21	70,0	22	73,3	0,999	–0,96	–1,17
How do you assess the child’s diet?	25	83,3	27	90,0	0,687	–1,80	–2,48
How do you advise mothers/caregivers about the child’s diet?	28	93,3	29	96,7	0,999	–2,89	–3,70
Do you carry out a physical examination of the child at the first childcare appointment?	28	93,3	30	100	0,472	–2,89	–
What anthropometric measurements do you usually consider when assessing a child’s growth?	18	60,0	25	83,3	0,065	–0,46	–1,84
What do you do when you identify a change in the child’s weight?	20	66,7	26	86,7	0,774	–0,79	–1,18
Do you routinely monitor child development at childcare appointments?	27	90,0	26	86,7	0,999	–2,43	–2,13
Which item do you use the most to assess the child’s development?	27	90,0	30	100	0,236	–2,43	–
What is your main justification for asking mothers/caregivers what they think of their child’s development?	24	80,0	28	93,3	0,219	–1,56	–2,94
How do you assess the child’s development during the childcare visit?	24	80,0	27	90,0	0,453	–1,56	–2,48
Do you advise mothers/caregivers on how to stimulate the child’s development?	27	90,0	30	100	0,236	–2,43	–
Where do you record the child’s growth and development data?	26	86,7	30	100	0,120	–2,08	–
Do you give guidance to mothers/caregivers on the results of the child’s growth assessment?	26	86,7	30	100	0,120	–2,08	–
Name two guidelines for assessing growth.	16	53,3	23	76,7	0,092	–0,15	–1,38
Do you know the danger signs / warning signs of a sick child?	27	90,0	30	100	0,236	–2,43	–
Name at least three danger signs.	14	44,7	25	83,3	0,013	–0,15	–1,84
Do you ever talk to mothers/caregivers about accident prevention?	27	90,0	29	96,7	0,325	–2,43	–3,70

Variable	Intervention	Mean	SD	Median	p-value
Nurses’ knowledge	Pre	9,57	1,99	9,50	<0,001^* *Wilcoxon test significance level; †IRT = Item Response Theory.
Nurses’ knowledge	Post	13,17	2,07	13,0
Degree of difficulty of the knowledge section	Pre	–0,17	1,93	–0,38	<0,001^† *Wilcoxon test significance level; †IRT = Item Response Theory.
Degree of difficulty of the knowledge section	Post	–1,49	1,05	–1,14
Nurses’ practice	Pre	76,92	18,70	86,7
Nurses’ practice	Post	86,70	15,63	86,7	0,002^* *Wilcoxon test significance level; †IRT = Item Response Theory.
Degree of difficulty of the practice section	Pre	–1,60	1,14	–2,08
Degree of difficulty of the practice section	Post	–2,05	1,16	–2,13	0,002^† *Wilcoxon test significance level; †IRT = Item Response Theory.

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Daniele de Souza Vieira, Universidade Federal da Paraíba Campus I, S/N, Loteamento Cidade Universitária, 58051-900 – João Pessoa, PB, Brazil, daniele.vieira2015@gmail.com