Vulnerabilities of children admitted to a pediatric inpatient care unit

Cross-sectional, descriptive study from April to September 2013 with36 children aged 30 days to 12 years old, admitted to medical-surgical pediatric inpatient units of a university hospital and their caregivers. Data concerning sociocultural, socioeconomic and clinical context of children and their families were collected by interview with the child caregiver and from patients, records, and analyzed by descriptive statistics.

RESULTS:

Of the total sample, 97.1% (n=132) of children had at least one type of vulnerability, the majority related to the caregiver's level of education, followed by caregiver's financial situation, health history of the child, caregiver's family situation, use of alcohol, tobacco, and illicit drugs by the caregiver, family's living conditions, caregiver's schooling, and bonding between the caregiver and the child. Only 2.9% (n=4) of the children did not show any criteria to be classified in a category of vulnerability.

CONCLUSIONS:

Most children were classified has having a social vulnerability. It is imperative to create networks of support between the hospital and the primary healthcare service to promote healthcare practices directed to the needs of the child and family.

Health vulnerability; Children; Family; Inpatient Care Units

Dimensions	Closed questions (tool)	Criteria for the presence of vulnerabilities
Educational level of the child	 Regularly attends daycare or school  Years of study	No regular attendance of daycare or school Fewer years of study than the recommended for age range^[6]
Family housing	Type of house Presence of running water, basic sanitation, garbage collection Number of people living in the house	Absence of at least ones of mentioned items More than 3.3 people living in the same house^[7]
Child’s health history	Number of consultations in the first year of life Number of hospitalizations Access to healthcare services	Number of consultations <7 in the first year of life Number of hospitalizations >3^[8]
Family situation of the parent/guardian	Marital status Number of children  Family relationship with the child	No partner Female gender^[9]
Level of schooling of the parent/guardian	Years of study of the parent/guardian	Illiteracy Unfinished elementary school^[6]
Financial situation of the parent/guardian	Current occupation Monthly family income Number of people that share the monthly income  Monthly family income versus basic needs of the family	Unemployment  Family income <1 minimum wage/month  Monthly family income does not meet basic needs of the family^[10]
Use of alcohol and illicit drugs by the parent/guardian	Use of tobacco, alcohol and illicit drugs	Use of tobacco (>10 cigarettes/day) Use of alcohol or illicit drugs^[11]
Family relationship between the parent/guardian and the child	Strengthened the emotional bonding (self-reported)	Strengthened the emotional bonding between the parent/guardian and the child^[12]

Characteristics	n (%)
Male gender	72 (52.9)
Ethnicity
White	98 (72.1)
Mixed race	22 (16.2)
Black	16 (11.7)
Does not attend school	95 (69.9)
Type of housing
Brick	90 (66.2)
Wood	23 (16.9)
Mixed	23 (16.9)
Basic sanitation
Running water	130 (95.6)
Basic sanitation	123 (90.4)
Garbage collection	130 (95.6)
Access to health care services	107 (78.7)
Participation in the MH program	99 (72.8)
Hospital admissions
First admission	58 (42.6)
Previous admissions	78 (57.4)
No chronic disease	86 (63.2)

Characteristics	n (%)
Female gender	126 (92.6)
Age
≤20 years	11 (8.1)
>20 years ≤ 40 years	88 (64.7)
>40 years	37 (27.2)
Marital status
Married and/or lives with partner	95 (69.9)
Single	24 (17.6)
Widowed	6 (4.4)
Divorced or separated	11(8.1)
Level of schooling (years)^a	7.9 ±3.5
Family income in minimum wages
Up to one minimum wage	46 (33.8)
Between one and two minimum wages	49 (36.0)
Between two and three minimum wages	39 (28.7)
More than three minimum wages	2 (1.5)
Income supports basic needs	79 (58.1)

Vulnerabilities	Vulnerable n (%)
Of the child
Level of schooling	5 (3.7)
Housing status	21 (15.4)
Presence of previous health problem	60 (44.1)
Of the parent/guardian
Family situation	54 (39.7)
Level of schooling	87 (64.0)
Economic status	77 (56.6)
Use of alcohol/illicit drugs	30 (22.1)
Adult/child relationship	2 (1.5)

Sociedade de Pediatria de São Paulo R. Maria Figueiredo, 595 - 10o andar, 04002-003 São Paulo - SP - Brasil, Tel./Fax: (11 55) 3284-0308; 3289-9809; 3284-0051 - São Paulo - SP - Brazil
E-mail: rpp@spsp.org.br

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[1] *Corresponding author.E-mail:mariacarolinawit@hotmail.com (M.C. Witkowski).

Brasil

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Vulnerabilities of children admitted to a pediatric inpatient care unit☆ ☆ Study conducted at Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSIONS:

Vulnerabilities of children admitted to a pediatric inpatient care unit^☆ ☆ Study conducted at Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.