Effectiveness of an intervention with mothers to stimulate children under two years

Torquato, Isolda Maria Barros; Collet, Neusa; Forte, Franklin Delano Soares; França, Jael Rúbia Figueiredo de Sá; Silva, Maria de Fátima de Oliveira Coutinho; Reichert, Altamira Pereira da Silva

doi:10.1590/1518-8345.3176.3216

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Revista Latino-Americana de Enfermagem

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Original Article • Rev. Latino-Am. Enfermagem 27 • 2019 • https://doi.org/10.1590/1518-8345.3176.3216 copy

Effectiveness of an intervention with mothers to stimulate children under two years^* * Paper extracted from doctoral dissertation “Vigilância de crianças com risco para o desenvolvimento psicomotor: um estudo de intervenção com mães”, presented to Universidade Federal da Paraíba, João Pessoa, PB, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

To analyze the effectiveness of an educational intervention with mothers to stimulate children under two years of age at risk for neuropsychomotor development.

Method:

Before-after intervention study, conducted with 52 mothers of children under two years old, enrolled in reference centers in early childhood education. Initially, maternal knowledge regarding child development and stimulation was assessed through a structured instrument. Then, workshops were held with the mothers and, after three months, maternal knowledge was revised, reapplying the data collection instrument. In the analysis, descriptive and inferential statistics were used, applying the McNemar and Wilcoxon tests and the Rasch Model from the Item Response Theory.

Results:

after the intervention, there was a significant increase in scores regarding the following aspects: knowledge of mothers about child development and stimulation from 5.77 ± 1.85 to 18.60 ± 1.94 (p <0.001); reduction of the maternal difficulty index in answering the instrument questions from 1.17 ± 0.57 to -1.98 ± 1.63 (p 0.01).

Conclusion:

the educational intervention contributed to the improvement of maternal knowledge regarding the development and forms of child stimulation, corroborating the importance of this action to advance the health of children at risk under maternal care at home.

Descriptors:
Child Development; Child Day Care Centers; Pediatric Nursing; Health Education; Mothers; Early Intervention

Variables	n	%
Maternal age (years)
19-29	26	50.0
30-39	25	48.1
>40	1	1.9
Marital Status
Married/common-law marriage	39	75.0
Others	13	25.0
Paid work
Yes	6	11.5
No	46	88.5
Family income
< 1 minimum wage^* * Minimum wage in Reais R$ 954.00 Brazil, 2018	33	63.5
1 minimum wage	18	34.6
2 to 3 minimum wages	1	1.9
Schooling (years of study)
Less than 1 year	2	3.9
1 to 3 years	6	11.5
4 to 7 years	14	26.9
8 years or more	30	57.7
Residence
Urban area	27	51.9
Rural Area	25	48.1
Number of children
1	35	67.3
2	14	26.9
3	3	5.8
Age of Child (Months)
1 to 6 months	2	3.9
7 to 12 months	19	36.5
13 to 24 months	31	59.6
Child’s sex
Female	27	51.9
Male	25	48.1
Total	52	100.0

Questions
	Pre		Post		p-value^* * P-value = McNemar Test
	%	n	%	n	p-value^* * P-value = McNemar Test
The mother should encourage interaction with the child from birth with smiles and games, talking with the child during the bath and diaper changes.	8	15.4	47	90.4	< 0.001
A child at 2 months can smile when looking at the face of an adult.	13	25.0	48	92.3	< 0.001
A child at 3 months is able to roll alone.	14	26.9	48	92.3	< 0.001
The child begins to duplicate syllables around 3 months.	29	55.8	38	73.1	0.093
For a child to have a firmer neck from the age of 3 (three) months, they must be placed face down and a colored object should be used, in front of them, to draw their attention.	7 7	13.5	49	94.2	< 0.001
4-month-old children lying on their stomach can lift and hold their head firmly.	8	15.4	45	86.5	< 0.001
Children utters their first word at 4 months.	20	38.5	44	84.6	< 0.001
At 4 months, the child should be seated with support so that they can exercise their head, making it firmer.	8	15.4	38	73.1	< 0.001
Objects and toys that encourage fitting functions should be offered to the child from 5 months.	12	23.1	38	73.1	< 0.001
Breastfeeding helps in the development of the child, so it should be practiced exclusively, without other fluids and foods, until 6 months.	18	34.6	47	90.4	< 0.001
A child sits on the floor without falling at 7 months.	16	30.8	46	88.5	< 0.001
A child at 7 months can reach for objects.	14	26.9	27	51.9	0.026
Music helps to develop the child’s hearing and creativity and should be used from the age of 8 months.	13	25.0	51	98.1	< 0.001
From 9 months, the child should be encouraged to play with paper and crayons to scribble.	11	21.2	41	78.8	< 0.001
The child should be encouraged to build cube towers at 11 months of age.	12	23.1	42	80.8	< 0.001
The child can walk with support at 12 months.	11	21.2	51	98.1	< 0.001
Most children at 12 months can pick up small objects using tweezer movement.	12	23.1	42	80.8	< 0.001
Affection and love are beneficial feelings for the development of children and must be demonstrated from 12 months of age.	27	51.9	50	96.2	< 0.001
From 12 months onwards, toys should be offered in front of the child so that they can try to drag and crawl.	15	28.8	37	71.2	< 0.001
The child should be encouraged to play kicking a ball from 12 months.	9	17.3	46	88.5	< 0.001
A child should be encouraged to locate pictures of books and magazines from 18 months of age.	11	21.2	50	96.2	< 0.001
Most children at 24 months are able to remove some garment with adult help.	12	23.1	50	96.2	< 0.001
Total	300	26.2	975	85.2	< 0.001

Variable	Intervention	Mean	Standard Deviation	Median	p-value*
Maternal knowledge	Pre	5.77	1.85	6	< 0.001
Maternal knowledge	Post	18.60	1.94	19	< 0.001
Degree of difficulty of maternal knowledge when answering the questionnaire	Pre	1.17	0.57	1.26	< 0.001†
	Post	-1.98	1.63	-2.18	< 0.001†

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[1] Corresponding author: Isolda Maria Barros Torquato. E-mail: isoldaufcg@gmail.com