Parmi les tiers qui gravitent autour d’un enfant, il en est un que le droit français de la famille peine à reconnaître la singularité : l’homme ou la femme qui est en couple avec le parent d’un enfant et qui, à l’égard de ce mineur, assure une prise en charge plus ou moins factuelle.Qu’il se greffe sur une famille ou qu’il la compose, ce tiers communément dénommé « beau-parent » semble désormais connu, par une partie du droit positif (jurisprudence et doctrine), sous le vocable de parent social.Il est à reprocher au droit actuel de ne pas parvenir à appréhender, par des règles autonomes, les relations personnelles unissant ce tiers à l’enfant du parent dont il est le concubin, partenaire pacsé ou conjoint, de sexe différent ou de même sexe. Certes, l’incursion de ce tiers dans le mécanisme de l’autorité parentale ne saurait s’affranchir des principes directeurs du droit la famille : la coparentalité, l’indisponibilité de ladite autorité et l’impérieux respect de l’intérêt supérieur de l’enfant. Par la présente étude, il s’agit de mettre en exergue l’inopportunité, de lege lata, de l’identification du parent social par assimilation juridique et de l’en extirper en concevant un statut sui generis . Surgirait, de lege ferenda, le beau-parent statutaire. / Among third parties gravitating around a child, French Family Law has difficulty recognizing the singularity of one of them: the one (he or she) who, being in relationship with a child’s parent, provides care for the latter to a certain extent.Whether he or she is bound to a family, or is part of it, this third party commonly named “stepparent” now seems to be known by some part of the positive Law (jurisprudence and doctrine) referred to as “social parent”.One can blame French Law for not succeeding in apprehending, with autonomous rules, these relationships between the third party and the child whose parent is his concubine, having registered a civil union or spouse as a same-sex couple or opposite sex. Indeed the incursion of this third party into the mechanism of parental authority should in no way free itself from the guiding principles of Family Law: joint parenthood /co-parenting; the unavailability of the so-called authority and the upmost respect of the best interest of the child. This study is aimed at highlighting the impropriety, of lege lata, of the identification of the social parent by legal assimilation removing it, thus conceiving a sui generis status. Therefore it might occur from lege ferenda, the statutory stepparent.

Uppsatsens övergripande syfte är att undersöka om, och i så fall hur, unga vuxnas erfarenheter av separation och vårdnadstvist mellan föräldrarna under barndomen inverkat när det gäller inställning till samlevnadsfrågor. Mer konkret är avsikten att söka svar på frågor som beaktar principen om barnets bästa, attityder gentemot relationer, separationer och giftermål liksom dagens relation till föräldrarna. Tolkningsramen som användes för att tolka och förstå uppsatsens empiriska material baseras på de inledande bestämmelserna enligt 6 kap. föräldrabalken, några risker med socialarbetarens förhållningssätt, barnets känsla av ansvar, lojalitet och hemlighållande, barnets överlevnadsstrategier och kognitiv dissonansteori. Dessa tolkningsredskap var effektiva för att belysa unga vuxnas erfarenheter från barndomen och deras attityder till samlevnadsfrågor. En kvalitativ metodansats tillämpades för att inhämta det empiriska materialet och fem kvinnliga respondenter intervjuades med hjälp av en semistrukturerad intervjuguide. Uppsatsens slutsatser indikerar att principen om barnets bästa inte alltid beaktades för de unga vuxna under barndomen. Deras attityder gentemot relationer, separationer och giftermål präglas av en öppen inställning till olika familjekonstellationer med goda kvalitéer, positiva respektive negativa följder av föräldrarnas separation och uppfattningen om att vilja gifta sig i framtiden. Dagens relation till den ena föräldern har visat sig vara fortsatt god medan relationen till den andra föräldern varierar. / The purpose of the essay is to examine whether, and if so how, young adults' experiences of separation and contested custody between parents during childhood influenced their attitudes to coexistence issues. Further, the intention is to seek answers to questions regarding: the best interests of the child, attitudes towards relationships, separation and marriage, as well as the current relationship to the parents. The interpretative framework adopted to interpret and understand the empirical material is based on the initial provisions under chapter 6, some risks with the social workers' approach, the children's sense of responsibility, loyalty and concealment, the child’s survival strategies as well as cognitive dissonance theory.  These are considered effective to highlight young adults' experiences in childhood and their attitudes to coexistence issues. A qualitative method was applied to obtain the empirical material. Five female respondents were interviewed using a semi-structured interview guide. The essay’s findings indicate that the principle of the child’s best interests is not always applicable for the young adults during childhood. Their attitude towards relationships, separation and marriage is characterized by an open attitude to different family constellations with good qualities, positive and negative consequences of their parents' separation and a desire to get married in the future. The relationship today remains good with one parent, while the relationship with the other parent differs.

Studiens syfte är att skapa en ökad förståelse om hur svenska förskolebarn i åldrarna fyra och fem år interagerar med och uppfattar de olika artefakterna på sin utegård. Med artefakter menas de fysiska redskap som finns på förskolans utegård. Vi har valt att inrikta oss på om barnen leker enskilt eller tillsammans med andra, om de leker utifrån given funktion eller skapad funktion samt hur de ser på artefakter med hänsyn till estetiska omdömen. Vi har använt oss av metoden the Mosaic approach som lyfter fram barns perspektiv. I vår studie har barn fotograferat utegården. Tio barn intervjuades om utegården där barnens fotografier användes för att samtala om och barnen fick sedan guida oss runt på utegården. I resultatet visade det sig att när barnen samtalade om bilderna kom de fram till många olika användningsområden och åsikter kring artefakterna. Under guidningar fick vi se hur fyra barn interagerade med artefakterna och vi fick även en omfattande bild av utegården. Det visade sig att barnen använde sand ihop med artefakterna, vilket kan bero på att sand är lättillgängligt och enkelt att förflytta. Det visade sig även att barn tänker på sin säkerhet eftersom barnen visade en oro att ramla ner från artefakter som var högt placerade. Vår slutsats är att utegården erbjuder enskildhet och lek tillsammans med andra samt att barnen använder givna och skapade funktioner tillsammans med artefakterna. Studiens resultat visar att artefakterna skapar en trivsam utegård, vilket visar sig när barnen gärna samtalar om och visar de olika artefakterna. / The study's purpose is to create a better understanding of how Swedish preschool children aged four to five years interact with and perceive the various artifacts on their patio. With artifacts means the physical tools that are on the preschool’s patio. We have chosen to focus on if the children play alone or with others, if they play by the given function or created function, and how they see the artifacts considering aesthetic judgments. We have used the method of the Mosaic approach that emphasizes the child's perspective. In our study have the children photographed the patio. Ten children were interviewed about the patio where the children's photographs were used to discuss. Four children guided us around the patio. The results showed that when the children talked about the pictures they came up with many different uses and opinions about the artifacts. During guided tours, we saw how four children interacted with the artifacts and we even got a comprehensive image of the patio. It turned out that the children used the sand together with the artifacts, which may be due to the sand is easily accessible and easy to move. It was also found that children think about their safety because the children showed a concern of falling from the artifacts that were highly placed. Our conclusion is that the patio offers privacy and play together with other children, and to use the given and created functions together with the artifacts. The results of the study show that the artifacts create a pleasant patio, which appears when the children gladly talk about and show the different artifacts.

The purpose of this law-sociological study was to, on the basis of the District Court's decree to single custody, analyze the District Court’s comprehensive ideas and fall-oriented interpretations of the concept of the best interest of the child and the way they are constructed in connection with the District Court's application of the new law regulation of 6kap. 5§ FB regarding collaboration between parents. Our empirical data consisted of ten decrees to single custody. The decrees were examined and analyzed on the basis of social constructionism as a theory and the idea-analysis as the study's method. Legal sources such as law and its legislative history and the law inSwedenandScandinaviain general, with both domestic and international previous research, gave us initial knowledge in the area which gradually grew during the study. Results show that sweeping presumptions for single custody, with vague connections between single child's best interest and decisions about single custody based on the parents' lack of cooperation, can be glimpsed in several of the judges' texts. The District Court’s ideas/interpretations of the concept of the best interest of the child reach for the most part in the decrees where an individual assessment has been made.

La préparation scolaire de l’enfant en maternelle est associée, selon maintes études, à sa réussite scolaire future. Plusieurs facteurs sont liés à la préparation scolaire, dont l’implication parentale en milieu scolaire, quoiqu’il n’y ait pas consensus à ce sujet. Ainsi, la présente étude vise deux objectifs. Il s’agit tout d’abord de définir quelles sont les caractéristiques de l’enseignant, de la famille et de l’enfant étant associées à l’implication parentale. L’objectif principal se centre, pour sa part, sur les liens possibles entre l’implication parentale et la préparation scolaire de l’enfant en maternelle. Les résultats révèlent que l’âge de l’enseignant et son expérience professionnelle, l’âge des parents et la scolarité de la mère sont les caractéristiques liées à l’implication parentale. De plus, chacune des dimensions de la préparation scolaire des enfants en maternelle (santé physique et bien-être, développement cognitif, intégration sociale et autorégulation) est associée à la communication entre l’enseignant et les parents et à la participation parentale à la vie scolaire de l’enfant. Ainsi, notre étude offre un apport intéressant au domaine des sciences de l’éducation en montrant que l’implication parentale est liée à la préparation scolaire de l’enfant. / A number of studies have linked a child’s school adjustment in kindergarten to his or her future academic success. This early preparation entails a number of factors, including parental involvement in the child’s school life, though there is no consensus on the issue. Our study therefore has two objectives. First, it determines which characteristics of the teacher, family and child are associated with parental involvement. The primary objective is to establish possible links between parental involvement and a child’s school adjustment in kindergarten. Our findings indicate that the teacher’s age and professional experience, the age of the parents, and the mother’s education level are factors associated with parental involvement. In addition, we show that each aspect of a child’s school adjustment in kindergarten (i.e. physical health and well-being, cognitive development, social integration, self-regulation, etc.) is associated with parent-teacher communication and parental involvement in the child’s school. Our study thus makes a valuable contribution to the field of education science, by demonstrating the relationship between parental involvement and a child’s school adjustment.

Barns inflytande i förskolan är ett aktuellt ämne som dessutom anses vara otroligt komplext, både att förstå begreppet och att arbeta med. Vårt syfte är att synliggöra de normer som kännetecknar en verksamhet där barn får möjlighet till inflytande och vilka konsekvenser det får för verksamheten. Arbetet tar avstamp i kulturanalytisk teori och utifrån ett normkritiskt perspektiv diskuteras sedan resultatet. Vi har utfört en mikroetnografisk studie och data har samlats in med hjälp av semistrukturerade intervjuer och observationer. Empirin har samlats in på två avdelningar på två olika förskolor. Vårt resultat synliggör såväl möjligheter som hinder för barns inflytande. Det som framkommer är att pedagogernas barnsyn ligger till grund för det förhållningssätt som de har till barns inflytande. Vidare påverkar deras barnsyn om de närmar sig ett barns perspektiv eller inte vilket är avgörande för barns möjlighet till inflytande.  Pedagogernas förhållningssätt är också avgörande för de normer som kommer till uttryck i verksamheten. Sammanfattningsvis visar resultatet att de normer som finns i förskolan skapar både möjligheter och hinder och att de samverkar med varandra. / Children’s influence in preschool is a highly debated subject and it contains much complexity, both defining the word and working with the subject. The purpose of this study is to highlight norms that signifies a preschool where children have the possibility to influence their everyday life and the consequences that arise. The study begins in the culture analytic theory and use a norm critical perspective to discuss the results. As a methodology we have used the micro-ethnographic approach, where data has been collected using semi-structured interviews and observations. The empirical material comes from two departments, from two different preschools. The result presents both possibilities for and obstacles to children’s influence. The prominent result shows that teacher’s view on children determines their approach to children’s influence. Their view on children also plays a significant part on whether or not they try to understand a child’s perspective, which is of great importance for children’s possibility to have influence. Also, the result shows that teacher approach plays a significant part in what norms become significant in preschool. As a conclusion our result shows that existing norms work both as possibilities and as obstacles to children’s influence and that these norms all coexists.

The aim of this study is to through six interviews, with six experienced, social workers’, in three cities, understand how the child’s position in the Swedish child protective services’ enquiries has change, and the factors behind it. The aim is also to compare if the social workers’ view of the child’s position in the enquire has change accordingly to Socialstyrelsens intentions of BBIC. The theoretical approaches that was used is the new institutionalism, the Shier’s pathways to participation and the term discretion. The results of the study shows that through the perspective of social workers, the factors that helped the child’s position to improve are the new organization of working patterns and the new documentation system, the new mindset of the social workers’ and the way the social workers’ talk to the children. The study also shows that through the child’s position in child protective enquiries has improved accordingly to Socialstyrelsens intentions of BBIC.

Orientador: Vera Lúcia Pamplona Tonete / Resumo: Introdução: o presente estudo apresenta como tema a Promoção da Saúde da Criança, recortando como objeto a inserção de suas premissas nos cuidados realizados por enfermeiros da Estratégia Saúde da Família. Objetivo: analisar as concepções e experiências de enfermeiros da Estratégia Saúde da Família, no que se refere à incorporação das premissas da Promoção da Saúde nos cuidados realizados com crianças e suas famílias. Aspectos metodológicos: pesquisa de abordagem mista, composta por duas etapas. Na primeira, foi realizado estudo qualitativo sobre o objeto em estudo na perspectiva dos enfermeiros da Estratégia da Saúde da Família de um município do interior paulista, com coleta e sistematização dos dados feita por entrevistas semiestruturadas gravadas e por técnicas de análise de conteúdo temática, respectivamente. Na segunda, realizou-se estudo quantitativo transversal e descritivo sobre 626 atendimentos clínicos realizados por enfermeiros a 222 crianças, as quais compuseram amostra probabilística e estratificada calculada a partir do universo de crianças nascidas entre 28 de fevereiro de 2015 a 27 de fevereiro de 2017, que foram atendidas em seus dois primeiros anos de vida nas referidas unidades. Os dados foram coletados dos prontuários das crianças e de suas mães, com enfoque nos tipos de atendimento a elas realizados, nos motivos/queixas, avaliações clínicas e nas propostas de cuidados elaboradas. Foi realizada análise descritiva das variáveis estudadas utilizando o Progr... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: the present study has as its theme the Child’s Health Promotion, outlining as object the insertion of its premises in cares carried out by Family Health Strategy nurses. Objective: analyze Family Health Strategy nurses’ conceptions and experiences concerning to Health Promotion premises incorporation in cares carried out with children and their families. Methodological aspects: mixed approach research, composed of two stages. In the first, it was carried out a qualitative study about the object of attention from the perspectives of Family Health Strategy nurses from an inland São Paulo city, with data collection and systematization made by recorded semi structured interviews and techniques of thematic content analysis, respectively. In the second, there was carried out a quantitative transversal and descriptive study about 62 clinical cares made by nurses to 222 children who composed probabilistic and stratified sample calculated from the universe of children who were born between February 28th, 2015 and February 27th , 2017, who were treated during their first two years of life in the cited health centers. Data was collected from children’s and their mothers’ medical records, focusing on the kinds of cares offered to them, on their reasons/complains, clinical evaluation and on their elaborated cares purposes. It was carried out a descriptive analysis of the studied variables using SAS System Program version 9.3. The discussion about the obtained results, in bot... (Complete abstract click electronic access below) / Mestre

Submitted by CARMEN SILVIA RIGHETTI NOBILE righetti nóbile (crighetti@tjsp.jus.br) on 2016-06-24T20:36:18Z No. of bitstreams: 1 TESE CARMEN SILVIA RIGHETTI NOBILE.pdf: 4135895 bytes, checksum: 44294081be20907e9e8487f8226d2282 (MD5) / Approved for entry into archive by Juliano Benedito Ferreira (julianoferreira@reitoria.unesp.br) on 2016-06-27T17:59:40Z (GMT) No. of bitstreams: 1 righettinobile_cs_dr_franca.pdf: 4135895 bytes, checksum: 44294081be20907e9e8487f8226d2282 (MD5) / Made available in DSpace on 2016-06-27T17:59:40Z (GMT). No. of bitstreams: 1 righettinobile_cs_dr_franca.pdf: 4135895 bytes, checksum: 44294081be20907e9e8487f8226d2282 (MD5) Previous issue date: 2016-06-13 / O presente estudo visa a demonstrar como é enfrentada pelo Poder Judiciário a questão “garantia de direitos versus a necessidade de implementação de políticas públicas”, na área da Infância e Juventude. Trata-se de uma pesquisa sócio-histórica, de cunho interdisciplinar, que articula as dimensões qualitativa e quantitativa, mediante o estudo dos autos judiciais dos casos de acolhimento institucional das Varas da Infância e Juventude das respectivas Comarcas que compõem a 26ª Circunscrição Judiciária do Estado de São Paulo, a qual abrange os Fóruns das Comarcas de Assis, Cândido Mota, Quatá, Palmital, Maracaí e Paraguaçu Paulista. Os procedimentos metodológicos utilizados foram: pesquisa bibliográfica, de campo e pesquisa documental (estudo dos autos judicias), com recorte temporal referente ao período compreendido entre janeiro e dezembro de 2013. A tese foi organizada em quatro capítulos. O primeiro capítulo traz ao debate os fatores que determinaram a origem do atendimento da Justiça nos casos da Infância e da Juventude, assim como a inserção do Assistente Social no Judiciário paulista, na área em questão. No segundo capítulo, discorreu-se sobre a trajetória e os resultados da pesquisa, apresentando brevemente os 10 (dez) casos estudados, reproduzindo os conflitos ocorridos e mostrando como o Tribunal de Justiça encaminhou a solução dos problemas expostos em cada um dos casos. O terceiro capítulo apresenta uma discussão sobre o Estado e a Política Pública e mostra como os processos impactantes que ocorreram nas sociedades ocidentais, ampliaram as funções do Estado na sociedade contemporânea. Também são enfocados, nessa terceira parte do trabalho, os desafios do Estado em face da política de redistribuição universal e da política do reconhecimento; nessa esteira, é discutida a política pública relativa à criança e ao adolescente, e as várias abordagens da intervenção judicial nas políticas públicas no Brasil são analisadas. O quarto capítulo proporciona uma reflexão a respeito das várias vertentes de pensamento relativas ao Estado e, consequentemente, acerca do Poder Judiciário. Durante todo este trabalho foram mencionados os resultados da pesquisa realizada nos autos dos processos judiciais, relacionando-os com a abordagem teórica. O aspecto que mais se evidenciou: as crianças, os adolescentes e as famílias de acolhidos institucionalmente são atendidos e acompanhados por vários profissionais, dos variados setores que compõem o Sistema de Garantia de Direitos (sejam eles pertinentes ao âmbito Municipal, ao Estadual ou ao Federal). Esses profissionais buscam decisões colegiadas para o problema apresentado, as quais serão homologadas, ou não, pelo Juiz. Na pesquisa que empreendemos, houve, em todas as situações, a homologação judicial dos acordos realizados pelos profissionais envolvidos. No entanto, observamos que nem a alteração da lei, nem o trabalho em rede, propiciaram uma alteração de posicionamento por parte dos profissionais (isto é, a culpabilização da família). Tal situação dificulta ainda mais, às crianças, aos adolescentes e a suas famílias, a defesa contra essa postura conjunta. Em relação ao objetivo de nossa tese, detectamos que essa circunstância vai além da ausência de políticas públicas a serem implantadas pelo Estado: os profissionais que têm o poder de apresentar alternativas, geralmente, são os atores que constroem a representação e a solução dos problemas. Eles indicam ou elegem situações nas quais o Estado irá intervir e se posicionam de modo a responsabilizar as famílias e a culpar (ou mesmo crimininalizar) o pobre. / Este estudio tiene como objetivo demostrar la forma en que se enfrenta por el poder judicial para emitir "derechos de garantía frente a la necesidad de implementar políticas públicas" en el ámbito de la infancia y juventud. Se trata de una investigación socio-histórico, carácter interdisciplinario, que combina las dimensiones cualitativas y cuantitativas, mediante el examen de los registros de la corte de casos de atención institucional de los tribunales de los niños y jóvenes de respectivos distritos que conforman el Circuito Judicial del Estado 26 Sao Paulo, que cubre los foros de los condados de Asís, Cândido Mota, Quatá, Palmital, Maracaí y Paraguaçú Paulista. Los procedimientos metodológicos utilizados fueron: investigación bibliográfica, de campo y trabajo de documentación (estudio del caso judicial) con plazo para el período comprendido entre enero y diciembre de 2013. La tesis se organiza en cuatro capítulos. El primer capítulo es una discusión de los factores que determinaron el origen del servicio de la justicia en los casos de niños y jóvenes, así como la inclusión de la trabajadora social en Sao Paulo justicia en el ámbito de que se trate. En el segundo capítulo, habló sobre la historia y los resultados de la encuesta, una breve presentación de los diez (10) de los casos estudiados, la reproducción de los conflictos que se producen y que muestra cómo el Tribunal se remitió la solución de los problemas expuestos en cada caso. El tercer capítulo se presenta una discusión de la política estatal y pública, y muestra cómo los procesos de impacto que se produjeron en las sociedades occidentales, ampliaron las funciones del Estado en la sociedad contemporánea. Se centran también, en esta tercera parte de la obra, los retos del estado en el rostro de la política de redistribución y universales política de reconocimiento; esta cinta de correr, la política pública es discutido en los niños y adolescentes, y los diversos enfoques de la intervención judicial en la política pública en Brasil se analizan. El cuarto capítulo se ofrece una reflexión sobre las distintas corrientes de pensamiento sobre la situación y, en consecuencia, sobre el poder judicial. A lo largo de este trabajo se mencionaron los resultados de la investigación llevada a cabo en el caso de los procedimientos judiciales, relacionándolos con el enfoque teórico. El aspecto que es más evidente: los niños, adolescentes y familias acogidas institucionalmente están atendidos y acompañados por varios profesionales de diferentes sectores que conforman el Sistema de Garantía de Derechos (que son relevantes a nivel municipal, estatal o federal del ). Estos profesionales buscan decisiones conjuntas al problema presentado, que será aprobado o no por el juez. En la investigación que llevamos a cabo, no era, en todas las situaciones, la homologación de los acuerdos realizados por los profesionales involucrados. Sin embargo, se encontró que de no cambiar la ley, o en red, da como resultado un cambio de posición por los profesionales (es decir, el chivo expiatorio de la familia). Esta situación hace que sea más difícil, niños, adolescentes y sus familias, defensa contra esta postura conjunta. En cuanto al objetivo de nuestra tesis, se encontró que este hecho va más allá de la ausencia de políticas públicas a ser implementadas por el Estado: los profesionales que tienen la facultad de presentar alternativas por lo general son los actores que construyen la representación y resolución de problemas. Indican o eligen a situaciones en las que el Estado va a intervenir y posicionarse para culpar a las familias y la culpa (o incluso crimininalizar) los pobres. / This study aims to show how the Judiciary faces the question, "guarantee rights versus the need to implement public policies" in the area of Children and Youth. It is a socio-historical work, its nature is interdisciplinary, and it blends the qualitative and quantitative dimensions, by examining the court records of cases regarding institutional care in Children and Youth Courts of the Districts that form the 26th Judicial Circumscription of the state of São Paulo, which includes the courthouses of the following towns: Assis, Cândido Mota, Quatá, Palmital, Maracaí, and Paraguaçu Paulista. The methodological procedures used were: bibliographic research, field research, and documentary research (study of court records) concerning the time span between January and December, 2013. This thesis is divided into four chapters. The first one debates the factors which determined the origin of Justice service in cases concerning Children and Youth, as well as the insertion of the case worker (or social worker) in the state of São Paulo Judiciary, particularly within the focused area. In the second chapter, we discuss the history and the results of the survey, briefly presenting the ten (10) cases we have studied, all of them reproducing the conflicts occurred, and showing how the Court dealt with the solutions of the problems in each case. The third chapter presents a discussion on State and Public Policy, and shows how the decisive processes that happened in Western societies expanded the State’s functions in contemporary society. We also focus, in this third part of the work, on the challenges faced by the State regarding the universal policy of redistribution and recognition policy. Public policy related to children and teenagers is discussed, and the various approaches to judicial intervention in public policy in Brazil are analyzed. The fourth chapter provides consideration of the various trends of thought on State and, as a consequence, on the Judiciary. Throughout this work we mention the results of our research on court records, relating them to the theoretical approach. The most evident aspect: Children, adolescents, and families are institutionally served and accompanied by several professionals from the different sectors that form the Rights Guarantee System (no matter if they are connected to the municipality, the State or the Federal Government). These professionals seek joint solutions, which will be approved, or not, by the judge. There was, in all situations, the court approval of the agreements made by the professionals involved. However, we found out that neither the change of laws nor networking have resulted in a change of position on the part of the professionals (i. e., there was a “scapegoating” of the families). That situation makes it more difficult, for children, adolescents, and their families, to defend themselves against this collaborative standpoint. Regarding the aim of our thesis, we have found out that this fact surpasses the lack of public policies to be implemented by the State: The professionals who have the power to present alternatives are usually the performers who are responsible for representation and problem solving. They indicate or elect situations in which the State will intervene and they act in a way which end up blaming families and reprehending (or even criminally reproaching) the poor.

Submitted by Aline Biondo Alcantara (aline.bap@hotmail.com) on 2018-04-21T17:59:30Z No. of bitstreams: 1 Aline Biondo Alcantara Dissetacao Mestrado Academico em Enfermagem.pdf: 2147104 bytes, checksum: 686d09b8321b94a2b4462a89e14e40fc (MD5) / Approved for entry into archive by ROSANGELA APARECIDA LOBO null (rosangelalobo@btu.unesp.br) on 2018-04-23T17:45:01Z (GMT) No. of bitstreams: 1 alcantara_ab_me_bot.pdf: 2147104 bytes, checksum: 686d09b8321b94a2b4462a89e14e40fc (MD5) / Made available in DSpace on 2018-04-23T17:45:01Z (GMT). No. of bitstreams: 1 alcantara_ab_me_bot.pdf: 2147104 bytes, checksum: 686d09b8321b94a2b4462a89e14e40fc (MD5) Previous issue date: 2018-02-26 / Introdução: o presente estudo apresenta como tema a Promoção da Saúde da Criança, recortando como objeto a inserção de suas premissas nos cuidados realizados por enfermeiros da Estratégia Saúde da Família. Objetivo: analisar as concepções e experiências de enfermeiros da Estratégia Saúde da Família, no que se refere à incorporação das premissas da Promoção da Saúde nos cuidados realizados com crianças e suas famílias. Aspectos metodológicos: pesquisa de abordagem mista, composta por duas etapas. Na primeira, foi realizado estudo qualitativo sobre o objeto em estudo na perspectiva dos enfermeiros da Estratégia da Saúde da Família de um município do interior paulista, com coleta e sistematização dos dados feita por entrevistas semiestruturadas gravadas e por técnicas de análise de conteúdo temática, respectivamente. Na segunda, realizou-se estudo quantitativo transversal e descritivo sobre 626 atendimentos clínicos realizados por enfermeiros a 222 crianças, as quais compuseram amostra probabilística e estratificada calculada a partir do universo de crianças nascidas entre 28 de fevereiro de 2015 a 27 de fevereiro de 2017, que foram atendidas em seus dois primeiros anos de vida nas referidas unidades. Os dados foram coletados dos prontuários das crianças e de suas mães, com enfoque nos tipos de atendimento a elas realizados, nos motivos/queixas, avaliações clínicas e nas propostas de cuidados elaboradas. Foi realizada análise descritiva das variáveis estudadas utilizando o Programa SAS System versão 9.3. A discussão dos resultados obtidos, em ambas as etapas, baseou-se nas premissas da Promoção da Saúde da Criança. O projeto desta pesquisa foi aprovado por Comitê de Ética em Pesquisa local (Parecer nº 1.851.368). Resultados: o grupo dos 11 enfermeiros se caracterizou pela maior parte ser do sexo feminino, estar na faixa etária entre 30 a 50 anos, ter oito a 26 anos de graduação e de um a 15 anos de atuação na Estratégia Saúde da Família. De modo ampliado, os participantes relacionaram a Promoção da Saúde da Criança a ações integrais e intersetoriais, que valorizam a Educação em Saúde, comprometimento e vínculo próximo das equipes com as famílias, para capacitá-las a modificar os determinantes do processo saúde-doença de seus filhos, visando sua melhor qualidade de vida e saúde. As dificuldades associadas às referidas ações foram: baixa participação familiar nas atividades programadas, preferência pelo atendimento médico, condições familiares e sociais adversas, carência de recursos de educação permanente na temática. As crianças se caracterizaram por apresentarem situações favoráveis quanto aos aspectos sociodemográficos, condições obstétricas e de nascimento, com parcelas menores daquelas que apresentaram riscos e vulnerabilidades ao nascer. Dos 626 atendimentos clínicos estudados, 548 (87,6%) ocorreram no primeiro semestre de vida, com 407 (65%) do tipo consulta agendada de rotina e 11 (1,8%) visitas domiciliares. Quanto às queixas/motivos, destacaram-se os sinais, sintomas e outros parâmetros clínicos alterados, com 425 (93,4%) registros, relativos principalmente ao sistema respiratório e ao tegumentar, que somaram 200 (43,7%) dos registros; evidenciando-se a febre como o sinal isolado registrado em 95 (20,9%). Em relação às áreas diagnósticas, sobressaiu-se a de Agravos Físicos com 445 (46,3%) avaliações, seguida pela de Alimentação/Hidratação com 206 (21,4%) avaliações e a do Crescimento e a do Desenvolvimento neuropsicomotor, que juntas somaram 197 (20,5%) das avaliações. Sobre as áreas de intervenção, a maior parte se configurou em Orientação 1200 (55,6%), especialmente sobre Higiene corporal/Higiene bucal com 392 (18,2%) e Alimentação/Hidratação com 288 (13,3%) registros, seguidas pelas condutas de Encaminhamento, Agendamento, Solicitação de exames de rotina, com 905 (41,9%) das propostas de cuidados. Considerando as Necessidades Essenciais da Infância, os resultados anteriores sustentam a ideia de que a mais explorada foi a Necessidade de Proteção Física, Segurança e Regulamentação. Considerações finais: as concepções apreendidas revelaram-se próximas às premissas científicas e políticas atuais sobre Promoção de Saúde da Criança. Por outro lado, as experiências relatadas apresentaram-se permeadas pelo enfrentamento de dificuldades e vulnerabilidades inerentes às crianças, aos seus contextos de vida e ao próprio serviço de saúde. Dentre os cuidados de enfermagem realizados na Estratégia Saúde da Família, verificou-se que nos atendimentos clínicos pediátricos, independentemente do tipo, são desenvolvidas ações de Promoção da Saúde. Entretanto, esses atendimentos ainda são fortemente influenciados pelo modelo biomédico, centrado em doenças e agravos à saúde, refletindo no predomínio de registros nas áreas de avaliações diagnósticas e de intervenção voltadas aos agravos físicos, não contemplando várias necessidades tidas como essenciais da infância. Considera-se que o estudo apresenta subsídios para a reorganização das ações de Promoção da Saúde da Criança, evidenciando potencialidades/desafios a serem considerados/superados pelos enfermeiros no contexto estudado e em outros relacionados. / Introduction: the present study has as its theme the Child’s Health Promotion, outlining as object the insertion of its premises in cares carried out by Family Health Strategy nurses. Objective: analyze Family Health Strategy nurses’ conceptions and experiences concerning to Health Promotion premises incorporation in cares carried out with children and their families. Methodological aspects: mixed approach research, composed of two stages. In the first, it was carried out a qualitative study about the object of attention from the perspectives of Family Health Strategy nurses from an inland São Paulo city, with data collection and systematization made by recorded semi structured interviews and techniques of thematic content analysis, respectively. In the second, there was carried out a quantitative transversal and descriptive study about 62 clinical cares made by nurses to 222 children who composed probabilistic and stratified sample calculated from the universe of children who were born between February 28th, 2015 and February 27th , 2017, who were treated during their first two years of life in the cited health centers. Data was collected from children’s and their mothers’ medical records, focusing on the kinds of cares offered to them, on their reasons/complains, clinical evaluation and on their elaborated cares purposes. It was carried out a descriptive analysis of the studied variables using SAS System Program version 9.3. The discussion about the obtained results, in both stages, was based on Child’s Health Promotion premises. This research project was approved by Ethical Committee in local Research (Opinion nº 1.851.368). Results: the group composed by 11 nurses was characterized as being mostly females, between 30 and 50 years old, eight to 26 years of under graduation and one to fifteen years of Family Health Strategy performance. Broadly, participants related Child’s Health Promotion to integral and intersectional actions which value Health Education, commitment and close bonds from teams towards families in order to enable them to modify determinants of their children’s healthillness process, aiming at their better quality of life and health. Difficulties associated with their stated actions were: poor family participation in programmed activities, medical care preference by this population, adverse family and social conditions, lack of material and organizational resources and permanent education on the subject. The children’s sample was characterized by presenting favorable situations regarding to the social demographic aspects, obstetrical and birth conditions, with smaller sectors of those who presented vulnerabilities as life threatening at birth. The analysis of 626 studied clinical cares revealed a higher frequency of these in the first semester of life 548 (87, 6%), with 407 (65%) routine scheduled visits, being only 11 (1,8%) home visits. As for the complaints/reasons related to these visits, signals, symptoms and other altered clinical parameters were highlighted, with 425 (93,4%) recorded, related mainly to tegumentary and respiratory systems, which summed together 200 (43,7%) of records, evidencing fever as an isolated signal recorded in 95 (20,9%). Relating to the diagnosed areas it was highlighted the Physical Injury one with 445 (46,3%) evaluations, followed by the Feeding/Hydration with 206 (21, 4%) evaluations and neuropsychomotor Growth and Development, which summed together 197 (20,5%) evaluations. Concerning to intervention areas most part of them was related to Orientation 1200 (55,6%), especially about Body Hygiene/Oral Hygiene with 392 (18,2%) records and Feeding/Hydration with 288 (13,3%) records, followed to Referral, Scheduling and Request for routine exams with 905 (41, 9%) of the care proposes. Considering essential childhood needs, the former results support the idea that the most explored one was the Physical Protection, Safety and Regulation Need. Final Considerations: the grasped conceptionswererevealed close to scientific premises and current policies about Child’s Health Promotion. On the other hand, reported experiences were presented permeated with coping difficulties and vulnerabilities inherent in children, in their lives contexts and in health service itself. Among cares carried out in Family Health Strategy it was verified that on pediatric clinical cares, irrespective of the kind, Health Promotion actions are developed. However, these cares are still strongly influenced by biomedical model, centered on illnesses and health problems which reflect on predominance of records in diagnoses evaluation’s areas and interventions based on physical injuries, not contemplating several necessities which are treated as essential during childhood. It is considered that the study presents subsidies to reorganization of Child’s Health Promotion actions putting in evidence potentialities/challenges to be considered/overcome by nurses in the studied context and others related to it.