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Thesis (DPhil (Social Work))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: The changes in child and youth care policies over the last fifteen years have had profound consequences for the staff at Youth Care and Education Centres (hereafter referred to as YCECs). These changes included systemic changes, philosophical changes, and changes in the way services are rendered to children and youth in their care. It was thus expected of team members to not only change their behaviours but to also make mind shifts. The mandates were that they move from working in silos (educators, residential educators and support team) to working in teams; from rendering generic services to developing individualised plans for children and youth; from following a medical (deficit) approach in service delivery to following a strength based- and developmental approach. Whereas a punitive approach to discipline was followed in the past staff members now have to follow a restorative approach. In addition, the emphasis on children’s rights, in general, and the abolishment of corporal punishment, in particular, brought about changes in the nature of the adultchild relationship. It was required of the team members to learn to use alternatives to this form of punishment. The study explored how the members of the institutional level teams at the four YCECs in the Western Cape were experiencing the implementation of changed child and youth policies. A combined quantitative and qualitative research methodology was followed in obtaining the data from the residential educators, as well as the educators and the support team members comprising of psychologists, school social workers, occupational therapists, and school nurses. The points of departure were the organisational learning model and the phases of team development. Findings derived from the empirical study were that the difference between the way the participants embraced and implemented changed policies and legislation had much to do with the guidance that the principal and senior management provided for them. Where the principal set the tone and conveyed the message that the implementation of the policies were not negotiable and gave staff members the opportunity to thoroughly discuss these changes, they eventually shared the underlying principles of the changed policies. Where the principal provided direction, support and encouragement for the implementation of the changed policies the participants felt secure and empowered. Where this support was not present participants felt uncertain and to some extent let down. When a shared vision was articulated to them the participants were able to align their personal visions thereto, which further led to a greater understanding of their roles within the team. Where participants, however, were not clear on the shared vision they seemed to struggle with role division and status and power issues. When team members were left to their own devices a measure of personal mastery still took place due to the commitment of individuals but team learning was either limited or virtually nonexistent. Systems thinking remained a challenge due to the forming of subgroups within the YCEC and the limited or nonexistent services rendered by external social workers to the families of the children and youth. The most important recommendations resulting from the study indicate that provision must be made for frameworks for the implementation of changes in policy and guidelines for team processes. To ensure that new staff is informed about the policies that guide their services an orientation programme must be in place. Training for principals in effective introduction and implementation of change should also be provided. To ascertain what the staff complement should be to effectively implement changes in the policies, a work-study and a fast track pilot project should be conducted. From this, job descriptions should be developed that make provision for the incumbent’s role within the team. Consideration should also be given to the incentive system that currently only makes provision for individual performance and could hamper teamwork. / AFRIKAANSE OPSOMMING: Die veranderinge in kinder- en jeugsorgbeleide oor die laaste vyftien jaar het diepgaande gevolge ingehou vir personeel by Jeugsorg- en Onderwyssentrums (hierna verwys as JSOS). Hierdie veranderinge het sistemiese en filosofiese veranderings, asook verandering in die wyse waarop dienste gelewer word, aan kinders en jeug in hul sorg, meegebring. Dit word dus van die spanlede verwag om nie net hul gedrag nie, maar ook hul denkwyse te verander. Die mandate vervat in die beleide is dat personeel skuif van werk in silos (opvoeders, residensiële opvoeders en ondersteuningspan) na werk in spanne; van die lewer van generiese dienste tot die ontwikkeling van individuale planne vir kinders en jeug; van die volg van ‘n mediese benadering aangaande dienslewering tot ‘n sterkte-gebaseerde- en ontwikkelingsbenadering. Waar daar in die verlede ‘n strafgerigte benadering gevolg is moet daar nou beweeg word na ‘n helende benadering. Verder het die klem op kinderregte in die algemeen, en die afskaf van lyfstraf in besonder, veranderings meegebring in die aard van die volwasse-kind verhouding. Dit was verwag van die spanlede om te leer om alternatiewes tot die vorm van straf aan te leer. Die studie het ondersoek ingestel na hoe lede van die inrigtingsgebaseerde span by die vier JSOS in die Weskaap die implementering van veranderde kinder- en jeugbeleid ervaar. ‘n Gekombineerde kwantitatiewe en kwalitatiwe navorsing metodologie was gevolg in die insamel van data van die residensiële opvoeders, die opvoeders en die lede van die ondersteuningspan (sielkundiges, skool maatskaplike werkers, arbeidsterapeute en skool verpleegkundiges). Die vertrekpunt was the organisasieleer model en die fases van spanontwikkeling. Bevindings wat gemaak is uit die empiriese studie was dat die verskille tussen die wyse waarop die deelnemers die veranderde beleid aanvaar en implementeer het baie te doen gehad het met die mate van leiding wat die prinsipaal en senior bestuur vir hul gegee het. Waar die prinsipaal die toon aangegee het en die boodskap oorgedra het dat die implementering van die beleide nie onderhandelbaar was nie en personeellede die geleentheid gebied is om die veranderings deeglik te bespreek, het hul geleidelik ingekoop in die veranderde werkswyses. Waar die prinsipaal rigting en ondersteuning vir die implementering van die veranderde beleid gebied het, het die deelnemers veilig en bemagtig gevoel. Waar die ondersteuning egter ontbreek het, het die deelnemers onseker en, tot ’n mate, in die steek gelaat gevoel. Wanneer ‘n gedeelde visie oorgedra is aan hulle was die deelnemers in staat om hul persoonlike visies in lyn te bring daarmee. Dit het verder aanleiding gegee tot beter begrip vir hul rolle binne die span. Waar deelnemers egter nie duidelik was oor die gedeelde visie nie, het dit geblyk dat hulle probleme gehad het met rolverdeling, status en magaangeleenthede in die span. Wanneer spanlede oorgelaat is aan hul eie lot het ‘n mate van persoonlike bemeestering nog plaasgevind as gevolg van die persoonlike toewyding van individue, maar spanleer was óf beperk óf feitlik afwesig. Sisteem denke was steeds ‘n struikelblok as gevolg van die vorming van subgroepe binne die JSOS en die beperkte of afwesige dienslewering deur eksterne maatskaplike wekers aan gesinne van die kinders en jong mense. Die belangrikste aanbevelings, wat voortspruit uit die studie, dui aan dat voorsiening gemaak moet word vir raamwerke vir die implementering van beleidsveranderings en riglyne vir spanprosesse. Om te verseker dat nuwe personeel ingelig is omtrent die beleide wat hul dienslewering rig moet ‘n oriënteringsprogram in plek wees. Opleiding van prinsipale in die effektiewe bekendstelling en implementering van veranderings moet ook voorsien word. Om vas te stel wat die aanvulling vir personeel moet wees om die veranderings in die beleid te implementeer, behoort ‘n werkstudie en ‘n snel loodsprojek onderneem word. Hieruit kan pligstate opgestel word wat voorsiening maak vir die ampsdraer se rol in spanverband. Oorweging moet geskenk word aan die aansporingstelsel wat tans net voorsiening maak vir individuele werksverrigting en wat spanwerk kan strem.

Thesis (M Social Work)--Stellenbosch University, 2002. / ENGLISH ABSTRACT: This study is concerned with children and youths in conflict with the law, who are additionally at risk of becoming or being in need of care. The study eventuated from concern for neglected children and youths from poor, disadvantaged and violent communities in the Western Cape Province, who inevitably lapsed into crime. Child and youth care, including juvenile justice, in South Africa is presently in a process of transformation, managed by the inter-ministerial committee on young people at risk. As an outcome of the transformation of the juvenile justice system, assessment centres were established at juvenile courts. Probation officers were appointed in terms of the Probation Services Act (Act 116 of 1991) to assess arrested children and youths before their first court appearance in view of a suitable awaiting trial placement and possible diversion of the criminal case. The researcher investigated how arrested children and youths, being in need of care, are managed within the criminal justice system. The research study showed that in spite of the implementation of policies and legislation to protect children and youths from detention in prison, the number of children and youths in prisons awaiting trial have steadily increased. A continuous shortage of vacancies in awaiting trial places of safety exists. It has further been established that professionals such as magistrates, prosecutors and probation officers recognize the needs of arrested children and youths who are additionally at risk of being or becoming in need of care. Factors such as the existing lack of vacancies in awaiting trial places of safety however result in children and youths not being protected in terms of care in all instances. The research study also indicated that arrested children and youths who are current subjects of the Child Care Act (Act 74 of 1983) as amended are often not effectively managed within the criminal justice system. A lack of sufficient knowledge of the said Child Care Act by especially prosecutors appears to be a contributing factor. A comprehensive criminal justice system for children and youths in South Africa is being envisaged, as contained in the draft Bill (Bill B), which will enable individualized but holistic services in respect of children and youths in conflict with the law. The role and tasks of probation officers carrying out assessments have as such become a key element in the management of arrested children and youths, as contained in the draft Bill (Bill B). Probation officers therefore playa significant role in advising the court regarding the appropriate management of arrested children and youths who are at risk of becoming or being in need of care. / AFRIKAANSE OPSOMMING: Hierdie studie het betrekking op kinders en jeudiges in botsing met die gereg, wat bykomend in gevaar is om sorgbehoewend te raak of sorgbehoewend is. Die studie het voortgevloei uit besorgdheid oor verwaarloosde kinders en jeugdiges van arm, agtergeblewe en geweldadige gemeenskappe in die Wes-Kaap Provinsie, wie noodwendig in misdaad verval het. Kinder- en jeugsorg, insluitend jeugreg in Suid-Afrika is tans in 'n proses van transformasie, wat deur die inter-ministeriële komitee vir jong persone in gevaar, bestuur word. As 'n uitkoms van die transformasie van die jeugregsisteem, is asseseringsentrums by jeughowe tot stand gebring. Proefbeamptes is in terme van die Wet op Proefdienste (Wet 116 van 1991) aangestel om gearresteerde kinders en jeugdiges te asseseer voor hulle eerste hofverskyning in die lig van 'n geskikte aanhouding terwyl verhoofafwagtend en moontlike afwending van die kriminele saak. Die navorser het ondersoek ingestel na die wyse waarop gearresteerde kinders en jeugdiges wat sorgbehoewend is, binne die kriminele jeugregstelsel hanteer word. Die navorsingstudie het getoon dat ten spyte van die implementering van beleid en wetgewing om kinders en jeugdiges van aanhouding in gevangenisse te beskerm, die hoeveelheid kinders en jeugdiges verhoorafwagtend in gevangenisse voortdurend toegeneem het. 'n Deurlopende tekort aan vakatures in plekke van veiligheid kom voor. Dit is verder vasgestel dat die behoeftes van gearresteerde kinders en jeugdiges wat bykomend in gevaar is om sorgbehoewend te raak of sorgbehoewend is, deur professionele persone soos landdroste, aanklaers en proefbeamptes erken word. Faktore soos die bestaande tekort aan vakatures in plekke van veiligheid veroorsaak egter dat kinders en jeugdiges nie ten alle tye beskerm word nie. Die navorsingstudie het ook aangedui dat gearresteerde kinders en jeugdiges wat steeds onderhewig is aan die Wet op Kindersorg (Wet 74 van 1983) soos gewysig dikwels nie doeltreffend binne die kriminele jeugregsisteem hanteer word nie. Gebrek aan voldoende kennis van die genoemde Wet op Kindersog deur veral aanklaers, blyk 'n bydraende faktor te wees. 'n Omvattende kriminele jeugregsisteem vir kinders en jeugdiges in Suid-Afrika word beoog, soos vervat in die konsep Wetsontwerp (Wetsontwerp B), wat die geleentheid vir individuele maar holistiese dienste ten opsigte van kinders en jeugdiges in botsing met die gereg sal bied. Die rol en take van proefbeamptes wat assesserings uitvoer het as sulks 'n sleutel element geword in die hantering van gearresteerde kinders en jeugdiges, soos vervat in die konsep Wetsontwerp (Wetsontwerp B). Proefbeamptes speel gevolglik 'n belangwekkende rol ten einde die hof te adviseer oor die gepaste hantering van gearresteerde kinders en jeudiges wat in gevaar is om sorgbehoewend te raak of sorgbehoewend is.

published_or_final_version / Social Work and Social Administration / Master / Master of Social Sciences

Résumé La présente thèse doctorale vise à déterminer sous quelles conditions la garde non-maternelle est associée (positivement/négativement) au niveau de stress et au développement cognitif des enfants. Elle comporte une recension des écrits et trois articles empiriques. Le premier article présente une recension des écrits (de type méta-analytique) qui synthétise les études portant sur le stress des enfants en services de garde et ayant utilisé le niveau de cortisol comme indicateur. Les résultats montrent que la garde non-maternelle est associée au niveau de stress des enfants, se reflétant dans des concentrations de cortisol élevées. Les niveaux de stress élevés s’observent particulièrement chez les enfants qui au départ ont tendance à être retirés, anxieux ou qui sont gardés dans un milieu de faible qualité. Cependant, certains éléments indiquent que les élévations de cortisol à la garderie sont temporaires et qu’elles disparaissent au fur et à mesure que l’enfant s’adapte à son milieu. Le deuxième article de thèse, réalisé dans le contexte de l’Échantillon longitudinal national des enfants et des jeunes [ELNEJ] (n = 3093), vise à déterminer dans quelle mesure l’association entre la fréquentation des services de garde et l’acquisition du vocabulaire réceptif au préscolaire dépend du milieu familial de l’enfant. Les résultats indiquent qu’à l’intérieur du groupe d’enfants défavorisés, ceux ayant été gardés à temps plein dans la première année de vie obtiennent des scores supérieurs sur une mesure de vocabulaire réceptif administrée à 4 ½ ans, comparativement aux enfants restés à la maison avec la mère (d=0.58). Le troisième article, réalisé dans le contexte de l’Étude longitudinale des enfants du Québec [ELDEQ]; (n=2,120), vise à documenter les bénéfices à long terme de la fréquentation des services de garde par les enfants issus de milieux désavantagés sur la préparation scolaire et les compétences académiques. Les résultats révèlent que les enfants dont la mère n’a pas terminé ses études secondaires obtiennent de meilleurs résultats sur une mesure de préparation scolaire cognitive (d=0.56) et de vocabulaire réceptif (d=0.30) en maternelle, et de connaissance des nombres (d=0.43) en première année, s’ils ont fréquenté un service de garde sur une base régulière. Par ailleurs, la garde non-parentale n’est pas associée aux compétences cognitives des enfants de milieux sociaux favorisés. L’objectif du quatrième article est d’examiner les facteurs de sélection quant à l’utilisation des services de garde dans le contexte de l’ELDEQ. Les résultats montrent que l’absence d’emploi de la mère pendant la grossesse, le faible niveau d’éducation de la mère; le revenu insuffisant de la famille, avoir plus de 2 frères et sœurs, la surprotection maternelle, et le faible niveau de stimulation cognitive sont associés à une faible utilisation des services de garde (30.7% de l’échantillon québécois). En d’autres termes, les enfants qui sont les plus susceptibles de retirer des avantages des services de garde sur le plan du développement, en raison de la présence de facteurs de risque dans leur milieu familial, sont aussi ceux qui utilisent le moins les services de garde. / Abstract The present doctoral thesis aims at determining under which conditions child-care experiences may be associated (positively or negatively) with children’s stress levels and cognitive development. It comprises one literature review and three empirical studies. The first study is a literature review (meta-analysis type) which summarizes the studies on child-care experiences and children’s stress (as indexed by cortisol) in order to identify individual and environmental conditions under which child-care is associated with elevated cortisol concentrations. Findings suggest that child-care may be more stressful, as reflected in higher salivary cortisol concentrations, for children who are less socially competent or who received low quality child-care services. However, some pieces of evidence suggest that cortisol elevations in child-care are transient and fade out as children grow older The second study uses data from the National Longitudinal Survey of Children and Youth [NLSCY]; (n=3093). The goal is to determine whether the association between non-maternal care and receptive vocabulary skills depend upon children’s home environment. Results show that children from low socioeconomic status who received full-time (< 25 hours/week) child-care services in their first year of life obtain higher scores on a measure of receptive vocabulary at 4 ½ years than those who were cared for by their mothers (d=0.58). The goal of the third study is to document further the longer-term benefits of early child-care attendance on disadvantaged children’s school readiness and school achievement. This study uses data from the Quebec Longitudinal Study of Child Development [QLSCD]; (n=2120). Findings reveal that child-care services produce benefits over maternal care for children from low educated mothers on a measure of receptive vocabulary (d=0.30) and cognitive school readiness (d=0.56) in kindergarten, and number knowledge in first grade (d=0.43). Overall, child-care services produce no advantage or disadvantage for children who do not experience risks in their home. The objective of the fourth study is to identify key family factors associated with low child-care services utilization, using the QLSCD sample. Results show that maternal unemployment during pregnancy, low levels of maternal education; insufficient household income, having more than two siblings, high levels of maternal overprotection, and low levels of cognitive stimulation are associated with lower child-care services use (30.7% of the Quebec sample). In sum, children who are the most likely to benefit from child-care services in terms of their development are also those who are less likely to receive it.

Contexte. De plus en plus d’enfants fréquentent les milieux de garde et y consomment leur repas. Les éducatrices présentes constituent des modèles dont les attitudes et les pratiques alimentaires peuvent contribuer au développement des habitudes alimentaires des enfants. Toutefois, peu d’études ont été menées sur le sujet. Objectifs. Décrire les attitudes et les stratégies d’éducatrices en milieux de garde au Québec à l’égard de l’alimentation des enfants et dégager les styles alimentaires dominants. Méthode. La collecte de données a eu lieu par sondage sur le site Web www.nospetitsmangeurs.org. À partir de 86 énoncés, la recherche a documenté les styles et pratiques alimentaires des éducatrices au moyen de huit mises en situation : mets principal non apprécié par l’éducatrice, aliment particulier non apprécié par un enfant, nouveau mets non désiré par les enfants, enfant difficile ne voulant pas manger, enfant qui n’a pas faim, fillette avec embonpoint, fillette de petit poids et enfant n’ayant pas terminé son repas. Analyse statistique. Des statistiques descriptives, des échelles de fiabilité et des corrélations ont été générées. Des tests de t pour échantillons appariés ont également été utilisés pour évaluer le degré relatif des styles alimentaires. Résultats. Au total, 371 répondants ont rempli l’ensemble du questionnaire. Globalement, les éducatrices étudiées utilisent le style alimentaire démocratique. Celles-ci mentionnent représenter des modèles pour les enfants. Elles encouragent aussi les enfants à manger et utilisent la division des responsabilités. Paradoxalement, la pratique alimentaire associée au style autoritaire la plus utilisée est la pression à manger, pratique en opposition avec le concept de division des responsabilités. Conclusion. Cette étude indique que les éducatrices démontrent des attitudes positives à l’égard de l’alimentation des enfants. Malgré certaines discordances à l’égard de stratégies utilisées, ces résultats sont encourageants, car le style alimentaire démocratique permet aux enfants de reconnaitre leurs signaux de faim et de satiété. / Context. More and more children go to daycare centres and have their meals in these settings. Caregivers are role models whose attitudes and feeding practices may contribute to the development of children's eating habits. However, few studies have been conducted on this subject. Objectives. To describe the attitudes and strategies of caregivers working in daycare settings with respect to children’s diets and identify dominant feeding styles. Methodology. Data collection was conducted by means of a survey on the www.nospetitsmangeurs.org website. A total of 86 statements were used to document the feeding styles and practices of caregivers as revealed through eight scenarios: a main dish not liked by the caregiver, a specific food not liked by a child, a new meal refused by children, a picky eater who does not want to eat, a child who is not hungry, an overweight little girl, a underweight girl and a child who has not finished his/her meal. Statistical analysis. Descriptive statistics, reliability scales and correlations were generated. T tests for paired samples were also used to assess the relative importance of feeding styles. Results. A total of 371 respondents completed the questionnaire. Overall, the caregivers use a democratic feeding style. They mentioned being role models for the children. They also encourage children to eat and they favor division of responsibilities. However, the most widely used feeding practice related to the authoritarian style is the pressure to eat, a practice contrary to the division of responsibilities concept. Conclusion. This study indicates that caregivers demonstrate positive attitudes towards child feeding. Despite some discrepancies with respect to strategies used, these results are encouraging since a democratic feeding style allows children to recognize their hunger and satiety cues.

This thesis deals with the communication ability of children living in institutional upbringing facilities. The work is divided into two parts, theoretical and practical. The first part of the thesis, which was created on the basis of perusing technical and specialized literature, provides a theoretical insight into the problematic of communication, speech and language. It also discusses the development of speech, communication abilities of pre-school children and their development. Last chapter of this thesis deals with substitutional child care, its definition. Practical part is devoted to qualitative research, whose main objective is to analyze the communication ability of children living in institutional upbringing facilities. The research was conducted in children's home and in Klokanek, a facility for children requiring immediate help. The research sample consisted of eight children, four of them living in children's home, four of them living in Klokanek. The research shows that in the investigated children appear difficulties in communication skills. As a conclusion a recommendation for practice was created. Governess in the childrens's home and Klokanek should have more opportunities to develop communication abilities of children. KEYWORDS communicational ability, institutional upbringing...

The goal of this thesis is to describe the historical development of child care in the Czech Republic and in the world. It was never easy for children in the adult world. At the origination, the leader of the tribe decided about their lives. In the past murders of little girls were common, men could fight and protect the tribe or nation better. Boys were often killed by enemies so there was no descendant left. It was not until the acceptance of Christianity in 16th century that it had changed. It was still not a peaceful childhood, but there were no child murders. On the other hand, a lot of childen ended up in monasteries without parents. Nowadays at least children in the developed world should have a real childhood. Unfortunately there is still a considerable amount of adverse cases. Another goal was to familiarize the reader with CAN Syndrome. In 1962 the term "Beaten Child Syndrome" was used, later the name CAN Syndrome became common. This syndrome was first described in the USA, where they noticed children have injuries their parents cannot make clear. Categories included in CAN Syndrome were established by the Council of Europe in 1992. One of the most important goals of the thesis was to focus on child neglect (its forms, conditions and signs of neglect). In the research part I determined...

Introdução: É crescente a discussão da segurança alimentar e nutricional (SAN) no cenário de políticas públicas nacional, principalmente com relação à atenção à saúde infantil. O nutricionista, por sua vez, é um dos profissionais aptos para desenvolver ações visando à SAN. Objetivo: Analisar as habilidades e competências adquiridas durante a graduação para a atuação em SAN entre nutricionistas que trabalham com crianças na atenção básica de saúde no Município de São Paulo. Métodos: Estudo de natureza qualitativa, no qual foram investigados 16 nutricionistas da atenção básica de saúde graduados a partir de 2004 e 22 cursos de Graduação em Nutrição do município, tendo como referências o seu coordenador e os projetos político-pedagógicos (PPPs). A percepção acerca da formação foi verificada por meio das técnicas do Discurso do Sujeito Coletivo, utilizando-se de entrevistas individuais, e de grupo focal. Os PPPs foram confrontados com referenciais teóricos da área. Resultados: A experiência profissional mostrou-se mais significativa do que a formação obtida na Graduação, segundo os nutricionistas. Coordenadores e nutricionistas concordam que atividades de estágios, a disciplina saúde pública e aquelas da área das ciências humanas, a discussão da atuação interdisciplinar e a abordagem transversal de SAN são relevantes para a formação do profissional. Nutricionistas tendem a apontar a formação por eles obtida como insuficiente para aquisição de habilidades e competências para atuação em SAN para crianças, enquanto que os coordenadores sinalizam que os cursos apresentam estrutura favorável para tal. Os PPPs remetem à limitação do tema de SAN para crianças com relação aos objetivos dos cursos, perfil profissional e princípios norteadores, porém indicam habilidades e competências relativas a sistemas de saúde e políticas públicas de alimentação e de nutrição. Conclusão: Verificou-se convergência entre nutricionistas e coordenadores ao refletirem sobre os aspectos da formação que favorecem a atuação em SAN para o público infantil no âmbito da atenção básica, como a estrutura do curso, disciplinas ministradas e estratégias de ensino. Porém, estes divergem sobre a qualidade da formação obtida/oferecida, indicando que as possíveis propostas construídas e desenvolvidas pelos cursos para o desenvolvimento de habilidades e competências não são percebidas pelos estudantes e, principalmente, limitam a sua tradução na prática profissional. / Introduction: The discussion on food security (FS) within the context of national public policies is increasing, mainly regarding attention to childrens health. Nutritionists, on their turn, are the professionals able to carry out actions based on FS. Objective: To analyze the skills and competences acquired during the graduation to work in FS among nutritionists who work with children on primary health care in the city of Sao Paulo. Methods: Qualitative study in which we investigated 16 primary health care nutritionists graduated from university from 2004 and on, and 22 graduate Nutrition courses in the city, using as reference their coordinators and political-pedagogical projects (PPP). The perception on formation was obtained by means of the techniques of the Discourse of the Collective Subject, using individual and focus group interviews. The PPPs were checked against the theoretical references of the area. Results: Professional experience showed to be more significant than the formation obtained in university, according to nutritionists. Coordinators and nutritionists agree that internship activities, public health subject and those subjects related to human sciences, the discussion on interdisciplinary work, and the transversal approach of FS are all relevant when it comes to formation of professionals. Nutritionists tend to point out that their formation is not enough to acquire the skills and competences to work with FS targeted at children, while coordinators indicate that the courses have structure that favor it. The PPPs remind us of the limitation of the FS for children theme regarding course goals, professional features, and guiding principles; however, they indicate skills and competences relating to health systems and public food and nutrition policies. Conclusion: It was verified that nutritionists and coordinators agree when reflecting about the formation aspects that favor the work in FS for children within the scope of basic care, as the course structure, the subjects and teaching strategies. Nonetheless, they disagree about the quality of formation obtained/offered, indicating that the possible proposals created and developed by the courses to develop skills and competences are not perceived by students and, mainly, restrict its translation into professional practice.

Introdução: O relacionamento estabelecido entre profissionais de saúde, criança e família durante os cuidados de final de vida é complexo e multidimensional. Poucas evidências mostram como os relacionamentos são estabelecidos no contexto de final de vida da criança e influenciam no luto após a morte de um filho. Objetivo: Interpretar a experiência de pais sobre os relacionamentos estabelecidos com os profissionais de saúde durante o final de vida da criança com câncer no hospital. Método: Trata-se de uma pesquisa qualitativa, guiada pela hermenêutica filosófica de Gadamer. A coleta dos dados foi realizada por meio de observações de campo em um hospital oncológico pediátrico com famílias de crianças hospitalizadas em situação de final de vida, entrevista com pais enlutados pelo menos 6 meses após o óbito da criança e análise de prontuários. Para a análise dos dados, o processo de transcrição, leitura e releitura dos dados, revisão das notas de campo e reflexão sobre os dados com outros pesquisadores ajudaram na compreensão do fenômeno para a geração de interpretações. Para tanto, foram identificadas unidades de significados nos dados que, posteriormente, foram agrupadas por similaridade para a formação indutiva de temas. Resultados: Os relacionamentos entre pais e profissionais da saúde no final de vida da criança com câncer hospitalizada desvelam fenômenos do encontro e da interação interpessoal presentes na situação de doença, morte e perda. Esses relacionamentos são permeados pela presença de valores humanos e são estabelecidos de forma dinamica com vínculos diversos. Existem componentes evidentes no relacionamento durante o final de vida da criança no hospital, tal como o amparo, o silêncio, a deterioração, a tolerância, a hierarquia, o compartilhamento e a confiança, bem como, fatores internos e externos que influenciam nas interações. Por meio dos relacionamentos, os pais reavaliam o próprio papel, enquanto vivenciavam a experiência inesperada de perder um filho e significados atribuídos à doença e à perda são associados aos encontros mesmo anos após a morte do filho. Considerações finais: Os relacionamentos servem de base para fortalecer e suportar os pais a exercerem o papel de cuidadores para garantir a excelência no cuidado do filho. A qualidade dos relacionamentos entre pais e profissionais da saúde torna-se uma lembrança marcante no processo de luto e estabelecem uma conexão permanente com o filho falecido. Um olhar para o relacionamento entre familiares e profissionais integrando a ciência do cuidado proporciona a base de paradigmas não positivistas, que são urgentes nas situações de final de vida. Este estudo pode contribuir com as políticas de enfermagem na consolidação de futuras diretrizes sobre a qualidade na prática do cuidado de final de vida da criança, facilitando para as famílias manter vínculos significativos durante o processo de doença, perda e luto. / Introduction: The relationship established between family and healthcare providers during the childs end-of-life care is complex and multidimensional. There are few evidences which explore how these relationships during the childs last hospitalization influence familial adaptation after loss. Objective: To interpret parents experience in their relationship with healthcare providers during the childs end-of-life with cancer in the hospital. Methods: This is a qualitative research, guided by Gadamers philosophical hermeneutics. Data collection was through field observations conducted in a pediatric oncology hospital with hospitalized families in end-of-life situation, interviews with bereaved parents at least 6 month after the childs death and medical records analysis. For the data analysis, the process of transcription, reading and re-reading the data, reviewing field notes and reflection on the data with other researchers helped understand the phenomenon to generate interpretations. Therefore, units of meaning emerged from the data were grouped, and themes were inductively determined and submitted to an interpretation process. Results: Relationships between parents and healthcare providers during a childs end-of-life process unveil the encounters and interpersonal interactions phenomena in illness and loss trajectory. These relationships are permeated with human values and are established in a dynamic way with various bondings. There are evident components in a child´s end-of-life context, such as presence, silence, deteriorations, tolerance, hierarchy, collaboration and trusting, as well as internal and external factors which influence the interactions. Through relationships, parents reevaluate their own role, while they live the unexpected experience of losing a child and attribute meanings to the loss. Final considerations: Relationships serve as a basis for strengthening and supporting parents in providing excellence in the child\'s care. The quality of the relationship between parents and healthcare providers is a remarkable memory of the child\'s life during the bereavement process. Looking into the relationship between parents and providers integrating it with caring science provides a basis for non-positivist paradigms which are urgent in end-of-life situations. This study aims to contribute to end-of-life nursing policies in recognizing the components to improve the quality of the relationships as a starting point for care which will allow families to have a safe base while experiencing the child\'s illness and the bereavement process.