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Avaliação da saúde emocional e comportamental nas crianças de 4 a 12 anos de idade atendidas nos cuidados de saúde primários no centro materno infantil de Bissau e de Bafatá, de janeiro a maio de 2021
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Introdução: Em muitos países, e particularmente em África, os problemas de saúde
mental são amplamente negligenciados e a sua dimensão pouco conhecida.
Nas crianças, os problemas emocionais e comportamentais têm um impacto imediato no
seu desenvolvimento e nas suas competências na escola e na comunidade, estando
associados a patologias do foro da saúde mental na fase adulta.
Conhecer os problemas emocionais e comportamentais nas crianças, assim como os
fatores associados ao seu desenvolvimento poderá contribuir para estratégias que
permitam intervenções precoces e organização da resposta dos serviços de saúde.
Objetivo: Comparar os resultados das dificuldades emocionais e comportamentais
obtidos com a escala da GB com aqueles que seriam obtidos usando os pontos de corte
da África do Sul e do Reino Unido.
Métodos: Estudo transversal. Participantes: crianças de 4 a 12 anos de idade, atendidas
no Centro Materno Infantil de Bissau e de Bafatá, de janeiro a maio de 2021, recrutadas
no momento das consultas. Os pais/cuidadores responderam, por entrevista face a face,
ao questionário sobre as características sociodemográficas das crianças e das suas
famílias, e ao questionário de dificuldades e capacidades (SDQ-versão pais) para
avaliação de problemas emocionais e comportamentais nas crianças.
Resultados: Das 300 crianças recrutadas, metade vivia em meio urbano, 132 (44%) eram
do sexo feminino e 168 (56%) eram do sexo masculino, com medianas de idade de 7 e 8
anos respetivamente. As famílias com maior rendimento (19% vs. 4%; p<0,001) e com
escolaridade média e superior (30% vs. 10%; p<0,001) residiam mais frequentemente em
meio urbano. O valor das dificuldades do SDQ-total, com pontos de corte definidos para
a Guiné-Bissau, não diferiu estatisticamente significativa entre meninos e meninas (14%
vs. 7%; p>0,001). A utilização dos pontos de corte da África do Sul e do Reino Unido
teria resultado num maior número de valores anormais. O nascimento prematuro,
agregados monoparentais, famílias com rendimento mensal baixo e com maior
desemprego (p<0,001) estiveram associados ao desenvolvimento de problemas
emocionais e comportamentais nas crianças.
Conclusão: Não se verificou associação entre o sexo das crianças e o desenvolvimento
de dificuldades emocionais e comportamentais, contudo, o nascimento prematuro das
crianças, o baixo rendimento, o desemprego e a monoparentalidade dos pais/cuidadores
estiveram associados ao desenvolvimento destas dificuldades. A utilização de pontos de
corte específicos para a Guiné-Bissau pode permitir a identificação de dificuldades
emocionais e comportamentais mais adaptadas às diferenças contextuais e culturais.
O presente estudo piloto, pode contribuir para apresentar o SDQ como um potencial
instrumento para o diagnóstico e intervenção precoces de dificuldades emocionais e
comportamentais nas crianças na Guiné-Bissau.
Introduction: Mental health problems are widely neglected in many countries, particularly those in Africa, where there is little knowledge of their extent. Emotional and behavioural problems in children can have an immediate impact on their development, school performance and relationship with their community, as well as being associated with mental health issues later in adult life. Gaining evidence on these problems and their associated factors in children can contribute to the implementation of strategies which will allow for early interventions and a better organization of health services response. Objective: To compare the results of emotional and behavioural difficulties calculated using the Guinea Bissau scale with those using the cut-off points for South Africa and the Unite Kingdom. Methods: Cross-sectional study. Participants: 4-12 years old children from rural and urban areas recruited while attending appointments in the Mother and Child Centres in Bissau and Bafatá between January and May 2021. Parents/guardians were interviewed face to face using one questionnaire to collect sociodemographic data and the Strengths and Difficulties Questionnaire (SDQ-parents version) to evaluate emotional and behavioural problems in children. Results: Half of the 300 children recruited lived in an urban setting; 132 (44%) were female and 168 (56%) male, medians for age were 7 and 8 years old respectively. Families from urban areas had higher incomes (19%vs4%; p<0,001) and higher education (30%vs10%; p<0,001). Using specific cut-off points for Guinea-Bissau, there were no differences in the SDQ total difficulties score among boys and girls (14% vs. 7%; p>0,001). SDQ cut-off points from South Africa and the UK resulted in a higher number of abnormal scores. Premature birth, single parent families, lower income, unemployment and living in urban areas were all associated (p<0,001) with the development of emotional and behavioural problems in children Conclusion: There was no association between the child’s gender and the development of emotional and behavioral difficulties; however, urban upbringing, low income, unemployment, single parent families, and premature birth are associated with the development of these difficulties. The use of SDQ cutoff points for Guinea-Bissau may allow the identification of emotional and behavioural difficulties better adapted to contextual and cultural differences. This study contributes to the awareness of SDQ as a potential instrument for the early diagnosis, and interventions, of emotional and behavioural difficulties in children in Guinea-Bissau
Introduction: Mental health problems are widely neglected in many countries, particularly those in Africa, where there is little knowledge of their extent. Emotional and behavioural problems in children can have an immediate impact on their development, school performance and relationship with their community, as well as being associated with mental health issues later in adult life. Gaining evidence on these problems and their associated factors in children can contribute to the implementation of strategies which will allow for early interventions and a better organization of health services response. Objective: To compare the results of emotional and behavioural difficulties calculated using the Guinea Bissau scale with those using the cut-off points for South Africa and the Unite Kingdom. Methods: Cross-sectional study. Participants: 4-12 years old children from rural and urban areas recruited while attending appointments in the Mother and Child Centres in Bissau and Bafatá between January and May 2021. Parents/guardians were interviewed face to face using one questionnaire to collect sociodemographic data and the Strengths and Difficulties Questionnaire (SDQ-parents version) to evaluate emotional and behavioural problems in children. Results: Half of the 300 children recruited lived in an urban setting; 132 (44%) were female and 168 (56%) male, medians for age were 7 and 8 years old respectively. Families from urban areas had higher incomes (19%vs4%; p<0,001) and higher education (30%vs10%; p<0,001). Using specific cut-off points for Guinea-Bissau, there were no differences in the SDQ total difficulties score among boys and girls (14% vs. 7%; p>0,001). SDQ cut-off points from South Africa and the UK resulted in a higher number of abnormal scores. Premature birth, single parent families, lower income, unemployment and living in urban areas were all associated (p<0,001) with the development of emotional and behavioural problems in children Conclusion: There was no association between the child’s gender and the development of emotional and behavioral difficulties; however, urban upbringing, low income, unemployment, single parent families, and premature birth are associated with the development of these difficulties. The use of SDQ cutoff points for Guinea-Bissau may allow the identification of emotional and behavioural difficulties better adapted to contextual and cultural differences. This study contributes to the awareness of SDQ as a potential instrument for the early diagnosis, and interventions, of emotional and behavioural difficulties in children in Guinea-Bissau
Descrição
Palavras-chave
Saúde pública Dificuldades emocionais e comportamentais Cuiddos de saúde primários Guiné-Bissau