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Examinando por Materia "Parents"

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    (Universidad Privada Norbert Wiener, 2018-06-25) Nina Cerna, Leslie Vanessa; Rojas Pascual, Gisela; Calero Híjar, Aldo
    Objective: To determine the sociodemographic factors and knowledge levels influencing the acceptance of the human papillomavirus (HPV) vaccine among parents of 4th to 6th-grade students at I.E. 2048 "José Carlos Mariátegui," Comas, 2017. Methodology: A descriptive, cross-sectional study was conducted with 110 parents of 4th to 6th-grade students. Results: Sociodemographic factors showed that parents aged 40 years or older (43.6%), females (73.6%), and those with completed secondary education (37.3%) had higher acceptance of HPV vaccination. The acceptance level of the HPV vaccine was 90.9%. Parents with medium knowledge of HPV infection (57.3%) showed higher acceptance, with 55.5% of those with medium knowledge levels being more likely to accept the vaccination. Conclusion: The acceptance of the HPV vaccine is high; however, it is necessary to continue educating parents about the health of girls and adolescents regarding HPV infection, as most have only basic knowledge about the topic.
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    Burnout syndrome and quality of nursing care in the neonatal intensive care service of a hospital in Lima, 2022
    (Universidad Privada Norbert Wiener, 2022-10-09) Muñoz Guzman, Alejandro Ignacio; Arevalo Marcos, Rodolfo Amado
    The study will focus on an extremely critical problem within the field of neonatal intensive care, due to the risk that burnout syndrome means for nurses physically, psychologically and emotionally, aspects that result in the quality of care, which can be significantly affected. negatively, exposing them to the occurrence of various risks or adverse events that can endanger their lives and that of the patients. Objective: Determine the relationship between burnout syndrome and quality of nursing care in the neonatal intensive care service of a hospital in Lima, 2022. Materials and methods: The study uses a hypothetical deductive method, quantitative approach, basic type. and non-experimental design. 50 nurses and 50 parents will participate. The survey will be used and the Maslach Burnout Inventory (MBI) validated by María Huanca in 2018 and the questionnaire will be applied to measure the quality of care variable developed by Roxana Puicón in 2022. The levels obtained by each variable will be measured at through Spearman's non-parametric Rho test.
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    Conocimientos y la participación de los padres en el cuidado del niño hospitalizado en un servicio de pediatría en un hospital nacional, 2024
    (Universidad Privada Norbert Wiener, 2024-11-10) Quispe Diaz, Brigitt Michelle; Rojas Ahumada, Magdalena Petronila
    El proceso de hospitalización para el niño, es sin duda, una experiencia nueva, que puede generar angustia, frustración e incertidumbre frente a lo desconocido; y los soportes más importantes para él, vienen a ser los padres, quien, como cuidadores, satisfacen sus necesidades más esenciales; puesto que los padres se encargan de dar el soporte a nivel físico y psicológico, les brindan amor, ternura, calman el llanto, es así que se transforma en un óptimo sostén y mantenimiento del paciente pediátrico con el objetivo de “Determinar el nivel de conocimientos y la participación de los padres en el cuidado del niño hospitalizado en un servicio de pediatría en un hospital nacional, 2024.”, el presente estudio será de tipo descriptivo, de enfoque cuantitativo, de diseño no experimental, y de corte transversal, para ello se necesita la muestra, que estará conformada por 90 personas. Para este presente estudio, la confiabilidad del instrumento (cuestionario) en su variable “conocimiento” en los padres, tuvo como Alfa de Cronbach= 0,7, se utilizará el programa estadístico SPS
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    Coping with stress and emotional overload in parents of children with autism
    (Universidad Privada Norbert Wiener, 2023-10-01) Astocóndor Castañeda, Tania del Rosario; Fernández Rengifo, Werther Fernando
    Objective: To determine coping with stress and emotional overload in parents of children with autism at the Carabayllo Mental Health Center, from April to July 2023. Materials and methods: Quantitative correlational study. The population will be made up of 100 parents with children who have been diagnosed with Autism between 6 months and a year prior to the start of the study and attend the Children and Adolescents Unit of the CSMC Carabayllo. The instrument that will be applied for emotional overload is the Zarit scale made up of 22 items grouped into three dimensions that will measure the level of overload of the family caregiver: impact of care, interpersonal relationship, self-efficacy expectations, and a level of reliability of the instrument of Cronbach's alpha 0.92. And for coping with stress, we will use the Lazarus and Folkman coping scale. Throughout the investigation, a research conduct will be maintained in accordance with ethical principles.
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    Desempeño psicomotor y estrés parental en un instituto de rehabilitación infantil, Comas – 2024
    (Universidad Privada Norbert Wiener, 2025-07-05) Gonzales Arias, Fatima Celeste; Puma Chombo, Jorge Eloy
    El trastorno del espectro autista (TEA) es una condición del neurodesarrollo que afecta las habilidades sociales, la comunicación y la capacidad para adaptarse a cambios, con una fuerte preferencia por rutinas. Aunque su origen exacto es desconocido, se considera el resultado de factores genéticos, biológicos y ambientales. La detección temprana es crucial, ya que permite implementar intervenciones terapéuticas oportunas que mejoran el desarrollo infantil y el pronóstico a largo plazo. Según la Organización Mundial de la Salud, se estima que cerca del 1% de la población infantil a nivel mundial presenta TEA, y en países como Estados Unidos, la prevalencia ha aumentado significativamente en las últimas décadas. Además de los desafíos sociales y comunicativos, los infantes con TEA presentan dificultades psicomotoras, lo que exige cuidados especiales que suelen generar una carga emocional y económica considerable en sus familias. El impacto del diagnóstico no solo afecta al infante, sino también a su entorno, especialmente a los cuidadores primarios, quienes experimentan un mayor riesgo de estrés, ansiedad y depresión. Los costos asociados al cuidado de estos niños son elevados, con estimaciones altas en países como Estados Unidos, Canadá y China, lo que pone de manifiesto la necesidad de apoyo integral a las familias afectadas.
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    Effect on the level of knowledge about healthy lunch boxes in parents of preschool students at I.E.I 557 in Villa el Salvador, Lima. 2023, after an educational intervention
    (Universidad Privada Norbert Wiener, 2024-06-05) Castro Yance, Piero Alonso; Yapo Espinoza, Víctor Eduardo; Cruz Maldonado, Rosa Elena
    Nutritional health during childhood poses significant global challenges, especially in developing countries. The aim of this research was to determine the effect of an educational intervention on the knowledge level of healthy lunchboxes among parents of preschool students at I.E.I. 557 in Villa el Salvador, Lima, 2023. A hypothetical-deductive method, applied, explanatory level, and non-experimental design were used. The study intervened with 120 parents, showing significant differences between the pretest and posttest. In the pretest, 20.33% had a high knowledge level, 34.17% had a medium level, and 45% had a low level. The posttest results showed 96.66% high and 3.34% medium, with the low level disappearing. Wilcoxon’s test yielded a p-value of 0.000, indicating a significant effect of the educational intervention. The conclusion is that educational nutritional interventions are crucial in teaching parents of preschool children how to provide healthy meals for their children.
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    Effective strategies to strengthen growth and development in children
    (Universidad Privada Norbert Wiener, 1905-07-09) Pereyra Campos, Cynthia Karin; Krederdt Araujo, Sherin Luz
    Objective: Systematize the best evidence in already completed research; That is, to what extent the research found adds new knowledge to the central question. Material and methods: Information was collected from different articles according to the level of evidence and degree of recommendation. Thus, descriptive and correlational studies were selected. Results: The factors that intervene in the non-attendance of the CRED control of the boy and girl, the mothers and/or caregivers report that the nursing staff is insufficient and they have difficulties with the hours of care, with the waiting time, diversity of tasks of the home. Conclusions: It is detailed that in the range of 4 to 8%, fathers, mothers, caregivers have difficulties taking their children to the CRED due to work schedules, leaving their children in the care of minors, due to ignorance of the importance of the CRED, generating a significant gap between the children who attend the CRED and those who do not attend, which could be decisive, so that the children do not reach optimal development, causing them to be limited in their cognitive development and school performance, limiting their possibilities to access other levels of education, and with low economic productivity when they reach the adult stage of life. This is why it is essential to generate effective strategies to strengthen the growth and development of children; it is necessary to involve the person, family and community in this context, to preserve family health in the population.
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    Effectiveness of an educational program on knowledge and practices about healthy eating in parents of school-age children
    (Universidad Privada Norbert Wiener, 1905-07-09) Robles Bocanegra, Tania Liz; Gamarra Bustillos, Carlos
    Objectives: Determine the effectiveness of an educational program on knowledge and practices about healthy eating in parents of school-age children and make recommendations based on the evidence found. Materials and Methods: The search was carried out in Scielo, Lilacs, Lipecs, Medline, the information was oriented using the keywords effectiveness, educational program, knowledge, practices, food and nutrition. Where original articles published in journals were found between January 2006 and September 2016. Of a total of 25 articles, 10 articles that met the eligibility criteria were analyzed, including experimental, pre-experimental and quasi-experimental studies that met the inclusion criteria. and exclusion. The levels of evidence and strength of recommendation were then evaluated. Results: In the final selection, 10 were chosen, we found that 100% (n=10/10) of them affirm that the educational programs aimed at parents are effective in knowledge and practices about healthy eating. Conclusions: The application of an educational program has a positive impact on the knowledge and practices about healthy eating for parents of school-age children, generating healthy practices for parents in food preparation and children with adequate healthy growth and development. .
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    Effectiveness of reminder system and parent education interventions to improve immunization coverage and demand in children under 5 years of age
    (Universidad Privada Norbert Wiener, 2020-03-08) Rivera Rios, Gianinna Del Rocio; Cortez Silva, Yoselyn Jhanette; Bonilla Asalde, César Antonio
    Objective: Systematize the evidence about the effectiveness of the reminder system and educational intervention aimed at parents to improve vaccination coverage and demand for children under 5 years of age. Material and Methods: The population constituted by the systematic review of 70 published scientific articles from which 10 articles collected from the database were taken as a sample; Pubmed, Sciencedirect, Redalyc, Cochrane Database, Dialnet, Scopus, BMC Public Health and references from other studies, all of them correspond to the quantitative type, high quality study design and strong recommendation strength 85% and only 15% of moderate strength . Results The 10 studies reviewed conclude that the reminder system and education strategies are effective in improving the acceptance of childhood immunization and increasing immunization rates. Likewise, together with education, they contribute to strengthening parents' knowledge, dispelling their doubts and fears, helps to improve their intention to vaccinate and their confidence in the vaccination decision. Conclusion: In general, in the studies reviewed, it was observed that applying the strategy through reminder systems, education and the combination of both can improve the level knowledge about vaccination and benefits, also improve the decision and acceptance of childhood vaccination.
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    Effectiveness of strengthening the parent-child attachment bond in the optimal development of children
    (Universidad Privada Norbert Wiener, 2018-08-26) Chahuas Rodriguez, Eulalia Maria; Matta Solis, Hernán Hugo
    Objective: Systematize the evidence that shows the effectiveness of optimal development of children with the development of parental attachment activities. Material and Method: The systematic review of the 10 scientific articles identified by degree of evidence according to Grade found on the effectiveness of strengthening the parental attachment bond in the optimal development of children, were found in the databases Lilacs, Scielo, Cochrane Plus, Pubmed, Medline, EBSCO. The articles reviewed are from: United States 20%, Canada 20%, Italy – Canada 10%, South Africa 10%, Australia 10%, United States - England 10%, United States-Portugal 10%, Spain 10%. Results: Of the 10 articles reviewed, 30% correspond to trials, 20% are meta-analysis, 10% are systematic review and meta-analysis, 10% are systematic review, the 20% correlational study, 10% are cross-sectional correlational quantitative study. Of the 10 articles systematically reviewed, 100% show the development of positive attachment activities of parents that promote the optimal development of boys and girls. Conclusion: It is concluded that the development of positive attachment activities of parents promotes optimal development of children.
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    Evidence-based educational interventions to increase the level of knowledge and improve healthy practices for the prevention of intestinal parasitosis in school-age children
    (Universidad Privada Norbert Wiener, 2020-08-02) Marcelo Montero, Ericka Beatriz; Nicho Ramos, Mayra Geraldine; Uturunco Vera, Milagros Lizbeth
    The search for full-text articles was carried out in the Cochrane, Scielo and Pubmed databases. 10 articles are included (7 clinical trials, 2 quasi-experimental and 1 cross-sectional design). They all demonstrate the effectiveness of evidence-based educational interventions to increase the level of knowledge and improve healthy practices for the prevention of intestinal parasitosis in children: they are usually educational interventions aimed at teachers, parents and school children taught to through educational talks, demonstration sessions, posters, videos, brochures, etc. on specific topics of parasites signs, symptoms and their prevention. Educational programs with teaching resources such as videos, social dramas and workshops achieve a positive effect in improving knowledge related to healthy practices and habits such as; hand washing, nail trimming, personal hygiene, environmental hygiene and proper disposal of excreta. The nurse plays an important role in the education of children at school. Through interventions in schools, we can contribute to increasing the child's knowledge and improving their healthy lifestyle practices.
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    Factors associated with alcohol consumption in adolescents
    (Universidad Privada Norbert Wiener, 1905-07-09) Meniz Romero, Elia Nancy; Romualdo Quillahuaman, Gloria Janet; Rivera Lozada de Bonilla, Oriana
    Objective: Determine the factors associated with alcohol consumption in adolescents. Methodology: The systematic review of the 14 scientific articles reviewed were found in the databases Lipecs, Lilacs, Scielo, Medline, Adolec and BDENF, all of them correspond to the type and design of studies Systematic, cohort, cross-sectional, correlational and descriptive reviews, The search was restricted to articles with full text and they were subjected to critical reading to identify their level of evidence. Results: In the final selection, 14 scientific articles from different countries were chosen, 43% corresponding to Brazil; 14.5% Spain and Colombia; 7% Cuba, Argentina, Bolivia and Peru. Of the articles reviewed, 100% (14) agree that adolescence is one of the stages where alcohol consumption begins (between 8 and 16 years with an average age of 12 years), frequent use from the age of 15, 50%(7) of studies refer to the presence of risk and protective factors for alcohol consumption mediated by family influence; 3(21%) influence from friends and peers, 8(57%) social pressure. Conclusions: it was evident that the factors associated with alcohol consumption in adolescents are related to the early appearance of use, media influence, problematic relationship with parents, use by family members, sexual abuse, domestic violence. , low self-esteem, curiosity, peer pressure, among others.
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    Factors associated with non-compliance with type II diabetes mellitus treatment in older adults
    (Universidad Privada Norbert Wiener, 1905-07-09) Rojas Rodriguez, Rosario Candelaria; Villafani Arenas, Ana María; Gómez Gonzales, Walter Edgar
    Objective: Determine the factors associated with non-compliance with the treatment of Type II Diabetes Mellitus in older adults. Materials and Methods: Systematic reviews are an observational and retrospective research design, which synthesizes the results of multiple primary investigations. They are an essential part of evidence-based nursing due to their rigorous methodology, identifying relevant studies to answer specific questions of clinical practice. Results: The 10 articles reviewed were located in the databases Scielo, Lilacs, :Lipecs and Dialnet, they show that there are many factors that are associated with non-compliance with treatment but in particular, those that present the highest levels of statistical association are treatment schemes, lifestyles, personal and family factors and access to quality primary care, also among the factors associated with non-compliance with treatment in type II diabetic patients is sedentary lifestyle and obesity. Conclusion: The factors associated with non-compliance with the treatment of type 2 diabetes mellitus in older adults are treatment regimens, lifestyles, personal and family factors, and sedentary lifestyle and obesity. Also associated are the level of family conflict, communication patterns, the degree to which parents are involved in caring for their children's diabetes, satisfaction in the couple's relationship, family functionality, and family structure. , stressful family events, and even family abilities to handle unforeseen situations, are associated with adherence to type 2 diabetes mellitus treatment in older adults.
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    Family cohesion and resilience in adolescents 3rd and 4th grade of secondary school of the private educational institution B - Group – Callao 2019
    (Universidad Privada Norbert Wiener, 2020-12-27) Mejía Díaz, María Del Rosario; Gonzales Saldaña, Susan Haydee
    Family cohesion is the level at which family members are interested in it, and are committed to helping each other. The family is an organism, it performs the social function of transferring values. Furthermore, it is proposed that the family is the one who provides emotional support. The family is the axis of humanity which has gone through changes in social, economic and political areas; variety is observed in family dynamics, affecting its activity and cohesion. This phase affects the adolescent who is in an evolutionary stage that is considered vulnerable since in this period there are hormonal changes, as well as cognitive immaturity since they are searching for their identity, admitting a change in the parent-child relationship. Resilience is the skill of the human being to face the difficulties that arise, being able to highlight and even be part of them. Resilience is the virtue to face misfortune and endure tragedies. Being resilient does not mean feeling discomfort, emotional pain or difficulty in the face of adversity. Materials and methods Research approach and design The approach will be quantitative, applied when the researcher is interested in collecting numerical data that can be analyzed by mathematical means. The design will be cross-sectional, correlational. Two surveys were used on family cohesion used by Olson (1985) and resilience used by Connor and Davidson (2003). Population, sample and sampling: The population considered for this study is made up of 100 students from the Private Educational Establishment of Callao, distributed by 45 women and 55 men, 25 students correspond to each classroom, there were 4 classrooms.
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    Habeas Corpus en el Derecho de Familia, Corte Superior de Justicia Lima, 2021 (Exp. 5955-2021)
    (Universidad Privada Norbert Wiener, 2024-08-12) Colombo Príncipe, Tania Eloisa; Saavedra Moncada, Santos Eladio
    El proceso de Habeas corpus se encuentra íntimamente relacionado al Derecho de familia en la medida que existen situaciones donde los progenitores restringen su derecho a ser libres, estos suelen darse en instituciones como la tenencia y el régimen de visitas. Tuvo como objetivo evaluar el impacto de la libertad personal en el Derecho de Familia, Corte Superior de Justicia Lima, 2021. La metodología usada fue un enfoque cualitativo, de tipo básico y nivel exploratorio; asimismo se aplicó el diseño de estudio de caso, método inductivo, y de técnica se tuvo al análisis documental. Los principales resultados fueron la alegación de una madre que señala la transgresión del derecho a la libertad del menor, acto cometido por el padre contenida en el expediente de la Tercera Sala Constitucional la cual fue declarada erróneamente como improcedente. Se concluyó que, el habeas corpus tiene un impacto positivo en el Derecho de Familia, no obstante, en el caso analizado su efecto fue contrario debido a la interpretación errónea del magistrado.
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    Humanized care and satisfaction of care perceived by parents of premature newborns in the neonatal intensive care unit in a private clinic in Lima, 2022
    (Universidad Privada Norbert Wiener, 2022-10-09) Mina Calderón, Clara Luz; Molina Torres, Jose Gregorio
    This research aims to: Determine the relationship that exists between humanized care and satisfaction of care perceived by parents of premature newborns in the Neonatal Intensive Care Unit in a private clinic in Lima. The methodology: hypothetical deductive method, non-experimental design, quantitative approach, descriptive, applied, correlational, cross-sectional; The sample will consist of 60 parents, the instruments that will be used for the research work will be the servqual questionnaire that will measure the satisfaction of the care perceived by parents and the Nyberg Caring Assessment Scale questionnaire (Humanized Care Evaluation Scale). which are already validated; Both instruments have a high level of statistical reliability (0.75 in Cronbach's alpha). The data collection will take approximately 30 minutes for each participant. Tables and graphs will be used for analysis and interpretation. . Likewise, to contract the hypothesis, the Spearman Test will be used as statistical estimation, with a confidence level of 95%, an error of 5%, which will be reflected in the contingency table of both variables.
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    Impacto de talleres de salud oral en padres de familia de la Institución Educativa Inicial 105 Alborada de Ventanilla - año 2025
    (Universidad Privada Norbert Wiener, 2025-10-17) Gutierrez Cortez, Diego Alonso; Vilchez Bellido, Dina
    La presente investigación tuvo como objetivo general determinar el impacto de los talleres de salud oral en los padres de familia de la Institución Educativa Inicial N.° 105 “Alborada” de Ventanilla en el año 2025. Para ello, se adoptó un método hipotético deductivo con enfoque cuantitativo, lo cual permitió recopilar y analizar datos de manera objetiva mediante técnicas estadísticas. El estudio fue de tipo aplicado, ya que buscó resolver un problema concreto en la comunidad educativa, y utilizó un diseño cuasi-experimental con pretest y postest en un solo grupo, lo que facilitó la medición del efecto de la intervención. La población estuvo conformada por los padres de familia con hijos matriculados en el turno mañana, ascendiendo a 120 personas. Dado el tamaño accesible y manejable, se trabajó con una muestra censal, incluyendo al 100 % de la población objetivo. Los resultados mostraron una mejora significativa en el nivel de conocimiento tras la intervención, pasando de un promedio de 12.45 puntos en el pretest a 17.74 en el postest (p < 0.001). Inicialmente, el 60.8 % presentó un nivel regular, el 19.2 % deficiente, y solo el 2.5 % alcanzó un nivel muy bueno; tras el taller, el 58.3 % logró un nivel muy bueno y el 39.2 % uno bueno, sin registros de nivel deficiente. Se concluyó que los talleres educativos generaron un impacto positivo y estadísticamente significativo en el conocimiento de los padres sobre salud oral infantil. Esta experiencia refuerza el valor de la educación preventiva en la promoción de la salud bucal desde el entorno familiar.
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    Importance of psycho-education in parents of patients with attention deficit hyperactivity disorder for the improvement of associated symptoms
    (Universidad Privada Norbert Wiener, 2021-08-01) Yactayo Auccapiña, Karen Lesley; Prado Villarreal, Jhonny José; Fernández Rengifo, Werther Fernando
    Systematization of evidence on the importance of psychocoeducation in parents of patients with Attention Deficit Hyperactivity Disorder for the improvement of associated symptoms. Material and methods: A systematic observational and retrospective review, quantitative and qualitative, was carried out, which was subject to critical ranking using the GRADE system to identify the degree of quality of the evidence found in the following databases: BVS, Scielo , Pubmed, Redalyc, Cochrane and Google scholar. Of the 10 studies systematically reviewed, it was found that: 20% (n= 2/10) are systematic reviews, another 70% (n= 7/10) are experimental, and 10% (n= 1/10) are experimental design. qualitative. They come from the countries of Spain (40%), the USA (20%), Peru (20%), England (10%) and Brazil (10%).
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    Knowledge about asthma in parents of children attending a national hospital in the pediatric service, 2019
    (Universidad Privada Norbert Wiener, 2020-12-20) Velasque Lazo, Olga Olinda; Mori Castro, Jaime Alberto
    Objective: Determine the knowledge about asthma in parents of children who attend a National Hospital in the Pediatric Service, 2019. Materials and methods: It was quantifiable, descriptive, and cross-sectional in design. The study population was 80 parents of children with asthma who attend the National Hospital in the Pediatric Service. The technique was a survey and the instrument was a Newcastle Asthma Knowledge Questionnaire (α=0.72). Results: Knowledge about asthma in parents of children who attend the National Hospital in the Pediatric Service, 56.3% do not know and 43.7% know. according to dimensions; 75% do not know the generalities of asthma and 25% know them; Regarding the acute crisis: recognition, triggers and management of asthma are unknown in 63.7% and known in 26.3%; Regarding maintenance treatment for asthma, 75% are unaware and 25% are aware; and according to the false myths about asthma, 62.5% are unaware and 37.5% know. Conclusions: Knowledge about asthma in parents of children who attend the National Hospital in the Pediatric Service, in the general dimension and according to unknown dimensions.
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    Knowledge about social handwashing and disinfection of parents of students from initial I.E.P. Inca Garcilaso de la Vega, May - 2020
    (Universidad Privada Norbert Wiener, 2020-11-26) Ayquipa Huillcapuma, Leyla Mariel; Gonzales Saldaña, Susan Haydee
    Objective: determine the level of knowledge about social hand washing and disinfection of parents of 5-year-old schoolchildren from the I.E.P. Inca Garcilaso de la Vega. Material and methods: quantitative, descriptive, applicative, and cross-sectional study, with a population of 160 parents, with a sample of 82 parents who met the inclusion and exclusion criteria, the technique was the questionnaire survey by the author Caypo 2012 ( 25), where the reliability value of the questionnaire was 0.798. Results: 58.5% are parents between the ages of 29 and 42, the vast majority being female with 82.9%, with professional education in 47.6%, and prevalent marital status of married with 42.7%, the hand washing dimension had a medium level of knowledge with 63.4% prevalently, while the disinfection dimension had a medium and low level of knowledge at the same time. of 42.7% each respectively, and the determination of the level of knowledge of social hand washing and disinfection is predominantly medium with 50.0%. Conclusion: the level of knowledge about social hand washing and disinfection of the parents of 5-year-old schoolchildren is predominantly medium, which is why educational intervention is promoted.
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