Información de la revista
Vol. 58. Núm. 2.
Páginas 128-135 (febrero 2003)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 58. Núm. 2.
Páginas 128-135 (febrero 2003)
Acceso a texto completo
Niños y adolescentes en acogimiento transitorio: problemas de salud y directrices para su cuidado
Children and adolescents in foster care:health problems and guidelines for their health care
Visitas
9341
G. Oliván Gonzalvo
Autor para correspondencia
drolivansant@ersupernet.com

Correspondencia: Servicios de Pediatría y Adolescencia.Avda. de las Torres, 93, 1.º F. 50007 Zaragoza. España.
Servicios de Pediatría y Adolescencia. Instituto Aragonés de Servicios Sociales.Departamento de Salud, Consumo y Servicios Sociales. Gobierno de Aragón. Zaragoza. España.
Este artículo ha recibido
Información del artículo
Resumen
Bibliografía
Descargar PDF
Estadísticas

En España, entre 8.000 y 10.000 niños y adolescentes entran en acogimiento transitorio residencial o familiar cada año. El objetivo de este artículo es presentar una revision actualizada que sirva para mejorar el conocimiento sobre los problemas de salud que presentan los menores en acogimiento transitorio.De la bibliografía consultada, el 65 % de los estudios se han elaborado en Estados Unidos, el 25 % en España y el 10 % en otros países desarrollados e industrializados. En estos estudios se observa que un elevado porcentaje de estos menores presenta serios y complejos problemas de salud física, mental y/o del desarrollo. Sin embargo, no se aprecian diferencias cualitativas apreciables en los problemas de salud que con mayor frecuencia presentan estos menores, coincidiendo en que las necesidades sanitarias prioritarias son la provisión de servicios preventivos y/o terapéuticos psicopedagógicos, psiquiátricos, dermatológicos, odontológicos, nutricionales, oftalmológicos, neumológicos y de inmunización. El fracaso en la identificación e intervención precoz de las necesidades sanitarias de estos menores no sólo puede afectar adversamente su calidad de vida en el futuro desarrollo físico, emocional e intelectual, sino que también puede conducir a incrementar las dificultades de adaptación mientras dure el acogimiento y su futura adaptación social, pudiendo comprometer la unión permanente con la familia biológica o adoptiva cuando cese el acogimiento transitorio. Por tanto, todos los niños y adolescentes en acogimiento transitorio necesitan recibir cribados iniciales, evaluaciones completas y seguimiento de su estado de salud físico, mental y del desarrollo. Sobre esta base, se ofrecen unas directrices para el cuidado de la salud de estos menores que sean de utilidad para los profesionales sanitarios que los atienden mientras permanecen en acogimiento transitorio.

Palabras clave:
Acogimiento transitorio
Centros residenciales
Maltrato infantil
Estado de salud
Trastornos mentales
Discapacidades del desarrollo
Demanda y necesidades de servicios sanitarios
Bienestar infantil
Papel del médico
Directrices

In Spain, between 8,000 and 10,000 children and adolescents enter foster or residential care every year. This article aims to provide a review to increase knowledge of the health problems of minors in foster care. Sixty-five percent of the studies consulted were performed in the USA, 25 % in Spain and 10 % in other developed and industrialized countries. These studies report that a high percentage of these minors present complicated and serious physical, mental, and/or developmental problems. However, no appreciable qualitative differences in the most frequent health problems presented by these minors have been observed and there is general consensus that the high-priority health needs are the provision of preventive and/or therapeutic psychopedagogic, psychiatric, dermatologic, dental, nutritional, ophthalmologic, respiratory and immunization services.Failure to identify and provide early treatment of the health needs of these minors not only adversely affects their quality of life and future physical, emotional and intellectual development, but can also increase their difficulties in adaptation while in foster care and their future social adaptation. Their permanent relationship with the biological or adoptive family when foster care stops could also be jeopardized. Therefore, all children and adolescents in foster care should receive initial health screenings, comprehensive assessments and monitoring of their physical, mental health, and developmental status. We provide guidelines for the healthcare of these minors, which should be of use to healthcare professionals taking care of these children and adolescents while they remain in foster care.

Key words:
Foster care
Residential facilities
Child abuse
Health status
Mental disorders Developmental disabilities
Health services needs demand
Child welfare
El Texto completo está disponible en PDF
Bibliografía
[1.]
Estadística básica de acogida a la infancia. Centro de Estudios. Boletín Estadístico n.°0. Madrid: Ministerio de Trabajo y Asuntos Sociales, Subdirección General de Programas de Servicios Sociales, diciembre de 1998
[2.]
Ley Orgánica 1/1996, de 15 de enero, de Protección Jurídica del Menor, de modificación parcial del BCódigo Civil y de la Ley de Enjuiciamiento Civil. BOE núm. 15, 17 de enero de 1996; p. 1225-38
[3.]
J. Fuertes Zurita, J. Fernández del Valle.
Recursos residenciales para menores.
Manual de protección infantil, pp. 393-445
[4.]
G. Oliván Gonzalvo, J. Fleta Zaragozano, C. Baselga Asensio, J. Andrés Sanz, M. Magaña Hernández, R. Nuel Quílez.
Centros de acogida de menores.
An Esp Pediatr, 41 (1994), pp. 97-101
[5.]
C. Barjau Capdevila.
Acogimiento familiar, un medio de protección infantil.
Manual de protección infantil, pp. 359-392
[6.]
M. Szilagyi.
The pediatrician and the child in foster care.
Pediatr Rev, 19 (1998), pp. 39-50
[7.]
G. Oliván Gonzalvo.
Características sociales y estado de salud de los menores que ingresan en centros de acogida.
An Esp Pediatr, 50 (1999), pp. 151-155
[8.]
J.I. Takayama, E. Wolfe, K.P. Coulter.
Relationship between reason for placement and medical findings among children in foster care.
Pediatrics, 101 (1998), pp. 201-207
[9.]
Oliván Gonzalvo G. Indicadores de maltrato infantil. Guías Clínicas 2002;2(44).Disponible en:http://www.fisterra.comguias2/maltrato.htm
[10.]
M.M. Dore, J.M. Doris.
Preventing child placement in substance- abusing families: Research-informed practice.
Child Welfare, 77 (1998), pp. 407-426
[11.]
P.L. Hazell, M. Tarren-Sweeney, G.V. Vimpani, D. Keatinge, K. Callan.
Children with disruptive behaviours II: Clinical and community service needs.
J Paediatr Child Health, 38 (2002), pp. 32-40
[12.]
American Academy of Pediatrics, Committee on Early Childhood, Adoption, and Dependent Care. Developmental issues for young children in foster care.
Pediatrics, 106 (2000), pp. 1145-1150
[13.]
American Academy of Pediatrics, Committee on Early Childhood, Adoption, and Dependent Care. Health care of young children in foster care.
Pediatrics, 109 (2002), pp. 536-541
[14.]
R. Chernoff, T. Combs-Orme, C. Risley-Curtiss, A. Heisler.
Assessing the health status of children entering foster care.
Pediatrics, 93 (1994), pp. 594-601
[15.]
N. Halfon, A. Mendonca, G. Berkowitz.
Health status of children in foster care: The experience of the Center for the Vulnerable Child.
Arch Pediatr Adolesc Med, 149 (1995), pp. 386-392
[16.]
M.D. Simms, H. Dubowitz, M.A. Szilagyi.
Health care needs of children in the foster care system.
Pediatrics, 106 (2000), pp. 909-918
[17.]
A. Cortés Lozano, E.J. Sánchez Zamora, M.M. Zahonero Coba.
Estudio descriptivo de la población infantil de un centro de acogida.
Acta Pediatr Esp, 58 (2000), pp. 339-343
[18.]
S.D. Blatt, R.D. Saletsky, V. Meguid, C.C. Church, M.T. OHara, S.M. Hallerleck.
A comprehensive, multidisciplinary approach to providing health care for children in out-of-home care.
Child Welfare, 76 (1997), pp. 331-347
[19.]
G. Oliván.
Maltreatment histories and mental health problems are common among runaway adolescents in Spain.
Acta Paediatr, 91 (2002), pp. 1274-1275
[20.]
G. Oliván Gonzalvo.
Maltrato en niños con discapacidades: características y factores de riesgo.
An Esp Pediatr, 56 (2002), pp. 219-223
[21.]
B. Needell, R.P. Barth.
Infants entering foster care compared to other infants using birth status indicators.
Child Abuse Negl, 22 (1998), pp. 1179-1187
[22.]
G. Oliván Gonzalvo.
Elevada incidencia de caries no tratada en dientes permanentes entre adolescentes en riesgo social.
An Esp Pediatr, 57 (2002), pp. 270-271
[23.]
Oliván G. Untreated dental caries is common among 6 to 12-year-old physically abused/neglected children in Spain. Eur J Public Health. En prensa
[24.]
D.T. Wyatt, M.D. Simms, S.M. Horwitz.
Widespread growth retardation and variable growth recovery in foster children in the first year after initial placement.
Arch Pediatr Adolesc Med, 151 (1997), pp. 813-816
[25.]
G. Oliván Gonzalvo.
Evaluación del crecimiento recuperador en lactantes maltratados.
An Esp Pediatr, 54 (2001), pp. 53-57
[26.]
J. Bel, A. Natal, F. Cachadiña, A. Mainou, M.L. Granada, C. Rodrigo.
Retraso de crecimiento y estado nutricional en niños ingresados en una institución de acogida.
Med Clin (Barc), 118 (2002), pp. 86-89
[27.]
G. Oliván.
Catch-up growth assessment in long-term physically neglected and emotionally abused preschool age male children.
Child Abuse Negl, 27 (2003), pp. 103-108
[28.]
G. . Oliván Gonzalvo.
Evaluación del estado nutricional de los menores que ingresan en centros de acogida.
An Esp Pediatr, 51 (1999), pp. 643-647
[29.]
Chung EK, Webb D, Clampet-Lundquist S, Campbell C. A comparison of elevated blood lead levels among children living in foster care, their siblings, and the general population. Pediatrics 2001;107:E81. Disponible en:http://www.pediatrics.org/cgi content/full/107/5/e81
[30.]
A.M. Baron, Y.M. Baron, N.J. Spencer.
The care and health needs of children in residential care in the Maltese Islands.
Child Care Health Dev, 27 (2001), pp. 251-262
[31.]
A. Bundle.
Health of teenagers in residential care: Comparison of data held by care staff with data in community child health records.
Arch Dis Child, 84 (2001), pp. 10-14
[32.]
R.W. Steel, M.A. OKeefe.
A program description of health care interventions for homeless teenagers.
Clin Pediatr (Phila), 40 (2001), pp. 259-263
[33.]
A.A. Rosenfeld, D.J. Polowsky, P. Fine, M. Thorpe, E. Fein, M.D. Simms.
Foster care: An update.
J Am Acad Child Adolesc Psychiatry, 36 (1997), pp. 448-457
[34.]
S.D. Blatt, M.D. Simms.
Foster care: Special children, special needs.
Contemp Pediatr, 14 (1997), pp. 109-129
[35.]
J.S. Harman, G.E. Childs, K.J. Kelleher.
Mental health care utilization and expenditures by children in foster care.
Arch Pediatr Adolesc Med, 154 (2000), pp. 1114-1117
[36.]
M. Schneiderman, M.M. Connors, A. Fribourg, L. Gries, M. Gonzales.
Mental health services for children in out-of-home care.
Child Welfare, 77 (1998), pp. 29-40
[37.]
E. Stein, B. Evans, R. Mazumdar, N. Rae-Grant.
The mental health of children in foster care: A comparison with community and clinical samples.
Can J Psychiatry, 41 (1996), pp. 385-391
[38.]
S.M. Horwitz, M.D. Simms, R. Farrington.
Impact of developmental problems on young childres exits from foster care.
J Dev Behav Pediatr, 15 (1994), pp. 105-110
[39.]
R. Reams.
. Children birth to three entering the state’s custody.
Infant Ment Health J, 20 (1999), pp. 166-174
[40.]
J.M. Clausen, J. Landsverk, W. Ganger, D. Chadwick, A. Litrownik.
Mental health problems of children in foster care.
J Child Fam Stud, 7 (1998), pp. 283-296
[41.]
A.F. Garland, J.L. Landsverk, R.L. Hough, E. Ellis-MacLeod.
Type of maltreatment as a predictor of mental health service use for children in foster care.
Child Abuse Negl, 20 (1996), pp. 675-688
[42.]
S.M. Horwitz, P. Owens, M.D. Simms.
Specialized assessments for children in foster care.
Pediatrics, 106 (2000), pp. 59-66
[43.]
R. Hukkanen, A. Sourander, L. Bergroth, J. Piha.
Psychosocial factors and adequacy of services for children in children’s homes.
Eur Child Adolesc Psychiatry, 8 (1999), pp. 268-275
[44.]
M.A. Carrasco-Ortiz, J.F. Rodríguez-Testal, B.M. Hesse.
Conduct problems in a sample of institutionalized minors with previous mistreatment.
Child Abuse Negl, 25 (2001), pp. 819-838
[45.]
D.A. Weiner, M.E. Abraham, J. Lyons.
Clinical characteristics of youths with substance use problems and implications for residential treatment.
Psychiatr Serv, 52 (2001), pp. 793-799
[46.]
S. Kools.
Self-protection in adolescents in foster care.
J Child Adolesc Psychiatr Nurs, 12 (1999), pp. 139-152
[47.]
H. Minnis, A.J. Pelosi, M. Knapp, J. Dunn.
Mental health and foster carer training.
Arch Dis Child, 84 (2001), pp. 302-306
[48.]
S.M. Horwitz, K.M.B. Balestracci, M.D. Simms.
Foster care placement improves children’s functioning.
Arch Pediatr Adolesc Med, 155 (2001), pp. 1255-1260
[49.]
Ruiz Cosano C, Muñoz Hoyos A, Molina Carballo A, Masegosa Jiménez C, Martínez Medina E, Molina Font JA. Análisis comparative entre distintos modelos de acogida. An Esp Pediatr 1998;(libro de actas I):186-8
[50.]
L.A. Reddy, S.I. Pfeiffer.
Effectiveness of treatment foster care with children and adolescents: A review of outcomes studies.
J Am Acad Child Adolesc Psychiatry, 36 (1997), pp. 581-588
[51.]
M.D. Simms.
Medical care of children who are homeless or in foster care.
Curr Opin Pediatr, 10 (1998), pp. 486-490
[52.]
American Academy of Pediatrics, Committee on Pediatrics AIDS. Identification and care of HIV-exposed and HIV-infected infants, children, and adolescents in foster care.
Pediatrics, 106 (2000), pp. 149-153
[53.]
B.T. Zima, R. Bussing, G.M. Crecelius, A. Kaufman, T.R. Belin.
Psychotropic medication use among children in foster care: Relationship to severe psychiatric disorders.
Am J Public Health, 89 (1999), pp. 1732-1735
[54.]
L.K. Leslie, J. Landsverk, R. Ezzet-Lofstrom, J.M. Tschann, D.J. Slymen, A.F. Garland.
Children in foster care: Factors influencing outpatient mental health service use.
Child Abuse Negl, 24 (2000), pp. 465-476
[55.]
E. Morehouse, N.S. Tobler.
Preventing and reducing substance use among institutionalized adolescents.
Adolescence, 35 (2000), pp. 1-28
[56.]
Comité Asesor de Vacunas (1998-2001), Asociación Española de Pediatría. Vacunaciones en el niño mal vacunado.
Manual de Vacunas en Pediatría, pp. 439-442
[57.]
Comité Asesor de Vacunas (1998-2001), Asociación Española de Pediatría. Vacunas en adolescentes.
Manual de Vacunas en Pediatría, pp. 407-416
[58.]
J.D. Smart.
Public health nursing in children’s protective services.
Public Health Nurs, 16 (1999), pp. 390-396
[59.]
Oliván Gonzalvo G. Adopción internacional. Guías Clínicas 2002;2(5). Disponible en: http://www.fisterra.com/guias2/ adopcion.htm
[60.]
American Academy of Pediatrics, Committee on Community Health Services. Health care for children of immigrant families.
Pediatrics, 100 (1997), pp. 153-156
[61.]
G. Oliván Gonzalvo.
Evaluación del estado de salud y nutrición de los adolescentes inmigrantes ilegales de origen magrebí.
An Esp Pediatr, 53 (2000), pp. 17-20
[62.]
G. Oliván Gonzalvo.
Adolescentes delincuentes: problemas de salud y recomendaciones sanitarias para centros de reforma juvenil.
An Esp Pediatr, 57 (2002), pp. 345-353
[63.]
B.F. Nordhans, A.J. Solnit.
Foster placement.
Child Adolesc Psychiatr Clin North Am, 7 (1998), pp. 345-356
[64.]
T. DeLay.
Fighting for children.
Am Psychol, 55 (2000), pp. 1054-1055
[65.]
M.E. Courtney, R.P. Barth.
Pathways of older adolescents out of foster care: Implications for independent living services.
Soc Work, 41 (1996), pp. 75-83
[66.]
M.E. Courtney, Y.I. Wong.
Comparing the timing of exits from substitute care.
Child Youth Serv Rev, 18 (1996), pp. 307-334
[67.]
S.G. Post, P.R. Fruting, J. Bennett.
The moral challenge of children at risk: Protective policies and pediatrics. A report of the Children’s Services, Inc. Task Force of Greater Cleveland.
Clin Pediatr (Phila), 36 (1997), pp. 625-633
[68.]
Taussig HN, Clyman RB, Landsverk J. Children who return home from foster care: A 6-year prospective study of behavioral health outcomes in adolescence. Pediatrics 2001;108:E10. Disponible en: http://www.pediatrics.org/cgi/content/full/ 108/1/e10
[69.]
A.B. Bergman.
The shame of foster care health services.
Arch Pediatr Adolesc Med, 154 (2000), pp. 1080-1081
Copyright © 2003. Asociación Española de Pediatría
Descargar PDF
Idiomas
Anales de Pediatría
Opciones de artículo
Herramientas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?