Cleide Carolina da Silva Demoro Mondini

Nasopharyngeal Intubation in Robin Sequence: Technique and Management:

Objective: To provide a detailed description of the nasopharyngeal intubation (NPI) technique and photographs, which should be helpful for those who may need to perform it for treating the airway obstruction in Robin sequence. Design: To describe and illustrate the NPI technique and the necessary considerations for its application. Setting: Hospital de Reabilitação de Anomalias Craniofacial of University of São Paulo, Brazil. Result: The NPI procedure involves the use of a whitish, Portex, number 3.0 or 3.5, silicone tube, introduced 8 cm deep into the infants nostril and fixed with Micropore tape. The tube is to be removed at least twice a day for proper hygiene (with running water, detergent, and swabs) and should be changed every 7 days. This procedure is taught to the childrens parents or caretakers by the nurse during hospitalization. Conclusion: The technique is so simple that it can be performed by the parents themselves, allowing continuation of the treatment at home.

Utilização do brinquedo terapêutico na assistência à criança hospitalizada

This is an exploratory and descriptive study that was jointly carried out by Nursing Care and Occupational Therapy as part of a Research Project that intended to prepare children for elective surgery at the University of Sao Paulos Hospital de Reabilitacao de Anomalias Craniofaciais. OBJECTIVE: using toys as a therapeutic resource for relieving the childs real and unconscious tensions concerning hospitalization for surgical treatment at the HRAC - USP. METHOD: 44 children participated in the study. An observation form was used to collect data and it was applied at two separate times: the first time was the day before the surgery was to take place and the second on the day of the surgery just before the event. Twenty one variables were elaborated by the researchers to categorize behaviors regarding hospitalization. The resources used were: storytelling, dramatization and demonstration of nursing interventions with puppets dressed in surgical garb (gloves, surgical gown, mask and cap) with medical equipment commonly used in hospital. RESULTS: of the 21 variables analyzed, 8 showed statistically significant differences on the McNemar Test (p<0.05). CONCLUSION: interactive play enables hospitalized children to interact in the hospital environment, so that they can express feelings and emotions and it contributes to humanized hospital assistance.

Alimentação da criança no pós-operatório imediato de palatoplastia: comparação entre as técnicas utilizando copo e colher

This prospective study conducted at the Hospital for the Rehabilitation of Craniofacial Anomalies aimed to compare the best technique - a cup or a spoon - for feeding children immediately after palatoplasty. We assessed 44 children and their caregivers during feeding every 4 hours; this generated 176 evaluations: 88 using a cup and 88 using a spoon. The Fisher exact test and the Mann-Whitney test were used for statistical analysis, with a significance level of 5% (p<0.05). When the spoon was used, the percentage of patients with food escaping through the labial commissure was lower (17%; p=0.024, the portion administrated was higher (12%; p=0.029), and coughing was less frequent (13%; p=0.026) compared with use of a cup. We conclude that using a spoon to administer food after palatoplasty is better than using a cup.Estudo prospectivo realizado no Hospital de Reabilitacao de Anomalias Craniofaciais, com o objetivo de analisar comparativamente a melhor tecnica para alimentar a crianca no pos-operatorio imediato de palatoplastia: utilizando copo ou colher. Foram acompanhados 44 criancas e seus cuidadores durante a alimentacao, em 4 horarios consecutivos, gerando 176 avaliacoes, 88 utilizando copo e 88 a colher. Os testes Exato de Fisher e de Mann-Whitney foram usados para analise estatistica, com nivel de significância de 5% (p<0,05). O escape de alimento pela comissura labial foi menor (p=0,024; 17%), o volume administrado foi maior (p=0,029; 12%) e a tosse foi menos frequente (p=0,026; 13%) com a tecnica que utiliza a colher. Conclui-se que a tecnica de administracao que utiliza colher para a alimentacao pos-palatoplastia e melhor que a que utiliza o copo.

[Feeding children in the immediate perioperative period after palatoplasty: a comparison between techniques using a cup and a spoon].

This prospective study conducted at the Hospital for the Rehabilitation of Craniofacial Anomalies aimed to compare the best technique - a cup or a spoon - for feeding children immediately after palatoplasty. We assessed 44 children and their caregivers during feeding every 4 hours; this generated 176 evaluations: 88 using a cup and 88 using a spoon. The Fisher exact test and the Mann-Whitney test were used for statistical analysis, with a significance level of 5% (p<0.05). When the spoon was used, the percentage of patients with food escaping through the labial commissure was lower (17%; p=0.024, the portion administrated was higher (12%; p=0.029), and coughing was less frequent (13%; p=0.026) compared with use of a cup. We conclude that using a spoon to administer food after palatoplasty is better than using a cup.Estudo prospectivo realizado no Hospital de Reabilitacao de Anomalias Craniofaciais, com o objetivo de analisar comparativamente a melhor tecnica para alimentar a crianca no pos-operatorio imediato de palatoplastia: utilizando copo ou colher. Foram acompanhados 44 criancas e seus cuidadores durante a alimentacao, em 4 horarios consecutivos, gerando 176 avaliacoes, 88 utilizando copo e 88 a colher. Os testes Exato de Fisher e de Mann-Whitney foram usados para analise estatistica, com nivel de significância de 5% (p<0,05). O escape de alimento pela comissura labial foi menor (p=0,024; 17%), o volume administrado foi maior (p=0,029; 12%) e a tosse foi menos frequente (p=0,026; 13%) com a tecnica que utiliza a colher. Conclui-se que a tecnica de administracao que utiliza colher para a alimentacao pos-palatoplastia e melhor que a que utiliza o copo.

Programa "mãe-participante"

This work was conducted at the Hospital de Reabilitação de Anomalias Craniofaciais of the University of São Paulo--USP Bauru, and it reports how to prepare the mother for discharge from the hospital, through the participating mother program, with the objective of giving orientations and preparing the mother and family members to give continuity to the patients post-operative care at home, thereby contributing to the healing process and to the aesthetic and functional surgery results during this phase of rehabilitation.

Comparação entre ambiente de trabalho de hospitais públicos acreditado e não acreditado

Objective To compare and identify the working environment of accredited and non-accredited public hospitals. Methods A quantitative approach with two cross-sectional studies in parallel, with 106 nurses from the hospitals, conducted between January and September of 2014. Hospital A was not accredited, and Hospital B was accredited. Data collection used a questionnaire with sociodemographic labor information and the Nursing Work Index - Revised - Brazilian version (B-NWI-R), with 57 items and four domains. The reliability of the instrument was measured using Cronbach’s alpha. Results The participants included 50 nurses of Hospital A and 56 of Hospital B. Hospitals were compared; there were statistically significant wage satisfaction (Hospital A showed greater salary satisfaction) and working hours (30-36 hours per week in Hospital B;40 hours in Hospital A). The environment was favorable to the four domains of B-NWI-R in both hospitals, regardless of accreditation status. Conclusion The administration of the instrument showed that hospital accreditation did not affect the nurses’ work environment.

Vídeo educativo: estratégia de treinamento para cuidadores de crianças com fissura labiopalatina

Objective To check the knowledge informal caregivers of children with cleft lip and palate acquire about the postoperative care of cheiloplasty and palatoplasty through the use of an educational video. Methods Randomized clinical trial conducted with 80 caregivers of children with cleft lip and palate, arranged into two groups: experimental (G1) and control (G2). Data collection occurred during the child’s hospital stay, in three stages, using a structured questionnaire and an educational video developed and validated for this study. Results There was evidence of improvement in the acquisition of knowledge about postoperative care in both groups (p <0.001), but it was higher in G1 compared to G2. Conclusion The educational video was shown to be effective to train caregivers of children with cleft lip and palate after cheiloplasty and palatoplasty.

Alimentacion del nino en el post operatorio inmediato de palatoplastia: una comparacion entre las tecnicas utilizando vaso y cuchara

This prospective study conducted at the Hospital for the Rehabilitation of Craniofacial Anomalies aimed to compare the best technique - a cup or a spoon - for feeding children immediately after palatoplasty. We assessed 44 children and their caregivers during feeding every 4 hours; this generated 176 evaluations: 88 using a cup and 88 using a spoon. The Fisher exact test and the Mann-Whitney test were used for statistical analysis, with a significance level of 5% (p<0.05). When the spoon was used, the percentage of patients with food escaping through the labial commissure was lower (17%; p=0.024, the portion administrated was higher (12%; p=0.029), and coughing was less frequent (13%; p=0.026) compared with use of a cup. We conclude that using a spoon to administer food after palatoplasty is better than using a cup.Estudo prospectivo realizado no Hospital de Reabilitacao de Anomalias Craniofaciais, com o objetivo de analisar comparativamente a melhor tecnica para alimentar a crianca no pos-operatorio imediato de palatoplastia: utilizando copo ou colher. Foram acompanhados 44 criancas e seus cuidadores durante a alimentacao, em 4 horarios consecutivos, gerando 176 avaliacoes, 88 utilizando copo e 88 a colher. Os testes Exato de Fisher e de Mann-Whitney foram usados para analise estatistica, com nivel de significância de 5% (p<0,05). O escape de alimento pela comissura labial foi menor (p=0,024; 17%), o volume administrado foi maior (p=0,029; 12%) e a tosse foi menos frequente (p=0,026; 13%) com a tecnica que utiliza a colher. Conclui-se que a tecnica de administracao que utiliza colher para a alimentacao pos-palatoplastia e melhor que a que utiliza o copo.

Programa "madre participante"

This work was conducted at the Hospital de Reabilitação de Anomalias Craniofaciais of the University of São Paulo--USP Bauru, and it reports how to prepare the mother for discharge from the hospital, through the participating mother program, with the objective of giving orientations and preparing the mother and family members to give continuity to the patients post-operative care at home, thereby contributing to the healing process and to the aesthetic and functional surgery results during this phase of rehabilitation.

Participating mother program

This work was conducted at the Hospital de Reabilitação de Anomalias Craniofaciais of the University of São Paulo--USP Bauru, and it reports how to prepare the mother for discharge from the hospital, through the participating mother program, with the objective of giving orientations and preparing the mother and family members to give continuity to the patients post-operative care at home, thereby contributing to the healing process and to the aesthetic and functional surgery results during this phase of rehabilitation.