Ivone Evangelista Cabral

Empoderamento da mulher cuidadora de crianças com necessidades especiais de saúde

The demands of caring for children with special health care needs contribute to the physical and mental burden of female caregivers. Qualitative research was applied to analyze the implications of such demands on caregiver empowerment. Eleven caregiver guests at a university hospital in southern Brazil participated in three group dynamics of the creative-sensitive method, during 2004-2005. Discourse analysis was applied to the empirical data. The individual empowerment of caregivers was constructed by facing the limiting situations of care and the therapeutic encounter with clinicians. The role of ‘good mother’ gave mothers an individual empowerment, leading them to abdicate their feminine condition. However, they were under suffering, stress, oppression, and social isolation. Once caregivers were considered in their motherhood but not in their feminine condition, an individual empowerment distanced them from collective empowerment. The practices of individual empowerment, centered upon abnegation and dedication made reflection-action possible in order to promote the collective empowerment process. reSUmen: La demanda de cuidados a los ninos con necesidades especiales de salud promueve el desgaste fisico y mental de la cuidadora. Para analizar las implicaciones de esas demandas sobre el empoderamiento de la cuidadora se desarrollo una investigacion cualitativa. Once cuidadoras acompanantes, de un hospital del sur de Brasil, fueron organizadas en tres grupos, a partir de dinamicas del metodo creativo sensible, entre 2004 y 2005. En el informe de los grupos se utilizo el analisis del discurso. El empoderamiento individual de las cuidadoras fue construido en el enfrentamiento de las situaciones limites de los cuidados y en el encuentro con los profesionales de salud. El papel de buena madre y de cuidadoras dedicadas, genero aislamiento social, sufrimiento y estres. El empoderamiento individual opresivo las distancio del empoderamiento colectivo libertador. Las practicas de empoderamiento individual, centradas en la abnegacion y dedicacion, posibilitan la reflexion y la accion en el proceso de empoderamiento colectivo. paLaVraS-CHaVe: Saude da mulher. Cuidadores. Saude da crianca. Educacao em saude. KeYWorDS: Woman’s health. Caregivers. Child health. Health education. paLabraS CLaVe: Salud de la mujer. Cuidadores. Salud del nino. Educacion en salud. Neves ET, Cabral IEA demanda de cuidados as criancas com necessidades especiais de saude promove desgaste fisico e mental da cuidadora. Para analisar as implicacoes dessas demandas sobre o empoderamento da cuidadora, desenvolveu-se uma pesquisa qualitativa. Onze cuidadoras acompanhantes, de um hospital do sul do Brasil, foram organizadas em tres grupos, entre 2004-2005. Utilizou-se a analise de discurso no relatorio de tres dinâmicas do metodo criativo-sensivel. O empoderamento individual das cuidadoras foi construido no enfrentamento das situacoes-limites dos cuidados e no encontro com os profissionais de saude. O papel de boa mae e de cuidadoras dedicadas, abnegadas levou-as a abdicar de sua condicao feminina, gerando isolamento social, sofrimento e estresse. O empoderamento individual opressivo as distanciou do empoderamento coletivo libertador; a cuidadora foi valorizada em sua condicao materna e nao na feminina. As praticas de empoderamento individual, centradas na abnegacao e dedicacao, possibilitam a reflexao e acao no processo de empoderamento coletivo.

Enhancing Generalizability: Moving From an Intimate to a Political Voice:

Weak external validity of qualitative data has been a subject of debate outside and within the field of qualitative health research. Though some narratives have the power to reveal universal existential issues and inform theoretical development, each story remains unique and cannot be generalized. If the goal of qualitative researchers is to have narrative knowledge effect social change, we are faced with a pervasive problem. Our main objective with this article is methodological; that is, to argue and illustrate that a sequential—consensual qualitative design can yield data with adequate external validity to influence clinicians and public health programming. We seek to contribute to the debate on the generalizability of qualitative research in the health field and provide a methodological template for this type of qualitative design so researchers can apply it to future projects to transfer and translate popular knowledge in a way that can influence social change.

Movimento analítico-hermenêutico heideggeriano: possibilidade metodológica para a pesquisa em enfermagem

The objective was to describe the analytic-hermeneutic movement applied in investigations with the child who had Acquired Immunodeficiency Syndrome by vertical transmission, and who is in transition from childhood to adolescence, sustained in the Heideggerian theoreticalphilosophical and methodological framework. The modes of conducting the stage of analysis are described, since the research question related to the interpretative analysis of meanings, culminating in the proposition of the assistance possibilities in caring for the study population. This framework proved to be coherent with the principles of humanistic nursing and with its object of study, and contributed to the approximation between theory and practice of care, by means of the comprehension of the phenomena that permeate the lived experience of health of individuals, families and society.

Pesquisa em enfermagem nas Américas

The purpose of the article was to identify a problematic, challenges and strategies recommended in those texts and analysis the applicability of such recommendations reflected on papers published from 2005-2008. A thematic analysis was applied to the full texts available on LILACS data base. Results showed that the development of nursing research was articulated to the neoliberal and globalization economic system, the national health system, the healthcare demands of population, and nursing profession. The post-graduation expansion in Latin America was a result of the international efforts of the Brazilian post-graduation programs, and the increase number of nurse researchers as well as Center of Nursing Research. Because the scientific production is inserted on academic field, the research findings do not become healthcare policy yet. Nursing organizations and their partners need to continue making efforts to overcome old challenges and to build new meanings for nursing research.Esto articulo tuvo como objetivo identificar las problematicas, desafios y estrategias recomendadas en los textos y analizar la aplicabilidad de las recomendaciones en las producciones de 2005-2008. Fue implementado el analisis tematico de los textos completos levantados a partir de la base LILACS. El desarrollo de la investigacion en enfermeria se articulo con el modelo economico neoliberal y globalizante, el sistema de salud local, las demandas de la poblacion y de la profesion de enfermeria. El crecimiento de la postgraduacion fue resultado del mayor esfuerzo de internacionalizacion de los programas brasilenos, del aumento en el numero de investigadores y de centros productores de conocimiento. La produccion cientifica incluida en la esfera academica continua alejada de los servicios y ejercio poca influencia en la formulacion de politicas publicas de salud. Las organizaciones de enfermeria y afines precisan continuar envidando esfuerzos para superar los viejos desafios y construir nuevos sentidos para la investigacion en enfermeria.

O cuidado à pessoa traqueostomizada: análise de um folheto educativo

Resumen K e y w o r d s : Nursing. Health Education. Teaching Materials. Tracheostomy. Palabras clave: Enfermería. Educación en Salud. Materiales de Enseñanza. Traqueostomía. O CUIDADO À PESSOA TRAQUEOSTOMIZADA: ANÁLISE DE UM FOLHETO EDUCATIVO Caring patient with tracheotomy: Analyze of an educative leaflet El cuidado a la persona traqueostomizada: Análisis de un folleto educatívo Ana Angélica de Souza Freitas1 Ivone Evangelista Cabral2 O estudo descritivo com abordagem qualitativa teve como objetivos identificar e analisar os recursos de comunicação expressos pelo folheto educativo para mediar conteúdos sobre o cuidado à pessoa traqueostomizada. A análise de enunciação proposta por Bardin subsidiou a elaboração do instrumento de coleta de dados. A análise temática levou à identificação de duas categorias: condições de produção da palavra e rodeio pela enunciação. Os recursos de comunicação empregados no folheto atendem em par te as necessidades de aprendizado do leitor. Embora os assuntos sejam apresentados na forma de perguntas, pressupondo um paciente vir tual com dúvidas, as respostas são mediadas por linguagens ambíguas (popular e científica). Iniciativas de produção de materiais educativos, que incorporem o paciente como sujeito do conhecimento em situação real, e não vir tual, facilitam a mediação de conteúdos, pois a linguagem fica mais próxima do entendimento do leitor e mais aderente à sua realidade. This descriptive study with qualitative approach had the aims of identifying and analyzing the communication resources expressed by the educative leaflet addressed to people who needs continuous tracheotomy caring. The Bardin’s utterance analyses guided the elaboration of the form applied to collect data. The thematic analyses showed two categories: the production condition of words and the meanings of utterances. The communication resources adopted by the leaflet attended par tially the readers’ needs of learning regarding the management of tracheotomy. Although the subjects were presented in the question pattern, based on the idea of virtual readers with doubts, the answers were mediated by ambiguous language (scientific and folks) and uncompleted thoughts. Initiatives of producing educative material, that consider the patient experience and knowledge from real perspective rather than unreal, enhance to mediate a proper contents, because language are closer to the readers understanding and have more adherence to their realities. El estudio es descriptivo con abordaje cualitativa tiene como objetivos identificar y analizar los recursos de comunicación expresos por el panfleto educativo para mediar contenidos sobre o cuidado a la persona portadora de traqueostomía La análisis de enunciación propuesta por Bardin subsidió la elaboración del instrumento de colecta de datos. El análisis temático llevó a la identificación de dos categorías: condiciones de producción de la palabra y rodeo por la enunciación. Los recursos de comunicación empleados en el panfleto atienden en parte las necesidades de aprendizaje del lector. Aunque los asuntos sean presentados en la forma de preguntas, presuponiendo un paciente virtual con dudas, las respuestas son mediadas por lenguajes ambiguas (popular y científica). Iniciativas de producción de materiales educativos, que incorporan el paciente como sujeto del conocimiento en situación real y no virtual, facilitan la mediación de contenidos ya que el lenguaje queda más próximo del entendimiento del lector y más adherente a su realidad. 1Enfermeira do Instituto Nacional de Câncer HCI. Especialista em Enfermagem Oncológica – INCA. Especialista em Educação e Saúde NUTES/UFRJ. 2Doutora em Enfermagem. Professora Associada do Departamento de Enfermagem Materno-Infantil – EEAN/UFRJ. Pesquisadora do Núcleo de Pesquisa de Enfermagem em Saúde da Criança. Membro do Programa de Pós-Graduação do NUTES/UFRJ. Pesquisadora CNPq. Esc Anna Nery Rev Enferm 2008 mar; 12 (1): 84 9. PesquisaAbstract Resumen Keywords:Nursing. Health Education. Teaching Materials. Tracheostomy.Palabras clave: Enfermeria. Educacion en Salud. Materialesde Ensenanza. Traqueostomia. O CUIDADO A PESSOA TRAQUEOSTOMIZADA:ANALISE DE UM FOLHETO EDUCATIVO Caring patient with tracheotomy:Analyze of an educative leafletEl cuidado a la persona traqueostomizada:Analisis de un folleto educativo Ana Angelica de Souza Freitas 1 Ivone Evangelista Cabral 2 O estudo descritivo com abordagem qualitativa teve como objetivos identificar e analisar os recursos de comunicacaoexpressos pelo folheto educativo para mediar conteudos sobre o cuidado a pessoa traqueostomizada. A analise deenunciacao proposta por Bardin subsidiou a elaboracao do instrumento de coleta de dados. A analise tematicalevou a identificacao de duas categorias: condicoes de producao da palavra e rodeio pela enunciacao. Os recursosde comunicacao empregados no folheto atendem em parte as necessidades de aprendizado do leitor. Embora osassuntos sejam apresentados na forma de perguntas, pressupondo um paciente virtual com duvidas, as respostassao mediadas por linguagens ambiguas (popular e cientifica). Iniciativas de producao de materiais educativos, queincorporem o paciente como sujeito do conhecimento em situacao real, e nao virtual, facilitam a mediacao deconteudos, pois a linguagem fica mais proxima do entendimento do leitor e mais aderente a sua realidade.This descriptive study with qualitative approach had the aimsof identifying and analyzing the communication resourcesexpressed by the educative leaflet addressed to people whoneeds continuous tracheotomy caring. The Bardin’s utteranceanalyses guided the elaboration of the form applied to collectdata. The thematic analyses showed two categories: theproduction condition of words and the meanings of utterances.The communication resources adopted by the leaflet attendedpartially the readers’ needs of learning regarding themanagement of tracheotomy. Although the subjects werepresented in the question pattern, based on the idea of virtualreaders with doubts, the answers were mediated by ambiguouslanguage (scientific and folks) and uncompleted thoughts.Initiatives of producing educative material, that consider thepatient experience and knowledge from real perspective ratherthan unreal, enhance to mediate a proper contents, becauselanguage are closer to the readers understanding and havemore adherence to their realities.El estudio es descriptivo con abordaje cualitativa tiene comoobjetivos identificar y analizar los recursos de comunicacionexpresos por el panfleto educativo para mediar contenidossobre o cuidado a la persona portadora de traqueostomiaLa analisis de enunciacion propuesta por Bardin subsidio laelaboracion del instrumento de colecta de datos. El analisistematico llevo a la identificacion de dos categorias: condicionesde produccion de la palabra y rodeo por la enunciacion. Losrecursos de comunicacion empleados en el panfleto atiendenen parte las necesidades de aprendizaje del lector. Aunque losasuntos sean presentados en la forma de preguntas,presuponiendo un paciente virtual con dudas, las respuestasson mediadas por lenguajes ambiguas (popular y cientifica).Iniciativas de produccion de materiales educativos, queincorporan el paciente como sujeto del conocimiento ensituacion real y no virtual, facilitan la mediacion de contenidosya que el lenguaje queda mas proximo del entendimiento dellector y mas adherente a su realidad.

The social network of children with special healthcare needs in the (in)visibility of nursing care

This study aimed to identify the (in)visibility of nursing care and discuss ways of (dis)articulating this care with family care in the social network of children with special healthcare needs. A qualitative research was performed with health professionals at a pediatric hospital, four units of the Family Medical Program (FMP), and childrens relatives living in Niterói (RJ). The field work was put in practice after IRB approval (HESFA/EEAN), consisting of five semi-structured interviews and two group dynamics. Critical Discourse Analysis indicated that nursing care is visible in the childs social network through the nurses educational and care activities and home visits by the nurisng aide of the FMP. Due to errors in the national health systems referral and counter-referral, mothers articulate the network and not the health service; thus, the reorganization of the system in the State would foster social networks that are less wearing for their families.

Modos de condução da entrevista em pesquisa fenomenológica: relato de experiência

This paper aimed to report the experience of driving modes of an interview on data production in phenomenological research. The proposed study is an experience report of a phenomenological investigation in which the researchers present their experience with children, considering the interview as an existential encounter. It describes ways of conducting the interview in its ontic and ontological dimensions. The ontic dimension refers to the facts related to the interview, presented in the researcher, in the researched subject and in the environment; both in its planning and its development. The ontological dimension is based on empathy and intersubjectivity. The interview enables the access to meaningful structures to comprehend the being, as a way of building investigative/assistance possibilities that enable to reveal the being of the human.El objetivo del presente articulo es informar la experiencia de los modos de conduccion de la entrevista en la produccion de datos en investigacion fenomenologica. El estudio propuesto es un relato de experiencia de una investigacion fenomenologica en que las investigadoras presentan su experiencia con los ninos, apoyada por la entrevista como encuentro existencial. Describe los modos de conduccion de la entrevista en sus dimensiones ontica y ontologica. La ontica se refiere a los hechos relacionados a la entrevista, presente en el investigador, en el sujeto investigado y en el ambiente, tanto en su planeamiento cuanto en su desarrollo. La dimension ontologica se basa en la empatia y la intersubjetividad. La entrevista posibilita el acceso a estructuras significantes para la comprension del ser, de modo a construir posibilidades investigador/asistenciales que permiten desvelar el ser del humano.

Analytical movement - Heideggerian hermeneutics: methodological possibility for nursing research

The objective was to describe the analytic-hermeneutic movement applied in investigations with the child who had Acquired Immunodeficiency Syndrome by vertical transmission, and who is in transition from childhood to adolescence, sustained in the Heideggerian theoreticalphilosophical and methodological framework. The modes of conducting the stage of analysis are described, since the research question related to the interpretative analysis of meanings, culminating in the proposition of the assistance possibilities in caring for the study population. This framework proved to be coherent with the principles of humanistic nursing and with its object of study, and contributed to the approximation between theory and practice of care, by means of the comprehension of the phenomena that permeate the lived experience of health of individuals, families and society.

O (não)dito da AIDS no cotidiano de transição da infância para a adolescência

Ninos infectados por transmision vertical del VIH transitan de la infancia para la adolescencia, y poco se sabe de su cotidiano. El estudio tuvo como objetivo comprender lo (no) dicho del SIDA en su cotidiano. Tras la aprobacion por los Comites de Etica en Investigacion de tres hospitales de Rio de Janeiro, se entrevisto 11 ninos de 12-14 anos, que conocian su diagnostico. La hermeneutica heideggeriana dio a conocer que el ser adoleciendo sabe que adquirio la enfermedad de la madre; es triste tener familiares enfermos; recuerda de la revelacion diagnostica y del prejuicio que los silencian. Se proyecta como ser de posibilidades en un movimiento existencial. El cuidado al ser adoleciendo precisa integrar las dimensiones biologica, clinica, socio-cultural, etica, politica y asistencial y existencial.HIV children infected by vertical transmission are crossing from childhood to adolescence, however, we do not know how they are caring for themselves during those transitional age. The objective was to understand the (un)said about AIDS in their quotidian. After approval by the Research Ethics Committee of three hospitals in Rio de Janeiro, the interview was conducted with eleven boys/girls from 12-14 years old, who knew their diagnosis. The Heideggerian hermeneutics unveiled that the adolescent-being knows that the disease was acquired by his/her mother; he/she was said that his/her relatives are sick; he/she reminds when the diagnosis was disclosure, and its relation to prejudice. He/she projects him/her as a being-of-possibilities inside an existential movement. One concludes that the care for adolescent-being needs to integrate the biological, clinical, socio-cultural, ethical, political, and existential dimensions.

O cuidado medicamentoso à criança com HIV: desafios e dilemas de familiares cuidadores

El cuidado medicamentoso al nino HIV/ SIDA esta marcado por desafios y dilemas. En este contexto, se objeta discutir las situaciones existenciales vivenciadas por cuidadores en la implementacion de este cuidado. Se trata de un estudio cualitativo desarrollado segun el Metodo Creativo y Sensible con 13 cuidadores atendidos en ambulatorio. Los datos fueron recogidos por la dinamica del concreto y analizados por el analisis del discurso. Se percibe un proceso de normalizacion de los medicamentos y se destaca la no utilizacion de recursos ludicos para su administracion. Se observa que el inicio del uso esta dificultado por los efectos colaterales y que posteriormente surgen cuestionamientos en cuanto a la necesidad del uso. Se concluye que el cuidado esta afectado por prejuicios y estigmas y se destaca la importancia del profesional enfermero como educador de la salud.The medication care to children with HIV/Aids is marked with challenges and dilemmas. In this context, the purpose of this study is to discuss on the existential situations lived by caregivers when administering that care. This is a qualitative study developed according to the Creative and Sensitive Method, with 13 caregivers seen at an outpatient clinic. The data were collected using the concrete dynamics and analyzed according to discourse analysis. It was observed there is a normalization process of the medications, and it is highlighted there is no use of recreational resources in the administration. It was also observed that starting the use is difficult due to the side effects and, later, questions emerge regarding the need of using the medication. In conclusion, the care is permeated with prejudice and stigmas, and it is emphasized that nursing professionals have an important role as health educators.