Lisabelle Mariano Rossato

Family Management Style Framework and Its Use With Families Who Have a Child Undergoing Palliative Care at Home

Palliative care settings in many countries acknowledge families as their prime focus of care, but in Brazil, to date, researchers have devoted scant attention to that practice setting. In this article, we report the findings of a study that explored how families define and manage their lives when they have a child or adolescent undergoing palliative care at home. Data included individual semistructured interviews with 14 family members of 11 different families. Interviews were transcribed and the coding procedure featured qualitative content analysis methods. The deductive coding was based on the major components of the Family Management Style Framework and the eight dimensions comprising these components. The analysis provides insight into families’ daily practices and problems inherent in managing their everyday lives that are encountered when they have a child in palliative care. The article features discussion of implications for the palliative care related development of family nursing practice.

Família como categoria de análise e campo de investigação em enfermagem

The increasing information about family in nursing literature expresses the progress in this area of knowledge. The research contribution on family nursing has included the illness experience, and both the context of care and interventions. The increase of family research in nursing studies demands consideration regarding the research quality, in view of the complexity of the studies that deal with family. Researching family represents more than defining a unique group of study. The aim of this study was to discuss theoretical and methodological aspects which should be taken into account by the researchers in their work with families. The reflections and challenges when studying family and illness have been described in this work and represent our 10-year experience investigating families and illnesses in our research group.The increasing information about family in nursing literature expresses the progress in this area of knowledge. The research contribution on family nursing has included the illness experience, and both the context of care and interventions. The increase of family research in nursing studies demands consideration regarding the research quality, in view of the complexity of the studies that deal with family. Researching family represents more than defining a unique group of study. The aim of this study was to discuss theoretical and methodological aspects which should be taken into account by the researchers in their work with families. The reflections and challenges when studying family and illness have been described in this work and represent our 10year experience investigating families and illnesses in our research group.

Utilizando instrumentos para avaliaçäo da percepçäo de dor em pré-escolares face a procedimento doloroso

Este estudo teve como objetivos: verificar se a escala de faces de intensidade de dor possibilita ao pre-escolar identificar sua experiencia dolorosa; identificar comportamentos indicadores de dor em pre-escolares submetidos a procedimentos doloroso conhecer palavras utilizadas pelo pre-escolar para descrever a dor em relacao a procedimento doloroso. Para tanto foram aplicados tres instrumentos em 41 criancas hospitalizadas submetidas a curativo ou coleta de sangue. Os instrumentos utilizados foram escala de faces, indicadores comportamentais e palavras descritoras de dor. A maioria dos pre-escolares compreendeu e utilizou corretamente a escala de faces, o que foi evidenciado pelo movimento crescente 0 (sem dor)® 4 (dor maxima) na escolha das faces antes e depois do procedimento doloroso. Os comportamentos choro imovel e franzir a testa predominaram como indicadores comportamentais, mostrando-se intensificados na vigencia do procedimento. As verbalizacoes do pre-escolar relativas a sua dor revelaram uma tendencia na utlizacao de termos concretos e de natureza avaliativa ou indicativa, resultando em conceitos variados e pouco precisos.The aim of this study was evaluate the utilization of tools for pain perception assessment in 41 hospitalized preschool children submitted to painful procedures: care of wounds or blood extraction. The utilizaded tools were the faces scale, behaviorial indicators and words which describe the pain. Most of the pre-schoolers understood and correctly answered to the faces scale, which can be noticed by the crescent moviment 0 (no pain)® 4 (maximum pain) during the choice of faces before and after the painful procedure. Crying, immortility and forehead wriking were the predominant behavioral indicators, intensified during the procedure. Preschoolers verbalizations about their pain showed up to be concret terms or evaluative-indicative nature, esulting in variable, precise or weakly precise concepts.

Multidimensional tools: application of pain quality cards in children

This pilot, descriptive and field exploratory study aimed to verify the representative of the quality of pain, applying the Pain Quality Cards to 50 children and teenagers hospitalized in the first half of 2004, after being approved by the Ethic Commission. Results have shown that there is no relationship between the age group and the number of positive answers. The identification of the cards was different to each group, 61.1% of the cards were identified for the pre-scholar, 77.8% for the scholar and 27.8 for the teenagers. The use of the instrument has revealed itself successful and able to evaluate, discriminate and measure the different dimensions of pain.This pilot, descriptive and field exploratory study aimed to verify the representative of the quality of pain, applying the Pain Quality Cards to 50 children and teenagers hospitalized in the first half of 2004, after being approved by the Ethic Commission. Results have shown that there is no relationship between the age group and the number of positive answers. The identification of the cards was different to each group, 61,1% of the cards were identified for the pre-scholar, 77,8% for the scholar and 27,8 for the teenagers. The use of the instrument has revealed itself successful and able to evaluate, discriminate and measure the different dimensions of pain.

Family as an analysis category and research field in nursing

The increasing information about family in nursing literature expresses the progress in this area of knowledge. The research contribution on family nursing has included the illness experience, and both the context of care and interventions. The increase of family research in nursing studies demands consideration regarding the research quality, in view of the complexity of the studies that deal with family. Researching family represents more than defining a unique group of study. The aim of this study was to discuss theoretical and methodological aspects which should be taken into account by the researchers in their work with families. The reflections and challenges when studying family and illness have been described in this work and represent our 10-year experience investigating families and illnesses in our research group.The increasing information about family in nursing literature expresses the progress in this area of knowledge. The research contribution on family nursing has included the illness experience, and both the context of care and interventions. The increase of family research in nursing studies demands consideration regarding the research quality, in view of the complexity of the studies that deal with family. Researching family represents more than defining a unique group of study. The aim of this study was to discuss theoretical and methodological aspects which should be taken into account by the researchers in their work with families. The reflections and challenges when studying family and illness have been described in this work and represent our 10year experience investigating families and illnesses in our research group.

Inventário de estratégias de enfrentamento: um referencial teórico

O estudo teve como objetivo identificar as estrategias de enfrentamento utilizadas por adolescentes na experiencia de ter diabetes mellitus tipo 1 (DM1). Trata-se de um estudo qualitativo, exploratorio-descritivo, que tem o Interacionismo Simbolico e o Inventario de Estrategias de Enfrentamento como referenciais teoricos e a Teoria Fundamentada nos Dados como o referencial metodologico. Participaram do estudo 10 adolescentes, de 12 a 18 anos, com DM1 diagnosticado ha pelo menos um ano. As estrategias de enfrentamento identificadas pertencem aos fatores: Confronto, Afastamento, Autocontrole, Suporte Social, Aceitacao de Responsabilidade, Fuga-Esquiva, Resolucao de Problemas, Reavaliacao Positiva. A identificacao das estrategias permitira que os enfermeiros proponham intervencoes que auxiliem o adolescente a conviver melhor com sua situacao de doenca.This study aimed to identify the coping strategies used by adolescents in his/her experience of having diabetes mellitus type 1 (DM 1). The research is a qualitative, exploratorydescriptive study. The Symbolic Interactionism and Ways of Coping Questionnaire were chosen as the theoretical frameworks and the Grounded Theory as the methodological one. Data were collected with 10 adolescents, 12 to 18 years-old, with DM1, diagnosed at least a year before. The coping strategies identified belong to the following scales of the Ways of Coping Questionnaire: Distancing, Escape-Avoidance, Social Support, Accepting Responsibility, Solving Problem and Positive Reappraisal. The identification of the adolescents coping strategies will enable nurses to propose interventions that really help the adolescent to live better with the illness.

Cuidando para a criança crescer apesar da dor: a experiência da família

This study aimed to understand the meaning of the experience of families having a child experiencing pain due to Juvenile Rheumatoid Arthritis and to construct a theoretical model representing this experience. Grounded Theory and Symbolic Interactionism were used as methodological framework and theoretical framework, respectively. Data were collected by semistructured interviews with 12 families. Data analysis allowed for the construction of the theoretical model Caring for the child to grow despite the pain, which describes an experience based on motivational elements: wanting to see the child without pain and wanting to see the child live a normal life, reviewing how the family lives the transition in its development cycles, retaking and integrating them in the family dynamic with the appearance of the disease and pain in the child. This theoretical model provides a framework for teaching, research and care, permitting advances in terms of theoretical nursing knowledge.Os objetivos desse estudo foram compreender o significado da experiencia da familia da crianca com dor decorrente de artrite reumatoide juvenil e construir um modelo teorico representativo dessa experiencia. A Teoria Fundamentada nos Dados e o Interacionismo Simbolico foram utilizados como referencial metodologico e teorico, respectivamente. Foram realizadas 12 entrevistas semi-estruturadas com familias das criancas. A partir da analise dos dados, emergiu o modelo teorico Cuidando para a crianca crescer, apesar da dor, constituido por elementos motivacionais: querendo ver a crianca livre da dor e querendo ver a crianca levar uma vida normal, alem de elementos intervenientes, revelando como a familia vivencia as transicoes em seus ciclos de desenvolvimento, retomando-os e integrando-os na sua dinâmica com a chegada da doenca e da dor na crianca. Esse modelo teorico proporciona um referencial para as praticas de ensino, pesquisa e assistencia, permitindo avancar em termos de conhecimento teorico para a enfermagem.

Mothers' View on Late Postoperative Pain Management by the Nursing Team in Children After Cardiac Surgery

Postoperative pain management in children is a complex, multidimensional and subjective phenomenon. It represents a challenge for children, parents and health professionals. This study aimed to understand how mothers assess their childrens pain management by the nursing team in the late postoperative phase of cardiac surgery. Empirical data collection was carried out through semistructured interviews with 17 mothers who accompanied their children. Data were subject to qualitative analysis, revealing that, for the mothers, taking good care results from the confidence they vest in the nursing team and from the observation of the medication interventions this team performs. Not taking good care of their children is a consequence of lack of information or inadequate communication between the team and the mothers. The results of this study permit identifying aspects that strengthen and weaken nursing care for these clients, contributing to the improvement of the delivered care.O manejo da dor pos-operatoria na crianca e fenomeno complexo, multidimensional e subjetivo. Constitui-se em desafio, para as criancas, pais e profissionais de saude. O objetivo deste trabalho foi compreender como as maes avaliam o manejo da dor de seus filhos, implementado pela equipe de enfermagem, no pos-operatorio tardio de cirurgia cardiaca. A coleta de dados empiricos foi realizada por meio de entrevista semiestruturada com 17 maes que acompanharam seus filhos. Procedeu-se a analise qualitativa dos dados e se apreendeu que, para as maes, cuidar bem e resultante da confianca que elas depositam na equipe de enfermagem e da observacao das intervencoes medicamentosas que essa equipe realiza. Nao cuidar bem de seus filhos e consequencia da falta de informacao, ou comunicacao inadequada entre equipe e maes. Os resultados deste estudo possibilitam identificar aspectos que fortalecem e fragilizam o cuidado de enfermagem a essa clientela, contribuindo para a melhoria do cuidado prestado.

Care delivery for the child to grow up despite the pain: the family's experience

This study aimed to understand the meaning of the experience of families having a child experiencing pain due to Juvenile Rheumatoid Arthritis and to construct a theoretical model representing this experience. Grounded Theory and Symbolic Interactionism were used as methodological framework and theoretical framework, respectively. Data were collected by semistructured interviews with 12 families. Data analysis allowed for the construction of the theoretical model Caring for the child to grow despite the pain, which describes an experience based on motivational elements: wanting to see the child without pain and wanting to see the child live a normal life, reviewing how the family lives the transition in its development cycles, retaking and integrating them in the family dynamic with the appearance of the disease and pain in the child. This theoretical model provides a framework for teaching, research and care, permitting advances in terms of theoretical nursing knowledge.Os objetivos desse estudo foram compreender o significado da experiencia da familia da crianca com dor decorrente de artrite reumatoide juvenil e construir um modelo teorico representativo dessa experiencia. A Teoria Fundamentada nos Dados e o Interacionismo Simbolico foram utilizados como referencial metodologico e teorico, respectivamente. Foram realizadas 12 entrevistas semi-estruturadas com familias das criancas. A partir da analise dos dados, emergiu o modelo teorico Cuidando para a crianca crescer, apesar da dor, constituido por elementos motivacionais: querendo ver a crianca livre da dor e querendo ver a crianca levar uma vida normal, alem de elementos intervenientes, revelando como a familia vivencia as transicoes em seus ciclos de desenvolvimento, retomando-os e integrando-os na sua dinâmica com a chegada da doenca e da dor na crianca. Esse modelo teorico proporciona um referencial para as praticas de ensino, pesquisa e assistencia, permitindo avancar em termos de conhecimento teorico para a enfermagem.

Morte encefálica em criança: subsídios para a prática clínica

El cuidado de los pacientes en muerte cerebral es una situacion compleja que, generalmente, se desarrolla como resultado de procesos agudos. Constituye una condicion medica que requiere accion inmediata y definitiva, en la que lo enfermero es responsable de gran parte de los servicios. Asi, a traves de este articulo, basado en un relato de experiencia tiene como objetivo proporcionar subvenciones para la practica de enfermeria en el manejo clinico de urgencia, para proponer temas relevantes para la discusion y reflexion entre profesores y estudiantes y puntuacion de los aspectos etico-legales asociados la practica de la enfermeria.