Maiara Rodrigues dos Santos

Morte digna da criança: percepção de enfermeiros de uma unidade de oncologia

Se objetivo identificar el significado y las intervenciones de enfermeros actuantes en oncologia pediatrica en la promocion de la muerte digna del nino. Se utilizaron interaccionismo simbolico e investigacion narrativa como referenciales teoricos y metodologicos. Datos obtenidos de ocho enfermeros de una unidad de oncologia pediatrica de hospital publico de Sao Paulo, mediante entrevistas semiestructuradas. El analisis permitio la identificacion de cinco categorias: Sentirse sin autonomia para la toma de decisiones; Cuidado de la familia; Ofrecer bienestar fisico; Valorizar el cuidado humanizado y Aprender a enfrentarse con la muerte y el morir. El estudio contribuye a ampliar la comprension de este proceso de cuidados y permite avanzar en la postulacion de un cuadro teorico que contemple la integracion de conocimientos y acciones que constituyan una atencion integral, trascendiendo la atencion de necesidades meramente clinicas y biologicas.The objective of this study was to identify the meaning of dignified death and the interventions employed by nurses in pediatric oncology to promote dignified death for children. We used Symbolic Interaction Theory as the theoretical framework and narrative research methods. The data were collected from eight nurses in the pediatric oncology unit of a public hospital in Sao Paulo through semi-structured interviews. The data analysis revealed five categories: feeling no autonomy in decision-making, caring for the family, offering physical comfort, valuing humanized care and learning to deal with death and dying. This study helps to extend the understanding of this process of care and postulates a theoretical framework that integrates the knowledge and actions that constitute care that transcends clinical and biological needs.

Facebook: um novo locus para a manifestação de uma perda significativa

Os objetivos deste estudo foram explorar a utilizacao da rede social Facebook pelos enlutados devido a morte de um ente querido e analisar o compartilhamento de conteudos no perfil do falecido, postumamente mediada por esta plataforma. Trata-se de um estudo qualitativo no qual foi utilizado analise de conteudo para tratamento dos dados. Ao total, foram analisados 195 comentarios postados no perfil do falecido postumamente durante o primeiro mes da morte dele. Foi possivel identificar categorias tematicas como comentarios ao falecido, sentimentos, emocoes, indicadores de estrategias de enfrentamento do luto, crencas religiosas e homenagens. As redes sociais virtuais impulsionam a manifestacao de sentimentos usualmente retraidos e permitem a interacao social de temas dificilmente tratados abertamente, favorecendo a elaboracao do luto de pacientes, familiares e profissionais que enfrentam o processo de morte/morrer e luto.

Parental expectations of support from healthcare providers during pediatric life-threatening illness: A secondary, qualitative analysis

Purposes To explain parental expectations of support from healthcare providers for their parenting roles and goals during a childs life‐threatening illness (LTI). Design and Methods Qualitative interpretive study guided by the Family Adjustment and Adaptation Response Model. Thematic analyses were conducted with data from 31 semi‐structured interviews of parents of children with LTI using systematic strategies to ensure rigor including audit trails and prolonged engagement. Results We identified three themes and one meta‐theme or overall theme: (1) “Help us survive this,” (2) “Lets fight together: please fight with me, not against me, to care for my family,” and (3) “Guide me through the darkness: I am suffering.” Overall, the parents conveyed that they expect mutuality with the health care providers and system in order to keep Fighting together for my family survival. Conclusions In the daily work of caring for their families, parents of children with LTI consider survival on multiple levels. They consider the life, illness, and potential death of one child while considering the on‐going survival and sustenance of family relationships. Practice Implications Parents are distressed and grapple with conflicted feelings about managing competing needs of various family members. Relationships with health care providers can influence parents’ management of the situation and be a source of support as their parenting role changes over the illness trajectory, time, and in response to adversity. HighlightsParents grapple with conflicting feelings regarding competing needs of their ill and healthy children and the expectations held of them as parents.Nurses can influence parents’ management of the situation and be a source of support as parenting roles change over illness course and time.Despite a childs LTI, parents want pediatric healthcare providers to engage with them to promote survival and growth of family relationships.

The practice of nurses caring for families of pediatric inpatients in light of Jean Watson

Objective To know the facilities and the difficulties of nurses in caring practice of hospitalized children’s families in the light of Jean Watson’s Theory of Human Caring. Method It was used the descriptive qualitative approach. The data collection was conducted in three stages: presentation of theoretical content; engagement with families in the light of Watson’s theory; and semi-structured interview with 12 pediatric nurses. The interviews were analysed using inductive thematic analysis, being possible to form three themes: Recognizing a framework for care; Considering the institutional context; and Challenges in family’s relationship. Results The theory favored reflections about self, about the institutions and about nurses’ relationship with the family of the child, normalized by a consciousness toward caring attitudes. Conclusion In this process, it is imperative that nurses recognize the philosophical-theoretical foundations of care to attend the child’s family in hospital.

[Dignified death for children: perceptions of nurses from an oncology unit].

Se objetivo identificar el significado y las intervenciones de enfermeros actuantes en oncologia pediatrica en la promocion de la muerte digna del nino. Se utilizaron interaccionismo simbolico e investigacion narrativa como referenciales teoricos y metodologicos. Datos obtenidos de ocho enfermeros de una unidad de oncologia pediatrica de hospital publico de Sao Paulo, mediante entrevistas semiestructuradas. El analisis permitio la identificacion de cinco categorias: Sentirse sin autonomia para la toma de decisiones; Cuidado de la familia; Ofrecer bienestar fisico; Valorizar el cuidado humanizado y Aprender a enfrentarse con la muerte y el morir. El estudio contribuye a ampliar la comprension de este proceso de cuidados y permite avanzar en la postulacion de un cuadro teorico que contemple la integracion de conocimientos y acciones que constituyan una atencion integral, trascendiendo la atencion de necesidades meramente clinicas y biologicas.The objective of this study was to identify the meaning of dignified death and the interventions employed by nurses in pediatric oncology to promote dignified death for children. We used Symbolic Interaction Theory as the theoretical framework and narrative research methods. The data were collected from eight nurses in the pediatric oncology unit of a public hospital in Sao Paulo through semi-structured interviews. The data analysis revealed five categories: feeling no autonomy in decision-making, caring for the family, offering physical comfort, valuing humanized care and learning to deal with death and dying. This study helps to extend the understanding of this process of care and postulates a theoretical framework that integrates the knowledge and actions that constitute care that transcends clinical and biological needs.

Factors influencing Intensive Care Units nurses in end-of-life decisions

OBJECTIVE To identify the factors that influence the Intensive Care Unit nurse in the decision-making process in end-of-life situations. METHOD Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-structured interviews with 10 nurses. RESULTS The inductive thematic analysis enabled us to identify four themes:The cultural context of the Intensive Care Unit: decision-making in situations of end-of-life; Beliefs and subjectivity of care in end-of-life situations; Professional experience and context characteristics of end-of-life care situations; and Humanization practices in end-of-life situations: the patient and family centered care. CONCLUSION Professional maturity, the ability to transmit information and the ability to negotiate are directly related to the inclusion of nurses in the decision-making process.Objective: To identify the factors that influence the Intensive Care Unit nurse in the decision-making process in end-of-life situations. Method: Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-structured interviews with 10 nurses. Results: The inductive thematic analysis enabled us to identify four themes: The cultural context of the Intensive Care Unit: decision-making in situations of end-of-life; Beliefs and subjectivity of care in end-oflife situations; Professional experience and context characteristics of end-of-life care situations; and Humanization practices in end-of-life situations: the patient and family centered care. Conclusion: Professional maturity, the ability to transmit information and the ability to negotiate are directly related to the inclusion of nurses in the decision-making process. descriPtOrs

The process of end-of-life care delivery to the families of elderly patients according to the Family Health Strategy

OBJECTIVE To understand the process of end-of-life care delivery to the families of elderly patients according to a Family Health Strategy (FHS) team, to identify the meanings the team attributes to the experience and to build a theoretical model. METHOD Symbolic Interactionism and Grounded Theory were applied. Fourteen professionals working in an FHS located in a country town in the state of São Paulo were interviewed. RESULTS Through comparative analysis, the core category overcoming challenges to assist the family and the elderly during the dying process was identified, and it was composed of the following sub-processes: Identifying situational problems, Planning a new care strategy, Managing the care and Evaluating the care process. CONCLUSION the team faces difficulties to achieve better performance in attending to the biological and emotional needs of families, seeking to ensure dignity to the elderly at the end of their lives and expand access to healthcare.OBJETIVOS: compreender o processo de cuidar de familias de idosos em situacao de final de vida para a equipe da Estrategia Saude da Familia (ESF), identificar os significados que a equipe atribui a experiencia e construir um modelo teorico. METODO: utilizaram-se o interacionismo simbolico e a teoria fundamentada nos dados. Foram entrevistados 14 profissionais da ESF de um municipio do interior paulista. RESULTADOS: a analise comparativa identificou a categoria central superando os desafios para acolher a familia e o idoso durante o processo de morrer, composta pelos subprocessos: identificando a problematica da situacao, planejando uma nova estrategia para o cuidar, manejando o cuidado e avaliando a sua trajetoria de cuidado. CONCLUSAO: a equipe enfrenta dificuldades para alcancar melhor desempenho, acolhendo as necessidades biologicas e emocionais das familias e buscando oferecer dignidade aos idosos em situacao de final de vida, ampliando o acesso a saude.

Family management styles: a possibility of evaluation in pediatric liver transplant

RESuMO Objetivo: Identificar os estilos de manejo familiar durante a experiencia do transplante hepatico da crianca, de acordo com o Family Management Style Framework. Metodos: Estudo descritivo, com abordagem qualitativa, realizado mediante uma analise secundaria de nove entrevistas semiestruturadas, previamente coletadas com oito familias que tiveram uma crianca que atravessava a experiencia de transplante hepatico. Resultados: Pela analise, foi possivel identificar cinco estilos de manejo: familia ajustada, familia em adaptacao, familia lutando, familia em conflito e familia em espera. Conclusao: O modelo mostrou-se util na avaliacao de familias no contexto do transplante pediatrico e seu uso e encorajado neste e em outros cenarios de doenca cronica. Descritores: Familia; Transplante; Enfermagem pediatricaObjective: To identify the styles of family management during the experience of liver transplantation of a child, according to the Family Management Style Framework. Methods: A descriptive study with a qualitative approach, conducted by means of a secondary analysis of nine semi-structured interviews previously collected with eight families who had a child who experienced a liver transplantation. Results: From the analysis, it was possible to identify five styles of management: adjusted family, family in adaptation, struggling family, family in conflict and family in waiting. Conclusion: The model proved useful in assessing families in the context of pediatric transplant and its use is encouraged in this and other scenarios of chronic disease.

Estilos de manejo familiar: uma possibilidade de avaliação no transplante hepático pediátrico

RESuMO Objetivo: Identificar os estilos de manejo familiar durante a experiencia do transplante hepatico da crianca, de acordo com o Family Management Style Framework. Metodos: Estudo descritivo, com abordagem qualitativa, realizado mediante uma analise secundaria de nove entrevistas semiestruturadas, previamente coletadas com oito familias que tiveram uma crianca que atravessava a experiencia de transplante hepatico. Resultados: Pela analise, foi possivel identificar cinco estilos de manejo: familia ajustada, familia em adaptacao, familia lutando, familia em conflito e familia em espera. Conclusao: O modelo mostrou-se util na avaliacao de familias no contexto do transplante pediatrico e seu uso e encorajado neste e em outros cenarios de doenca cronica. Descritores: Familia; Transplante; Enfermagem pediatricaObjective: To identify the styles of family management during the experience of liver transplantation of a child, according to the Family Management Style Framework. Methods: A descriptive study with a qualitative approach, conducted by means of a secondary analysis of nine semi-structured interviews previously collected with eight families who had a child who experienced a liver transplantation. Results: From the analysis, it was possible to identify five styles of management: adjusted family, family in adaptation, struggling family, family in conflict and family in waiting. Conclusion: The model proved useful in assessing families in the context of pediatric transplant and its use is encouraged in this and other scenarios of chronic disease.

Care for families after suicide loss: nursing academic experience

OBJECTIVE To understand how the nursing academics experience the process of taking care of bereaved families after a suicide loss, to identify the meanings of the experience and to build a theoretical model. METHOD Qualitative study that used symbolic interactionism and grounded theory. Open interviews were held with 16 nursing academics. Data were analyzed according to the constant comparative method. RESULTS The phenomenon seeking his/her own restoration to help the bereaved family to move on is represented by the theoretical model composed by the categories: facing the tragedy in the family, evaluating the caring scenario, mobilizing his/her internal resources, performing the care and reflecting on the repercussions of the experience. FINAL CONSIDERATIONS The process represents efforts undertaken by students in the pursuit of the familys restoration to provide the best care toward them, through embracement, listening, sensitivity and flexibility, so it creates opportunities for the family to strengthen and plan their future.