Michel Perreault

Differences and similarities between mothers’ and fathers’ experiences of parenting a child with a disability:

This qualitative study used focus groups to identify the differences and similarities in the experiences of parents of children with a disability. Two main themes emerged, showing the ways in which the mothers and fathers are alike or different. One concerns roles, actual and expected, in the various subsystems of family life. The other concerns the normalization and stigmatization that arise because of the child’s problem. Mothers tend to score better interms of interpersonal and group communications. It would seem that the fathers’ expectations are harder to fulfil than the mothers’. The fathers’ expectations are attuned to the outer world; the actual day-to-day tasks related to the child’s care are not their priority. The mothers are less demanding and their expectations are more self-focused. Interestingly, these families are similar to families of children without a disability; however,the difficulties they experience are accentuated by the presence of a child with a problem.

Longitudinal effects of an early family intervention programme on the adaptation of parents of children with a disability

This study assesses the longitudinal effects of an original early intervention programme on the adaptation of parents of children with a disability (Down syndrome and cleft lip/palate, i.e. DS and CLP). Variations in the effects of the programme according to the time of measurement, the type of disability and parents gender are also examined. Globally, the results show a better adaptation among parents who participated in the intervention programme compared to those who did not participated in the programme. These parents had lower levels of parental stress, they had more positive perceptions and attitudes concerning their childs disability and their parental situation, they were more confident in their own resources and the help they could receive from others, they had lower levels of emotional distress, anxiety and depression and they perceived more emotional support from their spouse. In general, these gains were maintained throughout the year when the children were between six and 18 months of age, they were relatively similar for parents of children with DS and parents of children with CLP, as well as for mothers and fathers.

Education and professional strengthening of the community health agent - an ethnography study

This inquiry explored the educative actions of Community health agents (CHAs) with socially disaffiliated populations in a Rio de Janeiro metropolitan area. Individual and group interviews, participant observation during visits to the shantytowns, and picture gathering apprehended the philosophical and empirical dimensions of such actions. The software ATLAS ti. 4.2 supported the coding procedures of the raw material. Abduction in communication framed findings’ analysis and interpretation. Analysis revealed their social professional identity, political awareness regarding their own organization as a professional group, plus criticisms regarding the negligence of occupational safety and the lack of governmental help. CHAs “voice” is a tool of social leadership and a main facilitator to empower the population, and to promote optimization of the health care system. Since their professional practice revealed conflicts, contradictions and paradoxes, it seems necessary a collective reflection on the needed support to sustain CHAs wishes for change and freedom to act.

Enhancing Critical Reflection of Brazilian Community Health Agents’ Awareness of Social Determinants of Health

This project aims to assess how Brazilian community health agents’ critical awareness of the social determinants of health was enhanced and led to a greater understanding of the major structural changes necessary to sustain health promotion initiatives. Educational workshops inspired by Paulo Freire’s ideas on critical pedagogy were delivered to 82 community health agents in three Brazilian cities. The workshops utilized evocative objects to link and develop participants’ conceptual and experiential knowledge. The participants exchanged connections and experiences and created hypothetical action plans to be implemented in collaboration with community members. The discussions were audio recorded, transcribed verbatim, and submitted to content analysis. The connections provoked by evocative objects were related to required assets for the development of a healthy community. As social advocates, they are already committed to a social movement for health equity to catalyze a more equitable distribution of social goods, promote social inclusion, and liberate communities.

Severe paternal sexual abuse in early childhood and systematic aggression against the family and the institution

This report examines incest and its sequela in individuals suffering from severe chronic mental illness. Descriptive data drawn from 11 cases paints a clinical picture characterized by severe chronic psychotic symptoms and aggressive behaviour that are often precipitated by the familys rejection. In all patients, the incest for occurred over a long period of time, was violent, and was perpetrated by the male parental figure. Health care professionals need to increase their knowledge of and skills in the identification and treatment of sexual abuse.

O familiar acompanhante como estimulo comportamental de pacientes internados em terapia intensiva

OBJETIVOS: identificar las expresiones verbales y no verbales presentes en el comportamiento del paciente antes y durante la insercion y permanencia del familiar acompanante en el centro de terapia intensiva y analizar comparativamente las alteraciones comportamentales del paciente durante eses momentos de la hospitalizacion. METODO: el escenario fue un centro de terapia intensiva de un hospital en Rio de Janeiro, convenio firmado con el Sistema Unico de Salud (SUS). El enfoque cualitativo resulto de la observacion libre sobre el comportamiento de cinco pacientes y de los registros en diario de campo durante tres dias consecutivos. Se ha dado prioridad a la observacion del paciente en el primer dia de hospitalizacion y despues de la insercion ininterrumpida del familiar acompanante por tres dias consecutivos. RESULTADOS: los cambios en las reacciones verbales y no verbales del paciente despues de los estimulos generados por la presencia del familiar cambiaron desde la ausencia de habla y movimientos y pasividad en el actuar, para reacciones de aceptacion de los procedimientos; comunicacion cinesica ampliada y mayor participacion en el cuidado.

Family companionship as a behavioural stimulus for intensive care patients

OBJETIVOS: identificar las expresiones verbales y no verbales presentes en el comportamiento del paciente antes y durante la insercion y permanencia del familiar acompanante en el centro de terapia intensiva y analizar comparativamente las alteraciones comportamentales del paciente durante eses momentos de la hospitalizacion. METODO: el escenario fue un centro de terapia intensiva de un hospital en Rio de Janeiro, convenio firmado con el Sistema Unico de Salud (SUS). El enfoque cualitativo resulto de la observacion libre sobre el comportamiento de cinco pacientes y de los registros en diario de campo durante tres dias consecutivos. Se ha dado prioridad a la observacion del paciente en el primer dia de hospitalizacion y despues de la insercion ininterrumpida del familiar acompanante por tres dias consecutivos. RESULTADOS: los cambios en las reacciones verbales y no verbales del paciente despues de los estimulos generados por la presencia del familiar cambiaron desde la ausencia de habla y movimientos y pasividad en el actuar, para reacciones de aceptacion de los procedimientos; comunicacion cinesica ampliada y mayor participacion en el cuidado.

El acompanante familiar como dispositivo para la estimulacion de pacientes internados en cuidados intensivos

OBJETIVOS: identificar las expresiones verbales y no verbales presentes en el comportamiento del paciente antes y durante la insercion y permanencia del familiar acompanante en el centro de terapia intensiva y analizar comparativamente las alteraciones comportamentales del paciente durante eses momentos de la hospitalizacion. METODO: el escenario fue un centro de terapia intensiva de un hospital en Rio de Janeiro, convenio firmado con el Sistema Unico de Salud (SUS). El enfoque cualitativo resulto de la observacion libre sobre el comportamiento de cinco pacientes y de los registros en diario de campo durante tres dias consecutivos. Se ha dado prioridad a la observacion del paciente en el primer dia de hospitalizacion y despues de la insercion ininterrumpida del familiar acompanante por tres dias consecutivos. RESULTADOS: los cambios en las reacciones verbales y no verbales del paciente despues de los estimulos generados por la presencia del familiar cambiaron desde la ausencia de habla y movimientos y pasividad en el actuar, para reacciones de aceptacion de los procedimientos; comunicacion cinesica ampliada y mayor participacion en el cuidado.

Evaluation of a prenatal peer counseling program with women living in poverty

Traditional medicine and modern public health have long failed pregnant women living in poverty. With birth outcomes less than optimal, they cumulate physical and psychosocial risks that are left unattended by approaches not based on the real needs of those women. The goal of this research was to describe and assess the empowerment process within a group of pregnant women living in poverty, a group of mothers from that community, and a group of health professionals all taking part in a prenatal peer counseling program. Interviews analyzed qualitatively led to the emerging middle range theory of prenatal peer counseling. The empowerment process, including group self determination, is described with both facilitating and limiting elements. If public health intends to attack problems of social justice, we will have to revisit our partnership and integrative models in order to look into other potential models.

Avaliação de um programa de acompanhamento pré-natal em meio carente

Traditional medicine and modern public health have long failed pregnant women living in poverty. With birth outcomes less than optimal, they cumulate physical and psychosocial risks that are left unattended by approaches not based on the real needs of those women. The goal of this research was to describe and assess the empowerment process within a group of pregnant women living in poverty, a group of mothers from that community, and a group of health professionals all taking part in a prenatal peer counseling program. Interviews analyzed qualitatively led to the emerging middle range theory of prenatal peer counseling. The empowerment process, including group self determination, is described with both facilitating and limiting elements. If public health intends to attack problems of social justice, we will have to revisit our partnership and integrative models in order to look into other potential models.