Myriam Aparecida Mandetta Pettengill

Vulnerabilidade da família: desenvolvimento do conceito

This study aimed to develop the concept of family vulnerability. Data were collected through Qualitative Concept Analysis, which involves two phases. In the first, theoretical phase, data from literature were used for identification of the theoretical attributes of the concept. In the second, field phase, data were collected by means of observations and interviews with twelve families going through the experience of a childs disease and hospitalization. Symbolic Interactionism was used as a theoretical framework, which supported Grounded Theory, applied to guide data collection and analysis in the field phase. As a result of phase II, a theoretical model was built, whose central category defines family vulnerability as FEELING THREATENED IN THEIR AUTONOMY, due to the interactions between family members, illness and health team. The comparison between the two analyses allowed for a theoretical proposition of family vulnerability and advances in terms of theoretical knowledge on family nursing.O objetivo deste estudo foi desenvolver o conceito vulnerabilidade da familia. Os dados foram coletados utilizando-se a estrategia da Analise Qualitativa de Conceito que consta de duas etapas: na primeira, a fase teorica, utilizou-se dados da literatura e, na segunda, a fase de campo, entrevista e observacao de 12 familias vivenciando uma experiencia de doenca e hospitalizacao de um filho. O referencial teorico foi o Interacionismo Simbolico, dando sustentacao a Teoria Fundamentada nos Dados, utilizada para guiar a coleta e analise dos dados na etapa de campo. Como resultado, construiu-se um modelo teorico cuja categoria central define a vulnerabilidade da familia como SENTINDO-SE AMEACADA EM SUA AUTONOMIA, em razao das interacoes com a doenca, familia e equipe. A comparacao das duas analises permitiu elaborar uma proposicao teorica de vulnerabilidade da familia e avancar em termos de conhecimento teorico para a area de enfermagem da familia.

Cuidado centrado na família no contexto da criança com deficiência e sua família: uma análise reflexiva

This theoretical-philosophical study addresses Family-Centered Care and the practice of healthcare teams in caring for children with disabilities and their families. The birth of a child with a disability brings about a crisis that affects the entire family, shaking its identity, structure, and functioning. Family members find themselves unprepared to cope with or manage this new way of being a family; the child with a disability does not meet expectations, there is change of roles, and families may even break apart. The Family-Centered Care Model can support strengthening of the family, encouraging their potential, and promoting empowerment. Although this model recognizes the family as a unit of care, a gap remains between theoretical knowledge and its application into clinical practice by health professionals, revealing the need for further research to indicate a means to transfer knowledge of this kind. DESCRIPTORS: Family nursing. Disabled children. Nursing care.This theoretical-philosophical study addresses Family-Centered Care and the practice of healthcare teams in caring for children with disabilities and their families. The birth of a child with a disability brings about a crisis that affects the entire family, shaking its identity, structure, and functioning. Family members find themselves unprepared to cope with or manage this new way of being a family; the child with a disability does not meet expectations, there is change of roles, and families may even break apart. The Family-Centered Care Model can support strengthening of the family, encouraging their potential, and promoting empowerment. Although this model recognizes the family as a unit of care, a gap remains between theoretical knowledge and its application into clinical practice by health professionals, revealing the need for further research to indicate a means to transfer knowledge of this kind. DESCRIPTORS: Family nursing. Disabled children. Nursing care.This theoretical-philosophical study addresses Family-Centered Care and the practice of healthcare teams in caring for children with disabilities and their families. The birth of a child with a disability brings about a crisis that affects the entire family, shaking its identity, structure, and functioning. Family members find themselves unprepared to cope with or manage this new way of being a family; the child with a disability does not meet expectations, there is change of roles, and families may even break apart. The Family-Centered Care Model can support strengthening of the family, encouraging their potential, and promoting empowerment. Although this model recognizes the family as a unit of care, a gap remains between theoretical knowledge and its application into clinical practice by health professionals, revealing the need for further research to indicate a means to transfer knowledge of this kind. DESCRIPTORS: Family nursing. Disabled children. Nursing care. O CUIDADO CENTRADO NA FAMÍLIA NO CONTEXTO DA CRIANÇA COM DEFICIÊNCIA E SUA FAMÍLIA: UMA ANÁLISE REFLEXIVA RESUMO: Trata-se de uma reflexão teórico-filosófica sobre a perspectiva do Cuidado Centrado na Família e a prática da equipe de saúde no cuidado à criança deficiente e sua família. O nascimento de uma criança com deficiência provoca uma crise que atinge toda a família, abalando sua identidade, estrutura e funcionamento. A família se vê despreparada para enfrentar ou lidar com esse novo modo de ser família, pois o filho deficiente representa a quebra de expectativas, a alteração de papéis e a não-continuidade da família. O Modelo de Cuidado Centrado na Família pode oferecer subsídios para fortalecer a família, estimulando seu potencial e promovendo seu empoderamento. Embora esse modelo reconheça a família como unidade de cuidado, há uma lacuna entre o conhecimento teórico e a aplicação na prática clínica pelo profissional de saúde, revelando a necessidade de ampliar estudos que apontem direções sobre como realizar a transferência de conhecimento. DESCRITORES: Enfermagem familiar. Crianças com deficiência. Cuidados de enfermagem. CUIDADO CENTRADO EN LA FAMILIA EN EL CONTEXTO DE LOS NIÑOS CON DISCAPACIDADES Y SUS FAMILIAS: UNA REVISIÓN REFLEXIVA RESUMEN: Es una reflexión teórico-filosófica sobre la perspectiva del Cuidado Centrado en la Familia con la práctica del equipo de salud en el cuidado al niño con discapacidad y su familia. El nacimiento de un niño con discapacidad provoca una crisis que perjudica toda la familia, con problemas para su identidad, estructura y funcionamiento. La familia se muestra sin preparación para enfrentar ese nuevo modo de verse familia, pues el hijo representa una experiencia traumática que puede alterar el estado emocional entero de los miembros. Las presuposiciones del Cuidado Centrado en la Familia pueden fortalecer a la familia, estimular su potencial y promover el fortalecimiento familiar en su trayectoria con el hijo. Aunque con las presuposiciones del Cuidado Centrado en la Familia se reconozca a la familia como la unidad de cuidado, una laguna se observa entre el conocimiento teórico y de aplicación en la práctica clínica por los profesionales de salud, revelando la necesidad de ampliar los estudios que indiquen caminos hacia la transferencia de conocimientos. DESCRIPTORES: Enfermería de la familia. Niños con discapacidad. Atención de enfermería. 194

Cuidado centrado na família e sua aplicação na enfermagem pediátrica

Family-centered care is a challenge for nursing area, although the home care was described in the professional history since its origins. The definition of this approach, its principles and the discussion about its application in pediatric nursing are described in the text aiming to lead to a reflection about the possibilities of family care, by means of attention to the individual and to the family unit. Among the several areas, the pediatric nursing is highlighted with researches and the development of theoretical assumptions.El cuidado centrado en la familia tiene representado un desafio para el area de enfermeria, a pesar de los cuidados domiciliares ya tengan sido descriptos desde sus origenes en la historia de la profesion. La definicion de este abordaje, sus principios y la discusion de su aplicacion en la enfermeria pediatrica estan descriptos en el texto con el objetivo de reflexionar acerca de las posibilidades de cuidado a la familia por medio de atencion al individuo y a la unidad familiar. De entre las distintas areas, la enfermeria pediatrica viene destacandose con pesquisas y desarrollo de los presupuestos teoricos.

Identificação da vulnerabilidade da família na prática clínica

Neste trabalho apresentamos o relato de uma situacao clinica em que identificamos a vulnerabilidade da familia, propiciando ao enfermeiro pediatra a utilizacao deste conceito na sua pratica e intervencao com familias. O estudo foi realizado com uma familia que experienciava uma situacao de doenca e hospitalizacao de um filho. A vulnerabilidade foi identificada nas interacoes da familia com a doenca, a propria familia e a equipe de saude, e serviu de guia para o planejamento da assistencia de enfermagem. As intervencoes realizadas permitiram o fortalecimento da familia para enfrentar a situacao e o reconhecimento da importância para o enfermeiro pediatra utilizar resultados de pesquisa teorica em sua pratica profissional.In this paper we present a report of a clinical situation in which we identified the vulnerability of the family, propitiating to pediatric nurses the use of this concept in their practice and intervention with families. The study was carried out with a family that was going through a situation of a child illness and hospitalization. The vulnerability was identified in the interactions of family members with the illness, with other family members and with the health staff, and served as a guide for planning the nursing assistance. The interventions led to the strengthening of the family to face the situation and, for pediatric nurses, the recognition of the importance of using the results of theoretical research in their professional practice.

Criança com anomalia congênita: estudo bibliográfico de publicações na área de enfermagem pediátrica

OBJECTIVE: To identity pediatric nursing publications regarding children with congenital defects. METHODS: This study was a literature review of articles published in the main health care databases from 1995 to 2005. RESULTS: The retrieved publications were organized into five themes: 1) exposition to risk factors for congenital defects, 2) use of technology to provide care to children with congenital defects, 3) evaluation of the delivery of care to children with congenital defects and their family, 4) nurses competence to provide quality care to children with congenital defects, and 5) reports of lived experiences of professional nurses who provide care to children with congenital defects, and lived experience of children with congenital defects and their family. CONCLUSION: Nurses who provide care to children with congenital defects base their practice on strong theoretical and practical foundations; and, evidence based nursing interventions to provide the most efficacious care to children with congenital defects and their family continues to evolve.Objective: To identity pediatric nursing publications regarding children with congenital defects. Methods: This study was a literature review of articles published in the main health care databases from 1995 to 2005. Results: The retrieved publications were organized into five themes: 1) exposition to risk factors for congenital defects, 2) use of technology to provide care to children with congenital defects, 3) evaluation of the delivery of care to children with congenital defects and their family, 4) nurse’s competence to provide quality care to children with congenital defects, and 5) reports of lived experiences of professional nurses who provide care to children with congenital defects, and lived experience of children with congenital defects and their family. Conclusion: Nurses who provide care to children with congenital defects base their practice on strong theoretical and practical foundations; and, evidence based nursing interventions to provide the most efficacious care to children with congenital defects and their family continues to evolve.

A experiência de vulnerabilidade da família da criança hospitalizada em Unidade de Cuidados Intensivos Pediátricos

Este estudo buscou compreender a experiencia de vulnerabilidade da familia da crianca internada em Unidade de Cuidados Intensivos Pediatricos (UCIP). O Interacionismo Simbolico e o Conceito de Vulnerabilidade da Familia foram utilizados como fundamentacao para a compreensao dessa experiencia. A Analise Qualitativa de Conteudo foi o referencial metodologico aplicado. Os dados foram coletados por meio de entrevista e observacao com 11 familias de criancas hospitalizadas em uma UCIP de um hospital universitario, do Municipio de Sao Paulo. Emergiram seis categorias analiticas da experiencia da familia que, ao serem comparadas as categorias conceituais da Vulnerabilidade da Familia, revelam os elementos definidores do conceito nesse contexto. Para a familia, a internacao de um filho em UCIP desencadeia sofrimento intenso, pois remete a possibilidade de uma perda definitiva. Assim, o poder e a autonomia da familia em relacao ao filho sao diminuidos, intensificando o sentimento de vulnerabilidade.The objective of this study was to understand the vulnerability experienced by the family of children hospitalized in a Pediatric Intensive Care Unit (PICU). The Symbolic Interactionism and the Concept of Family Vulnerability were the frameworks used to understand this experience. Qualitative Content Analysis was used. Data was collected through interviews and observation with 11 families of children hospitalized in a PICU of a university hospital in São Paulo. Six analytical categories regarding the family experience emerged. The categories were compared to the conceptual categories of Family and Vulnerability, and revealed the elements that defined the concept within this context. The childs hospitalization in a PICU triggers intense suffering within the family, as it refers to the possibility of losing their child. Thus, the power and the autonomy of the family in relation to their child are reduced, intensifying the feeling of vulnerability.

Ultra-sonografia na punção intravenosa periférica: inovando a prática de enfermagem para promover a segurança do paciente

This study’s goal was to describe the use of ultrasonography as a guiding method for puncturing peripheral veins, a practice which has been described since the early 1990s. This practice has the premise of promoting more effective and efficient care, since peripheral venous puncturing is one of the most frequently performed procedures in healthcare institutions. Thus, the possible improvement of this nursing procedure can increase security and satisfaction of patients and families in relation to the care provided. The development of portable ultrasound equipment for use at bedside makes it possible to study innovations of the nursing practice, contributing for the improvement of the care provided to the population.

The vulnerability experienced by the family of children hospitalized in a pediatric intensive care unit

Este estudo buscou compreender a experiencia de vulnerabilidade da familia da crianca internada em Unidade de Cuidados Intensivos Pediatricos (UCIP). O Interacionismo Simbolico e o Conceito de Vulnerabilidade da Familia foram utilizados como fundamentacao para a compreensao dessa experiencia. A Analise Qualitativa de Conteudo foi o referencial metodologico aplicado. Os dados foram coletados por meio de entrevista e observacao com 11 familias de criancas hospitalizadas em uma UCIP de um hospital universitario, do Municipio de Sao Paulo. Emergiram seis categorias analiticas da experiencia da familia que, ao serem comparadas as categorias conceituais da Vulnerabilidade da Familia, revelam os elementos definidores do conceito nesse contexto. Para a familia, a internacao de um filho em UCIP desencadeia sofrimento intenso, pois remete a possibilidade de uma perda definitiva. Assim, o poder e a autonomia da familia em relacao ao filho sao diminuidos, intensificando o sentimento de vulnerabilidade.The objective of this study was to understand the vulnerability experienced by the family of children hospitalized in a Pediatric Intensive Care Unit (PICU). The Symbolic Interactionism and the Concept of Family Vulnerability were the frameworks used to understand this experience. Qualitative Content Analysis was used. Data was collected through interviews and observation with 11 families of children hospitalized in a PICU of a university hospital in São Paulo. Six analytical categories regarding the family experience emerged. The categories were compared to the conceptual categories of Family and Vulnerability, and revealed the elements that defined the concept within this context. The childs hospitalization in a PICU triggers intense suffering within the family, as it refers to the possibility of losing their child. Thus, the power and the autonomy of the family in relation to their child are reduced, intensifying the feeling of vulnerability.

FAMILY VULNERABILITY: CONCEPT DEVELOPMENT

This study aimed to develop the concept of family vulnerability. Data were collected through Qualitative Concept Analysis, which involves two phases. In the first, theoretical phase, data from literature were used for identification of the theoretical attributes of the concept. In the second, field phase, data were collected by means of observations and interviews with twelve families going through the experience of a childs disease and hospitalization. Symbolic Interactionism was used as a theoretical framework, which supported Grounded Theory, applied to guide data collection and analysis in the field phase. As a result of phase II, a theoretical model was built, whose central category defines family vulnerability as FEELING THREATENED IN THEIR AUTONOMY, due to the interactions between family members, illness and health team. The comparison between the two analyses allowed for a theoretical proposition of family vulnerability and advances in terms of theoretical knowledge on family nursing.O objetivo deste estudo foi desenvolver o conceito vulnerabilidade da familia. Os dados foram coletados utilizando-se a estrategia da Analise Qualitativa de Conceito que consta de duas etapas: na primeira, a fase teorica, utilizou-se dados da literatura e, na segunda, a fase de campo, entrevista e observacao de 12 familias vivenciando uma experiencia de doenca e hospitalizacao de um filho. O referencial teorico foi o Interacionismo Simbolico, dando sustentacao a Teoria Fundamentada nos Dados, utilizada para guiar a coleta e analise dos dados na etapa de campo. Como resultado, construiu-se um modelo teorico cuja categoria central define a vulnerabilidade da familia como SENTINDO-SE AMEACADA EM SUA AUTONOMIA, em razao das interacoes com a doenca, familia e equipe. A comparacao das duas analises permitiu elaborar uma proposicao teorica de vulnerabilidade da familia e avancar em termos de conhecimento teorico para a area de enfermagem da familia.

Experiência do irmão sadio em relação à doença e hospitalização do irmão com câncer

OBJECTIVE: To understand the meaning of the experience of having a sibling with cancer from the perspective of healthy brother. METHODS: A descriptive qualitative research approach. Semi-structured interviews were conducted with five siblings of children with cancer who were receiving care in a philanthropic institution located in Sao Paulo. RESULTS: The central theme that emerged was suffering as it was revealed that the healthy brother became mature because of the suffering that is imposed in the course of events. They valued family and small acts of daily life that are often undetected. CONCLUSION: The health care team must recognize the experience of the brother and include it in the care provided at all stages of the disease.