Noeli Marchioro Liston Andrade Ferreira

Apoio social à família do paciente com câncer: identificando caminhos e direções

Rede e apoio social sao recursos que enfermeiros podem oferecer as familias. Esta revisao identifica que aspectos estao sendo pesquisados sobre apoio social a familia do doente com câncer. Localizaram-se 51 artigos, sendo 70% de metodologia quantitativa e 26% publicados nos dois ultimos anos. Os temas abordados foram: Cuidador familiar como provedor de apoio social; Fatores que interferem no apoio social; Religiosidade como apoio social e o apoio social proveniente de programas educativos, atividades grupais e recursos tecnologicos. Dos artigos, 49% foram escritos por enfermeiros, sendo a enfase internacional para avaliacao das necessidades, experiencias das familias e apoios oferecidos, enquanto que os artigos nacionais enfatizavam a definicao de conceitos e identificacao das necessidades das familias visando ao planejamento de intervencoes.Network and social support are resources that nursing can offer to families. This review identifies which aspects of social support are being investigated for the family of the cancer patient. Fifty one articles were found of which 70% were quantitative research and 26% were published in the last two years. The issues addressed were: Family caregivers as provider of social support; Factors that interfere with social support; Religiosity as social support as well as support coming from educative programs, group activity and technological resources. Of these papers, 49% were written by nurses, with international emphasis on needs assessment, family experiences and support offered, while national articles emphasize definition concepts and identifying family needs focusing on intervention planning.

A difícil convivência com o câncer: um estudo das emoções na enfermagem oncológica

The present study represents an attempt to verify which emotions are present in nursing activities with cancer patients and how nurses deal with them. In order to reach this goal, a quantitative approach was used in order to allow a comprehension of the population studied and their work conditions. After that, field observations and structured and semiestructured interviews were carried out so as to understand how emotion was experienced and dealt with.Thematic analysis of the nurses discourse was conducted in order to identify the core of the emotional issues and to elaborate the Maps of Association of ideas. The main themes were: the disease, the patient, the team and the health instituition, the emotions that emerged and ways of coping. Data analysis allowed to identfy which emotions are present in every day situations of nursing care, the ways of coping that are used with difficult situation and the mediation of the institutional culture in the control of emotional expressions.O presente estudo e uma tentativa de verificar quais as emocoes presentes no trabalho de Enfermagem com o paciente oncologico e identificar de que forma elas sao enfrentadas pelos enfermeiros no dia-a-dia da assistencia de Enfermagem. Para alcance deste objetivo, foi inicialmente feita a opcao por uma abordagem quantitativa que permitisse a contextualizacao da populacao estudada e a de suas condicoes de trabalho. A partir desses dados, foi realizado um aprofundamento da questao com a utilizacao de metodologia qualitativa, atraves de tecnicas de entrevistas estruturadas e semi- estruturadas, bem como da realizacao de observacao de campo. A analise tematica dos discursos dos enfermeiros permitiu a identificacao dos nucleos de sentidos que foram destacados pela elaboracao dos Mapas de Associacao de Ideias, sendo eles: a doenca, o paciente, a equipe e a instituicao, as emocoes emergentes e as formas de enfrentamentos. Estes dados nos permitiu identificar as emocoes apresentadas no dia a dia da assistencia de enfermagem, as formas como enfrentam as situacoes consideradas dificeis e a mediacao da cultura institucional como elemento controlador da expressao emocional.

Alcoolismo e família: a vivência de mulheres participantes do grupo de autoajuda Al-Anon

OBJECTIVE: To investigate the experience of family members who participate in Al-Anon support group in relation to alcoholism. METHOD: The research was accomplished with 6 women, 10 invited, attending the group of self-help Al-Anon. The data collection was through semi-structured interviews. The theoretical and methodological reference to the qualitative analysis was based on Symbolic Interactionism and Grounded Theory in Data, in its initial steps. RESULTS: The data resulted in 3 conceptual categories: 1) Denying alcoholism and suffering yours consequences; 2) Searching for help, learning with the support group; 3) Waiting for cure, experiencing sobriety and facing relapses. Besides the support of family and religion, women pointed to the importance of self-help group to support them in facing the problems of alcoholism. CONCLUSION: We hope that the results this research may contribute to enhancing the support offered by Al-Anon, stimulate new studies in the area and strengthen, among health professionals, recognizing the group as important to support effective resource for families.

O envolvimento emocional para a equipe de enfermagem: realidade ou mito?

O presente tra balho tem como objetivo analisar o que os componentes da equipe de enfermagem de um hospital geral pensam sobre o envolvimento emocional em suas relacoes com o paciente. Os dados foram coletados atraves da aplicacao de formulario aos varios integrantes da equipe de enfermagem (enfermeiro, auxiliar e atendente de enfermagem). Estes foram analisados, em um primeiro momento, separadamente por categoria funcional para, em um segundo momento, ser feita uma analise global. Pudemos ao final concluir que existe na enfermagem uma politica do nao envolvimento, sendo o enfermeiro, ao contrario do esperado, o que mais a verbaliza. Dentre os fatores considerados negativos acarretados pelo envolvimento esta o sofrimento psiquico dos integrantes da equipe. Isto nos leva a identificar o nao envolvimento com o paciente como uma tecnica coletiva de defesa contra o sofrimento.The present study aims to analyze what the members of the nursing team think about their emotional involvement with the patients during their relationship. Data were collected through the application of an instrument to members of the nursing team (registered nurse, nursing aides and attendants). The analysis was done, at first, separately by functional categories and after that, as a whole. We concluded that, there is in nursing a policy of no involvement with the patients and that the registered nurse is the one that most verbalizes it. One of the negative factors of the involvement with the patient is the psychological suffering of the nursing team members. This leads us to identify the no involvement behavior as a collective defence mechanism against suffering.

Discovery of hearing impairment by the family: seeing an idealized future collapse

Objective: To portray the family experience when the discovery of hearing impairment in their child. Methods: Qualitative research with Symbolic Interactionism and Grounded Theory as theoretical and methodological frameworks. Data collection instrument: semi-structured interview. The study included nine families (32 participants). Results: The theme, “Seeing an idealized future collapse”, shows that for the family, discovered the possibility of having a child with hearing loss is a moment that involves many negative feelings. Conclusion: Discover the hearing loss has a meaning of the expected loss of the perfect child, frustrated expectations and uncertain future. The family has been inadequately approached and the diagnosis has been made late, which requires immediate changes to the practices of professionals.

The perceptions of families with children having chronic diseases and their relationships with healthcare professionals

The prevalence of chronic disease in childhood has increased, placing families in constant contact with health professionals. In such situations the relationship with health professionals has an important role. Few scientific studies address this theme, in spite of its being highlighted as fundamental for effective interaction. The aim of this study was to characterize how the family of a child with a chronic disease perceives its relationship with health professionals. Twenty caregivers for children with chronic diseases were interviewed. The theoretical and methodological frameworks were, respectively, symbolic interactionism and thematic content analysis. The analytical process revealed four themes: role of the caregiver, stressful relationships, services and professionals, and seeking welcoming relationships. The outcomes of this interactional process, which show an incongruity of expectations and behaviors between professionals and families, are poor and generate feelings of abandonment. These can be eased through listening and understanding by other families in similar situations.The prevalence of chronic disease in childhood has increased, placing families in constant contact with health professionals. In such situations the relationship with health professionals has an important role. Few scientific studies address this theme, in spite of its being highlighted as fundamental for effective interaction. The aim of this study was to characterize how the family of a child with a chronic disease perceives its relationship with health professionals. Twenty caregivers for children with chronic diseases were interviewed. The theoretical and methodological frameworks were, respectively, symbolic interactionism and thematic content analysis. The analytical process revealed four themes: role of the caregiver, stressful relationships, services and professionals, and seeking welcoming relationships. The outcomes of this interactional process, which show an incongruity of expectations and behaviors between professionals and families, are poor and generate feelings of abandonment. These can be eased through listening and understanding by other families in similar situations.

O apoio social para a família do doente com câncer em situação de pobreza

Este estudo objetivou compreender o significado que a familia em situacao de vulnerabilidade social atribui ao apoio social e a rede social em sua vivencia com o câncer. Trata-se de um estudo qualitativo, orientado pelo Interacionismo Simbolico, como referencial teorico, e a Teoria Fundamentada nos Dados, como referencial metodologico. Os dados foram coletados de 2008 a 2009, mediante entrevistas com seis familias que possuiam um de seus membros com diagnostico de câncer, referenciados por uma Unidade de Saude da Familia, em uma cidade do interior paulista. Os resultados da analise comparativa constante dos dados apontaram dois fenomenos dinamicamente interligados: Percebendo-se vulneravel e Apoiando-se para cuidar. O significado de rede e apoio social, para estas pessoas, vem sendo construido durante o cuidado, em um contexto de pobreza, sofrimento, vulnerabilidade e exclusao social. O estudo evidencia a necessidade de intervencoes de enfermagem adequadas a real necessidade das familias de doentes com câncer em situacao de vulnerabilidade social.

Descoberta da deficiência auditiva pela família: vendo o futuro idealizado desmoronar*

Objective: To portray the family experience when the discovery of hearing impairment in their child. Methods: Qualitative research with Symbolic Interactionism and Grounded Theory as theoretical and methodological frameworks. Data collection instrument: semi-structured interview. The study included nine families (32 participants). Results: The theme, “Seeing an idealized future collapse”, shows that for the family, discovered the possibility of having a child with hearing loss is a moment that involves many negative feelings. Conclusion: Discover the hearing loss has a meaning of the expected loss of the perfect child, frustrated expectations and uncertain future. The family has been inadequately approached and the diagnosis has been made late, which requires immediate changes to the practices of professionals.

Cochlear Implant: the complexity involved in the decision making process by the family

Objective to understand the meanings the family attributes to the phases of the decision-making process on a cochlear implant for their child. Method qualitative research, using Symbolic Interactionism and Grounded Theory as the theoretical and methodological frameworks, respectively. Data collection instrument: semistructured interview. Nine families participated in the study (32 participants). Results knowledge deficit, difficulties to contextualize benefits and risks and fear are some factors that make this process difficult. Experiences deriving from interactions with health professionals, other cochlear implant users and their relatives strengthen decision making in favor of the implant. Conclusion deciding on whether or not to have the implant involves a complex process, in which the family needs to weigh gains and losses, experience feelings of accountability and guilt, besides overcoming the risk aversion. Hence, this demands cautious preparation and knowledge from the professionals involved in this intervention.OBJETIVO: compreender os significados atribuidos pela familia as etapas do processo de tomada decisao para o implante coclear no filho. METODO: pesquisa qualitativa, tendo o Interacionismo Simbolico e a Teoria Fundamentada nos Dados como referenciais teorico e metodologico, respectivamente. Instrumento de coleta de dados: entrevista semiestruturada. Participaram do estudo nove familias (32 participantes). RESULTADOS: deficit de conhecimento, dificuldades em contextualizar beneficios e riscos, e medo sao alguns dificultadores desse processo. Experiencias advindas das interacoes estabelecidas com profissionais de saude, outros usuarios de implante coclear e seus familiares fortalecem a tomada de decisao para o implante. CONCLUSAO: decidir ou nao pelo implante envolve um processo complexo, em que a familia precisa pesar ganhos e perdas, vivenciar sentimentos de responsabilizacao e culpabilidade, alem de superar a aversao aos riscos. Assim, demanda cauteloso preparo e conhecimento dos profissionais envolvidos nessa intervencao.

O atendimento por instituição pública de saúde: percepção de famílias de doentes com câncer

Este estudo objetivou analisar como as familias de pessoas com câncer perceberam o atendimento prestado pelos profissionais de um ambulatorio publico especializado, utilizando Analise Tematica de Bardin. Foram entrevistadas 7 familias, totalizando 14 membros familiares que, em seus discursos, enfatizaram a relacao medico-paciente, avaliando-a como impessoal e superficial, gerando inseguranca e descrenca. A familia procura participar, mas sente-se pouco valorada e excluida do cuidado. As informacoes necessarias e nao recebidas sao buscadas na midia, e o conforto e alcancado na espiritualidade. A formacao dos diversos profissionais da saude precisa estimular o olhar para a familia como unidade de cuidado, articulando formacao e modos de cuidar em saude.