Viviane Marten Milbrath

Família da criança com paralisia cerebral: percepção sobre as orientações da equipe de saúde

O tornar-se familia de uma crianca com paralisia cerebral e um processo complexo. Exige da equipe de saude, preparo profissional, alem dos aspectos eticos e esteticos do processo de cuidar dessa familia. Sob este prisma, objetivou-se conhecer como a familia de criancas com paralisia cerebral percebe a transmissao das orientacoes da equipe de saude para o cuidado a crianca com a paralisia cerebral. O estudo foi fundamentado com base na perspectiva de Heidegger e Gadamer. Consiste em um estudo qualitativo, exploratorio-descritivo, realizado na cidade do Rio Grande-RS, tendo como participantes seis familias, totalizando nove sujeitos. Utilizou-se entrevistas semiestruturadas para a coleta das informacoes, as quais foram analisadas segundo Analise Tematica. Na interpretacao das informacoes foram encontradas incongruencias entre as orientacoes proferidas pela equipe de saude e as demandas apresentadas pelas familias para prestar o cuidado a crianca com necessidades especiais. Constatou-se a relevância de uma equipe de saude instrumentalizada para o cuidado integral, focado nas necessidades dessas criancas e suas familias.

The family of children with cerebral palsy: perception about health team orientations

O tornar-se familia de uma crianca com paralisia cerebral e um processo complexo. Exige da equipe de saude, preparo profissional, alem dos aspectos eticos e esteticos do processo de cuidar dessa familia. Sob este prisma, objetivou-se conhecer como a familia de criancas com paralisia cerebral percebe a transmissao das orientacoes da equipe de saude para o cuidado a crianca com a paralisia cerebral. O estudo foi fundamentado com base na perspectiva de Heidegger e Gadamer. Consiste em um estudo qualitativo, exploratorio-descritivo, realizado na cidade do Rio Grande-RS, tendo como participantes seis familias, totalizando nove sujeitos. Utilizou-se entrevistas semiestruturadas para a coleta das informacoes, as quais foram analisadas segundo Analise Tematica. Na interpretacao das informacoes foram encontradas incongruencias entre as orientacoes proferidas pela equipe de saude e as demandas apresentadas pelas familias para prestar o cuidado a crianca com necessidades especiais. Constatou-se a relevância de uma equipe de saude instrumentalizada para o cuidado integral, focado nas necessidades dessas criancas e suas familias.

TEORIA DO APEGO, INTERACIONISMO SIMBÓLICO E TEORIA FUNDAMENTADA NOS DADOS: ARTICULANDO REFERENCIAIS PARA A PESQUISA

Objective: to present and reflect on the articulation between the Attachment Theory, Symbolic Interactionism and Grounded Theory in the study of bonding and interaction between caregivers and institutionalized children. Method: the data were collected between April and July 2015 through intensive interviews, structured observation and a field diary, at a shelter institution that welcomes children between zero and eight years old in a city in the South of Brazil. Fifteen caregivers and six children participated in the research. Results: the Attachment Theory and Symbolic Interactionism permitted understanding the implications of the establishment and rupture of bonds and the strategies the caregivers use in this interaction. The Grounded Theory guided the elaboration of the theoretical model “Perceiving the work/care for institutionalized children”. Conclusion: the articulation among the Attachment Theory, Symbolic Interactionism and Grounded Theory demonstrated its consistency for the study developed, contributing to care in the context of children’s shelter. DESCRIPTORS: Child, institutionalized. Caregivers. Interpersonal relations. Qualitative research. Nursing. Grounded theory. TEORIA DO APEGO, INTERACIONISMO SIMBÓLICO E TEORIA FUNDAMENTADA NOS DADOS: ARTICULANDO REFERENCIAIS PARA A PESQUISA

ESTRATÉGIAS UTILIZADAS PELOS PROFISSIONAIS DA ENFERMAGEM NA ABORDAGEM A CRIANÇA HOSPITALIZADA

Introduction: Childhood hospitalization can develop confused and dichotomous feelings in the child and family, such as death and healing, sadness and joy, fear and trust, thus making the hospital an environment of painful experiences of great importance for life, thus, it is important that nursing professionals develop strategies that minimize these feelings. Objective: To know the strategies used by nursing professionals to approach hospitalized children. Method: Descriptive and exploratory study, with qualitative approach, carried out in the period from June to December 2015, in the pediatrics of a Teaching Hospital in the south of Rio Grande do Sul/Brazil, with eight nursing professionals (three nurses and five nursing technicians). The study was approved by the Research Ethics Committee of the College of Medicine of the Federal University of Pelotas, under number 1.195.440, 08/24/2015. Results: The nursing team uses playful actions, as well as the dialogue in order to approach the child in the hospital environment, in order to create a bond and minimize the trauma that hospitalization can cause. Conclusions: The nursing team needs to use strategies such as toys and dialogue in order to reduce the impact of hospitalization for children, favoring a humanized care not only for the child, but also for the family.

Children with chronic renal failure on conservative management: clinical profile and family configuration

This study aimed to know the clinical profile and the configuration of children on renal conservative management. It is a descriptive methodology of qualitative approach, developed from semi-structured interviews and the construction of the genogram and ecomap of family caregivers of children on renal conservative management. The data collection occurred from April to August 2015 and it was used descriptive analysis. The results allowed us to characterize the children on renal conservative management, which showed a predominance female, white, from two months to 11 years-old age group; presented initial diagnosis of neonatal urinary tract malformations and glomerulopathies, on renal conservative management duration of two months to three years, family risk for chronic kidney disease; live with the nuclear family in urban areas and have siblings. They used public services for chronic renal failure treatment and most of them received Welfare Benefits. The importance for nurses assessing family history configuration and references to kidney disease using genograms as therapeutic tools is stressed, seeking to reduce the time between the diagnosis and early treatment. It should be noted that primary care nurses can reduce anxiety in families of children on renal conservative management in need of invasive procedures at school, as well as providing relevant healthcare

Cuidado prestado pela equipe de saúde às famílias de crianças que sofreram Asfixia Perinatal Grave

Objective: To know the care provided by the health team to the families of children who have suffered severe perinatal asphyxia. Methodology: Exploratory, descriptive, qualitative. Held in a city in southern Rio Grande do Sul, with the participants fourteen professional health team from the neonatal intensive care unit and pediatrics of a university hospital from April to May of 2011. Semi-structured interviews were used and the Thematic Analysis of Minayo. Results: They reveal that in transmitting the diagnosis of severe perinatal asphyxia, lack a positive feedback, as professionals inform the diagnosis without that families understand their meaning. Conclusion: Basic care is provided, but the follow-up needs a service that can cover this care family in a holistic and comprehensive manner, with multidisciplinary teams to prospects for increased autonomy for family child care are met.

O sentido da espiritualidade na transitoriedade da vida

Objective: This study aimed to comprehend the meaning of the spirituality for integral care to people receiving palliative care. Methods: Qualitative methodology based on the theoretical framework of Viktor Frankl. Participants were nine people receiving palliative care at home. Data were collected through observation and interviews conducted from June to October 2014, recorded, transcribed and converted to text that was interpreted with phenomenological hermeneutic approach. Results: The following categories emerged: sense of continuity of life; sense of relief of suffering; sense of naturalness of death, and sense of valorization of life. Conclusion: For integral care it is necessary to include spirituality in the practice of health care. The study led to the confirmation of the hypothesis that spirituality provides the existential encounter between the person in palliative care and the professionals that provide integral care.Objetivo: Compreender o sentido da espiritualidade para a pessoa em cuidados paliativos. Metodos: Abordagem qualitativa, fundamentada na fenomenologia existencialista e referencial de Viktor Frankl. Os participantes foram nove pessoas em cuidados paliativos atendidas no domicilio. Informacoes coletadas por meio da observacao e de entrevista realizadas no periodo de junho a outubro de 2014, gravadas, transcritas e transformadas em texto interpretado com a abordagem fenomenologica hermeneutica. Resultados: Surgiram as seguintes categorias: sentido de continuidade da vida; sentido de alivio do sofrimento; sentido de naturalidade da morte e sentido de valorizacao do viver. Conclusao: Para a integralidade da atencao faz-se necessario a inclusao da espiritualidade na pratica do cuidado em saude. A espiritualidade proporciona o encontro existencial entre a pessoa em cuidados paliativos e os profissionais que a cuidam em sua integralidade.Objetivo: Comprender el sentido de la espiritualidad para la persona en cuidados paliativos. Metodos: Estudio con abordaje cualitativo, fundamentado en la fenomenologia existencialista y referencial de Viktor Frankl. Participaron nueve personas en cuidados paliativos atendidas en domicilio. Informaciones colectadas a traves de la observacion y de entrevistas realizadas entre junio y octubre de 2014, grabadas, transcritas y transformadas en texto interpretado con abordaje fenomenologica hermeneutica. Resultados: Emergieron las siguientes categorias: sentido de continuidad de la vida; sensacion de alivio del sufrimiento; sentido de naturalidad de la muerte y un sentido de apreciacion de la vida. Conclusion: Para obtener la integralidad de la atencion, se necesita la inclusion de la espiritualidad en la practica asistencial. La espiritualidad proporciona el encuentro existencial entre la persona en cuidados paliativos y los profesionales que la atienden en su totalidad.

REVELANDO O DIAGNÓSTICO DA ASFIXIA PERINATAL GRAVE À FAMÍLIA: PERSPECTIVA DOS PROFISSIONAIS DA SAÚDE

Introduction: Disclosure of the diagnosis of Cerebral Palsy is a moment that can be crucial to the child’s family. Therefore, the professionals must have theoretical and practical knowledge of the disease to inform the family in the best possible way, with clear language, so the family can understand what happened and make the necessary adaptations to the new situation. Objective: Know how health professionals reveal the diagnosis of severe perinatal asphyxia to the family. Patients and Methods: This is an exploratory, descriptive study using a qualitative approach. Study sample was composed of 14 health professionals working at the neonatal and pediatric intensive care unit of a hospital located in the southern region of Rio Grande do Sul state. We collected data from April to May 2011 through a semi-structured interview. The analysis was carried out according to thematic analysis proposed by Minayo. Results: Two thematic categories emerged. However, this article will present the results and discussion of the following issue: “Revealing the diagnosis of severe perinatal asphyxia family: a perspective of health professionals.” The physician presents the disclosure of the diagnosis, which is further complemented by other health professionals, such as nurses and licensed practical nurses. Conclusion: There is a need of having a greater integration between health professionals, who will deliver a positive feedback to the family, so the family members can understand the child’s condition and, at the same time, they can develop strong bonds to the team in order to remedy certain questions. Descriptors: Asphyxia Neonatorum; Child; Family, Diagnosis.

Familia del niño con parálisis cerebral: percepción sobre de las orientaciones del equipo de salud

O tornar-se familia de uma crianca com paralisia cerebral e um processo complexo. Exige da equipe de saude, preparo profissional, alem dos aspectos eticos e esteticos do processo de cuidar dessa familia. Sob este prisma, objetivou-se conhecer como a familia de criancas com paralisia cerebral percebe a transmissao das orientacoes da equipe de saude para o cuidado a crianca com a paralisia cerebral. O estudo foi fundamentado com base na perspectiva de Heidegger e Gadamer. Consiste em um estudo qualitativo, exploratorio-descritivo, realizado na cidade do Rio Grande-RS, tendo como participantes seis familias, totalizando nove sujeitos. Utilizou-se entrevistas semiestruturadas para a coleta das informacoes, as quais foram analisadas segundo Analise Tematica. Na interpretacao das informacoes foram encontradas incongruencias entre as orientacoes proferidas pela equipe de saude e as demandas apresentadas pelas familias para prestar o cuidado a crianca com necessidades especiais. Constatou-se a relevância de uma equipe de saude instrumentalizada para o cuidado integral, focado nas necessidades dessas criancas e suas familias.