Willyane de Andrade Alvarenga

WEAKENED SOCIAL NETWORK: THE EXPERIENCE OF CAREGIVERS OF THE HIV-EXPOSED INFANT

This study aimed to know the social network and social support the caregiver had available to take care of children exposed to HIV in the postnatal period. It is a descriptive study with a qualitative approach that used the theoretical framework of Symbolic Interactionism. Data were collected through interviews with 36 caregivers of children born to HIV-infected mothers who were followed up in a specialized service in the Northeast of Brazil and they were analyzed by inductive content analysis. The results revealed three categories that show the family and expert service as the main social networks of the caregiver and little emotional, information, instrumental and appreciation support received both in the family and in the context of health services. Interventions are needed to strengthen the weakened social network of the caregiver and to qualify and include nursing care in the context of children exposed to HIV.Este estudo objetivou conhecer a rede social e o apoio social que o cuidador dispos para cuidar da crianca exposta ao HIV, no periodo pos-natal. E um estudo descritivo, com abordagem qualitativa, que utilizou como referencial teorico o Interacionismo Simbolico. Os dados foram coletados por meio de entrevista com 36 cuidadores de criancas nascidas de maes infectadas pelo HIV, que estavam em seguimento em um servico especializado no Nordeste do Brasil, e foram analisados pela analise de conteudo indutiva. Os resultados revelaram tres categorias, que evidenciam a familia e o servico especializado como as principais redes sociais do cuidador e o pouco apoio emocional, informativo, instrumental e de apreciacao recebidos tanto no âmbito familiar quanto no contexto dos servicos de saude. Intervencoes sao necessarias para fortalecer a rede social fragilizada do cuidador e para qualificar e efetivar a insercao da enfermagem neste contexto de cuidado a crianca exposta ao HIV.

Experience of taking care of children exposed to HIV: a trajectory of expectations

OBJECTIVE: to learn about the experience of caregivers/mothers providing care to infants exposed to HIV through vertical transmission. METHODS: this qualitative study used Symbolic Interactionism as the theoretical framework. A total of 39 caregivers of children exposed to HIV in follow-up at a specialized service were interviewed. Data were analyzed through inductive content analysis. RESULTS: four categories were identified that report on the lonely experience of handling the childs antiretroviral therapy, mainly due to a lack of information or incomplete information; being attentive to required care, such as the use of prophylaxis for pneumonia, vaccines, and other practices restricted to the mother-child interaction; the desire to omit the HIV out of fear of prejudice and fear of the disease, considering future prospects. CONCLUSION: the HIV and the threat this infection may affect the child cause apprehension and feelings such as fear, guilt and anxiety in the caregivers. Healthcare workers need to work together with mothers so they are able to cope with demands and distress. Only then will the treatment to avoid vertical transmission be efficient and will mother and child be supported during the process, despite apprehension with the outcome.Objetivo: conhecer a experiencia do cuidador/mae em relacao ao cuidado para com a crianca exposta ao virus da imunodeficiencia humana por transmissao vertical, na trajetoria pos-natal. Metodo: pesquisa qualitativa, que utilizou o Interacionismo Simbolico como referencial teorico. Foram realizadas entrevistas com 39 cuidadores de criancas expostas ao virus da imunodeficiencia humana e em seguimento em um servico especializado. Os dados foram analisados pela analise de conteudo indutiva. Resultados: apreenderam-se quatro categorias que reportam a experiencia solitaria de manuseio da terapia antirretroviral da crianca, no que se refere principalmente a ausencia ou incompletude de informacoes recebidas; estar atento aos cuidados, que incluem o uso da profilaxia para pneumonia, vacinas e outros restritos a interacao mae/crianca; querer omitir a presenca do virus da imunodeficiencia humana pelo medo do preconceito e olhar o futuro e temer a doenca. Conclusao: a presenca do virus da imunodeficiencia humana e a ameaca dessa infeccao na crianca sao capazes de gerar apreensao e tantos outros sentimentos como medo, culpa e ansiedade no cuidador. Os profissionais de saude precisam trabalhar conjuntamente com a mae para o enfrentamento das demandas e sofrimentos. Assim, o tratamento para evitar a transmissao vertical sera eficiente e a mae, juntamente a crianca, vivera essa trajetoria com apoio, apesar da apreensao pelo resultado.

The Effect of Music on the Spirituality of Patients: A Systematic Review:

Purpose: Although some studies have suggested that music can positively affect physical and psychological variables, few have evaluated its effects on spirituality. This study aimed to evaluate the effects of musical interventions on the spirituality of patients, regardless of diagnoses. Method: This was a systematic literature review that followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations conducted through a relevant search of terms in six databases (PubMed, Web of Science, CINAHL, PsycINFO, ScienceDirect, and LILACS) without temporal delimitation. Experimental or quasi-experimental studies were included, involving participants regardless of diagnoses, to assess the effect of music on spirituality, either through musical intervention as music medicine or through music therapy. The methodological quality of included studies was evaluated using the Physiotherapy Evidence Database scale. Results: A total of 147 studies were identified; 7 met the inclusion criteria. Five studies were randomized controlled trials involving six music therapists leading the musical intervention with the active participation of patients. The interventions used were heterogeneous. Three studies were associated with improved spirituality after the intervention. Four studies used measurements to evaluate spiritual well-being. Conclusion: This review did not allow ascertaining the positive impact of music intervention on spirituality in patients, which motivates further research.

A rede e apoio social do transplantado renal

Objective to know the social network and support of those who experience the process of kidney disease and transplantation. Methods a descriptive qualitative study, based on the concept of social network and social support from Sherbourne and Stewart. Semi-structured interviews were conducted from November 2013 to September 2014, with 12 kidney transplantees, which passed through content analysis. This study had the following selection criteria: the interviewee must have had a transplant five years ago, at most, be at lease 16 years of age and have preserved cognitive and language skills. Results three categories were constructed from the analysis process that link the family as the main component of the social network, health service offers support in its various dimensions, even if it is occasionally disconnected; other interpersonal relationships are mentioned as vulnerable in this process; spirituality helps in coping. Conclusions despite the different forms of support for transplantees, weaknesses were observed in these networks and social supports.Objetivo: Conhecer a rede e o apoio social da pessoa que vivencia o processo de adoecimento e o transplante renal. Metodos: Estudo descritivo com abordagem qualitativa, fundamentado nos conceitos de rede e apoio social de Sherbourne e Stewart. Foram realizadas entrevistas semiestruturadas no periodo de novembro de 2013 a setembro de 2014, com 12 transplantados renais, as quais passaram por analise de conteudo. Os criterios de selecao foram os seguintes: realizacao do transplante, ha no maximo, cinco anos, ter idade acima de 16 anos, ter cognicao e linguagem preservadas. Resultados: A partir do processo de analise, foram elaboradas tres categorias que apontam a familia como o principal componente da rede social: o servico de saude oferta apoio em suas varias dimensoes, ainda que ocasionalmente desarticulado; demais relacoes interpessoais sao mencionadas como fragilizadas neste processo; a espiritualidade auxilia no enfrentamento. Conclusoes: Apesar das diferentes formas de apoio aos transplantados, foram observadas fragilidades nessas redes e apoios sociais. Palavras-chave: Doenca cronica. Transplante de rim. Enfermagem familiar. Apoio social.

REDE SOCIAL FRAGILIZADA: A EXPERIÊNCIA DO CUIDADOR DA CRIANÇA NASCIDA EXPOSTA AO HIV

This study aimed to know the social network and social support the caregiver had available to take care of children exposed to HIV in the postnatal period. It is a descriptive study with a qualitative approach that used the theoretical framework of Symbolic Interactionism. Data were collected through interviews with 36 caregivers of children born to HIV-infected mothers who were followed up in a specialized service in the Northeast of Brazil and they were analyzed by inductive content analysis. The results revealed three categories that show the family and expert service as the main social networks of the caregiver and little emotional, information, instrumental and appreciation support received both in the family and in the context of health services. Interventions are needed to strengthen the weakened social network of the caregiver and to qualify and include nursing care in the context of children exposed to HIV.Este estudo objetivou conhecer a rede social e o apoio social que o cuidador dispos para cuidar da crianca exposta ao HIV, no periodo pos-natal. E um estudo descritivo, com abordagem qualitativa, que utilizou como referencial teorico o Interacionismo Simbolico. Os dados foram coletados por meio de entrevista com 36 cuidadores de criancas nascidas de maes infectadas pelo HIV, que estavam em seguimento em um servico especializado no Nordeste do Brasil, e foram analisados pela analise de conteudo indutiva. Os resultados revelaram tres categorias, que evidenciam a familia e o servico especializado como as principais redes sociais do cuidador e o pouco apoio emocional, informativo, instrumental e de apreciacao recebidos tanto no âmbito familiar quanto no contexto dos servicos de saude. Intervencoes sao necessarias para fortalecer a rede social fragilizada do cuidador e para qualificar e efetivar a insercao da enfermagem neste contexto de cuidado a crianca exposta ao HIV.

Care provided by the father to the child with cancer under the influence of masculinities: qualitative meta-synthesis

OBJECTIVE To synthesize and interpret findings and conclusions of qualitative research addressing the experience of the father in the care of the child with cancer. METHOD Meta-synthesis of 16 qualitative studies from six databases, analyzed through taxonomic analysis. RESULTS Child and adolescent cancer have several repercussions on the daily life of the father, especially related to the stigma around the disease, the fear of the unknown and the social and family role. Faced with the illness and the need to care for the child, the father seeks to recover normality in the family and transitions between hegemonic masculine behaviors and practices culturally recognized as female. FINAL CONSIDERATIONS The complex experience of the father, influenced by masculinities, was evidenced. The limitations regard the restricted understanding of the contextual specificities of the experiences, due to the limited characteristics of the parents and children described in the studies. The knowledge produced is useful to promote involvement of fathers in the care of the child, as well as to strengthen and assist him in this task.

Systematic review of the psychometric properties of instruments to measure sexual desire

BackgroundSexual desire is one of the domains of sexual function with multiple dimensions, which commonly affects men and women around the world. Classically, its assessment has been applied through self-report tools; however, an issue is related to the evidence level of these questionnaires and their validity. Therefore, a systematic review addressing the available questionnaires is really relevant, since it will be able to show their psychometric properties and evidence levels.MethodA systematic review was carried out in the PubMed, EMBASE, PsycINFO, Science Direct, and Web of Science databases. The search strategy was developed according to the following research question and combination of descriptors and keywords, including original studies with no limit of publication date and in Portuguese, English, and Spanish. Two reviewers carried out the selection of articles by abstracts and full texts as well as the analysis of the studies independently. The methodological quality of the instruments was evaluated by the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist.ResultsThe search resulted in 1203 articles, of which 15 were included in the review. It identified 10 instruments originally developed in the English language. Unsatisfactory results on methodological quality were evidenced in cultural adaptation studies with no description of the steps of the processes and inadequacy of techniques and parameters of adequacy for models. The Principal Component Analysis with Varimax rotation predominated in the studies.ConclusionsThe limitation of the techniques applied in the validation process of the reviewed instruments was evident. A limitation was observed in the number of adaptations conducted and contexts to which the instruments were applied, making it impossible to reach a better understanding of the functioning of instruments. In future studies, the use of robust techniques can ensure the quality of the psychometric properties and the accuracy and stability of instruments. A detailed description of procedures and results in validation studies may facilitate the selection and use of instruments in the academic and/or clinical settings.Systematic review registrationPROSPERO CRD42018085706.

Metassíntese sobre o homem como pai e cuidador de um filho hospitalizado

ABSTRACT Objective: to identify, analyze and synthesize the father’s experience in care for a hospitalized child from results of primary qualitative studies. Method: this is a qualitative meta-synthesis through which 12 articles were analyzed, selected in the Cumulative Index to Nursing and Allied Health Literature databases, Latin American and Caribbean Literature in Health Sciences, Public Medline, Scopus, PsycINFO and Web of Science, published between 1995 and 2015. The methodological steps proposed by Sandelowski and Barroso were used to systematize the review, as well as concepts from the anthropology of masculinities to analyze and discuss the synthesis. Results: the synthesis was presented by means of two themes: 1) paternal dilemmas - what man feels and faces during the hospitalization of the child, highlighting the emotional involvement and change in the family and work relationship, and 2) paternal identities - masculinities readjusted in view of the child’s illness, which reveals identity marks and repressed fatherhood in the hospital environment. Both themes illustrate the challenges and readjustment of parental identity. Final considerations: to get to know the experiences of the father during the hospitalization of the child and the way in which the challenges for the readjustment of roles related to masculinity could broaden the range of nursing and other health professionals, alerting to the importance of including the father as a protagonist or coadjuvant in the care for hospitalized children.Objetivo: identificar, analizar y sintetizar los resultados de estudios cualitativos primarios que discuten la experiencia del padre en el cuidado al hijo hospitalizado. Metodo: se trata de metasintesis cualitativa por medio de la cual fueron analizados 12 articulos, seleccionados en las bases de datos Cumulative Index to Nursing and Allied Health Literature, Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Public Medline, Scopus, PsycINFO y Web of Science, publicados entre 1995 y 2015. Las etapas metodologicas propuestas por Sandelowski y Barroso se utilizaron para sistematizar la revision, asi como conceptos de la antropologia de las masculinidades, para analisis y discusion de la sintesis. Resultados: la sintesis fue presentada por dos temas: 1) dilemas paternos - lo que el hombre siente y enfrenta durante la hospitalizacion del hijo, destacando el involucramiento emocional y cambio en la relacion familiar y laboral, y 2) identidades paternas - masculinidades reajustadas ante el adolecer del hijo, que revela marcas identitarias y la paternidad reprimida, en el ambiente hospitalario. Ambos temas ilustran los retos y el reajuste de la identidad paterna. Consideraciones finales: conocer las vivencias del padre durante la hospitalizacion del hijo y la manera como los desafios para el reajuste de papeles relativos a la masculinidad puede ampliar el alcance de la enfermeria, y de los demas profesionales de salud, alertando sobre la importancia de incluir al padre como protagonista o coadyuvante en el cuidado del nino hospitalizado.

The possibilities and challenges in providing pediatric spiritual care

The purpose of this article was to present discussions on how pediatric nurses can perform spiritual care to children and adolescents and discuss the challenges of integrating such care in health-care settings. Based on the literature, the article presents an overview of spiritual care in pediatric settings highlighting the assessment of spirituality, expected outcomes, and the corresponding nursing interventions. Spiritual care provided to children and adolescents should take into account all aspects of the developmental stage, life experiences, and familiar and sociocultural contexts. Different approaches can be used to perform spiritual care. However, lack of knowledge and time are highlighted as the main challenges in integrating spiritual care into the clinical practice. Spiritual care is crucial to the well-being of children and adolescents in times of illness and hospitalization when the goal is to provide holistic care.

RED SOCIAL DEBILITADA: LA EXPERIENCIA DE LOS CUIDADORES DE LOS NIÑOS EXPUESTOS AL VIH

This study aimed to know the social network and social support the caregiver had available to take care of children exposed to HIV in the postnatal period. It is a descriptive study with a qualitative approach that used the theoretical framework of Symbolic Interactionism. Data were collected through interviews with 36 caregivers of children born to HIV-infected mothers who were followed up in a specialized service in the Northeast of Brazil and they were analyzed by inductive content analysis. The results revealed three categories that show the family and expert service as the main social networks of the caregiver and little emotional, information, instrumental and appreciation support received both in the family and in the context of health services. Interventions are needed to strengthen the weakened social network of the caregiver and to qualify and include nursing care in the context of children exposed to HIV.Este estudo objetivou conhecer a rede social e o apoio social que o cuidador dispos para cuidar da crianca exposta ao HIV, no periodo pos-natal. E um estudo descritivo, com abordagem qualitativa, que utilizou como referencial teorico o Interacionismo Simbolico. Os dados foram coletados por meio de entrevista com 36 cuidadores de criancas nascidas de maes infectadas pelo HIV, que estavam em seguimento em um servico especializado no Nordeste do Brasil, e foram analisados pela analise de conteudo indutiva. Os resultados revelaram tres categorias, que evidenciam a familia e o servico especializado como as principais redes sociais do cuidador e o pouco apoio emocional, informativo, instrumental e de apreciacao recebidos tanto no âmbito familiar quanto no contexto dos servicos de saude. Intervencoes sao necessarias para fortalecer a rede social fragilizada do cuidador e para qualificar e efetivar a insercao da enfermagem neste contexto de cuidado a crianca exposta ao HIV.