The involvement of parents in the healthcare provided to hospitalzed children

Objective

to analyze the answers of parents and health care professionals concerning the involvement of parents in the care provided to hospitalized children.

Method

exploratory study based on the conceptual framework of pediatric healthcare with qualitative data analysis.

Results

three dimensions of involvement were highlighted: daily care provided to children, opinions concerning the involvement of parents, and continuity of care with aspects related to the presence and participation of parents, benefits to the child and family, information needs, responsibility, right to healthcare, hospital infrastructure, care delivery, communication between the parents and health services, shared learning, and follow-up after discharge.

Conclusion

the involvement of parents in the care provided to their children has many meanings for parents, nurses and doctors. Specific strategies need to be developed with and for parents in order to mobilize parental competencies and contribute to increasing their autonomy and decision-making concerning the care provided to children.     

Women experiencing the intergenerationality of conjugal violence

Objective:

to analyze the family relationship, in childhood and adolescence, of women who experience conjugal violence.

Method:

qualitative study. Interviews were held with 19 women, who were experiencing conjugal violence, and who were resident in a community in Salvador, Bahia, Brazil. The project was approved by the Research Ethics Committee (N. 42/2011).

Results:

the data was organized using the Discourse of the Collective Subject, identifying the summary central ideas: they witnessed violence between their parents; they suffered repercussions from the violence between their parents: they were angry about the mother''s submission to her partner; and they reproduced the conjugal violence. The discourse showed that the women witnessed, in childhood and adolescence, violence between their parents, and were injured both physically and psychologically. As a result of the mother''s submission, feelings of anger arose in the children. However, in the adult phase of their own lives, they noticed that their conjugal life resembled that of their parents, reproducing the violence.

Conclusion:

investment is necessary in strategies designed to break inter-generational violence, and the health professionals are important in this process, as it is a phenomenon with repercussions in health. Because they work in the Family Health Strategy, which focuses on the prevention of harm and illness, health promotion and interdepartmentality, the nurses are essential in the process of preventing and confronting this phenomenon.     

Primary Health Care Evaluation: the view of clients and professionals about the Family Health Strategy

Objective:

to evaluate the attributes of primary health care as for access; longitudinality; comprehensiveness; coordination; family counseling and community counseling in the Family Health Strategy, triangulating and comparing the views of stakeholders involved in the care process.

Method:

evaluative research with a quantitative approach and cross-sectional design. Data collected using the Primary Care Assessment Tool for interviews with 527 adult clients, 34 health professionals, and 330 parents of children up to two years old, related to 33 family health teams, in eleven municipalities. Analysis conducted in the Statistical Package for Social Sciences software, with a confidence interval of 95% and error of 0.1.

Results:

the three groups assessed the first contact access - accessibility with low scores. Professionals evaluated with a high score the other attributes. Clients assigned low score evaluations for the attributes: community counseling; family counseling; comprehensiveness - services rendered; comprehensiveness - available services.

Conclusions:

the quality of performance self-reported by the professionals of the Family Health Strategy is not perceived or valued by clients, and the actions and services may have been developed inappropriately or insufficiently to be apprehended by the experience of clients.     

Adolescents with attention deficit hyperactivity disorder and exposure to violence: parents' opinion

Objective:

to identify the opinion of parents or guardians of adolescents diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) about their children''s exposure as perpetrators or victims of violence situations in family life or outside.

Method:

qualitative study with use of thematic oral history. Nine parents of 07 adolescents with ADHD participated. Data were collected from April to September of 2013 using thematic interview. The interviews were recorded at scheduled times at the participants'' home, with an average duration of 30 minutes. The findings were submitted to inductive thematic analysis.

Results:

data analysis allowed the identification of the occurrence of "Conflicts in family life" and "Conflicts in the context of school and community". Parents reported the involvement of their children as victims, perpetrators and witnesses of physical and psychological violence, and the difficulty of them and the school to understand and handle these situations.

Conclusion:

violence occurs in ADHD adolescents'' interpersonal relationships. Communication between health professionals, school and families is precarious. Through the systematization of nursing care, nurses can plan strategies that articulate support networks and interpersonal relationships of adolescents with the disorder (family and school).     

Experience of nurses in the process of donation of organs and tissues for transplant

Objective

to investigate the meaning of the action of nurses in the donation process to maintain the viability of organs and tissues for transplantation.

Method

this qualitative study with a social phenomenological approach was conducted through individual interviews with ten nurses of three Organ and Tissue Procurement Services of the city of São Paulo.

Results

the experience of the nurses in the donation process was represented by the categories: obstacles experienced in the donation process, and interventions performed. The meaning of the action to maintain the viability of organs and tissues for transplantation was described by the categories: to change paradigms, to humanize the donation process, to expand the donation, and to save lives.

Final considerations

knowledge of the experience of the nurses in this process is important for healthcare professionals who work in different realities, indicating strategies to optimize the procurement of organs and tissues for transplantation.     

Conjugal violence in the perspective of "Family Health Strategy" professionals: a public health problem and the need to provide care for the women

Objective

to construct a theoretical matrix based on the meanings of the interactions and actions experienced by the professionals regarding the nursing care practices and the health of women in situations of conjugal violence in the ambit of the Family Health Strategy.

Methods

research based in Grounded Theory. Following approval by the Research Ethics Committee, 52 professionals were interviewed in Santa Catarina, Brazil. The analysis was based on open, axial and selective codifications.

Results

the theoretical model was delimited based on the phenomenon "Recognizing conjugal violence as a public health problem, and the need for management of the care for the woman", which reflects the experience of the professionals in relation to care for the woman, as well as the meanings attributed to this care.

Conclusions

the phenomenon allows one to understand the movement of action and interaction regarding the care for the woman in a situation of conjugal violence.     

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.     

Strengths and weaknesses of Problem Based Learning from the professional perspective of registered nurses

OBJECTIVE:

to identify competency strengths and weaknesses as perceived by nursing professionals who graduated with a integrated curriculum and competency-based through Problem Based Learning in small groups.

METHOD:

an intrinsic case study method was used, which analyzes this innovation through former students (from the first class) with three years of professional experience. The data were collected through a questionnaire and discussion groups.

RESULTS:

the results show that their competency level is valued in a very satisfactory manner. This level paradoxically contrasts with the lack of theoretical knowledge they perceived at the end of their education, when they started working in clinical practice.

CONCLUSIONS:

the teaching strategy was key to motivate an in-depth study and arouse the desire to know. In addition, Problem Based Learning favors and reinforces the decision to learn, which is that necessary in the course of professional life.     

Care for technology dependent children and their relationship with the health care systems

OBJECTIVE:

to understand the experience of care delivery to technology dependent children based on the mothers'' experience.

METHOD:

exploratory study with qualitative approach, based on the theoretical framework of medical anthropology and the narrative method. Twelve mothers participated and, as the technique to obtain the narratives, open interviews were held at the participants'' homes.

RESULTS:

the narratives were organized into three thematic categories: the family system, identifying the care forms, the association between popular and scientific knowledge and the participation of the social network; the professional system, which discusses the relations between professionals and family, the hegemony of the biomedical model and the role of nursing; and the popular system, presenting popular care practices like spirituality and religiosity.

CONCLUSION:

the study provided support for a health care project that takes into account the families'' moral and symbolic values and beliefs in view of the illness of a technology-dependent child. The results found can contribute towards changes in the health work process, so that its foundation is guided not only by the biomedical model, allowing the integration of the sociocultural dimensions into the health care movement.     

Presence and extent of the primary health care attributes among children hospitalized for pneumonia

OBJECTIVE:

to analyze the presence and extent of the primary health care attributes among children hospitalized for pneumonia.

METHOD:

observational and retrospective study with hospital-based case-control design, developed in three hospitals associated to the Brazilian Unified Health System, located in a city of the State of São Paulo, Brazil. The study included 690 children under five years old, with 345 cases and 345 controls.

RESULTS:

both groups scored high for access to health services. In contrast, high scores for attributes such as longitudinality and coordination of care were observed for the controls. Despite low scores, integrality and family counseling were also high for the controls.

CONCLUSION:

knowledge of the aspects involving the primary health care attributes and its provision for child care are very important because they have the potential to support professionals and managers of the Brazilian Unified Health System in the organization of health services.     

"The group facilitates everything": meanings patients with type 2 diabetes mellitus assigned to health education groups

OBJECTIVE:

to interpret the meanings patients with type 2 diabetes mellitus assign to health education groups.

METHOD:

ethnographic study conducted with Hyperdia groups of a healthcare unit with 26 informants, with type 2 diabetes mellitus, and having participated in the groups for at least three years. Participant observation, social characterization, discussion groups and semi-structured interviews were used to collect data. Data were analyzed through the thematic coding technique.

RESULTS:

four thematic categories emerged: ease of access to the service and healthcare workers; guidance on diabetes; participation in groups and the experience of diabetes; and sharing knowledge and experiences. The most relevant aspect of this study is the social use the informants in relation to the Hyperdia groups under study.

CONCLUSION:

the studied groups are agents producing senses and meanings concerning the process of becoming ill and the means of social navigation within the official health system. We expect this study to contribute to the actions of healthcare workers coordinating these groups given the observation of the cultural universe of these individuals seeking professional care in the various public health care services.     

Activities of the healthcare team for women who smoke during pregnancy and the puerperium

OBJECTIVE:

to identify activities developed by the healthcare team for pregnant and postpartum women who smoke.

METHOD:

cross-sectional study with a sample of 135 healthcare team members who assist pregnant and postpartum women in a university hospital located in southern Brazil. The data was collected using questionnaires and analyzed using the Statistical Package for Social Sciences software.

RESULTS:

76 (56.3%) staff members reported that they always addressed smoking cessation; however, the approach occurred in only two periods of the hospitalization and/or prenatal consultations, not including family members. In regard to the effectiveness of their actions, the health team assessed it as fair or poor, and mentioned the need for updating knowledge regarding this issue.

CONCLUSIONS:

the health team did not perform the approach as recommended by the tobacco control guidelines, requiring training to offer a qualified and efficient intervention.     

Factors associated with reporting of abuse against children and adolescents by nurses within Primary Health Care

OBJECTIVE:

to analyze the factors associated with the underreporting on the part of nurses within Primary Health Care of abuse against children and adolescents.

METHOD:

cross-sectional study with 616 nurses. A questionnaire addressed socio-demographic data, profession, instrumentation and knowledge on the topic, identification and reporting of abuse cases. Bivariate and multivariate logistic regression was used.

RESULTS:

female nurses, aged between 21 and 32 years old, not married, with five or more years since graduation, with graduate studies, and working for five or more years in PHC predominated. The final regression model showed that factors such as working for five or more years, having a reporting form within the PHC unit, and believing that reporting within Primary Health Care is an advantage, facilitate reporting.

CONCLUSION:

the study''s results may, in addition to sensitizing nurses, support management professionals in establishing strategies intended to produce compliance with reporting as a legal device that ensures the rights of children and adolescents.