BRINQUEDO: UM CAMINHO PARA A COMPREENSÃO DA CRIANÇA HOSPITALIZADA

Pediatric Hospital: The Paradigms of Play in Brazil

The role of play in Brazilian children's hospitals is highlighted, as well as the perspective of humanization in Brazil. Some aspects of our culture are crucial to understanding the importance of play considering our society. Sabara Children's Hospital ("Hospital Infantil Sabará") in Brazil is used particularly to discuss humanization. To understand the issue of play in Brazil, it is important to discuss hospitals in their social context, their history, current roles in children's care, humanization history and child development, according to the approaches of Piaget and Winnicott that are used in our culture.

[From fantasy to reality: understanding the way of playing of institutionalized children victims of violence through therapeutic play]

This qualitative research is based on the reference framework of Phenomenology--analysis of the structure of the situated phenomenon, and aims to understand institutionalized children victims of violence through therapeutic play sessions. Participants were three sheltered children of preschool age, one boy and two goals. The therapeutic play sessions of the drama type were held in a reserved place and ranged from 30 to 50 minutes, using the following guiding proposal: "Let us play that we are children who live at the shelter?" Two broad theme categories could be captured: playing and pretending and playing and reality. When they are pretending while playing, sometimes calmly, sometimes violently, the children brought contents that evidenced situations in their daily family reality. When they expose their reality, the children addressed questions about the shelter institution and the bond with these professionals and with the relatives. It can be affirmed that therapeutic play allowed for the children's effective communication by expressing their feelings, desires, experiences, criticism against the environment they live in and family relations, besides permitting a moment of pleasure and relaxation.

Evaluation of the behavior of the preschool one just admitted in the unit of pediatrics and the use of the therapeutic toy

OBJECTIVE

To evaluate the behavior of children before and after a therapeutic play session.

METHODS

A quantitative and descriptive study was carried out in a major hospital of the city of Santos, State of São Paulo, involving 30 preschool children recently admitted to a pediatric ward. A behavior scale was applied before and after a therapeutic play session. This scale comprises six categories: moving, gazing, expressing feelings, talking, playing, and not responding to stimuli or requests. Each category is scored from 1 to 3, the lowest score representing the least interaction.

RESULTS

Before therapeutic play sessions, children showed no interest and were scored 1 and 2: moving parts of their bodies and expressing emotions, such as seriousness, and gazing rapidly to a place as if expecting something. After therapeutic play, the children progressed to level 3: changing position, moving with a purpose, observing attentively to what they saw, and expressing emotions such as joy.

CONCLUSION

Children interact well with the toys, representing home and hospital situations, and expressing feelings of anger and love. We also observed that therapeutic play improved the interactions of children with this new situation, making it easier for them to accept treatment and perceiving hospitalization as less aggressive and painful.

Brinquedo terapêutico: estratégia de alívio da dor e tensão durante o curativo cirúrgico em crianças

OBJETIVO: Comparar as reações manifestadas pela criança durante o curativo realizado antes e após o preparo emocional com o brinquedo terapêutico instrucional (BTI). MÉTODOS: A amostra constituiu-se de 34 crianças internadas para cirurgia em um hospital público pediátrico da cidade de São Paulo. Os comportamentos da criança e a avaliação da dor foram considerados durante o curativo em dois momentos: antes e após o brinquedo terapêutico. RESULTADOS: Comportamentos indicativos de maior adaptação e aceitação ao procedimento tornaram-se mais freqüentes após o brinquedo, ao contrario daqueles que indicavam menor adaptação e aceitação. Os escores de dor também diminuíram após o brinquedo terapêutico. CONCLUSÃO: O brinquedo terapêutico se evidenciou como estratégia efetiva na redução do medo, da tensão e da dor da criança durante o curativo.

[Protocol for the preparation of preschool children to venous puncture using therapeutic play]

This exploratory-descriptive study aims at elaborating a protocol, using therapeutic play, for the preparation of preschool children to venous puncture and also at testing its efficiency and applicability. The children that attended the play session were more cooperative when they were punctured. They understood the need and technical aspects of this clinical procedure; manifested their feelings, elaborated familiar and hospital situations that resulted in a better relationship with the other children and the nursing team. Authors concluded that this protocol is feasible and useful and suggested that it should be incorporated in the nursing care plan to hospitalized children.

[Therapeutic play in the care of hospitalized children: experience of an undergraduate student]

This study describes a phenomenological analysis of a nursing under graduated student's discourse, who used the therapeutic play for caring a hospitalized child. The goal of the study was to understand the meaning of the experience for this student.

Preparo da criança e família para procedimentos cirúrgicos: intervenção de enfermagem

A autora apresenta os fundamentos do preparo da criança e sua família para procedimentos cirúrgicos, relacionando também aspectos relevantes como: o quê considerar ao realizar um preparo adequado; recursos necessários para implementá-lo; quando, onde e como fazê-lo, bem como o quê esperar da criança que foi adequadamente preparada.

[Interaction with hospitalized children. Use of therapeutic techniques and measures]

The aim of this study is to describe an experience of a nursing student caring for a child in a pediatric unit. Using therapeutic communication techniques and therapeutic nursing measures, the student developed a help relationship with the child, which enabled the implementation of a thorough nursing process, where the student got fully involved with the patient sharing beneficial experiences for both.

A influência do brinquedo na humanização da assistência de enfermagem à criança hospitalizada

O estudo do tipo experimental, objetivou verificar a influência das orientações na humanização da assistência à criança hospitalizada, utilizando bonecos e materiais próprios para terapêutica de venipunção. Apoiou-se em WHALEY e WONG, considerando as experiências desagradáveis e dolorosas do pré-escolar. Participaram da amostra 10 (dez) crianças, que foram avaliadas antes e após as orientações na presença e na ausência da mãe. A hipótese nula previu que as crianças orientadas antes dos procedimentos terapêuticos, na presença e/ou ausência da mãe, apresentam os mesmos comportamentos daquelas orientadas. A hipótese nula foi rejeitada ao nível 0,01 para resultados obtidos fora do intervalo (-2,58, 2,58). Concluiu-se que a humanização da criança hospitalizada é possível, a partir das orientações feitas com o auxílio de brinquedo terapêutico e inserção da mãe no tratamento.

[Toys in the hospital]

No trabalho a autora apresenta algumas considerações a respeito da importância e da utilização do brinquedo na assistência à criança hospitalizada.

[The effect of the type of approach for intramuscular injections on the reactions of preschoolers]

This study propose to verify the influence of kind of approach in the administration of intramuscular injection, and the preschool reactions. Sixteen children were observed in first-aid-clinics and divided in two groups: control and experimental.