Percepção da criança hospitalizada acerca do brinquedo terapêutico instrucional na terapia intravenosa

Transforming Nasal Irrigation Experience of Children and Families with Therapeutic Instructional Plays

In Brazil, nasal irrigation is a common procedure for children hospitalized with respiratory conditions. However, it often causes stress for both the child and their family. Nurses need to rethink their approach to care, and the use of therapeutic play can be an ally in transforming the stressful context. To understand the family perceptions of nasal irrigation in hospitalized children after an educational intervention mediated by instructional therapeutic play (ITP). This descriptive, exploratory, and qualitative study was conducted from the perspective of Herbert Blumer's Symbolic Interactionism in a hospital in São Paulo, Brazil. The study included family members of hospitalized children aged 3-6 years who participated in an ITP intervention and remained for 6 hours afterward. Participants self-reported literacy with preserved cognition and verbal communication. This study was conducted between March 2023 and January 2024 using semi-structured interviews with 38 family members. Data were analyzed using Bardin's thematic content and lexical analysis with IRAMUTEQ® software. The interaction of families with ITP for nasal irrigation in children led to a redefinition of the procedure from distressing to enjoyable. ITP was evaluated as an essential and stimulating method that familiarized the child with the procedure, facilitating the understanding process for both the child and the family. ITP is a caregiving technology that nurses can use to assist with nasal irrigation, re-signifying the experiences of children and their families during the procedure.

[Validation of an instructional therapeutic tool to demonstrate cardiac catheterization]

The scope of this work was to validate a toy and a narrative as an instructional tool to present to children who are to be submitted to cardiac catheterization. Content validation was performed by 23 specialist judges (storytellers, child educators, nurses, medics, educational psychologists, occupational therapists, and a psychologist), by using a form considering the following topics: goals, structure and presentation, as well as relevance. Quantitative data was analyzed through the Content Validation Index (CVI) and a cutoff of 0.80 was adopted. Qualitative data was then submitted to thematic content analysis. The toy is composed of: figurines representing the child, the healthcare team, and the person responsible for the child, prototypes of the angiography equipment and the anesthesia equipment, and objects used in hospital for anesthetic induction and vein puncture. The narrative addresses the physical structure of the Hemodynamics room and all steps comprising pre-, trans- and post-cardiac catheterization in a playful way. The technology was validated by the judges with a total CVI of 0.95. The validated toy and narrative constitute a dialog between health, education and art that may contribute to integral and humanized care to the child.

Visita à criança hospitalizada em terapia intensiva: vivências de irmãos reveladas por meio do brinquedo terapêutico dramático

Resumo Objetivo: compreender, por meio do brinquedo terapêutico dramático, o significado, para o irmão, de visitar a criança hospitalizada em terapia intensiva. Método: pesquisa qualitativa, modalidade fenomenológica, que utilizou o brinquedo terapêutico dramático para acessar às experiências dos irmãos. Foi realizada em Unidade de Terapia Intensiva Pediátrica do interior do estado de São Paulo, Brasil. Participaram das sessões de brinquedo terapêutico 11 irmãos menores de 10 anos, as quais foram analisadas à luz da Teoria do Amadurecimento. Resultados: os irmãos, tendo um lugar para brincar, dramatizaram situações, anteriormente, vividas, de seu cotidiano e da visita à criança hospitalizada. Ao viver, criativamente, revelaram que brincar é fazer a integração das experiências do “eu”, favorecendo o continuar a ser diante da situação vivida. Conclusões e implicações para a prática: o Brinquedo Terapêutico Dramático compreendido à luz de um referencial teórico possibilitou que o irmão significasse a visita como uma experiência de integração do “eu”, revelando emoções, desejos e preferências do cotidiano. Nesse sentido, o cuidado ao irmão da criança hospitalizada define-se pela oferta do brincar livre, para que ele demonstre o sentimento de continuar a ser em suas interações com o mundo, no qual o contexto hospitalar tornou parte da realidade.