Imposições e conflitos no cotidiano das famílias de crianças com doença crônica

Care demands experienced by family caregivers of children with Primary Immunodeficiency

OBJECTIVE

to understand the experiences of family caregivers of children with Primary Immunodeficiency in view of care demands.

METHODS

a qualitative research. Data collection was subsidized by an open interview with five family caregivers, and the data were analyzed using the Bardin Content Analysis technique, thematic modality. The Callista Roy's Adaptation Model of Nursing was used to interpret the data.

RESULTS

from participants' reports, the following categories emerged: Maternity: facing adversity; Remodeling of daily life; The Social Support Network resource.

FINAL CONSIDERATIONS

family caregivers experience several feelings such as anguish and low self-esteem due to the fear of losing their child and the routine of illnesses and hospitalizations, in addition to needs that are often not reached due to incompatibility with the family budget. The Social Support Network is strengthened for most caregivers, playing an essential role as a coping strategy for caregivers.

Governança e suporte da rede social secundária na atenção à saúde de crianças e adolescentes com doenças crônicas

Resumo Estudo de abordagem qualitativa com o objetivo de analisar as características estruturais dos sistemas de governança e suporte ofertado pela rede social secundária na atenção à saúde de crianças e adolescentes com doença crônica. Pesquisa realizada em unidades da Estratégia Saúde da Família, ambulatório especializado e hospital público pediátrico de João Pessoa - PB, de fevereiro a outubro de 2013, por meio de entrevista semiestruturada e grupo focal. Participaram do estudo: 06 gestores, 14 profissionais de saúde e 12 familiares cuidadores de crianças ou adolescentes com doenças crônicas. Os dados foram analisados seguindo-se os princípios da análise temática de conteúdo. Na atenção à saúde das crianças e adolescentes com doenças crônicas evidenciou-se o sistema de governança do tipo colaborativo, bem como limitações da governança pública do tipo gerencial, que fragilizam a rede social secundária com repercussões no suporte oferecido aos familiares e na articulação entre os serviços. Conclui-se que essa realidade pode apresentar impacto negativo na qualidade e efetividade do cuidado prestado às crianças e adolescentes em condição crônica, por não atender as reais necessidades dessa população.

Criança diabética do tipo 1 e o convívio familiar: repercussões no manejo da doença

RESUMO A pesquisa objetivou escrever a repercussão do convívio familiar da criança diabética no manejo da doença. Trata-se de um estudo qualitativo descritivo, tipo estudo de caso, com criança diabética em seguimento ambulatorial de um hospital universitário, por meio de grupo focal. Análise de dados por análise de conteúdo do tipo temática. Observou-se que Adriana (nome fictício), 11 anos, não adere às orientações e tratamentos propostos pela equipe de saúde, resultando em inadequado manejo do diabetes e altos índices glicêmicos, decorrente da relação desarmoniosa com a família e da carência de gestão dos serviços de saúde. Condições crônicas de saúde interferem no cotidiano familiar e dificultam o tratamento, especialmente de crianças. A Atenção Primária à Saúde deve utilizar ferramentas como a gestão de caso e o projeto terapêutico singular para que, em conjunto com a família e com a criança, possa obter melhor adesão ao tratamento.

Uncertainties of mothers of children in conservative renal treatment

Abstract Objective: To understand the uncertainties of mothers of children undergoing conservative renal treatment due to the child's illness. Method: A qualitative study was carried out with 11 mothers of children undergoing conservative renal treatment at a pediatric nephrology service in the southern region of Brazil. For the data collection, a semi-structured interview and conventional content analysis were performed. Results: Two categories of statements emerged: "Uncertainties regarding the disease and adaptation methods" and "Experiencing unpredictability". The uncertainties were due to the ambiguity of the symptoms and reasons for the development of the disease, lack of information, clarity and unpredictability in relation to the future. Conclusion and implications for practice: Faced with uncertainties, mothers seek to maintain emotional balance, but need support from the healthcare team and nursing team, in primary health care, in order to promote , assurance by giving clear information on how this process occurs, reducing anxiety regarding the unpredictability of the disease in the future.

Paternal care to children and adolescent with chronic disease: maternal perception

OBJECTIVE

To analyze the maternal perception about the paternal care and to understand how this care Is made effective In practical actions in the care of the child/adolescent with chronic disease in the family routine.

METHODS

Exploratory-descriptive, qualitative study, carried out at the pediatric outpatient clinic of a public hospital in the state of Paraíba, between November/2013 and April/2014, with 10 mothers whose children had more than six months of diagnosis. Semi-structured interview subsidized the data collection, which was submitted to thematic analysis.

RESULTS

Parents participated in activities such as routine care of the child, medication management, leisure, binomial support and household chores. They took on different roles in the care depending on the availability of time and the maternal freedom given for their participation. Among the separated couples, the distance between parents in the care reflected on the child's health.

CONCLUSION

It is important to involve fathers in the care of the child with chronic diseases. However, there is a need for a greater involvement of fathers in the performance of this care.

Experiências e sentimentos de mães diante da doença de Moyamoya de seus filhos

Resumo A doença de Moyamoya é uma grave enfermidade crônica, caracterizada por oclusão das grandes artérias na base do cérebro e é considerada importante causa de acidente vascular cerebral. O objetivo deste estudo consistiu em investigar a experiência e os sentimentos de mães diante do diagnóstico e da evolução da doença de Moyamoya e de seu tratamento em seus filhos. Trata-se de uma pesquisa descritiva, com análises quantitativa e qualitativa. Participaram do estudo oito mães de filhos com diagnósticos da doença de Moyamoya provenientes de três estados da região Sudeste do Brasil. Os dados foram coletados por meio de questionários via página da Internet. Os resultados mostram que o processo de diagnóstico da doença foi vivido com temores e tristeza, agravados pelas dificuldades diagnósticas e escassez de informações. As mães relataram desespero, medo, dificuldade de aceitação, culpa e temor na realização de angiografia cerebral e cirurgia. A fé e a espiritualidade foram referidas como fontes de apoio e de manutenção da esperança. Assinala-se a necessidade de estudos que colaborem para maior esclarecimento sobre a doença e a vivência de doentes e familiares.

Network and social support in family care of children with diabetes

OBJECTIVE:

to understand the influence of network and social support in the care of a child with type 1 diabetes.

METHOD:

qualitative study, with assumptions of ethnonursing, conducted in a reference service specialized in the treatment of diabetes, in 2014, in the city of Fortaleza, state of Ceará, Brazil. Twenty-six members of the family and their respective school children participated in the study. The process of collection and analysis followed the observation-participation-reflection model.

RESULTS:

the analytical categories showed that the social network in the care of children with diabetes helped sharing of information and experiences, moments of relaxation and aid in the acquisition of supplies for treatment, with positive repercussions in the family context, generating well-being and confidence in the care of children with diabetes.

CONCLUSION:

the cultural care provided by nurses strengthens the network and social support because it encourages autonomy in the promotion of the quality of life of children with type 1 diabetes and their families.

STRATEGIES OF FAMILIES IN THE CARE OF CHILDREN WITH CHRONIC DISEASES

ABSTRACTthis study aimed to know the strategies of families in the care of children with chronic diseases. A descriptive and exploratory research was carried out using a qualitative approach, in a Pediatric Unit of a university hospital in the south of Brazil, during the first and second halves of 2013. The study involved 15 participating families. Data were collected by means of interviews subjected to thematic analysis. It was identified as strategies: balance work, study and care, share tasks throughout the day, adapt the physical area of the house, engage the child in their own care, seek resources in the network of social support and faith, seek assistance in another city; and engage in physical activity to reduce stress. It was concluded that it is necessary that the nurses participate of the family support network, as a support source for the strengthening of the family to the care, acquiring skills and expertise to a positive coping of the child's chronic disease.

Scoring interventions in family relations regarding the care for the child with a chronic condition

The study aimed to reveal intervening conditions towards the care of children with chronic condition. The Complex Thought was used as theoretical framework and the Grounded Theory as methodological. Data were collected from January to August 2012, through semi-structured interviews in two follow-up services for children with chronic conditions and in the homes of participants. Participated 16 relatives of children with chronic conditions, divided into three sample groups. The category "Scoring the intervening conditions towards care of the child with chronic condition" reveals that multiple events experienced by the family in the care of children with chronic conditions are determined by the relationships and interactions of family members and influence the forms of organization for the care of child. Highlights the importance of the nurse to know and understand the multiple family experiences in order to encompass child and their family members as care units.