Repositório RCAAP

ABSTRACT Objective: To analyze situations in which premature children are vulnerable in home care, in the first six months after hospital discharge. Method: Qualitative study, from the perspective of philosophical hermeneutics, carried out in a Brazilian city on the border. In-depth interviews were conducted, with a data analysis considering the method of interpretation of meanings. 18 mothers of premature children discharged from a hospital unit participated. 25 home visits and 56 calls were made. Results: The reports from the mothers express situations of vulnerability, concerns, needs for care, singularities of the development of the premature baby, and repercussions of institutional routines in home care. Final considerations: There are vulnerable circumstances in prematurity that reaffirm interconnected individual, social, and institutional dimensions. It is important to highlight that the institutional dimension involves the responsibility of health professionals not to increase individual and social vulnerabilities, but to promote care and seek to reduce situations that generate risks, uncertainties, concerns, and damages.

ABSTRACT Objectives: to understand the context of vulnerability experienced by adolescents from the perspective of health professionals from the Family Health Strategy. Methods: a descriptive-exploratory qualitative study developed with 80 Family Health Strategy professionals in the Midwest region of Brazil. Data collection was developed from July to September 2018 through a focus group, and submitted to Thematic Analysis. Results: it was understood that the vulnerability experienced by adolescents is not an exposure to something isolated, but is linked to risk and protection factors, socioeconomic and cultural contexts, public and health policies. Final Considerations: there are still gaps in public policies for this population, which impacts on the access and development of promotion actions by health professionals.

ABSTRACT Objective: to analyze the transition of blind women to motherhood from the perspective of Transitions Theory. Method: a qualitative, descriptive study, which had as participants 11 blind women. An open interview was conducted using the narrative method. Analysis occurred in the light of Transitions Theory, with approval from the Research Ethics Committee with Human Beings. Results: the age group was 32 to 63 years, mostly Catholic, with social security benefits. Transition to motherhood mainly evidenced the experience when becoming a mother and feelings related to this new phase of life. Final considerations: the women in the study adapted themselves to the maternal role, even with difficulties, developed healthy relationships with their children, overcame their disability and nurtured dreams and desires. They were aware of their role, achieving with mastery a healthy transition. It was evidenced scarcity of nursing therapies.

ABSTRACT Objective: To analyze the association between vulnerabilities to Sexually Transmitted Infections (STIs/HIV/AIDS) of adolescents in poverty and their level of resilience. Method: Cross-sectional study with 287 students between 11 and 17 years old in a school in the outskirts of Fortaleza-Ce. The study was conducted from August to October 2016. Three instruments related to characterization, vulnerability to STIs/HIV/AIDS and resilience were used. The association between the instruments was calculated using the Mann-Whitney and Kruskal-Wallis tests. Association between vulnerability to STIs/HIV/AIDS and resilience was assessed through the Spearman’s correlation coefficient. Statistical significance was set at p<0.05. Results: There was a significant association between the factors “housing” (p=0.022), “family income” (p=0.037) and vulnerability to STIs/HIV/AIDS. Adolescents whose father has completed high school (p=0.043) have moderately high resilience. Conclusion: Adolescents with low socioeconomic status and who live on less than a minimum wage tends to be more susceptible to vulnerabilities to STIs/HIV/AIDS and to have low resilience.

ABSTRACT Objective: To develop a workflow protocol for Home Care (HC) services in the HC2 modality for children with special health care needs (CSHCN) in the state of Parana. Method: Quantitative, descriptive, exploratory, multiple case studies. Data was collected with professionals from the eight home care services in Parana. Data were analyzed using the Strengths, Weaknesses, Opportunities and Threats (SWOT) methodology, from which a 5W2H method of action plan was developed, resulting in a flow chart. Results: Considering the strategies found in Home Care services, such as planned hospital discharge, caregiver training, organized transportation and singular therapeutic project, a flow organization protocol for children with special health care needs in Home Care services was developed. Conclusion: The protocol developed makes it possible to organize the care provided to children with special health care needs in home care.

ABSTRACT Objective: to understand the experience of discrimination perceived by overweight women. Methods: a qualitative research conducted at an outpatient clinic in Salvador, Bahia, where eleven women were interviewed. The interviews were transcribed and submitted to thematic content analysis. Results: the analysis of the statements expressed three categories: Suffering discrimination in different social contexts: denounced disrespect, hostility, veiled and/or explicit exclusion, prejudice, injustice and insults lived in public transport, at work, in the family environment, in social events and commercial establishments; Experiencing negative feelings about discrimination: revealed inferiority, sadness, shame, fear, anger, frustration, low esteem and discouragement faced by women; Reacting to discrimination: expressed isolation of marital intimacy and social encounters, removal from work, concealment of body and feelings and even illness of women. Final considerations: the discrimination experienced in various settings has caused suffering, embarrassment, negative feelings, shame, isolation and loss in women’s lives.

ABSTRACT Objective: to identify the domains developed by Community Health Agents in health promotion skill towards adolescents. Method: qualitative study conducted with 16 Community Health Agents, based on the methodological framework of professional skills. Results: two categories and nine domains of health promotion skills emerged: Knowledge (Concept; Health determinants and conditioning factors; Main population health problems and coping; Intersectoriality); and Skill (Identifying the relationship between health problems; Conducting educational activities; Organizing discussion groups; Proposing and implementing intersectoral actions and establishing articulation with social facilities; Supporting social literacy actions). Final consideration: it was noted that there were some domains of skills in health promotion of Community Health Agents among adolescents, but there is a need for continuing education regarding the approach, for these professionals, in relation to knowledge and skills of health promotion.

ABSTRACT Objective: to understand the experience of pregnancy and motherhood by adolescents/young people who were born infected with HIV. Method: we carried out a qualitative study specialized in HIV service in Porto Alegre (RS/Brazil). Ten adolescents/young people were interviewed from June 2017 to March 2018. Thematic analysis was performed, using a vulnerability framework to reflect about unplanned pregnancy and its implications for care. Results: four categories were highlighted: Discovery of the ongoing pregnancy: ambivalent feelings towards seropositivity; Breaking the news of the pregnancy to partner, family and health professionals; Experience of childbirth and prophylaxis of vertical transmission of HIV; and Experience of motherhood: implications for life stories and future projects. Final considerations: the study contributes to addressing situations of vulnerability to the occurrence of unplanned pregnancy, showing the need for dialogical proposals that respect human rights in the production of comprehensive care and reproductive planning.

ABSTRACT Objective: To Identify Quilombola women’s social representations about health care and to characterize practices performed by them. Method: a descriptive, qualitative study, applying the Social Representations Theory, conducted with 30 women from a Quilombola community in the Brazilian Amazon. Individual interviews and thematic content analysis were carried out. Results: Health care practices are related to the home, people, families, and environment, indicating a Quilombola women’s extended understanding about health care. In the first instance, natural resources derived from traditional knowledge and use of herbs are applied, in the second instance, the official health system, with the mother-woman being the main caregiver of the family. Final Considerations: the mother enables a health care in the family daily life, and she is the main way of access health professionals have to enter the Quilombola community and provide proper care from the official health system to the group.

ABSTRACT Objective: to know the family management experience of children with sickle cell disease in the light of the Family Management Style Framework. Methods: a qualitative case study carried out between September/2015 and July/2016 with 12 members of eight families registered in a blood center in Minas Gerais. The semi-structured interviews were recorded, and the data were analyzed and interpreted by the hybrid model thematic analysis. Results: three management styles were identified: five families in the accommodating style; two families in the struggling style; and only one family in the enduring style.It was noted that empowerment was paramount in the acquisition of skills and abilities to care for these children. Final considerations: family management knowledge of children with sickle cell disease provided a reflection on nurses’ role in supporting, orienting and encouraging the empowerment of these families aiming at the search for comprehensive care.

ABSTRACT Objective: To analyze how nurses consider, in their practice of healthcare, the sociocultural context of women with sexually transmitted infections. Method: Qualitative research, carried out in October 2017, with ten nurses working in teams of the Estratégia de Saúde da Família (Family Health Strategy). The data were collected through semi-structured interviews, subsequently transcribed, and submitted to the organization supported by the Discourse of the Collective Subject method and analyzed according to Madeleine Leininger’s transcultural theory. Results: Nurses identified the sociocultural aspects of women with sexually transmitted infections and recognized the presence of influencing factors: technological, religious, economic, political, and legal, kinship and social, cultural values, and lifeways. Final Considerations: The study found that the provision of care by nurses in Primary Health Care is close to the sociocultural aspects of these women when considering the beliefs and values of each individual, especially regarding the life context and their care experiences.

ABSTRACT Objective: to reveal the adaptive problems of the woman abandoned by the child’s parent after Congenital Zika Syndrome, in the light of Roy’s Adaptation Model. Method: a qualitative, descriptive study, based on Roy’s Adaptation Model, developed with six women abandoned by their child’s parent after Zika Congenital Syndrome diagnosis, through interview and Content Analysis technique. Results: adaptive problems appeared in nutrition, activity, rest, and protection patterns, due to limitations in self-care; self-concept, related to dissatisfaction with body image and personal being; in the role of transition role, through difficulties in taking over new roles and in interdependence, related to changes in affective needs. Final considerations: the overload of care for children with Congenital Zika Syndrome, added to the challenges of the abandoned woman by her child’s parent, led to adaptive problems, showing their main difficulties of coping.

ABSTRACT Objective: to identify the reasons associated with alcohol consumption in women living in rural contexts. Method: a descriptive study with a qualitative approach, whose data were obtained from semi-structured interviews, conducted between March and August 2018, with a total of 23 women in alcohol consumption who live in rural areas in Central Western Rio Grande do Sul. We used a discursive textual analysis, marked by the Bioecological Theory of human development. Results: The reasons associated with alcohol consumption are: leisure time, transportation, territorial and cultural characteristics, but they differ between women living in rural areas and those living in settlements. Final considerations: The context in which rural women live influences alcohol consumption. Therefore, it is necessary to include guidelines in public policies that address the problematic of rural women.

ABSTRACT 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.

ABSTRACT Objective: To develop and validate a Nursing History instrument for a Pediatric Intensive Care Unit, based on the Theory of Basic Human Needs. Methods: Methodological study, developed between October 2018 and April 2019, based on the establishment of a theoretical-conceptual structure; construction of items and of the response scale; selection and organization of items; structuring the instrument; expert opinion; and content and appearance validation. Results: The instrument was organized in three sequential and complementary stages. The first stage considered data collection; the second, the collection of additional information, like Psychobiological, Psychosocial and Psychospiritual Needs; and the third collected data related to a physical examination. The instrument had good internal consistency (0,75) and an agreement percentage equal to or greater than 0,83. Conclusion: The Nursing History instrument developed and validated here can be considered relevant and pertinent in terms of content, clarity, scope, and appearance.

ABSTRACT Objective: To analyze the care practices of family members of premature infants admitted to a Neonatal Intensive Care Unit in the light of Leininger’s transcultural theory. Methods: Qualitative, descriptive and exploratory study. Participant observation and semi-structured interviews were conducted with 16 family members of newborns, admitted to the neonatal unit of a public maternity hospital, during the months of May and June 2019. The software called Interface de R pour analyses Multidimensionnelles de Textes et de Questionnaire ® and the Bardin Content Analysis technique. Results: Two thematic categories emerged: Family care in the neonatal unit; (in)effective support for shared care. Conclusion: The participation of families in the care of babies is still unstable, but it must be an inseparable element of culturally congruent care, thus collaborating with the full recovery of the premature.

ABSTRACT Objective: To know the experiences of family members of children with cystic fibrosis under the light of the theory of Callista Roy. Method: Qualitative research that used the adaptation theoretical framework of Callista Roy for inductive content analysis. Fifteen family members, in a university hospital, between 23 and 63 years old, participated in the study, from September to October 2018. Results: Two categories were elaborated: “Evaluation of stimuli” and “Evaluation of behaviors”. The first has three subcategories: “focal”, “contextual” and “residual”. And the second, four subcategories: “physiological domain”, “self-concept”, “role function” and “interdependence”. Final Considerations: During the evaluation of stimuli, work overload and stress were identified as focal stimuli. Regarding contextual stimuli, it was noticed that the social life of caregivers was prejudiced. As for residual stimuli, the fear of loss is constant, and it appears that the emotional aspect of family members is the most affected comparing with physical exhaustion.

ABSTRACT Objective: to evaluate the clinical conditions and the risk classification of children and adolescents treated in a hospital emergency, according to the Pediatric Risk Classification Protocol. Method: cross-sectional study, with 200 participants, using an instrument based on the Pediatric Risk Classification Protocol and using odds ratio for the analysis. Results: most participants were male patients in early childhood and who were or weren’t in daycare. As for clinical conditions, most showed changes in vital (24.5%) and respiratory (20.0%) signs, most patients (57.5%) did not present pain; 35.5% were classified as urgent and 45.0% as non-urgent. There was a greater chance of being classified as very urgent (orange) when compared to non-urgent (blue). Conclusion: the protocol used contributed to an effective classification and was considered a valid and reliable health technology for determining the priority of care.

ABSTRACT Objective: To identify the prevalence of xerostomia in women undergoing chemotherapy for breast cancer. Method: Prospective cohort with 27 women who underwent up to 16 sessions of intravenous chemotherapy. Data collection was performed at the outpatient clinic of a university hospital in the city of São Paulo, where two forms were applied before the start of treatment and the Xerostomia Inventory before and after each chemotherapy session. Results: Complaints of dry mouth were present in 48.1% of women before chemotherapy, and they were approximately 28 times more likely to develop dry mouth during treatment. It was observed that the use of antiemetics contributed to the occurrence of xerostomia, and the anti-ulcerous were presented as a protective factor. Conclusion: The study identified both a high prevalence of xerostomia regardless of the chemotherapy used and the need to create protocols to improve the quality of life of these patients.

ABSTRACT Objective: Identify the level of reproductive autonomy of quilombola women and associate it with sociodemographic characteristics and aspects of sexual and reproductive health. Methods: Cross-sectional census study carried out in quilombola communities in a municipality in Bahia. Data was collected through questionnaires from the National Health Survey and the Reproductive Autonomy Scale, applied to quilombola women who agreed to participate. Descriptive statistics procedures were used and associations were made between reproductive autonomy scores and sociodemographic and reproductive characteristics. Results: The average total score for reproductive autonomy was 2.06. An association was found between the “decision-making” score and marital status. The score for “total reproductive autonomy” was associated with the use of contraceptive method. Conclusion: The reality of the study participants converges with the literature regarding the interference of sociodemographic and reproductive factors in the reproductive autonomy of black women.