The therapeutic pathway of families of children with cancer: difficulties faced in this journey. / O itinerário terapêutico de famílias de crianças com câncer: dificuldades encontradas neste percurso.

OBJECTIVE: To know the difficulties faced by families in the therapeutic pathway of children with cancer. METHOD: Qualitative, descriptive and exploratory research, with a quantitative approach, performed from March to November 2016, through face-to-face semi-structured interviews, with 21 relatives of children undergoing oncological treatment at a federal university hospital in Rio de Janeiro, whose data were submitted to content analysis. RESULTS: The difficulties of these families traverse the identification and investigation by health professionals regarding the signs and symptoms of children as well as the passage of relatives through various health services until diagnostic confirmation. FINAL CONSIDERATIONS: The early diagnosis of childhood cancer depends on actions from health and teaching institutions for the appropriate investigation of the disease by professionals, including the nurse who works with risk classification in emergency departments and in primary care, besides the appropriate operation of the reference and counter-reference system of the health system.

Palliative care in paediatric oncology in nursing education. / Cuidado paliativo em oncologia pediátrica na formação do enfermeiro.

OBJECTIVE: To identify and understand the view of students regarding palliative care in paediatric oncology during a graduate programme. METHODS: Exploratory research with a qualitative approach conducted in a school of nursing in Rio de Janeiro. Data were collected from September to November 2014, through semi-structured interviews with 20 students enrolled in the last period of a graduate programme. The data were subjected to thematic analysis. RESULTS: The results produced two thematic units: the (un)preparedness of nursing students regarding palliative care in paediatric oncology and how the subject of palliative care in paediatric oncology is approached in the graduate programme. The students mentioned difficulties in providing this care and their lack of exposure to the topic during their graduate studies. They stated strategies to prepare for the provision of care, and talked about how the subject should be addressed in their curricular programme. CONCLUSION: It is necessary to expand discussions on palliative care in paediatric oncology during the nurses' graduate programme.

Evaluation of the mobile application "Descomplicando a Amamentação" by family members of newborns. / Evaluación de la aplicación móvil Descomplicando a Amamentação por familiares de recién nacidos.

to evaluate the semantics, appearance and usability of the mobile application "Descomplicando a Amamentação" for family members of newborns.applied methodological study, developed with 20 family members of newborns users of educational technology, including pregnant women, postpartum women and family members of newborns. An evaluation instrument containing questions about semantics and appearance was applied, in addition to the System Usability Scale to evaluate usability. In data analysis, the Agreement Index was used, with a cutoff point of 0.8 (80%).when evaluating semantics and appearance, the application achieved a Global Agreement Index of 0.99 (99%), varying from 0.95 (95%) to 1.0 (100%) between the items evaluated. In usability, a global average of 93 was achieved, presenting the best usability achievable in all system characteristics.the technology was considered understandable, relevant, and efficient, as well as easy to use and low inconsistency with high user satisfaction, demonstrating excellent potential for families.

Family caregivers' itineraries of preschool children who survived leukemia: implications for primary healthcare nursing.

OBJECTIVES: to analyze the path taken by family caregivers of preschool children who survived leukemia and discuss the implications for primary healthcare nursing. METHODS: the narrative interview guided by a talking map and body knowledge was used with family members of children who survived leukemia, living in Rio de Janeiro (capital) and São Paulo (countryside). Conversation analysis was applied to the data. RESULTS: five family groups (seven people) of five children started their journey in the professional subsystem of private services; four were assisted in the private sector since the onset of the illness; one was assisted in public and private services. Living conditions reduced barriers to accessing supplementary health, facilitating coordination, and listening to a reference professional. FINAL CONSIDERATIONS: the itinerary was marked by attentive listening to family caregivers by reference professionals, favoring early diagnosis, initiation of treatment, and resolution of leukemia with the cure of children.

Development and validation of a video on first aid for choking incidents in the school environment.

OBJECTIVE: To develop and validate an educational video on first aid for choking incidents in children in the school environment. METHOD: Methodological study, conducted between 2021 and 2022, in six stages: search for themes through interviews with 13 teachers and staff members who work in early childhood education in Niterói; theoretical study; development of the video; validation with 17 expert judges; video adaptation and validation with 17 teachers and staff. The interviews were analyzed using the Iramuteq software and the validation through the concordance index, with a desirable value of 70%. RESULTS: The animated video, lasting 4 minutes and 10 seconds, addressed the identification and management of the child experiencing choking and was validated with a concordance index of 97% among the judges and 96% with target audience. CONCLUSION: The video is a validated technology that can be used to develop educational practices with professionals in the school environment.

Development and validation of an instrument for nursing consultation with pediatric patients in the preoperative period.

OBJECTIVE: To develop and validate an instrument for nursing consultation with pediatric patients in the preoperative period. METHOD: This is a methodological study, consisting of five steps: identification of nursing diagnoses, discussion and evaluation of diagnoses with nurses from the institution, instrument development, instrument content validation with experts through the Delphi Technique, and instrument restructuring. The Nursing Minimum Data Set, Wanda Horta's human needs, and the NANDA-NOC-NIC connections were used as theoretical framework. RESULTS: In its final version, the instrument includes an assessment of psychobiological, psychosocial, and psychospiritual human needs, 38 nursing diagnoses, 65 nursing interventions, 113 nursing activities, and 62 nursing outcomes. The instrument obtained a content validity index between 0.90 and 1.0 in the first round, and suggestions, validated in the second round, obtained agreement from 70 to 100%. CONCLUSION: The instrument developed can be a tool for use in nursing consultations in the preoperative period for children, providing greater assertiveness to nursing actions for this clientele.

Technological innovation to colostomy bags: quasi-experimental study.

OBJECTIVE: To verify the effect of the bag with irrigation valve on the pattern of (dis)comfort of the colostomy person. METHOD: Quasi-experimental study, with a single group, through pre and post-test, carried out from June to September/2020 with 33 colostomized patients from a municipal rehabilitation center in Rio de Janeiro, Brazil. The pattern of (dis)comfort was analyzed using fuzzy logic, considering the attributes of bag cleaning, gas elimination and odor control. RESULTS: When analyzing the difficulty presented in each attribute before (T0) and after intervention (T1), a reduction was observed in relation to "bag cleaning" for 17 (56.7%) participants, in "odor control", for 24 (80.0%) and "gas removal" for 16 (53.3%) participants. By crossing the three attributes at the two moments, 21 (69.9%) participants indicated a reduction in (dis)comfort at T1. CONCLUSION: There was a reduction in the pattern of discomfort with the use of the bag with irrigation valve compared to the traditional colostomy bag.

Production and validation of educational video to encourage breastfeeding.

OBJECTIVE: To produce and validate an educational technology in health in video format to encourage breastfeeding in families. METHODS: Methodological study, carried out in a virtual environment, from February to August 2021, in seven stages. The Content Validity Index was used, with desirable values ​​equal to or greater than 0.70. RESULTS: The video lasting 7 minutes and 38 seconds was validated by 20 expert judges and 20 pregnant women, postpartum women, and family members, using a Global Content Validity Index of 0.97 and 1.00, respectively. All items evaluated regarding functionality, usability, efficiency, audiovisual technique, environment, procedure, objectives, organization, video style, appearance and motivation reached indexes equal to or greater than 0.95. CONCLUSIONS: The video produced is a validated educational technology that can be used to encourage breastfeeding with families, as it elucidates, in an innovative and creative way, different issues related to breastfeeding.

Children with type 1 diabetes mellitus: the experience of disease.

OBJECTIVE: To identify the main challenges faced by children with type 1 diabetes mellitus and describe their coping strategies. METHOD: Qualitative study conducted with a semi-structured interview with children aged 8 to 11 with type 1 diabetes mellitus diagnosis who received care in the outpatient clinic of a university hospital in the state of Rio de Janeiro, Brazil. The results have been analyzed and categorized as per thematic analysis. RESULTS: Five children have participated. The reports have emerged from the systematization of the qualitative data, in a process of apprehending meaning from statements of children and adolescents, which led to the category "Living with diabetes", including two subcategories: "Challenges to disease coping" and "Family participation and support in the disease process". CONCLUSION: The process of disease coping is observed to occur differently for each child. However, family participation and support, as well as communication with health professionals, are fundamental in this process.

Home care for children with gastrostomy.

OBJECTIVES: to describe home care practices performed by family members for maintaining the life of children with gastrostomy. METHODS: qualitative research using the Sensitive Creative method, with the Criatividade e Sensibilidade Corpo Saber [Corpo Saber Creativity and Sensitivity] dynamics. The participation included ten family caregivers of children with gastrostomy. The outpatient clinic of a federal hospital in Rio de Janeiro was the setting. Lexical analysis was used through the IRaMuTeQ® software. RESULTS: Theme 1, entitled "The care for maintaining life performed by family members of children with gastrostomy at home", was analyzed, comprising three classes: "The gastrostomy tube home care routine"; "The care with the gastrostomy/stoma"; and "Food and medication home care routine of children with gastrostomy". FINAL CONSIDERATIONS: family caregivers used strategies to maintain the device and acquired new knowledge in this field, and in nursing competence, regarding stoma care, food administration, medication, and syringes.

The therapeutic itinerary of health workers diagnosed with COVID-19.

OBJECTIVE: to analyze the therapeutic itinerary of health workers diagnosed with COVID-19. METHOD: qualitative study conducted with 132 health workers diagnosed with COVID-19. Data were collected using a semi-structured form sent through the social media and processed with the Interface de R pour Analyses Multidimensionnelles de Textes et de Questionnaires, according to the Descending Hierarchical Classification. RESULTS: the participants included 116 women and 16 men with 14 different professions within the health field. Five classes of excerpts emerged from the text, revealing the therapeutic itinerary from the onset of symptoms, up to referrals for testing and confirming COVID-19. Additionally, the aspects that facilitated or hindered access to testing in healthcare units were identified, in addition to misinformation and the need for workers to pay for the tests to obtain a diagnosis. CONCLUSION: this study's results show the difficulties health workers experienced to access the tests and related information and the delay in accessing the results and obtaining a sick leave to remain in isolation at home. The health workers who did not get support in terms of management and monitoring from the facilities where they worked adopted an active search.

Children with congenital heart disease in COVID-19 pandemic times: an integrative review.

OBJECTIVE: to identify the scientific production in health about children with congenital heart disease in COVID-19 pandemic times. METHOD: this is an integrative review, carried out in June 2020 in the information resources Latin American and Caribbean Literature in Health Sciences (LILACS), National Library of Medicine, National Institutes of Health (PubMed), Scientific Electronic Library Online Journal Portal (SciELO) and Brazilian Institute of Information Science and Technology (Oasis Ibict). RESULTS: 14 studies composed this review. Most studies pointed to tests, interventional procedures and surgery for children with heart disease in pandemic times; others discussed possible complications of COVID-19 among children with congenital heart disease. CONCLUSION: the incipient production of studies and the weak level of evidence denote an important knowledge gap so far, highlighting the need for studies with strong scientific evidence for the formulation of care guidelines aimed at children with heart disease.

The path from suspicion to diagnosis of people with Covid-19.

OBJECTIVE: To know the therapeutic itinerary of people diagnosed with Covid-19 from suspicion to the diagnosis. METHOD: Qualitative research. 65 people diagnosed with Covid-19 residing in Rio de Janeiro participated. Data collected using a semi-structured form sent via social media and processed in the software Interface de R pour Analyses Multidimensionnelles de Textes Et de Questionnaires by Descending Hierarchical Classification and Correspondence Factor Analysis. RESULTS: Three classes of text segments were obtained that revealed the therapeutic itinerary, with emphasis on the search for care; shortage of tests; need to return to the units for diagnosis and follow-up; and the path to confirmatory test. CONCLUSION: The therapeutic itinerary of patients with Covid-19 showed weaknesses in the face of difficulties related to access to diagnostic tests and the organization of the system to meet the population's demand in the face of the pandemic.

Perceptions of adolescents with cancer undergoing palliative care about their illness process.

OBJECTIVE: To understand the perception of adolescents with cancer undergoing palliative cares about their illness process. METHOD: An exploratory and qualitative study, per formed at a federal public hospital specialized in oncology disease in Rio de Janeiro, through interviews with nine adolescents aged 12 to 20 years old, from July to August 2017. Data was submitted to thematic analysis and the theoretical framework was Hildegard Peplau's Theory of Interpersonal Relationships. RESULTS: Three categories emerged: Living the difficult moment of the trajectory of the disease; Feeling the social isolation and that life has stopped; and Overcoming the difficult stage of the disease. They addressed the trajectory of the disease since the diagnosis, with the awakening of feelings of isolation and stagnation of life. Moreover, they highlighted the overcoming power of these adolescents. FINAL CONSIDERATIONS: The study made it possible to know the difficulties experienced during the course of the disease, providing subsidies for the practice of nurses to happen in a sensitive, individualized manner and focused on the individual's need thus enhancing comfort and quality of life.

Educational demands of family members of children with special health care needs in the transition from hospital to home.

OBJECTIVES: to analyze the educational demands of family members of children with special health care needs in the transition from hospital to home Methods: qualitative research conducted between February and June 2018, using the handbook on creativity and sensitivity dynamics, from the sensitive creative method; the participants were nine family caregivers of children admitted to a public hospital in Rio de Janeiro; the data were subjected to French discourse analysis Results: the educational demands were clinical, centered on the categories complex and continuous care, technological care, modified habits, medication, development and mixed care, and social, related to the supplies and rights of children Final Considerations: the social educational demand has emerged as a new demand to be incorporated in the care of these children. The transition from hospital to home should be progressive and have the nurse as its coordinator, with the objective of providing participatory, safe, quality care, articulated within a social network.

Educational practices for families of children and adolescents using a permanent venous catheter.

OBJECTIVES: to identify, in the scientific literature, the educational practices performed by nurses with the families of children and adolescents using long-term venous catheters, concerning home care. METHODS: integrative review in LILACS, PubMed, SCOPUS, Web of Science and CINAHL databases, from August to September 2018. RESULTS: we analyzed eight articles that met the inclusion criteria. The results showed that all studies are international, mostly North American and with low level of evidence. The educational practices found were home visits, production of printed educational materials, use of mannequins for simulation, creation of an educational video, and combined educational practices. Final Considerations: the care provided by families at home in the countries studied is more complex than in Brazil, and the conclusion is that Brazilian studies need to advance in publications related to this area.

Challenges faced by pediatric nursing workers in the face of the COVID-19 pandemic.

OBJECTIVE: to identify the challenges pediatric nursing workers face as a result of the COVID-19 pandemic. METHOD: qualitative study, using a semi-structured electronic form applied to nursing workers from pediatric services in the state of Rio de Janeiro, Brazil. Data were submitted to lexicographic analysis using the Interface de R pour Analyses Multidimensionnelles de Textes et de Questionnaires, Word Cloud technique, and Similitude Analysis. RESULTS: different challenges concerning the COVID-19 pandemic were reported, including the need to promote comprehensive and quality care while being concerned with protecting oneself and others, with an emphasis on fear. A lack of protective equipment, training, diagnostic tests, and knowledge/information concerning the disease was also reported, in addition to a reduced number of nursing workers and a lack of appreciation for the profession. CONCLUSION: managerial guidelines need to be adopted for properly allocating human and material resources in the health field, including the pediatric services, in addition to providing training on standard precautions. Actions to encourage, value, motivate, and support the nursing staff are needed during and after the pandemic to protect the physical and mental health of these professionals.

Nursing interventions in palliative care in Pediatric Oncology: an integrative review.

OBJECTIVE: to identify, in scientific productions, nursing interventions in palliative care in children and adolescents with cancer. METHOD: integrative review of the literature through the databases: CINAHL, MEDLINE, IBECS, LILACS and SCIELO, carried out in October and November 2017. RESULTS: we analyzed 18 articles that met the inclusion criteria. The results showed that, among the articles selected, Brazil is the country with the largest number of publications and that interventions such as music therapy, massage, ludic application, early consultation of palliative care, social interventions and physical exercises aimed at the resolution of a specific symptom obtained better results when compared to interventions that aimed at the comprehensiveness of palliative care. FINAL CONSIDERATION: we conclude that greater emphasis should be given to palliative care in academic and professional training and that further studies in search of the best evidence should be conducted to support nursing Evidence-Based Practices.

Cuidado domiciliar da criança em uso de traqueostomia: perspectiva dos cuidadores no contexto amazônico / Home care for children using a tracheostomy: caregivers' perspective in the amazon context / Atención domiciliaria a niños con traqueostomía: la perspectiva de los cuidadores en el contexto amazónico

RESUMO Objetivo: descrever a percepção dos cuidadores de crianças traqueostomizadas sobre os desafios no processo de alta para o domicílio no contexto amazônico. Método: estudo descritivo, qualitativo, realizado com 16 cuidadores de crianças traqueostomizadas que vivenciaram a desospitalização, em um Hospital Infantil de Rio Branco - Acre - Brasil. Amostragem definida por saturação, dados coletados com roteiro semiestruturado de agosto a dezembro de 2021, submetidos à Análise de Conteúdo de Bardin. Resultados: a análise resultou em quatro categorias: (1) sentimentos vivenciados com o uso do dispositivo traqueal; (2) cuidados rotineiros com a traqueostomia que os cuidadores julgam importantes; (3) dúvidas e relatos sobre a aspiração traqueal; e (4) condutas diante de intercorrências nas crianças em uso de traqueostomia. Considerações finais: o temor em aprender a técnica de aspiração traqueal e da alta hospitalar reforça a necessidade de educação precoce e contínua dos cuidadores, com foco no atendimento de rotina e de emergência para as crianças traqueostomizadas.

ABSTRACT Objective: To describe caregivers' perception of tracheostomized children about the challenges in discharge to their homes in the Amazonian context. Method: A descriptive, qualitative study was conducted with 16 caregivers of tracheostomized children who experienced dehospitalization in a children's hospital in Rio Branco - Acre - Brazil. Saturation-defined sampling, data collected with a semi-structured script from August to December 2021, submitted to Bardin Content Analysis. Results: the analysis resulted in four categories: (1) feelings experienced with the use of the tracheal device; (2) routine tracheostomy care that caregivers consider important; (3) questions and reports about tracheal aspiration; and (4) conduct in the face of complications in children using tracheostomy. Final remarks: the fear of learning the tracheal aspiration technique and of being discharged from the hospital reinforces the need for early and continuous education for caregivers, focusing on routine and emergency care for tracheostomized children.

RESUMEN Objetivo: describir la percepción de los cuidadores de niños traqueostomizados sobre los desafíos del alta domiciliaria en el contexto amazónico. Material y método: estudio descriptivo, cualitativo, realizado con 16 cuidadores de niños traqueostomizados que pasaron por la experiencia de des-hospitalización en un Hospital Infantil de Rio Branco - Acre - Brasil. Muestreo definido por saturación, datos recogidos mediante guion semiestructurado de agosto a diciembre de 2021, sometidos al Análisis de Contenido de Bardin. Resultados: el análisis dio lugar a cuatro categorías: (1) sentimientos experimentados con el uso del dispositivo traqueal; (2) cuidados rutinarios con la traqueostomía que los cuidadores consideran importantes; (3) dudas e informes sobre la aspiración traqueal; y (4) comportamiento en caso de complicaciones en niños que utilizan una traqueostomía. Consideraciones finales: el miedo a aprender la técnica de aspiración traqueal y a recibir el alta hospitalaria refuerza la necesidad de una formación precoz y continuada de los cuidadores, centrada en los cuidados rutinarios y de urgencia de los niños traqueostomizados.

Evidências acerca do brincar no hospital na perspectiva do familiar da criança: revisão integrativa / Evidence about playing in the hospital from the perspective of the child's family: integrative review / Evidencias sobre jugar en el hospital desde la perspectiva de la familia del niño: revisión integrativa

Objetivo: identificar estudos na literatura nacional e internacional acerca do brincar no hospital na perspectiva do familiar da criança. Método: revisão Integrativa realizada no período de março a maio de 2022, nas fontes de informações: Scielo; LILACS e BDENF via BVS; MEDLINE via PUBMED; Scopus e o Google Scholar como estratégia adicional. Foram incluídos artigos originais, nos idiomas inglês, português e espanhol; sem recorte temporal; e que tivessem como participantes familiares e/ou acompanhantes de crianças hospitalizadas. Resultados: as famílias reconhecem o brincar como promotor na redução da ansiedade das crianças frente aos procedimentos invasivos, além de auxiliar no enfrentamento da hospitalização e na melhora do humor e comportamento delas. Também destacaram a brinquedoteca hospitalar como um importante espaço que promove distração e continuidade do desenvolvimento. Conclusão: a partir da perspectiva dos familiares acerca do brincar, a equipe de enfermagem deve incentiva-las serem coparticipante dessa atividade durante a hospitalização da criança.

Objective: to identify studies in the national and international literature about playing in the hospital from the perspective of the child's family. Method: integrative review carried out from March to May 2022, in the information sources: Scielo; LILACS and BDENF via VHL; MEDLINE via PUBMED; Scopus and Google Scholar as an additional strategy. Original articles in English, Portuguese and Spanish were included; no temporal clipping; and that had family members and/or companions of hospitalized children as participants. Results: families recognize playing as a promoter in reducing children's anxiety in the face of invasive procedures, as well as helping to cope with hospitalization and improving their mood and behavior. They also highlighted the hospital toy library as an important space that promotes distraction and continuity of development. Conclusion: from the perspective of family members about playing, the nursing team should encourage them to be a co-participant in this activity during the child's hospitalization.

Objetivos:identificar estudios en la literatura nacional e internacional sobre el juego en el hospital desde la perspectiva de la familia del niño. Método: revisión integradora realizada de marzo a mayo de 2022, en las fuentes de información: Scielo; LILACS y BDENF vía BVS; MEDLINE vía PUBMED; Scopus y Google Scholar como estrategia adicional. Se incluyeron artículos originales en inglés, portugués y español; sin recorte temporal; y que tuvo como participantes a familiares y/o acompañantes de niños hospitalizados. Resultados: las familias reconocen jugar como un promotor en la reducción de la ansiedad de los niños frente a los procedimientos invasivos, además de ayudar a sobrellevar la hospitalización y mejorar su estado de ánimo y comportamiento. También destacaron la ludoteca del hospital como un espacio importante que promueve la distracción y la continuidad del desarrollo. Conclusión: desde la perspectiva de los familiares sobre el juego, el equipo de enfermería debe incentivarlos a ser copartícipes de esa actividad durante la hospitalización del niño.