Factors associated with cigarette smoking among public school adolescents. / Fatores associados ao consumo do cigarro entre adolescentes de escola pública.

Objective Estimating the prevalence of cigarette smoking and its association with sociodemographic variables, sexual initiation and experience with domestic violence among adolescents from public schools in Guanambi, Bahia, Brazil. Method A crosssectional study carried out with adolescents. Data were collected through interviews guided by a structured instrument, and analyzed according to descriptive and inferential statistics with multiple logistic regression. Results A total of 370 adolescents participated in the study. The prevalence of cigarette smoking was 17.6% and a statistically significant association was observed between the variables: age over 15 years (PR = 5.63 and 95% CI: 1.33 - 23.85), males (PR = 2.53 and 95% CI: 1.47 - 4.37), no reported religion (PR = 1.93 and 95% CI: 0.99 - 3.75), working (PR = 2.17 and 95% CI: 1.25 - 3.74), onset of sexual activity (PR = 10.64 and CI= 95%: 5.31 - 21.33) and experience of domestic violence (PR = 3.61 and 95% CI: 2.07 - 3.28). Conclusion The prevalence of cigarette smoking and the associated variables point to the need for intervention strategies among more vulnerable groups of adolescents, encompassing family involvement and assistance from teachers and health professionals, in particular nurses working in Primary Care.

[Promoting health in vulnerable communities: social technologies for poverty reduction and sustainable development]. / Promovendo saúde em comunidades vulneráveis: tecnologias sociais na redução da pobreza e desenvolvimento sustentável.

OBJECTIVE: To report the experience of implementing social technologies in vulnerable communities to foster individual and community potential for health promotion, poverty reduction and sustainable development. METHOD: The experience reports were collected from July 2010 to June 2015 with 200 individuals residing in vulnerable communities, in Bahia, Brazil. The experiences were reported in stages: 1) Awareness and diagnostics; 2) Workshops on different subjects; 3) Deployment of social technologies. RESULTS: The participants were notified of the importance of sustainable development and the environmental and health conditions were diagnosed. Actions for sustainable development were planned, with the implementation of acoustic artefacts (natural fibres) and experimental kitchens (homemade sweets). CONCLUSIONS: Considering that health comprises actions that promote the quality of life, the use of social technologies favoured health promotion because they stimulated the potential of the participants. It also allowed the diversification of the community's income source and sustainable development, which reduces poverty and fosters sustainability, quality of life and health promotion.

Black immigrants in São Paulo-Brazil: sociodemographic profile, reason for coming, embracement, and health.

OBJECTIVE: To understand the factors interfering in the living conditions (health) of black immigrant women. Therefore, we sought to know the sociodemographic profile, the reasons that led them to immigration, the embracement provided in the country, the presence of post-immigration illness, and the type of disease. METHOD: Quali-quantitative, cross-sectional study, carried out between March and October 2018, in the city of São Paulo-Brazil, with 33 black immigrant women. Data were obtained through interviews, guided by a semi-structured questionnaire. The responses were analyzed using the Discourse of the Collective Subject technique. RESULTS: Findings showed that 69% of the immigrants studied came from Angola, 45% feel discriminated against, 45.6% report post-immigration illness, with emotional issues being highlighted. CONCLUSION: The need to organize an internal agenda to serve similar groups is acknowledged, an essential attribution to the nation that aims to receive people, a commitment that refers to the promotion of means to embrace, aggregate, and incorporate people as citizens.

Primary Healthcare of black immigrants during the COVID-19 pandemic.

OBJECTIVE: To analyze how the healthcare of black immigrants was conducted during the COVID-19 pandemic in Primary Healthcare. METHOD: An exploratory-descriptive study with a qualitative approach, carried out through semi-structured interviews with professionals who worked in 10 Health Units in the city of Curitiba, Brazil, from October 2020 to January 2021. Structural racism was the conceptual framework. The statements were submitted to content analysis after using the MAXQDA program as support. RESULTS: A total of 21 professionals from the multidisciplinary team participated and three categories emerged from the analyzes: Healthcare for black immigrants in PHC during the Covid-19 pandemic; Limits and potentialities of PHC for healthcare for black immigrants; Structural racism in PHC practices aimed at black immigrants. CONCLUSION: Action in the pandemic was guided by protocols that did not expand healthcare to vulnerable populations, including black immigrants. The main barrier was communication, as most black immigrants in the surveyed locations were Haitians. Structural racism was identified in professional practice.

Hospital structure elements demarcating (in)visibilities of institutional violence against children.

OBJECTIVES: to analyze the hospital structure elements that demarcate (in)visibilities of institutional violence in hospitalized children. METHODS: this is a descriptive-exploratory qualitative study that used approaches with Foucault's thinking. Ten companions and 39 healthcare professionals from a university hospital in Salvador, Bahia participated. Data collection took place from November 2018 to June 2019 through semi-structured interviews. The discourse analysis method was used. The study was approved by the Institutional Review Board. RESULTS: institutional violence was understood in the violations and invisibilities of the structure of health services through the problems: in infrastructure (physical structure, lack of human and material resources, scrapping of equipment); administrative and management; pilgrimage. FINAL CONSIDERATIONS: it is necessary to realize the invisibilities of the infrastructure to act in confronting institutional violence to hospitalized children.

Child and adolescent victims of sexual violence: aspects of physical and emotional development.

OBJECTIVE: to identify the multidisciplinary health team's perception on aspects of the physical and emotional development of children and adolescents who have suffered sexual violence. METHODS: a qualitative study, carried out with 30 health professionals in a hospital in Bahia, Brazil, between June and July 2019. Data were collected from an interview guided by a semi-structured questionnaire. The results were interpreted according to Symbolic Interactionism. RESULTS: some sexually violated children were under five years old and healthy, others had physical/mental disabilities. Victimized adolescents were in the pre-pubertal phase, with fragile body structure, not emotionally mature and unaware of sexuality. FINAL CONSIDERATIONS: children's physical and emotional aspects make children vulnerable to sexual victimization, as they facilitate the control and dominion that offenders need to have over them. As a protection strategy, it is recommended using sexual and health education linked to greater surveillance of family members, multidisciplinary team and educators.

Biographical ruptures by the COVID-19 pandemic on adolescent and young trans men and transmasculine people: demands for nursing.

OBJECTIVE: to understand the biographical ruptures caused by the COVID-19 pandemic on adolescent and young trans men and transmasculine people in the Brazilian context. METHOD: qualitative study - multicenter, online survey. A total of 97 self-identified trans men and 22 transmasculine people participated and completed a semi-structured form in two stages. The data was subjected to Reflective Thematic Content Analysis. The interpretation was made on a sociological basis, based on the concept of biographical rupture. RESULTS: five categories were derived: interruption of hormonization, surgeries and specialized follow-up; discomforts caused by the rupture of masculine characteristics, self-image, self-perception, and identity; vulnerability from the losses of family members and significant people, employment, and weakening of support networks; emergence of psycho-emotional problems, such as loss of meaning in life; demands for nursing care and valuing the life of transmasculine adolescents and young men in post-pandemic times. CONCLUSION: the biographical ruptures caused by the pandemic threatened the identities of trans and transmasculine people of adolescents and youth, degraded and interrupted biographies, leading them to the loss of meaning in life. Nursing professionals can be strategic and essential in overcoming threats by intervening early. KEYPOINTS: (1) Shows biographical ruptures in transmasculinities during the pandemic. (2) Elucidates threats to achieving the desired trans identity. (3) Reveals barriers in services that hinder hormone transition. (4) Presents the discourse of suicide and new stressors in mental health. (5) Raises calls for nursing practice/care in adolescent health.

Perception of family members and health professionals about institutional violence against hospitalized children.

OBJECTIVE: To understand the perception of family members and health professionals about institutional violence against hospitalized children. METHODS: Qualitative, exploratory-descriptive study, used approximations with Foucault's thinking, carried out in a pediatric unit of a large hospital in Salvador - Bahia. 10 mothers and 39 health professionals participated. Data collection took place between November/2018 and October/2019 through semi-structured interviews. Data content analysis was performed with the help of the NVIVO12 software. The study, approved by Ethics Committee, complied with resolution 466/2012. RESULTS: The Institutional Violence was understood by the participants evidenced in three categories: abusive care practices; problems in the relationships between professionals, child and family; precariousness of the hospital structure. CONCLUSION: The perception of family members and health professionals about the presence of Institutional Violence in children's hospital care demonstrates the need to establish actions in their confrontation to ensure the dignity of the child during hospitalization.

Prevention of hypothermia in newborn submitted to surgical procedures: an integrative review.

OBJECTIVE: to discuss in the scientific literature the strategies used to prevent hypothermia in newborns undergoing surgical procedures. METHODS: this is an integrative literature review, with structured search in April and May 2020 in 08 databases, using the descriptors: Hypothermia; Surgical Procedures, Operative; Infant, Newborn; Protocols. Four primary studies were selected and analyzed using three instruments to assess the methodological quality of the Joanna Briggs Institute and content analysis. RESULTS: Among the strategies used, the following stand out: room temperature control; establishment of humidification and quality of air conditioning cleanliness; use of a heated incubator or cradle; use of thermal mattress; use of caps and blanket; heated fluids; temperature monitoring and abdominal organ coverage. CONCLUSION: good hypothermia prevention strategies were identified, despite the small number of publications on this topic; thus, it points out the need for research with strong evidence.

Clinical overview for pediatric population with SARS-CoV-2 and care: review.

OBJECTIVE: To identify in the scientific literature the clinical overview of the pediatric population that tested positive for SARS-CoV-2 and care recommendations and recommendations among children who tested positive for SARS-CoV-2 in the scientific literature. METHOD: Rapid review based on the guidelines of the Joana Briggs Institute: elaboration of the research question, structured search of the literature in April 2020, in nine databases, selection and critical analysis of the eighteen primary studies (using two instruments to assess methodological quality), elaboration of the synthesis, incorporation of suggestions and dissemination. RESULT: The most frequent clinical overview was respiratory, gastrointestinal symptoms and fever. The images showed irregular frosted glass opacification. It is recommended to screen the pediatric population and family members who show signs and symptoms and to adopt isolation for more than fourteen days. CONCLUSION: The clinical overview in pediatric population is varied, not exclusively with respiratory symptoms, and a significant number of asymptomatic patients. The importance of new investigations is highlighted, such as randomized clinical trial or cohort studies, identifying their participation in the transmission of COVID-19.

Expressions of domestic violence against adolescents: Educators' speeches.

OBJECTIVES: to describe the expressions recognized by domestic violence educators experienced by school adolescents. METHODS: it is a qualitative study based on Paulo Freire's liberating pedagogy. Semi-structured interviews were conducted with 20 teachers from a public elementary school in the city of Salvador, state of Bahia, Brazil. The data were systematized through the Discourse of the Collective Subject. RESULTS: collective discourse reveals that educators identify schoolchildren who experience physical, psychological and negligent abuse, being denied even love and affection. CONCLUSIONS: although not alluding to sexual abuse, educators recognize that students are inserted in the context of domestic violence, knowledge necessary for the development of actions that enable the exit of the student from the oppressed and overcoming the lived experience.

Practice of breastfeeding in quilombola communities in the light of transcultural theory.

OBJECTIVES: to identify factors that interfere with the practice of exclusive breastfeeding in quilombola communities. METHODS: qualitative research based on the Transcultural Theory proposed by Madeleine Leininger, performed with quilombola mothers. For data collection, we used the semi-structured interview, conducted from June 2018 to January 2019. Content analysis was guided by the interactive model of Miles and Huberman. RESULTS: it was revealed that intergenerational cultural myths and customs interfere with breastfeeding practice, and identified the influence of professional nurses on best breastfeeding practices. FINAL CONSIDERATIONS: cultural and intergenerational factors favor early weaning and expose the child to illness.

Thermoregulation protocol implementation for newborns in surgical procedures. / Implantação do protocolo de termorregulação para recém-nascido em procedimentos cirúrgicos.

OBJECTIVE: To describe the thermoregulation protocol implementation for newborns (NB). METHODS: An experimental report, conducted at a neonatal unit in Salvador, Bahia, from January 2016 to January 2017. The Plan, Do, Check, Action cycle guided the construction, implementation and applicability of the protocol. RESULTS: Implementation of the protocol that allowed the reduction of adverse events due to thermal instability during surgical procedures and introduction of new technologies. CONCLUSION: The protocol could improve and strengthen the care practices related to safe surgery in newborns.

Factors related to quilombola attendance to child follow-up appointments.

OBJECTIVE: To understand factors interfering with the attendance of quilombola children to growth and development follow-up appointments. METHOD: It is a qualitative research based on Symbolic interactionism, during which 14 mothers of children bellow 1 year-old were interviewed, who attended to the Family Health Unit at Ilha de Maré, Bahia, Brazil. RESULTS: Appointment attendance is affected by factors intrinsic to mothers (meaning of child health follow-up; association between appointments and children falling ill; personal issues) and extrinsic factors, related to the service (availability, long waiting time for appointments and its quality). FINAL CONSIDERATIONS: An administration prioritizing the service's organization is required, which can prioritize attendances and the reduction of waiting time, specially given the personal issues that compromise going to the unit.

Black immigrants in São Paulo-Brazil: sociodemographic profile, reason for coming, embracement, and health / Inmigrantes negras en São Paulo, Brasil: perfil sociodemográfico, motivo de llegada, acogida y salud / Imigrantes negras em São Paulo-Brasil: perfil sociodemográfico, motivo da vinda, acolhimento e saúde

ABSTRACT Objective: To understand the factors interfering in the living conditions (health) of black immigrant women. Therefore, we sought to know the sociodemographic profile, the reasons that led them to immigration, the embracement provided in the country, the presence of post-immigration illness, and the type of disease. Method: Quali-quantitative, cross-sectional study, carried out between March and October 2018, in the city of São Paulo-Brazil, with 33 black immigrant women. Data were obtained through interviews, guided by a semi-structured questionnaire. The responses were analyzed using the Discourse of the Collective Subject technique. Results: Findings showed that 69% of the immigrants studied came from Angola, 45% feel discriminated against, 45.6% report post-immigration illness, with emotional issues being highlighted. Conclusion: The need to organize an internal agenda to serve similar groups is acknowledged, an essential attribution to the nation that aims to receive people, a commitment that refers to the promotion of means to embrace, aggregate, and incorporate people as citizens.

RESUMEN Objetivo: Aprehender los factores que interfieren en las condiciones de vida (salud) de las mujeres negras inmigrantes. Para ello se buscó conocer el perfil sociodemográfico, los motivos que las llevaron a la inmigración, la acogida recibida en el país, la presencia de enfermedades post-inmigración y el tipo de enfermedad. Método: Estudio cuali-cuantitativo, transversal, realizado entre marzo y octubre de 2018, en la ciudad de São Paulo-Brasil, con 33 mujeres negras inmigrantes. Los datos fueron obtenidos a través de entrevistas, guiadas por un cuestionario semiestructurado. Las respuestas fueron analizadas mediante la técnica del Discurso del Sujeto Colectivo. Resultados: Entre los hallazgos, se observó que el 69% de los inmigrantes estudiados procedían de Angola, el 45% se siente discriminado, el 45,6% relata enfermedad post-migración, destacándose cuestiones emocionales. Conclusión: Se reconoce la necesidad de organizar una agenda interna para atender a grupos similares. Atribución esencial a la nación que se propone recibir, compromiso que se refiere a la promoción de medios para acoger, agregar e incorporar a las personas como ciudadanos.

RESUMO Objetivo: Apreender os fatores que interferem nas condições de vida (saúde) de mulheres negras imigrantes. Para tanto, buscou-se conhecer o perfil sociodemográfico, os motivos que as levaram à imigração, o acolhimento recebido no país, a presença de adoecimento pós-imigração e a tipologia da doença. Método: Estudo qualiquantitativo, transversal, realizado no período entre março e outubro de 2018, no município de São Paulo-Brasil, com 33 mulheres negras imigrantes. Os dados foram obtidos por meio de entrevistas, norteadas por um questionário semiestruturado. As respostas foram analisadas atendendo à técnica do Discurso do Sujeito Coletivo. Resultados: Dentre os achados, observou-se que 69% das imigrantes estudadas vieram de Angola, 45% sentem-se discriminadas, 45,6% relatam adoecimento pós imigração, destacando-se as questões emocionais. Conclusão: Reconhece-se a necessidade de organizar uma agenda interna para atender a grupos semelhantes, atribuição essencial à nação que se propõe a receber, compromisso que remete à promoção de meios para acolher, agregar e incorporar as pessoas como cidadãs.

Promotion of health, sustainability and social development of a vulnerable community.

OBJECTIVE: to report the experience of research phases on promoting sustainable development based on social technologies with palm fiber artifacts in a vulnerable community. METHOD: this is an experience report that describes the phases of a multiprofessional project that sought sustainable development, and was conducted with inhabitants from a vulnerable community. RESULTS: the actions were developed in four phases: exploratory, planning, implementation and evaluation. These phases encompassed a situational diagnosis, planning and performing health education workshops, training meetings, production of handcrafted window shutters with insulation and acoustic comfort. The most emphatic result was the possibility of a new source of income. FINAL CONSIDERATIONS: the project actions favored the individual and collective empowerment of the participants regarding their health, especially considering the recovery of self-esteem, valuation of traditional knowledge and a new source of income.

Promoção da paternidade ativa na amamentação de recém-nascidos / Promotion of active paternity in breastfeeding newborns / Promoción de la paternidad activa en recién nacidos lactantes

Objetivo: Apreender a percepção de pais de recém-nascidos sobre seu papel na promoção da amamentação e instituir estratégias de promoção da paternidade ativa. Método: Estudo qualitativo, realizada com 11 pais de recém-nascidos investigados em um serviço público de saúde do município da Bahia, Brasil. Os dados foram coletados por entrevistas individuais e de imagens após um ensaio fotográfico com os pais e bebês, que derivou estratégias de promoção da paternidade ativa. Procedeu-se à análise de conteúdo e icnonográfica, interpretadas pelo referencial a Política Nacional de Atenção Integral à Saúde do Homem. Resultados: Os pais expressaram sentidos e significados positivos relacionados ao exercício da paternidade que revelaram e a mobilização masculina para o desempenho do aleitamento dos recém-nascidos. Conclusão: A paternidade ativa pode contribuir para a promoção do aleitamento materno. Cabe aos profissionais de saúde a motivação para o engajamento e integração masculina nos cuidados com mãe-bebê.

Objective: To apprehend the perception of parents of newborns about their role in promoting breastfeeding and institute strategies to promote active parenthood. Method: Qualitative study, carried out with 11 parents of newborns investigated in a public health service in the city of Bahia, Brazil. Data were collected through individual and image interviews after a photo essay with parents and babies, which derived strategies to promote active parenthood. A content and iconographic analysis was carried out, interpreted by reference to the National Policy for Comprehensive Attention to Men's Health. Results: The fathers expressed positive senses and meanings related to the exercise of fatherhood that they revealed and the male mobilization for the performance of breastfeeding the newborns. Conclusion: Active fatherhood can contribute to promoting breastfeeding. It is up to health professionals to motivate male engagement and integration in mother-baby care.

Objetivo: Aprehender la percepción de los padres de recién nacidos sobre su papel en la promoción de la lactancia materna e instituir estrategias para promover la paternidad activa. Método: Estudio cualitativo, realizado con 11 padres de recién nacidos investigados en un servicio público de salud de la ciudad de Bahía, Brasil. Los datos fueron recolectados a través de entrevistas individuales y de imagen después de un ensayo fotográfico con padres y bebés, que derivó en estrategias para promover la paternidad activa. Se realizó un análisis iconográfico y de contenido interpretado con referencia a la Política Nacional de Atención Integral a la Salud del Hombre. Resultados: Los padres expresaron sentidos y significados positivos relacionados con el ejercicio de la paternidad que revelaron y la movilización masculina para la realización del amamantamiento de los recién nacidos. Conclusión: La paternidad activa puede contribuir a la promoción de la lactancia materna. Corresponde a los profesionales de la salud motivar el compromiso y la integración de los hombres en el cuidado maternoinfantil.

Desafios para o exercício da advocacia em saúde à criança hospitalizada durante a pandemia COVID-19 / Challenges for exercising health advocacy to hospitalized children during the COVID-19 pandemic / Challenges for exercising health advocacy to hospitalized children during the COVID-19 pandemic / Desafíos para el ejercicio de la defensa en salud de niños hospitalizados durante la pandemia de COVID-19

Resumo Objetivo Analisar os desafios para o exercício da advocacia em saúde à criança hospitalizada durante a pandemia COVID-19. Métodos Estudo qualitativo descritivo-exploratório on-line. Participaram 28 profissionais de enfermagem matriculados na disciplina Enfermagem na Atenção à Saúde da Criança e do Adolescente em um Programa de pós-graduação de uma universidade federal do nordeste brasileiro. A coleta de dados ocorreu em junho de 2021 através de roda de conversa e entrevista coletiva. Como instrumentos utilizou-se: o formulário do google forms e roteiro semiestruturado. O estudo foi aprovado pelo Comitê de Ética em Pesquisa. Como método de análise, foi empregada a Análise Textual Discursiva (ATD). Para a organização dos dados, utilizou-se o software Atlas.ti 8.4.15 (Qualitative Research and Solutions). Resultados Emergiram duas categorias: 1) Impactos da pandemia para assistência e advocacia pediátrica, constatou-se o isolamento infantil e um cenário de atenção à saúde onde a criança foi colocada em segundo plano. 2) Barreiras existentes que se agravaram com a crise sanitária, identificou-se: sobrecarga de trabalho, precarização da estrutura e dificuldade nas condições de trabalho, que gerou violações nos direitos infantis e agravou o panorama de dificuldades na oferta de serviços pediátricos. Conclusão Os desafios para o exercício da advocacia em saúde à criança hospitalizada durante a pandemia, evidenciados pelos impactos e barreiras para a assistência, ampliaram o trabalho das equipes de saúde tornando o exercício da advocacia no cuidado pediátrico ainda mais dificultoso. Cabe repensar e ajustar políticas de acesso e atendimento após a pandemia para assegurar que o cuidado infantil não seja restringido.

Resumen Objetivo Analizar los desafíos para el ejercicio de la defensa en salud de niños hospitalizados durante la pandemia de COVID-19. Métodos Estudio cualitativo descriptivo exploratorio en línea. Participaron 28 profesionales de enfermería inscriptos en la asignatura Enfermería en Atención a la Salud del Niño y del Adolescente en un programa de posgrado de una universidad nacional del nordeste brasileño. La recopilación de datos ocurrió en junio de 2021 a través de rondas de conversación y entrevista colectiva. Como instrumentos se utilizaron: un formulario de google forms y un guion semiestructurado. El estudio fue aprobado por el Comité de Ética en Investigación. Como método de análisis, se utilizó el Análisis Textual Discursivo (ATD). Para la organización de los datos, se utilizó el software Atlas.ti 8.4.15 (Qualitative Research and Solutions). Resultados Surgieron dos categorías: 1) Impactos de la pandemia en la atención y en la defensa pediátrica, se verificó el aislamiento infantil y un escenario de atención en salud en la que el niño fue colocado en segundo plano. 2) Barreras existentes que se agravaron con la crisis sanitaria, se identificó: sobrecarga de trabajo, precarización de la estructura y dificultad en las condiciones de trabajo, lo que generó violaciones de los derechos infantiles y agravó el panorama de dificultades en la oferta de servicios pediátricos. Conclusión Los desafíos para el ejercicio de la defensa en salud de niños hospitalizados durante la pandemia, evidenciados por los impactos y barreras para la atención, ampliaron el trabajo de los equipos de salud, lo que dificultó aún más el ejercicio de la defensa del cuidado pediátrico. Cabe reflexionar y ajustar políticas de acceso y atención después de la pandemia para asegurar que no se restrinja el cuidado infantil.

Abstract Objective To analyze the challenges for exercising health advocacy to hospitalized children during the COVID-19 pandemic. Methods This is an online descriptive-exploratory qualitative study. Participants were 28 nursing professionals enrolled in the subject Nursing in Health Care for Children and Adolescents in a graduate program at a federal university in northeastern Brazil. Data collection took place in June 2021 through a conversation wheel and press conference. As instruments, we used Google forms and a semi-structured script. The study was approved by the Research Ethics Committee. As an analysis method, Discursive Textual Analysis (DTA) was used. For data organization, Atlas.ti 8.4.15 software (Qualitative Research and Solutions) was used. Results Two categories emerged: 1) Impacts of the pandemic on pediatric care and advocacy: child isolation and a health care scenario where children were placed in the background were observed. 2) Existing barriers that worsened with the health crisis: work overload, precarious structure and difficulty in working conditions were identified, which led to violations of children's rights and aggravated the overview of difficulties in the provision of pediatric services. Conclusion The challenges for exercising health advocacy for hospitalized children during the pandemic, evidenced by the impacts and barriers to care, have expanded health teams' work, making the exercise of advocacy in pediatric care even more difficult. It is necessary to rethink and adjust access and care policies after the pandemic to ensure that child care is not restricted.

Preparo dos pais para a desospitalização de crianças em uso de traqueostomia e gastrostomia / Preparación de los padres para la deshospitalización de niños en uso de traqueostomía y gastrostomía / Parents' preparation for the dehospitalization of children using tracheostomy and gastrostomy

RESUMO Objetivo: relatar a experiência de uma ação educativa para o preparo dos pais para a desospitalização de crianças em uso de traqueostomia e gastrostomia. Método: relato de experiência sobre uma ação educativa, que é parte de um Programa de Treinamento de um hospital público de alta complexidade referência em pediatria, no período de dezembro de 2017 a dezembro de 2018. Resultados: o preparo dos responsáveis para a desospitalização de crianças em uso de traqueostomia e gastrostomia foi feito a partir de 5 etapas: 1) Instruções aos pais; 2) Treinamento dos pais para manuseio do dispositivo utilizado pela criança; 3) Manipulação dos dispositivos pelos pais sob supervisão do enfermeiro; 4) Feedback oferecido pela Enfermagem; e 5) Avaliação da ação educativa. Considerações finais: Acredita-se que a educação terapêutica fornecida aos envolvidos contribuiu na qualificação do cuidado à criança em uso de traqueostomia e gastrostomia, favorecendo sua qualidade de vida e reduzindo as intercorrências domiciliares relacionadas ao manuseio inadequado dos dispositivos em questão.

resumen Objetivo: relatar la experiencia de una acción educativa para la preparación de los padres para la deshospitalización de niños en uso de traqueostomía y gastrostomía. Método: relato de experiencia sobre una acción educativa, que hace parte de un Programa de Entrenamiento de un hospital público de alta complejidad referencia en pediatría, en el período de diciembre de 2017 a diciembre de 2018. Resultados: la preparación de los responsables para la deshospitalización de niños en uso de traqueostomía y gastrostomía se hizo a partir de 5 etapas: 1) Instrucciones a los padres; 2) Entrenamiento de los padres para manejo del dispositivo utilizado por el niño; 3) Manipulación de los dispositivos por los padres bajo supervisión del enfermero; 4) Feedback ofrecido por la Enfermería; y 5) Evaluación de la acción educativa. Consideraciones finales: Se cree que la educación terapéutica proporcionada a los involucrados contribuyó en la calificación del cuidado del niño en uso de traqueostomía y gastrostomía, favoreciendo su calidad de vida y reduciendo las complicaciones domiciliarias relacionadas con el manejo inadecuado de los dispositivos en cuestión.

ABSTRACT Objective: to report the experience of an educational action for the preparation of parents for the dehospitalization of children using tracheostomy and gastrostomy. Method: experience report on an educational action, which is part of a Training Program of a public hospital of high complexity reference in pediatrics, from December 2017 to December 2018. Results: the preparation of those responsible for the dehospitalization of children using tracheostomy and gastrostomy was made from 5 stages: 1) Instructions to parents; 2) Training of parents to handle the device used by the child; 3) Manipulation of the devices by parents under the supervision of the nurse; 4) Feedback offered by Nursing; and 5) Evaluation of educational action. Final considerations: It is believed that the therapeutic education provided to those involved contributed to the qualification of care for children using tracheostomy and gastrostomy, favoring their quality of life and reducing home complications related to inadequate handling of the devices in question.

A complexidade do cuidado para o controle térmico do recém-nascido prematuro / The complexity of care for the thermal control of the premature infant

RESUMO Objetivo compreender a percepção dos enfermeiros sobre a complexidade do cuidado para o controle térmico do recém-nascido prematuro. Métodos estudo qualitativo realizado com 13 enfermeiros de maternidade pública, por meio de entrevista virtual, com roteiro semiestruturado, submetido à Análise de Conteúdo e interpretado pelo suporte teórico do modelo do sistema adaptativo complexo de cuidado. Resultados os fatores presentes nos cuidados dos enfermeiros no controle térmico do recém-nascido prematuro estão relacionados à complexidade permeada por fatores ambientais como a temperatura da unidade e a distribuição das correntes de ar condicionado; fatores institucionais como a disponibilização e uso correto de tecnologias, e aos relacionados com o profissional, como atuação, treinamento e capacitação. Conclusão adequar a temperatura da unidade; melhor distribuição das correntes do ar condicionado; a disponibilidade de tecnologias; política de educação continuada no serviço; treinamentos de manuseio dos equipamentos; fiscalização e exigência de manutenção preventiva e corretiva dos aparelhos podem influenciar a redução dos eventos de instabilidade térmica do recém-nascido prematuro. Contribuições para a prática estimular a qualificação profissional, planejamento de ações intersetoriais para a estruturação tecnológica e manutenção preventiva das unidades, sistematização da assistência ao recém-nascido prematuro no controle térmico minimizando o risco de morbimortalidade neonatal por instabilidade térmica.

ABSTRACT Objective to understand the perception of nurses about the complexity of care for thermal control of the premature infant. Methods qualitative study conducted with 13 nurses from a public maternity hospital, through virtual interviews, with semi-structured script, submitted to Content Analysis and interpreted by the theoretical support of the complex adaptive care system model. Results the factors present in nurses' care in thermal control of premature infants are related to the complexity permeated by environmental factors such as the temperature of the unit and distribution of air conditioning currents; institutional factors such as the availability and correct use of technologies, and those related to the professional, such as performance, training, and qualification. Conclusion adjusting the temperature of the unit; better distribution of the air conditioning currents; availability of technologies; a policy of continued education in the service; training in handling the equipment; supervision and requirement for preventive and corrective maintenance of the devices can influence the reduction of thermal instability events in premature infants. Contributions to practice stimulating professional qualification, planning of intersectoral actions for technological structuring and preventive maintenance of the units, systematization of assistance to premature infants in thermal control minimizing risk of neonatal morbimortality due to thermal instability.