NADA Acupuncture in Specialized Palliative Care: Patients' and Family Caregivers' Experiences.

CONTEXT: Over the last 30 years, non-pharmacological treatment with ear acupuncture, including National Acupuncture Detoxification Association (NADA) acupuncture, has become popular in Western society to relieve cancer-related symptoms. OBJECTIVES: This study aim is to explore whether NADA acupuncture plays a role in relieving suffering experienced by patients hospitalized in a specialized palliative care ward and their family caregivers and whether it contributes to their coping skills. METHODS: A qualitative study with a hermeneutic approach utilizing inductive thematic content analysis. Purposeful sampling took place in a specialized palliative care ward in Denmark and all data were collected through semi-structured interviews with patients and family caregivers as either individual or family interviews. RESULTS: A total of 10 patients and 15 family caregivers participated in interviews. Four themes emerged: (1) communication about treatment with NADA acupuncture, (2) relief of suffering generates extra energy and inner strength, (3) sharing the experience with the family is beneficial, and (4) physical and psychological effects after receiving NADA acupuncture. CONCLUSION: Patients in palliative care and their family caregivers experienced relief of suffering after receiving NADA acupuncture, as well as improved well-being, and extra energy and inner strength to cope with their life situation. The ability to share NADA acupuncture gave family caregivers the feeling of being cared for and contributed to feelings of fellowship and togetherness within the family, strengthening their ability to communicate and cope.

Partnership-based nursing practice framework for patients with advanced chronic obstructive pulmonary disease and their families-A discursive paper.

AIM: The increase in the number of people with chronic obstructive pulmonary disease (COPD) and the disease burden, has prompted concerted efforts to improve healthcare, particularly outpatient services. In line with these attempts the Partnership-Based Nursing Practice Theoretical Framework for People with COPD was developed to guide outpatient nursing care. The principal approach of the framework is a 'Dialogue' with the patients, which has four components: 'Establishing family involvement', 'Assisting living with symptoms' and 'Facilitating access to healthcare', with the primary goal being 'Enhancement of the health experience'. With new knowledge, research on the framework, and extensive experience in using it, a need arose to modify the framework to maximize its clinical utility. DESIGN: Discursive paper. METHODS: A narrative review and critical reflection was conducted to revise the nursing practice framework via selected literature search from 2012 to 2022, research on the framework, and the authors' reflections on the clinical experience of using the framework. RESULTS: The nursing practice framework highlights capacities and possibilities that lie in the nurse-patient relationship. The overarching dialogue in the revised framework includes both patients and families. The action-related component 'Assisting living with the disease' was added to the framework to underscore the significance of attempting to understand what may lie ahead for patients and families. The other action-related components are as follows: 'Assisting living with symptoms' and 'Facilitating access to healthcare'. The primary goal remains unchanged: enhancing the 'Health experience'. CONCLUSION: Using the revised nursing practice framework in outpatient care may help to enhance the lives of people with COPD and their families, particularly at advanced stages of the disease. It may have transferability to other groups of people living with progressive diseases dealing with complicated health problems, and to reduce the usage of costly healthcare resources such as hospital care. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The partnership-based nursing practice framework assumes an extension of conventional specialized respiratory service and embraces a comprehensive account for that which may influence the patient's health problems. This guidance, which holistically attends to patient-family needs of living with complicated and progressive health predicaments, is fundamental. It contributes to strengthening the disciplinary focus of nursing, interdisciplinary collaboration, person-family-centred quality nursing care and inspires research initiatives. Critical reflections and updates on nursing practice frameworks, such as this revision, are essential to advance nursing and healthcare. PATIENT OR PUBLIC CONTRIBUTION: There is no direct patient- or public contribution.

Nurses' experiences of the ethical values of home care nursing: A qualitative study.

Objective: Considering the importance of out-of-hospital services, the emergence of home care nursing, and the need for an ethical framework in nursing practice, the present study aimed to explore the nurses' experience of ethical values of home care nursing. Methods: The data of the study was collected using face-to-face individual interviews. Through purposive sampling, 20 nurses who worked in the home care centers in four cities of Iran in 2020 were interviewed. They shared their experiences of the ethical values of home care nursing. Then, the interviews were analyzed based on the content analysis approach and using Graneheim and Lundman method. Results: In the present study, 416 codes were extracted. Merging these codes based on the similarity, seven main themes, and 16 sub-themes were extracted. The themes included perception of the professional identity, respect for the client's autonomy, respecting privacy, establishing human interaction, maintaining mutual safety, observance of justice, and cultural-religious competence. The sub-themes included responsibility, development of professional and inter-professional interactions, maintaining the professional status at home, providing the holistic artistic care, patient's privacy, nurse's privacy, and maintaining the confidentiality of information, respect for the client's choice, honestly informing, empathetic interaction, adjusting the power positions, client's safety, nurse's safety, establishing justice, respect for the religious beliefs at home and cultural sensitivity. Conclusion: The participants stated that due to entering the patient's privacy in the home care cases, the ethical values such as perception of the professional identity, privacy, family interactions' management, mutual security, and cultural-religious competence became doubly important compared to the hospital caring.

Tactics and Strategies of Family Adaptation among Parents Caring for Children and Youth with Developmental Disabilities.

The stressors experienced by families caring for children and youth with developmental disabilities (DD) impact quality of life for all family members. Families employ creative practices to cope and thrive in the midst of such challenges. This study sought to understand the adaptive practices, tactics, and strategies engaged in by parents. We interviewed 39 parents of 46 children and youth with DD in Canada. Thematic analysis elucidated three categories of adaptations and twelve tactics and strategic actions at three ecological levels: within the system-adapting with everyday tactics and strategies; within our family-constructing spaces of care; within myself-adjusting perceptions of adversity. Our critical interpretation highlights an ecology of parental labor across varying psychosocial and health care service contexts in which parents strive to make a good life for their children and families. Nurses can empower and enhance their well-being by conducting holistic assessments and targeted family nursing interventions.

Sensibilização das mães de crianças com microcefalia na promoção da saúde de seus filhos / Sensibilización de las madres de niños con microcefalia en la promoción de la salud de sus hijos / Sensitizing mothers of children with microcephaly in promoting the health of their children

RESUMO Objetivo Relatar as experiências educativas das mães ou cuidadoras de crianças com microcefalia, desenvolvidas por equipe acadêmica na temática da promoção da saúde dessas crianças. Método Trata-se de relato de experiência vivenciado por alunos do curso de graduação em enfermagem, discentes e docentes do programa de Pós-Graduação em Saúde e Ambiente da Universidade Tiradentes sobre intervenções educativas realizadas em três unidades de referência no atendimento à criança com microcefalia no estado de Sergipe. A amostra do estudo foi de conveniência. Resultados Participaram da pesquisa 70 mães ou cuidadoras principais de crianças com diagnóstico confirmado de microcefalia, durante os meses de setembro a dezembro. Os eixos temáticos-teóricos selecionados para descrever as atividades foram promoção da alimentação saudável, importância do vínculo mãe e filho e estimulação precoce de crianças com microcefalia. Conclusão A experiência relatada demostrou a importância das estratégias educativas na promoção da saúde de crianças com microcefalia, proporcionando capacitação adicional às mães/cuidadoras para que estas ofereçam um cuidado holístico e humanizado a essas crianças.

RESUMEN Objetivo Relatar las experiencias educativas de las madres o cuidadoras de niños con microcefalia, desarrolladas por equipo académico en la temática de la promoción de la salud de esos niños. Método Se trata de relato de experiencia vivida por alumnos de la carrera universitaria de enfermería, discentes y docentes del programa de Posgrado en Salud y Ambiente de la Universidad Tiradentes acerca de intervenciones educativas realizadas en tres unidades de referencia en la atención al niño con microcefalia en el Estado de Sergipe. La muestra del estudio fue de conveniencia. Resultados Participaron en la investigación 70 madres o cuidadoras principales de niños con diagnóstico de microcefalia, durante los meses de septiembre a diciembre. Los ejes temáticos-teóricos seleccionados para describir las actividades fueron promoción de la alimentación sana, importancia del vínculo madre e hijo y estimulación precoz de niños con microcefalia. Conclusión La experiencia relatada demostró la importancia de las estrategias educativas en la promoción de la salud de niños con microcefalia, proporcionando capacitación adicional a las madres/cuidadoras a fin de que estas proporcionen un cuidado holístico y humanizado a esos niños.

ABSTRACT Objective To report the educational experiences of mothers or caregivers of children with microcephaly, as developed by an academic team with the theme of promoting these children's health. Method This is an experience report by undergraduate nursing students and Health and Environment Post-Graduation students and professors of Tiradentes University on educational interventions carried out in three reference units for the care of children with microcephaly in the state of Sergipe. The study sample was taken by convenience. Results A total of 70 mothers or primary caregivers of children with a confirmed diagnosis of microcephaly during the months of September to December participated in the study. The thematic-theoretical axes selected to describe the activities were promotion of healthy eating, importance of the mother and child bond, and early stimulation of children with microcephaly. Conclusion The experience reported demonstrates the importance of educational strategies in promoting the health of children with microcephaly, providing additional training to mothers/caregivers to provide holistic and humanized care to these children.

Indigenous mothers' experiences of using acute care health services for their infants.

AIMS AND OBJECTIVES: To develop an understanding of how Indigenous mothers experience selecting and using health services for their infants can assist nurses in improving their access to care. This understanding may ultimately lead to improved health outcomes for Indigenous infants and their families. BACKGROUND: Access to acute care services is important to minimise morbidity and mortality from urgent health issues; however, Indigenous people describe difficulties accessing care. Indigenous infants are known to use the emergency department frequently, yet little is known about the facilitators and barriers their mothers experience when accessing these services. DESIGN: This study undertook a qualitative, interpretive description design. METHODS: This article adheres to the reporting guidelines of COREQ. Data collection methods included interviews and a discussion group with Indigenous mothers (n = 19). Data analysis was collaborative and incorporated both Indigenous and Western ways of knowing, through the application of Two-Eyed Seeing. RESULTS: A thematic summary resulted in six themes: (a) problematic wait times; (b) the hidden costs of acute care; (c) paediatric care; (d) trusting relationships; (e) racism and discrimination; and (f) holistic care. CONCLUSIONS: The experiences of Indigenous mothers using acute care services for their infants suggest a role for culturally safe and trauma and violence-informed care by health providers in the acute care context. RELEVANCE TO CLINICAL PRACTICE: Nurses can improve access to acute care services for Indigenous mothers and infants through the provision of culturally safe and trauma and violence-informed approaches care, by building rapport with families, providing care that is respectful and nonjudgemental, eliminating fees associated with using acute care services and linking families with cultural resources both in hospital and within the community.

Family centered care of hospitalized children: A hybrid concept analysis in Iran.

Background: Family centered care of hospitalized children (FCCHC) is a multidimensional concept, which is directly associated with the context and healthcare system. This study was conducted to analyze the concept of FCCHC in Iran. Methods: This concept analysis was conducted with the use of hybrid model in 3 phases: a literature review in the theoretical phase, semi-structured interviews and descriptive observations in the fieldwork phase, and combination of the results of 2 previous phases in the final analytical phase. Results: The 4 main themes extracted in theoretical phase included "family and healthcare professional participation", "information sharing with families", "family and healthcare professional relationship based on dignity and respect" and "individualized care of family".Moreover, 4 themes were emerged in the fieldwork phase, including "family as a nonparticipant visitor", "one-way education", "non-supportive interactions" and "non-specific care of family". In third phase with combination of the results of 2 phases, the final definition of the concept was presented. Conclusion: FCCHC is a comprehensive care that is affected by human and organizational factors and requires full participation of staff and family, effective interaction with family, education and information sharing with them, and individualized care of each family. By knowing the dimensions of the FCCHC, we will be able to run our activities to provide facilities and features for its optimal implementation in Iran.

A vulnerabilidade dos cuidadores de idosos com demência: revisão integrativa / Vulnerabilidad de los cuidadores de personas mayores con demencia: revisión integradora / Vulnerability of caregivers for the elderly with dementia: integrative review

Objective: To analyze the vulnerability of caregivers of elderly with dementia. Method: This is an integrative review of quantitative and qualitative nature. The data collection period was from 01/09/14 to 10/30/14.Results: Of the articles analyzed, 26% point interventions to relieve overload; 20% analyze the depression load; 16% of studies address caregiver burden; 14% guided their discussions in physical and spiritual well-being, psychological and social well-being and damage to quality of life; 12% adress stress. Conclusion: Researchers from several countries show the care impact on the life of the caregiver, highlighting: the emotional overload, routine stress, and depressive symptoms. However, there are mitigation measures identified through the research that can contribute to the everyday stress relief, such as the daily practice of yoga meditation, religion, the positive relationship between the family, the elderly and the caregiver.

Objetivo: Analisar a vulnerabilidade dos cuidadores de idosos com demência. Método: Trata-se de uma revisão integrativa de natureza quanti-qualitativa. O período de coleta de dados ocorreu de 01/09/14 a 30/10/14. Resultados: Do total de artigos analisados, 26% apontam intervenções para alívio da sobrecarga; 20% analisam a carga de depressão; 16% dos estudos abordam a sobrecarga do cuidador; 14 % pautaram suas discussões no bem-estar físico e espiritual, bem-estar psicológico e social e nos prejuízos à qualidade devida; e 12% abordaram o estresse. Conclusão: Pesquisadores de diversos países apontam os impactos do cuidado na vida do cuidador destacando a sobrecarga emocional, estresse rotineiro e sintomas depressivos. Entretanto, existem medidas atenuantes, identificadas através das pesquisas, que podem contribuir para alívio do estresse cotidiano, por exemplo, a prática diária de meditação yogue, a religiosidade, o relacionamento positivo entre a família,o idoso e o cuidador.

Objetivo: Analizar la vulnerabilidad de los cuidadores de ancianos con demencia. Método: Se trata de una revisión integradora de la naturaleza cuantitativa y cualitativa. El período de recolección de datos fue de 09/01/14a 30/10/14. Resultados: De los artículos analizados, 26% puntuaron intervenciones para aliviar la sobrecarga; 20% analizaron la carga de la depresión; 16% de los estudios abordaron la carga del cuidador; 14% guió sus discusiones en buena salud física y espiritual, psicológico y social y dañar la calidad de vida; 12% se refirió al estrés. Conclusión: Investigadoresde varios países apuntan los impactos del cuidado en la vida del cuidador, destacando: la sobrecarga emocional, el estrés y la rutina de los síntomas depresivos. Sin embargo, hay medidas de mitigación identificadas a través de la investigación que pueden contribuir al alivio de la tensión diaria, tales como: la práctica diaria de la meditación del yoga, la religión, la relación positiva entre la familia, los ancianos y el cuidador.

Elements of Family-Centered Care in the Pediatric Intensive Care Unit: An Integrative Review.

This paper reports result from a systematic search and thematic analysis of qualitative literature to identify key issues related to family-centered care, behaviors, and communication skills that support the parental role and improve patient and family outcomes in the PICU. Five themes were identified: 1) sharing information; 2) hearing parental voices; 3) making decisions for or with parents; 4) negotiating roles; and 5) individualizing communication. These themes highlight several gaps between how parents want to be involved and perceive clinicians engage them in the care of their child. Parental preferences for involvement differ in the domains of information sharing, decision making, and power-sharing across a spectrum of parental roles from parents as care provider to care recipient. The PICU setting may place clinicians in a double bind trying to both engage families and protect them from distress. Asking families of critically ill children about their preferences for participation across these domains may improve clinician-family relationships.

A qualitative exploration of oncology nurses' family assessment practices in Denmark and Australia.

BACKGROUND: The nurses' ability to provide supportive care to the patient and the family is influenced by their family assessment skills, which provide them with understanding of the family needs and strengths. When a patient is diagnosed with cancer, it is the family who provides the long-term support for the patient, and nurses need to understand the family needs in order to provide holistic care. OBJECTIVE: The objective of the present study is to understand the factors that influence nurses' family assessment practices in adult oncology setting in Denmark and Australia. METHODS: An interpretive qualitative study was conducted guided by the family systems theory. Focus groups were completed with 62 nurses working in adult oncology areas in Denmark and Australia. A thematic analysis and a computer-generated concept mapping were completed to identify themes within the data. RESULTS: Overall, the nurses valued family as part of the patient care and worked to understand the family concerns. However, the family assessment process was unstructured and did not enable holistic family support. Nurses from both countries discussed that experience and ability to engage with the family influenced the nurse's role in family assessment. CONCLUSION: This study identified that nurses value family as part of patient care, however struggle to assess and support families during oncology care. There is a need for a structured assessment approach and education on family assessment, which could be used across the two countries and possibly internationally.

A família no cuidado de enfermagem à criança: revisão Integrativa / The family in nursing care for children: an integrative review / El papel de la familia en el cuidado de enfermería al niño: revisión integrativa

This study aimed to investigate the scientific production on nursing care for children with a family focus. An integrative review was undertaken in five databases in June 2016. The inclusion criteria were: scientific publications disseminated between 2010 and 2015, in the form of a scientific article, in English, Portuguese and Spanish, and available through open access. The sample consisted of 16 articles, from which two thematic categories emerged: recognition of the family unit; limitations for childcare with a family focus. Childcare with a family focus values the relatives' participation in its execution, favors the professional-family bond with recognition of continuing care, and evidences the peculiarities of each family (AU).

Este estudo objetivou investigar a produção científica sobre o cuidado de enfermagem à criança com enfoque na família. Trata-se de uma revisão integrativa realizada em cinco bases de dados, no mês de junho de 2016.Os critérios de inclusão foram: publicações científicas divulgadas entre 2010 a 2015, no formato de artigo científico, nos idiomas inglês, português e espanhol, e de livre acesso. A amostra foi composta por 16 artigos, dos quais emergiram duas categorias temáticas: reconhecimento da unidade familiar; limitações para o cuidado à criança com enfoque na família.O cuidado à criança com enfoque na família valoriza a participação dos familiares na sua execução, favorece o vínculo profissional-família com reconhecimento do cuidado contínuo, e evidencia as peculiaridades de cada família (AU).

Este estudio tuvo la finalidad de investigar la producción científica acerca de cuidado de enfermería al niño enfocándose el papel de la familia. Es una revisión integrativa realizada en cinco bases de datos, en el mes de junio de 2016. Los criterios de inclusión fueron: publicações científicas divulgadas entre 2010 y 2015, en forma de artículo científico, en los idiomas inglés, portugués y español, y de libre acceso. La muestra se compuso por 16 artículos, de los cuales resultaron dos categorías temáticas: reconocimiento de la unidad familiar; limitaciones para el cuidado al niño con enfoque en la familia. El cuidado al niño con enfoque en la familia valora la participación de los familiares en su ejecución, favorece el vínculo profesional-familia con reconocimiento del cuidado continuo, además de evidenciar las peculiaridades de cada familia (AU).

Interventions for Reducing Parenting Stress in Families With Pediatric Conditions: An Integrative Review.

Parenting stress increases in the presence of serious-acute or chronic pediatric health conditions, potentially triggering negative outcomes for families. Parenting stress reduction interventions have been widely disseminated. The current review describes the types, components, and outcomes of these interventions in diverse pediatric populations. A systematic literature search yielded 26 experimental and quasi-experimental studies describing such interventions. Quality assessment was conducted by two doctorally prepared nursing researchers using the Downs and Black's checklist for randomized and nonrandomized studies of health care interventions. Interventions were categorized as follows: interventions with supporting and cognitive components (n = 3), interventions with empowerment and skill development components (n = 18), interventions targeted to children's condition (n = 9), and interventions focusing on the parent-child relationship (n = 5). Most interventions reduced immediate parenting stress levels (n = 23), but failed to demonstrate long-term gains. Future family interventions should target long-term parenting stress, while focusing on specific family needs across pediatric conditions.

Aplicação do Modelo Calgary de Avaliação Familiar no contexto hospitalar e na atenção primária à saúde. Revisão integrativa / Aplicación del Modelo Calgary de Evaluación Familiar en el contexto hospitalario y en la atención primaria a la salud. Revisión integradora / Application of the Calgary Family Assessment Model in Hospitals and in Primary Health Care: An Integrative Review

RESUMO Objetivo: caracterizar as publicações sobre a aplicação do Modelo Calgary de Avaliação Familiar, no contexto hospitalar e na atenção primária à saúde, divulgadas em periódicos on-line da área de saúde. Material e Método: revisão integrativa da literatura. O levantamento do material foi realizado mediante a busca no portal Capes, Pubmed, Medline, Lilacs, BDENF, na CidSaúde e Ibecs. Foram adotados os seguintes critérios de inclusão: artigos on-line, disponíveis na íntegra, publicados nos idiomas português, inglês e espanhol, entre Janeiro de 2008 a dezembro de 2013. A amostra foi composta por 25 trabalhos. Resultados: os anos 2008, 2010 e 2013 evidenciaram um número maior de produções, predominaram artigos originais, 64,0 % dos estudos foram realizados na atenção primária à saúde. Quanto à autoria dos estudos, a pesquisa mostrou que houve a participação do enfermeiro em 88,0 % das publicações. Conclusões: foi possível evidenciar que a aplicação do MCAF, tanto no contexto hospitalar quanto na atenção primária à saúde, possibilita uma abordagem mais aprofundada sobre a estrutura, o desenvolvimento e o funcionamento familiar, o que se configura como uma ferramenta efetiva para identificar diagnósticos familiares.

RESUMEN Objetivo: caracterizar las publicaciones sobre la aplicación del Modelo Calgary de Evaluación Familiar, en el contexto hospitalario y en la atención primaria a la salud, divulgadas en periódicos en línea del área de salud. Material y método: revisión integradora de la literatura. La compilación del material se realizó mediante la búsqueda en el portal Capes, Pubmed, Medline, Lilacs, BDENF, en la CidSaúde e Ibecs. Se adoptaron los siguientes criterios de inclusión: artículos en línea, disponibles en su totalidad, publicados en los idiomas portugués, inglés y español, entre enero de 2008 y diciembre del 2013. La muestra estuvo compuesta por 25 trabajos. Resultados: en los años 2008, 2010 y 2013 se evidenció un número mayor de producciones, predominaron artículos originales, 64,0 % de los estudios se realizaron en la atención primaria a la salud. En cuanto a la autoría de los estudios, la investigación mostró que hubo la participación del enfermero en 88,0 % de las publicaciones. Conclusiones: fue posible evidenciar que la aplicación del MCAF, tanto en el contexto hospitalario como en la atención primaria a la salud, posibilita un abordaje más profundizado sobre la estructura, el desarrollo y el funcionamiento familiar, lo que se configura como una herramienta efectiva para identificar diagnósticos familiares.

ABSTRACT Objective: Characterize articles published in online health journals concerning application of the Calgary Family Assessment Model (CFAM) in hospitals and in primary health care. Material and methods: An integrative review of the literature was conducted through a search of Capes, PubMed, Medline, Lilacs, BDENF, CidSaúde and IBECS. The following inclusion criteria were adopted: online articles available in full, published in Portuguese, English and Spanish from January 2008 to December 2013. The sample included of 25 works. Results: The largest output was in the years 2008, 2010 and 2013. Original articles predominated and 64.0% of the studies were carried out in the context of primary health care. As for authorship of the studies, the research showed that nurses participated in 88.0% of the publications. Conclusions: It was demonstrated that application of the CFAM, both in hospitals and in primary health care, allows for a more in-depth focus on the structure, development and functioning of the family, which is organized as a diagnosis of family identification.

American Indians' Family Health Concern on a Northern Plains Reservation: "Diabetes Runs Rampant Here".

OBJECTIVES: The objective was to identify significant family health concerns from the perspective of adult tribal members residing in a reservation setting on the Northern Plains of the United States. Findings were used to cocreate culturally appropriate strategies to address the most significant family health concern. DESIGN AND SAMPLE: A focused ethnography within a participatory framework was employed. An advisory council, comprised of seven tribal members, guided the research team. A purposive sampling technique with a snowball process was used. Twenty-one adult tribal members volunteered to participate. MEASURES: Face-to-face, audio-recorded, semi-structured interviews were conducted and transcribed verbatim. Other data sources included field notes of approximately 100 hours of field work, windshield surveys, and a focus group. Data were analyzed using Spradley's guidelines. RESULTS: The significant family health concern was "diabetes runs rampant here" with inter-related cognitive, emotional, and behavioral responses. These responses were compounded by accumulated emotional trauma from witnessing premature deaths and severe comorbidities associated with diabetes. Contextual factors shaping "diabetes runs rampant here" were identified. CONCLUSION: Holistic approaches are urgently needed in diabetes prevention and management programs. Implications for public health nurses are discussed and recommendations are provided for future research.

Os sentidos das experiências de mães de crianças e adolescentes oncológicos com a terapia complementar / The senses of the experiences with complementary therapies shared by mothers of children and adolescents

O diagnóstico de câncer infantojuvenil e as demandas do seu tratamento transforma a vida da família, particularmente das mães que acompanham seus filhos de perto e não medem esforços para oferecer-lhes o melhor. O cuidado prestado pelas mães é permeado de influências culturais que podem favorecer a introdução de terapias complementares no cuidado dos seus filhos. O objetivo deste estudo foi analisar os sentidos das experiências de um grupo de mães de crianças e adolescentes com câncer com a terapia complementar. Para alcançar este objetivo, realizou-se estudo com abordagem metodológica qualitativa, adotando o referencial teórico da Antropologia Médica e a narrativa como método. Após aprovação ética da pesquisa, foram convidadas a participar do estudo quinze mães de crianças e adolescentes com câncer, em acompanhamento terapêutico em serviço de saúde localizado no interior do estado de São Paulo. A coleta de dados foi realizada por meio de duas entrevistas semiestruturadas com cada participante, realizadas nas dependências do complexo hospitalar e nos domicílios, no período de julho de 2014 a julho de 2015. A partir das entrevistas foram construídas as narrativas individuais das participantes e utilizamos os pressupostos dos modelos explicativos para organizar os dados relativos à reconstrução das experiências das mães acerca da causa, tratamento e o prognóstico da doença. Para a análise dos dados provenientes das narrativas, utilizou-se a análise temática indutiva. Relacionaram-se os aspectos semelhantes e os particulares das narrativas sobre as experiências das mães com os tratamentos complementares e eles foram integrados em dois temas representativos, apresentados sob a forma de sínteses narrativas ou unidades de sentidos. Os resultados foram analisados e apresentados a partir das narrativas temáticas: Quando um filho tem câncer, não se imagina a força de uma mãe, em que se apresenta a persistência, energia, entusiasmo e motivação das mães para lidar com as demandas do diagnóstico oncológico e tratamento do câncer, bem como a sua influência nas decisões que garantem a qualidade do tratamento dos filhos, incluindo ou não a incorporação de práticas alternativas; e A utilização da terapia complementar motivada pela esperança, em que o sentido atribuído pelas mães à incorporação de terapias complementares no cuidado do filho é o de renovação da esperança, com o propósito de promoção do bem-estar da criança ou adolescente e cura da doença. Os sentidos dessas experiências foram explicados por meio de conceitos derivados da antropologia. A interpretação das narrativas centradas na experiência de um grupo de mães de crianças e adolescentes oncológicos com a terapia complementar, a partir do sistema cultural, permitiu-nos explicar compreensivamente como a cultura influencia o cuidado prestado pelas mães aos seus filhos, por meio dos sentidos. Os sentidos das experiências desse grupo de mães constituem-se em conhecimento que pode ser aplicado na prática clínica e em pesquisas futuras

The childhood cancer diagnosis and its treatment demands change the life of the family, particularly the mothers who are close to their children and make great effort to provide them the best. The care provided by mothers to their children is permeated with cultural influences that may favor the introduction of complementary therapies. The goal of this study was to analyze the senses of the experiences with the complementary therapy shared by a group of mothers of children and adolescents affected by cancer. To achieve such a goal, a qualitative methodological approach study was held, adopting the theoretical framework of Medical Anthropology and narrative as a method. Once the ethical approval of the study was obtained, fifteen mothers of children and adolescents with cancer under therapeutic follow-up at a health service located in the state of São Paulo were invited to participate in the study. Data collection was performed by means of two semi-structured interviews with each participant, held on the premises of the hospital complex and at participants' homes, from July, 2014 to July, 2015. Individual narratives were assembled using the interview data from participants, and we used the assumptions of explanatory models to organize data related to the reconstruction of the experiences shared by mothers regarding the cause, treatment and prognosis of the disease. For the analysis of data deriving from the narratives, the inductive thematic analysis was used. Specific and similar aspects from the narratives were related to the experiences of mothers whose children were undergoing complementary treatment and they were integrated into two meaningful themes, presented in the form of narrative summaries or units of meaning. The results were analyzed and presented based on two thematic narratives: When a child has cancer, one cannot imagine the strength of a mother as for the persistence, the energy, the enthusiasm and motivation that mothers are able to gather to cope with the demands of a cancer diagnosis and the treatment of such a disease, as well as the mothers' influence over decisions that would ensure the quality of care of their children, with or without the incorporation of alternative practices; and The use of complementary therapy motivated by hope, in the sense that the meaning attributed by mothers regarding the incorporation of complementary therapies in the care of their child represents the renewal of hope, aiming at the promotion of the children or adolescent well-being and the healing of the disease. The meaning of these experiences was explained by way of concepts derived from anthropology. The interpretation of narratives centered on the experience of a group of mothers of children and adolescents affected by cancer undergoing complementary therapy, from the cultural system standpoint, allowed us to explain, comprehensively, how culture influences the care provided by mothers to their children by way of meanings. The meaning of the experiences for this group of mothers amounts to knowledge that can be applied in clinical practice and in future research

Understanding Parental Experiences Through Their Narratives of Restitution, Chaos, and Quest: Improving Care for Families Experiencing Childhood Cancer.

The purpose of this secondary analysis was to develop an enhanced understanding of the experiences of parents who have children in treatment for cancer. Data collected from 16 parents (12 mothers and 4 fathers) were analyzed using Frank's dialogical narrative analysis. Findings demonstrated that parents' experiences were represented in chaos, restitution, and quest narratives. Each of these narratives was only one instance of a very complex and changing parental experience that cannot be understood in isolation from the others. The holistic understanding provided by these findings contributes to a more comprehensive understanding of parental experiences of their child's illness and highlights the need for health professionals to invite conversations about parents' illness experience and attend to the specific narrative type parents are presenting to support them adequately. Additional research is required to develop supportive approaches for each narrative which takes into account the complexities of parents' experiences.

Consulta de enfermagem em puericultura: a vivência do enfermeiro na Estratégia de Saúde da Família / Nursing consultation in child care: the experience of nurses in the Family Health Strategy / Consulta de enfermería en puericultura: la vivencia del enfermero en la Estrategia Salud de la Familia

Este estudo objetivou compreender o significado atribuído à consulta de enfermagem em puericultura, pelo enfermeiro que atua na Estratégia Saúde da Família. O referencial teórico foi o Interacionismo Simbólico e o metodológico, a Teoria Fundamentada nos Dados. A coleta de dados foi realizada com sete enfermeiros, por meio de entrevista semi-estruturada e observação participante. A análise comparativa dos dados identificou a categoria conceitual Promovendo mudanças individuais e coletivas por meio de uma assistência abrangente revelando que o enfermeiro valoriza a consulta de enfermagem em puericultura, considera-a importante e reconhece sua potencialidade ao promover mudanças abrangentes significativas em relação às crianças, às suas famílias e no contexto da comunidade, tanto no aspecto preventivo como no curativo, sentindo-se gratificado. Porém, interage com dificuldades pessoais, estruturais, com a influência de crenças, valores e condições sociais da população assistida, e reconhece a necessidade de maior preparo para o desempenho dessa atividade.

The objective of this study was to understand the meaning that the nurses working in the Family Health Strategy assign to the nursing consultation in child care. The theoretical framework was Symbolic Interactionism, and the methodological was the Grounded Theory. Data collection was performed with seven nurses by means of a semi-structured interview and participant observation. The comparative data analysis identified the conceptual category: Promoting individual and collective changes by means of comprehensive care. It was found that nurses value the nursing consultation in child care, they consider it important and acknowledge its potential to promote significant comprehensive changes regarding children, their families, and in the context of the community, in the preventive as well as in the curative aspect, and thus they feel fulfilled. Nevertheless, nurses deal with personal and structural difficulties, and are affected by the beliefs, values and social conditions of the assisted population, and, therefore, recognize they need better preparation to perform this activity.

Se objetivó comprender el significado atribuido a la consulta de enfermería en puericultura por el enfermero actuante en la Estrategia Salud de la Familia. El referencial teórico fue el Internacionalismo Simbólico, y el metodológico, la Teoría Fundamentada en los Datos. La recolección de datos se efectuó con siete enfermeros mediante entrevista semiestructurada y observación participativa. El análisis comparativo de los datos identificó la categoría conceptual Promoviendo cambios individuales y colectivos mediante una atención integral revelando que el enfermero valoriza la consulta de enfermería en puericultura, la considera importante y reconoce su potencialidad de promover cambios integrales significativos en relación al niño, su familia y el contexto comunitario, tanto en el aspecto preventivo como en el curativo, sintiéndose gratificado. Sin embargo, interactúa con dificultades personales, estructurales, con influencias de creencias, valores y condiciones sociales de la población atendida, y reconoce la necesidad de mayor preparación para el desempeño de la actividad.

A música na terminalidade humana: concepções dos familiares / Music in human terminality: the family members' conceptions / La música en pacientes terminales: concepciones de los familiares

Estudo qualitativo que utilizou a estratégia metodológica do estudo de casos múltipos e a fenomenologia existencial heideggeriana para analisar os dados. O objetivo foi compreender como os familiares percebem a influência das vivências musicais na saúde física e mental de um familiar que experiencia a terminalidade. Os dados foram coletados junto a sete indivíduos pertencentes a duas famílias por meio de entrevista e observação em maio e junho de 2009. Os resultados mostraram que a utilização da música no cuidado dos seres que vivenciam o câncer pode proporcionar bem-estar aos pacientes e cuidadores. Considerando-se o déficit de lazer e a monotonia do ambiente domiciliar, a utilização da música contempla os preceitos filosóficos e humanitários dos cuidados paliativos, caracterizando-se como um recurso complementar no cuidado de enfermagem, pois além de constituir um recurso de comunicação, promove melhor relacionamento interpessoal entre o doente e sua família.

This qualitative study was performed using the multiple case study method and Heidegger's existential phenomenology for data analysis. The objective was to understand how family members perceive the influence of musical experiences on the physical and mental health of a relative living with a terminal illness. Participants were seven individuals belonging to two families. Data collection was performed through interviews and observation from May to June 2009. Results showed that using music while providing care to beings living with cancer can provide well-being to patients as well as their caregivers. Considering the deficit of leisure and the monotony of the home environment, using music contemplates the philosophical and humanitarian precepts of palliative care, thus being characterized as a complementary resource to nursing care, as besides being a communication resource, it improves the interpersonal relationship between patients and their families.

Estudio cualitativo que utilizó la estrategia metodológica del estudio de casos múltiple y la fenomenología existencial heideggeriana para analizar los datos. El objetivo fue comprender el modo en que los familiares perciben la influencia de las experiencias musicales en la salud física y mental de un familiar en estado terminal. Los datos fueron recolectados en mayo y junio de 2009, junto a siete individuos pertenecientes a dos familias, a través de entrevistas y observación. Los resultados mostraron que la utilización de música en el cuidado de los pacientes de cáncer puede proporcionarles bienestar, tanto a los pacientes como a sus cuidadores. Considerándose el déficit de placer y la monotonía del ámbito domiciliario, la utilización de la música contempla los preceptos filosóficos y humanitarios de los cuidados paliativos, caracterizándose como un recurso complementario en el cuidado de enfermería, pues más allá de constituir un recurso de comunicación, promueve una mejor relación interpersonal entre el enfermo y su familia.