Revealing an HIV diagnosis for children and adolescents: subsidy for the practice of care. / Revelação do diagnóstico de HIV para crianças e adolescentes: subsídios para prática assistencial.

OBJECTIVE: To collectively build a guide for following-up on HIV diagnosis disclosure to children and adolescents in a specialized service. METHOD: Convergent-care research approach with observation triangulation, interview and groups, conducted from May to June 2015 with seven health professionals in a pediatric outpatient clinic for infectious diseases. Thematic content analysis was developed. RESULTS: The discussion of understanding the disclosure, its triggers, actors involved, used strategies, and limits and possibilities listed by the professionals subsidized the construction of a guide to be applied in the stages: analyzing children's questions and curiosities; evaluating their cognitive ability; discussing the reasons to reveal; listing the professionals involved on follow-up process; including family; developing strategies for disclosure. CONCLUSION: This guide may mediate changes in care practice to ensure the child's rights and to make the professionals co-accountable.

Health care for women in situations of violence: discoordination of network professionals.

OBJECTIVE: To learn the conceptions and actions of health professionals on the care network for women in situations of violence. METHOD: A qualitative, descriptive, exploratory study was conducted between April and July 2015 with the participation of 21 health professionals from four primary health care teams in a city of the central region of the state of Rio Grande do Sul. Data were collected by means of individual semi-structured interviews. Content analysis was used for data systematization. RESULTS: Health professionals recognized the importance of the health care network for coping with the problem of violence against women. However, their conceptions and actions were limited by the discoordination or absence of integration among professionals and services of the care network. CONCLUSION: The conceptions and actions of health professionals contribute to the discoordination among the services. It is necessary to reflect on the daily practices of care for women in situations of violence. OBJETIVO: Conhecer as concepções e ações de profissionais de saúde sobre a rede de atenção às mulheres em situação de violência. MÉTODO: Estudo qualitativo, descritivo e exploratório, realizado no período de abril a julho de 2015. Participaram 21 profissionais de saúde de quatro equipes da Atenção Primária à Saúde em um município da região central do estado do Rio Grande do Sul. A coleta de dados ocorreu mediante entrevistas semiestruturadas e individuais. Para sistematização dos dados, empregou-se a análise de conteúdo. RESULTADOS: Os profissionais de saúde reconheciam a importância da rede de atenção à saúde no enfrentamento da problemática da violência contra as mulheres. Contudo, suas concepções e ações eram limitadas pela desarticulação ou ausência de integração entre os profissionais e serviços da rede de atenção. CONCLUSÃO: As concepções e ações dos profissionais de saúde contribuem para a desarticulação entre os serviços. Faz-se necessário refletir acerca das práticas cotidianas de cuidados direcionados às mulheres em situação de violência.

Women's autonomy in the process of labour and childbirth: integrative literature review. / Autonomia feminina no processo de parto e nascimento: revisão integrativa da literatura.

OBJECTIVE: To identify the available evidence in scientific literature on healthcare practices that interfere with the autonomy of Brazilian women in the labour and delivery process. METHOD: The search for papers was conducted in the databases LILACS, Scopus and PubMed, between 1996 and 2015, according to a guiding question and exclusion criteria, resulting in the selection of 22 papers to compose the analytic body. RESULTS: The main practices that favoured the exercise of women's autonomy were out-of-hospital care practices; care practices of support and comfort; and educational care practices. By contrast, the practices that limited autonomy were authoritarian care practices; standardised or routine care practices; care practices that intensify the painful sensation of childbirth; and impersonal and cold care practice. CONCLUSION: There was an alarming contrast between the daily healthcare routine and ministerial recommendations.

Evaluation of the quality of primary health care for children and adolescents with HIV: PCATool-Brasil. / Avaliação da qualidade da atenção primária à saúde de crianças e adolescentes com HIV: PCATool-Brasil.

OBJECTIVE: Assess the overall score of the Primary Health Care in municipalities where children and adolescents living with HIV reside, according to the PCATool-Brazil instrument, professional version. METHODS: Quantitative study with 527 professionals in 25 municipalities where children and adolescents living with HIV reside. Data collection took place between March and August 2014, by applying PCATool-Brazil instrument, professional version. In the data analysis, we used Pearson's chi-square test, the Mann Whitney test and Poisson regression. All ethical aspects were respected. RESULTS: The overall assessment of the Basic Health Unit (BHU) and the Family Health Strategy's (FHS) service quality was satisfactory (6.80). When BHU and FHS were compared, only the latter showed a high score (7.06). CONCLUSIONS: Despite the satisfactory overall score, the need to expand the FSH coverage, and encourage the promotion of competitive public service examinations and the qualification of these professionals.

[Understanding what is lived by the being-couple in face of the prophylaxis of vertical HIV transmission]. / Compreensão do vivido do ser-casal diante da profilaxia da transmissão vertical do HIV.

OBJECTIVE: To understand the couple's perspective, the experience of prevention care against the vertical transmission of HIV. METHOD: Heidegger's phenomenological research conducted with 14 participants, through interviews from December / 2011 to February / 2012 in a hospital in the countryside of Rio Grande do Sul, Brazil. Analysis performed with Martin Heidegger's framework. RESULTS the being-couple unveiled the sense of fear, initially in the variation of dread when terrified due to the HIV infection discovery, and later in the horror variation when treatment was needed during gestation and finally in the terror variation when considering the chances of viral transmission to their child. CONCLUSIONS: Health care attention that enables the couple to assume a leading role in the prophylaxis of vertical transmission is recommended, which will reflect positively on the health of pregnant women and in reducing neonatal and infant mortality as a result from AIDS.

Website for families of non-breastfed children: development and validation of content and interface.

OBJECTIVES: to develop and validate the content and interface of a guidance website to support families in promoting Food and Nutrition Security for children under six months who are not breastfed. METHODS: methodological study, Knowledge Translation, in two stages of creation: 1) content and validation on the criterion of accuracy in a panel of experts; 2) interface and validation on the criteria of content, language, illustrations, layout, motivation, culture and applicability. RESULTS: the "Milky Way" website is freely available: https://www.ufsm.br/pet/ciencia-da-computacao/alimentacao-lactea. The content was structured in a decision tree made up of types of milk: milk formula, whole cow's milk and powdered milk; and utensils: bottle, cup and measuring spoon. There were 46 illustrations to elucidate the content, facilitate understanding and engage the target population. The Content Validity Index was 0.91. CONCLUSIONS: the website is a validated technology with evidence-based written and pictorial content translated for use with families.

Assessment of educational technology in lactation physiology by health students.

OBJECTIVES: to assess the suitability, facilitators, and barriers of using a video clip for teaching lactation physiology to health students. METHODS: a cross-sectional study was conducted with online data collection at a higher education institution, using the Assistive Technology Assessment Instrument and open-ended questions. The sample consisted of 88 students. RESULTS: the video clip was deemed suitable in all attributes. Facilitators identified included attractiveness, musicality, and ease of access. Barriers noted were the music's speed and the necessity for prior knowledge. The video clip achieved adequate scores for interactivity (1.71), purpose (1.77), relevance (1.64), and clarity (1.77). The overall average of the attributes was 1.72. CONCLUSIONS: the video clip can serve as an effective learning strategy to enhance hybrid education, potentially contributing to the promotion and support of breastfeeding. However, some barriers underscore the importance of prior knowledge for a complete understanding of the content.

Lactation physiology video clip: health professionals` assessment in hospital care.

OBJECTIVE: To evaluate the usability of a lactation physiology video clips by healthcare professionals and to identify barriers and facilitators for this usage in hospitals. METHOD: Cross-sectional study juxtaposed with the Knowledge Translation Model. The video clip was evaluated with the System Usability Scale self-applied to 63 health professionals from a university hospital in southern Brazil, from April to September 2022. Spearman's correlation test was used. RESULTS: The usability of the video clip obtained the best imaginable classification with a positive association with longer training time (p=0.038) and motivation for using it (p=0.035). The facilitators went to have institutional capacity building; physical space and moments of guidance for breastfeeding; brevity of the video clip with easy and playful information. Barriers were overcrowding and turnover, limited audiovisual equipment and internet equipment. CONCLUSION: The excellence of the usability of the video clip in the hospital highlights the potential for its application in continuing education with professionals and in health education with users. It is concluded that the longer the training time and the motivation for using technologies in daily care, the better professionals evaluate usability.

Reproductive planning and pregnancy of HIV serodiscordant couples: a phenomenological study.

OBJECTIVE: To understand the experience of reproductive planning and pregnancy for HIV serodiscordant couples. METHOD: Qualitative study, with phenomenological approach, theoretical-philosophical-methodological framework of Martin Heidegger. The field stage took place in a reference service in the care for people living with HIV, in southern Brazil. From an intentional sample, a phenomenological interview was conducted with 11 couples between August 2013 and April 2014. The analysis was hermeneutic. RESULTS: It was possible to understand, from the meaning units that: couples accept and overcome the serological discordance together; experiencing pregnancy is difficult; there is an effort to have a normal life; the diagnosis is silenced by prejudice and stigma; comes the couple's relief after the child's negative diagnosis. CONCLUSION: It is necessary to recognize the couple as a unit of care with a view to a non-fragmented care in the field of sexual and reproductive health.

[Child with HIV/AIDS: perception of the antiretroviral treatment]. / Criança com HIV/AIDS: percepção do tratamento antirretroviral.

This article presents a cutting from the multicentric study carried out in the municipalities of Porto Alegre and Santa Maria/ RS with the objective of unveiling the perception and the life experience of the child regarding the antiretroviral treatment. With qualitative approach, the study was carried out with seven children of five to ten years of age, in the period from 2006 to 2010, after approval by Committee National for Ethics in research and the Committees of Ethics in research. Based on the thematic analysis was obtained the results: the day-to-day life of the child with medicines; the family care upon the adhesion to the antiretroviral treatment; the professional care:perception of children with infection. Observation showed that the children face adversities, know and appreciate the treatment in spite of the paradoxical movement of rejection/acceptance expressed by the fight against the syndrome.

Effectiveness of auriculotherapy for anxiety, stress or burnout in health professionals: a network meta-analysis.

OBJECTIVE: to analyze the effectiveness of auriculotherapy, when compared to the control group, placebo or usual treatment for anxiety, stress or burnout in health professionals. METHOD: a systematic review conducted in nine information sources, being selected experimental or quasi-experimental studies with auriculotherapy intervention in health professionals, compared to control, placebo or usual treatment groups. Descriptive analysis and network meta-analysis by means of direct and indirect comparison. Quality of the outcomes was assessed with the Confidence in Network Meta-analysis. RESULTS: 15 articles were included: 66.6% with Nursing teams and 53.3% with interventions involving semi-permanent needles. The shen men, brainstem, kidney, sympathetic, lung and liver acupoints predominated. There was a reduction in anxiety with semi-permanent needles (CI -8.18, -6.10), magnetic palettes (CI -7.76, -5.54), placebo (CI -5.47, -3.36) and seeds (CI -6.35, -4.05); as well as in stress with semi-permanent needles (CI -37.21, -10.88) and seeds with (CI -28.14, -11.70) and without a closed protocol (CI -36.42, -10.76). Meta-analysis was unfeasible for burnout; however, significant reductions were verified when it was treated with auriculotherapy. CONCLUSION: Auriculotherapy is effective to reduce anxiety and stress in health professionals; however, this assertion cannot be made in the case of burnout. It was evidenced that workers' health is favored with the use of auriculotherapy.

Confronting situations of violence against children and adolescents from the perspective of Guardianship Counselors.

OBJECTIVE: To describe the potentialities and limits in confronting situations of violence against children and adolescents seen from the perspective of Guardianship Counselors. METHOD: Qualitative research, developed with 18 Guardianship Counselors from two municipalities in the central region of the State of Rio Grande do Sul, Brazil. Data were generated between June and July 2021, using the focus group technique, and were subjected to thematic content analysis. RESULTS: The following were identified as potentialities for combating violence against children and adolescents: denunciations; networking; and media coverage. As limits, we have: naturalization of violence; pandemic of the Covid-19; de-structuring of the intersectoral network; lack of training; and difficulty in developing preventive actions. CONCLUSION: The Guardianship Councilors require training to act in cases of violence against children and adolescents, as well as support from other sectors, such as health, education, public safety, and social assistance, in order to fully attend to these cases.

[Adolescents under socio-educational measures: everyday ways of being and possibilities for nursing]. / Adolescente que cumpre medida socioeducativa: modos de ser no cotidiano e possibilidades para enfermagem.

This study aimed to understand the routine of the adolescent-being, who is under semi-liberty socio-educational measures. A phenomenological research was developed in unit of the Socio-Educational Treatment Foundation (Fundação de Atendimento Socioeducativo), in the state of Rio Grande do Sul, Brazil. Interviews were held with nine adolescents, from February to May, 2009. The Heideggerian analysis un-veiled that this socio-educational measure means a prison for them, something bad. They know they are not in the prison system due to their age and re-cognize they have thrown away their adolescence. In the institution, these youngsters go to school to learn something, to get some job. They express themselves through gossip, ambiguity and occupation. The conclusion is that the teenager is-thrown in that which is determined and remain in impersonality. For social reintegration they need the help of the socio-educational system, mediated by interdisciplinary work, and a support network for which the family, community and State are co-responsible.

Communication of HIV diagnosis in proper time: scoping review.

OBJECTIVE: To map how the communication of the HIV infection diagnosis occurs in pediatrics. METHODS: Scoping review of the 64 original articles. We selected research papers in Portuguese, English, or Spanish, with the participants: child, adolescent, relative/family, and/or health professional from 2011-2020. We accessed the following sources: PubMed, CINAHL, Scopus, WoS, ASSIA, PsycINFO, ERIC, Sociological Abstracts, Edubase, LILACS, BDENF, and IndexPsi. RESULTS: Regarding the population, it was evident to us that the relative must be the sender of the diagnosis with the professionals' support; regarding the reasons for the communication, the child maturity, expressed by questions, the necessity of therapy adherence, abilities to communicate and the right of knowing the diagnosis must be considered. The communication channel is centered on materials that promote comprehension, quantity, and quality of information. That indicated an interactive process. Regarding the effects, they are beneficial when the communication occurs at a proper time. CONCLUSION: Communication must occur through a process that includes professional support to the relatives/family, development of abilities to evaluate the appropriate moment, and the monitoring effect.

Content validation to support the monitoring of disclosure of HIV diagnosis in childhood.

OBJECTIVES: to create and validate the content of a guide for monitoring the communication of the HIV diagnosis in childhood. METHODS: methodological study, with a design guided by the Knowledge-to-Action (KTA) Framework, supported by a participatory approach. The guide's content was structured according to the communication elements proposed by Lasswel from review studies. RESULTS: the content was validated by 26 experts from nursing, medicine, psychology and pedagogy, using a Likert-type scale for relevance, clarity and precision. Data collection took place online and achieved a Content Validity Index of 0.94. CONCLUSIONS: the guide can contribute to the practice of professionals who care for children living with HIV, to support the family in communication and to the child's right to know their diagnosis. For further research, it is recommended to create and validate the face of the technology in order to implement it.

Intentionality of women's actions in labor: a study in social phenomenology.

OBJECTIVE: to understand the intentionality of women's autonomous actions in labor. METHODS: a study in Alfred Schütz's social phenomenology, developed with 15 puerperal women admitted to a university hospital in southern Brazil. Data were collected through phenomenological interviews and analyzed according to the adopted framework and the comparison with scientific productions. RESULTS: the actions intended to receive physical and emotional support from their companions, from pregnancy, for a peaceful delivery with less pain, fast and without interventions. The intention was to do the right things for the child's well-being and, after delivery, to be painless and active to take care of their children. FINAL CONSIDERATIONS: women's actions have intentionality arising from their knowledge, which is guided by the social relationships established in the world of life.

Humanized childbirth: the values of health professionals in daily obstetric care.

OBJECTIVE: To understand health professionals' values in the process of thinking and feeling about obstetric care, based on their experienced needs in the care process. METHODS: Phenomenological study based on the Schelerian framework, with 48 health professionals from four maternity hospitals within the Metropolitan Region II of the state of Rio de Janeiro. Data collection was done through a phenomenological interview; and the analysis, with the Ricoeurian methodological framework. RESULTS: The vital value was signified in care centered on physiological processes, for an individualized and safe monitoring. The ethical value was signified in the attitudes that provide women with autonomy in their way of giving birth, and recognize dialogue as a process of sympathy, affection, and bonding. CONCLUSION: The resignification of obstetric practice, articulated with public policies in the field of delivery and birth, supported by a vital ethical value, positively contributes to the humanization of care for women.

[The daily routine of women infected with HIV/AIDS way of being in the face of the impossibility of breastfeeding]. / Cotidianidade da mulher que tem HIV/AIDS: modo de ser diante da (im)possibilidade de amamentar.

The purpose of this phenomenological research is to understand the daily routine of women infected with the virus of human immunodeficiency (HIV) prevented from breastfeeding. Twelve women were interviewed in a university hospital in southern Brazil. Their statements, analyzed through a Heideggerian approach, showed that the women reveal themselves as beings-in-the-world and are mainly impersonal. The way of being of de-cadence was unveiled and expressed by occupation, gossip, curiosity, ambiguity, fear, and the inauthenticity of the pact of silence and the unsaid. The helpful care mediated by a dialogic relationship between mother and son/daughter between the woman and the professional, showed the possibility of movement from inauthenticity to authenticity. We recommend the use of direct and dialogued interaction as an assistance strategy, mediated by listening, empathy and intersubjectivity, and developed through the comprehension of the way of being of the human being in the face of the impossibilities imposed by the serological condition and in their attempt to unveil their possibilities.

[Analysis of scientific production of warning about the newborn of low birth weight in ICU]. / Análise da produção científica acerca da atenção ao recém-nascido de baixo peso em UTI.

This study aims to analyse the nature and trend from articles about low weight children's health. It is an integrative review developed in August, 2009, with the descriptors: "Infant, low birth weight" or "infant, very low birth weight" and "intensive care units, neonatal, which appeared in articles published between 1990 and 2008. Six-hundred and eight abstracts were submitted to thematic content analysis. The results of clinic-epidemiological studies contemplate risk factors of low weight and neonatal morbi-mortalits and those with assistential tendency contribute to the care and routine given. It becomes evident that the Advances in the newborn health care, clinical complexity and implications to their assistance are made evident. It stans out that there is a gap in research that exposes the family subjectivity, support and inclusion in the care process and in coping with this situation.

Effectiveness of interventions for adherence to antiretroviral therapy in adults with HIV: a systematic review. / Efetividade de intervenções para adesão à terapia antirretroviral em adultos com HIV: revisão sistemática.

OBJECTIVE: To identify the best available evidence of intervention effectiveness for adherence to antiretroviral therapy for HIV in adults. METHOD: The methodology proposed by the Cochrane Collaboration was used, with search in the databases: PubMed, Embase, LILACS, CINAHL, Web of Science and SCOPUS. Randomized clinical trials of interventions to promote adherence to antiretroviral therapy for HIV, in the ≥ 18-year-old population, published from 2010 onward, were considered. The eligibility, inclusion and extraction of results were developed by two independent researchers. RESULTS: The five studies included in the quantitative analysis were effective interventions that developed educational actions with the patient, especially mediated by software, the use of medication schedule reminders and the inclusion of treatment supporters that also received educational actions to develop such role. CONCLUSION: The combination of interventions strengthens the promotion of adherence. There is a need for investment in the implementation of educational actions with patients, such as the inclusion of supporters, in addition to counseling and electronic devices for reminders, which must be offered in the services in an articulated and continuous manner.