Connecting to (Re)connect: Video Calling as a Resource to Unite Families and Children in a Pediatric Intensive Care Unit During the COVID-19 Era.

Video calling emerged as an important resource during coronavirus disease 2019 (COVID-19) to reconnect child and family, bringing the possibility of communication even during isolation. The objective of this study was to understand the experiences of families who communicated with their children through video calls during isolation by COVID-19 in the pediatric intensive care unit (PICU). This was a qualitative study employing the theory of symbolic interactionism and the research method of grounded theory, with 14 families of children in PICU who used video calling as a communication resource. The data were collected through semi-structured interviews. The analysis revealed the main category of "Connecting to (re)connect: Video calling as a resource to unite families and children in PICU in the COVID-19 era," from which a theoretical model explaining the experience was built. Video calling is an important resource to mitigate the effects of family-child separation during hospitalization, and its use is encouraged in other contexts.

O cuidado centrado na família em unidade de terapia intensiva neonatal: Conceções dos técnicos de enfermagem / Family-centered care in neonatal intensive units: The perceptions of nursing technicians / Cuidados centrados en la familia en una unidad de cuidados intensivos neonatales: Concepciones de los técnicos de enfermeira

Resumo Enquadramento: O cuidado centrado na criança e na família (CCCF) em unidades neonatais possui diversos benefícios como diminuir o sofrimento dos pais pela sua participação e autonomia, aumento do aleitamento materno, diminuição de sequelas da prematuridade. Objetivo: Compreender as conceções de técnicos de enfermagem sobre o CCCF praticado em unidade de terapia intensiva neonatal (UTIN). Metodologia: Investigação qualitativa desenvolvida em UTIN de um hospital-escola localizado no interior de São Paulo, Brasil, com entrevistas abertas e semiestruturadas junto a seis técnicos de enfermagem. Os dados foram analisados por análise temática, à luz dos pressupostos do CCCF. Resultados: Foram encontrados seis temas - Incluir a família no cuidado, Promover a aproximação da unidade familiar, Acolher a unidade familiar, Partilha de informações com a família, Reconhecer a UTIN como ambiente stressor à família e Limitações para oferecer o CCCF na UTIN. Conclusão: O estudo evidenciou limitações na compreensão do CCCF pelos profissionais de enfermagem e a necessidade de incluir o assunto na formação dos futuros profissionais e em atividades de educação continuada.

Abstract Background: Using the child- and family-centered care (CFCC) model provides neonatal units with considerable benefits, such as decreasing parents' suffering through their participation and autonomy, increasing breastfeeding rates, and decreasing sequelae of prematurity in infants. Objective: To understand nursing technicians' perceptions of CFCC delivery in a neonatal intensive care unit (NICU). Methodology: A qualitative research study was conducted at a NICU of a teaching hospital located in the interior of São Paulo, Brazil, using open and semi-structured interviews with six nursing technicians. Data were analyzed using thematic analysis, based on the principles of CFCC. Results: The study identified the six themes Integrating families into the care process; Promoting the family unit's closeness; Welcoming the family unit; Sharing information with the families; Recognizing the NICU as a stressful environment for families; and Limitations of delivering CFCC at the NICU. Conclusion: The results show that nursing professionals have a limited understanding of CFCC and that it is crucial to include this topic in the education of future professionals and continuous training activities.

Resumen Marco contextual: El cuidado centrado en el niño y la familia (CCCF) en las unidades neonatales tiene varios beneficios, como reducir el sufrimiento de los padres mediante su participación y autonomía, aumentar la lactancia materna, reducir las secuelas de la prematuridad. Objetivo: Comprender las concepciones de los técnicos de enfermería sobre el CCCF practicado en una unidad de cuidados intensivos neonatales (UTIN). Metodología: Investigación cualitativa desarrollada en una UTIN de un hospital universitario situado en el interior de São Paulo, Brasil, con entrevistas abiertas y semiestructuradas a seis técnicos de enfermería. Los datos se analizaron mediante análisis temático, atendiendo a los supuestos del CCCF. Resultados: Se encontraron seis temas - Incluir a la familia en los cuidados, Promover la cercanía de la unidad familiar, Acoger a la unidad familiar, Compartir información con la familia, Reconocer que la UTIN es un entorno estresante para la familia y Limitaciones para ofrecer el CCCF en la UTIN. Conclusión: El estudio puso de manifiesto las limitaciones en la comprensión del CCCF por parte de los profesionales de enfermería y la necesidad de incluir el tema en la formación de los futuros profesionales y en las actividades de formación continua.

A Pediatric Intensive Care Checklist for Interprofessional Rounds: The R-PICniC Study.

BACKGROUND: The use of checklists in the pediatric intensive care unit can help improve the quality of care and patient safety. OBJECTIVES: To build and validate a checklist for use in interprofessional rounds in a pediatric intensive care unit. METHODS: This methodological study was conducted in a 20-bed pediatric intensive care unit serving children up to 14 years old. A checklist prototype was constructed through review of the literature and achievement of consensus among the professionals providing care in the unit. Content validation was performed using a modified Delphi technique involving specialists with more than 5 years of experience in pediatric intensive care, methodological studies, and patient safety. Content validity ratios were calculated for the elements of the checklist, which were considered valid when they reached values greater than 0.78. The checklist was tested for usability, application time, and effects on patient care, and feedback was obtained from potential users. RESULTS: Before content validation, the checklist contained 11 domains, 32 items, and 6 daily goals. The invitation to validate content was sent to 86 specialists, and content validity was achieved after 2 rounds of evaluation, with the checklist elements having content validity ratios ranging from 0.94 to 0.97. The mean application time of the checklist was 5 minutes. The final version consisted of 11 domains, 33 items, and 8 daily goals. CONCLUSIONS: This study resulted in a useful and valid instrument for application in interprofessional rounds that was tailored to the needs of local health care professionals.

Support group for families with children in a pediatric intensive care unit / Equipo de apoyo a las familias de niños en Unidad de Cuidados Intensivos Pediátricos / Grupo de apoio para famílias de crianças em unidade de terapia intensiva pediátrica

ABSTRACT Objective: To describe the process of creating and implementing a support group for families with children in a pediatric intensive care unit. Methods: A professional experience report described using a management and planning tool. Results: This is a pioneering initiative in the hospital. The application of the tool enabled the delineation of the scope, justification, location, frequency, responsible persons, approach, and budget. After its implementation, the group enables significant interaction between health professionals-families and families-families, favoring the formation of therapeutic bonds and stimulating social and emotional support networks. Conclusion: The tool effectively planned the group and highlighted its effects on family coping and the relationships between professionals and families.

RESUMEN Objetivo: Describir el proceso de creación e implementación de equipo de apoyo a las familias de niños en unidad de cuidado intensivo pediátrico. Métodos: Relato de experiencia profesional descripto mediante una herramienta de gestión y planeamiento. Resultados: Se trata de iniciativa pionera en el hospital. La utilización de la herramienta posibilitó el delineamento del objetivo, justificativa, local, frecuencia, responsables, abordaje y presupuesto. Después de su implantación, el equipo está posibilitando interacción significativa profesionales de salud-familias y familias-familias, favoreciendo la formación de vínculo terapéutico y estimulando redes de apoyo social y emocional. Conclusión: La herramienta fue eficaz en el planeamiento del equipo y destacó los efectos de este en el enfrentamiento familiar y en la relaciones entre profesionales y familias.

RESUMO Objetivo: Descrever o processo de criação e implementação de grupo de apoio às famílias de crianças em unidade de terapia intensiva pediátrica. Métodos: Relato de experiência profissional descrito mediante uma ferramenta de gerenciamento e planejamento. Resultados: Trata-se de iniciativa pioneira no hospital. A utilização da ferramenta possibilitou o delineamento do escopo, justificativa, local, frequência, responsáveis, abordagem e orçamento. Após sua implantação, o grupo está possibilitando interação significativa profissionais de saúde-famílias e famílias-famílias, favorecendo a formação de vínculo terapêutico e estimulando redes de apoio social e emocional. Conclusão: A ferramenta foi eficaz no planejamento do grupo e destacou os efeitos deste no enfrentamento familiar e nos relacionamentos entre profissionais e famílias.

Support group for families with children in a pediatric intensive care unit.

OBJECTIVE: To describe the process of creating and implementing a support group for families with children in a pediatric intensive care unit. METHODS: A professional experience report described using a management and planning tool. RESULTS: This is a pioneering initiative in the hospital. The application of the tool enabled the delineation of the scope, justification, location, frequency, responsible persons, approach, and budget. After its implementation, the group enables significant interaction between health professionals-families and families-families, favoring the formation of therapeutic bonds and stimulating social and emotional support networks. CONCLUSION: The tool effectively planned the group and highlighted its effects on family coping and the relationships between professionals and families.

The experience of grandparents of children hospitalized in Pediatric Intensive Care Unit. / A experiência dos avós de crianças hospitalizadas em Unidade de Terapia Intensiva Pediátrica.

OBJECTIVE: To understand the experience of grandparents of children hospitalized in pediatric intensive care units. METHOD: This was a qualitative study based on the symbolic interactionism theoretical framework and the grounded theory as methodological framework carried out with grandparents of children hospitalized in the pediatric intensive care unit of a teaching hospital in a city in the state of São Paulo. Data were collected by means of participatory observation and semi-structured interviews, and analyzed following the open and axial codification stages of grounded theory. RESULTS: Nine grandparents were interviewed. Two phenomena were identified: "finding themselves inside a storm" and "fighting to be the anchor of the family", which explain the suffering experienced and support role developed by grandparents during the hospitalization period. CONCLUSION: Grandparents develop an important family support role during the crisis. Therefore, family care strategies must be developed to include this generation of the family, who are increasingly present and participatory in several healthcare settings.

A experiência dos avós de crianças hospitalizadas em Unidade de Terapia Intensiva Pediátrica / The experience of grandparents of children hospitalized in Pediatric Intensive Care Unit / La experiencia de los abuelos de niños hospitalizados en Unidad de Terapia Intensiva Pediátrica

RESUMO Objetivo: Compreender a experiência dos avós de ter um neto hospitalizado em Unidade de Terapia Intensiva Pediátrica. Método: Estudo qualitativo, que utilizou o referencial teórico do Interacionismo Simbólico e, como referencial metodológico, os pressupostos da Teoria Fundamentada nos Dados, realizado com avós de crianças hospitalizadas em Unidade de Terapia Intensiva Pediátrica de um hospital-escola de uma universidade do interior de São Paulo. Os dados foram coletados por meio de observação participante e entrevistas semiestruturadas e analisados seguindo as etapas de codificação aberta e axial da Teoria Fundamentada. Resultados: Foram entrevistados nove avós. Identificaram-se dois fenômenos: "Percebendo-se envoltos em uma tempestade" e "Lutando para ser a âncora da família", que compreendem o sofrimento vivenciado e o papel de suporte desenvolvido pelos avós durante a hospitalização. Conclusão: Os avós desenvolvem um importante papel de sustentação familiar durante a crise, portanto é essencial que se pense em estratégias de cuidado da família que envolvam também essa geração familiar, cada vez mais presente e participativa nos diferentes cenários de atenção à saúde.

ABSTRACT Objective: To understand the experience of grandparents of children hospitalized in pediatric intensive care units. Method: This was a qualitative study based on the symbolic interactionism theoretical framework and the grounded theory as methodological framework carried out with grandparents of children hospitalized in the pediatric intensive care unit of a teaching hospital in a city in the state of São Paulo. Data were collected by means of participatory observation and semi-structured interviews, and analyzed following the open and axial codification stages of grounded theory. Results: Nine grandparents were interviewed. Two phenomena were identified: "finding themselves inside a storm" and "fighting to be the anchor of the family", which explain the suffering experienced and support role developed by grandparents during the hospitalization period. Conclusion: Grandparents develop an important family support role during the crisis. Therefore, family care strategies must be developed to include this generation of the family, who are increasingly present and participatory in several healthcare settings.

RESUMEN Objetivo: Comprender la experiencia de los abuelos que tienen un nieto hospitalizado en Unidad de Terapia Intensiva Pediátrica. Método: Estudio cualitativo, que utilizó el referencial teórico del Interaccionismo Simbólico y, como referencial metodológico, los presupuestos de la Teoría Fundamentada en los Datos, realizada con abuelos de niños hospitalizados en Unidad de Terapia Intensiva Pediátrica de un hospital-escuela de una universidad del interior de Sao Paulo. Los datos fueron recolectados por medio de observación participante y entrevistas semiestructuradas y analizados siguiendo las etapas de codificación abierta y axial de la Teoría Fundamentada. Resultados: Fueron entrevistados nueve abuelos. Se identificaron dos fenómenos: "Percibiéndose envueltos en una tempestad" y "Luchando para ser el ancla de la familia", que resumen el sufrimiento vivido y el papel de soporte desarrollado por los abuelos durante la hospitalización. Conclusión: Los abuelos desarrollan un importante papel de sustentación familiar durante la crisis, por lo que es esencial que se piense en estrategias de cuidado de la familia que involucren también a esta generación familiar, cada vez más presente y participativa en los diferentes escenarios de atención a la salud.