Quando a vida começa diferente: cuidado postural no cotidiano da equipe multiprofissional em terapia intensiva pediátrica / Cuando la vida empieza distinta: el cuidado postural en la rutina del equipo multiprofesional de cuidados intensivos pediátricos / When life begins different: postural care on daily life of the multiprofessional team in pediatric intensive care

Objetivo: Compreender as práticas da equipe multiprofissional no cuidado postural da criança cardiopata na unidade de terapia intensiva. Métodos: Trata-se de estudo descritivo de cunho qualitativo, realizado na Unidade de Terapia Intensiva cardiopediátrica de um hospital de referência de Fortaleza, Ceará, Brasil, no tratamento de doenças cardíacas e pulmonares em abril de 2016, com profissionais de saúde lotados há pelo menos seis meses na unidade atuando no manejo da criança no leito. A coleta de dados foi através da observação participante e da entrevista semiestruturada. Utilizou-se a Análise de Conteúdo para a análise das informações. A pesquisa cumpriu a Resolução 466/12 e foi iniciada após a aprovação do Comitê de Ética do referido hospital com parecer de nº 53399616.4.0000. Resultados: Emergiram as seguintes categorias de análise: "Só mais uma vez... amanhã talvez": a distância dos sujeitos nos processos de cuidado em saúde e "Oh me vira aqui... me mexe aqui": outros modos de ser profissional de saúde. Conclusão: Há que se refletir criticamente acerca das ações e interações no contexto dos serviços de saúde sobre o que, como e quando falar; o que, como e quando olhar; como se posicionar e tocar a criança. Importa compreender o que a criança transmite e tentar atender às suas necessidades como pessoa e não só como paciente.

Objetivo: Comprender las prácticas del equipo multiprofesional para el cuidado postural del niño con cardiopatía en la unidad de cuidados intensivos. Métodos: Se trata de un estudio descriptivo y cualitativo realizado en la Unidad de Cuidados Intensivos cardiopediátrico de un hospital de referencia de Fortaleza, Ceará, Brasil, para el tratamiento de enfermedades cardíacas y pulmonares en abril de 2016 con profesionales sanitarios que trabajaban desde hace por lo menos seis meses en la unidad en el manejo del niño en la cama. La recogida de datos se dio a través de la observación participante y de la entrevista semiestructurada. Para el análisis de las informaciones se utilizó el Análisis de Contenido. La investigación ha cumplido la Resolución 466/12 y se ha iniciado tras la aprobación del Comité de Ética del referido hospital con el informe de nº 53399616.4.0000.Resultados: Emergieron las siguientes categorías de análisis: "Solo una vez más….mañana tal vez": la distancia de los sujetos en los procesos del cuidado en salud y "Oye, voltéame aquí…me mueve aquí": otros modos de ser profesional sanitario. Conclusión: Hay que reflexionar críticamente sobre las acciones y interacciones en el contexto de los servicios de salud sobre el que, cómo y cuándo hablar; el que, cómo y cuándo mirar; como posicionarse y tocar el niño. Es importante comprender lo que el niño trasmite y intentar atender sus necesidades como persona y no solo como paciente.

Objective: To understand the practices of the multiprofessional team in the postural care of the cardiopath child in the intensive care unit. Methods: This is a qualitative descriptive study, carried out in the Cardiopediatric Intensive Care Unit of a reference hospital in Fortaleza, Ceará, Brasil, in the treatment of heart and lung diseases in April of 2016, with health professionals who had been working for at least six months at the unit dealing with child in bed. A semistructured interview and participants observation was used to collect data. Content Analysis was used to analyze the information. The research complied with Resolution 466/12 and it started after the approval of the Ethics Committee of said hospital with the opinion of nº 53399616.4.0000. Results: The following categories of analysis emerged: "Only once more ... maybetomorrow ": the distance of the subjects in the processes health care and "Oh turn me here ... move me here": other ways of being a health professional. Conclusion: It is necessary to reflect critically on the actions and interactions in the context of the health services on what, how and when to speak; what, how and when to look; how to stand and touch the child. It is important to understand what the child transmits and try to meet their needs as a person and not only as a patient.

Illness experiences of persons with chronic obstructive pulmonary disease: self-perceived efficacy of home-based pulmonary rehabilitation.

This qualitative study explores the illness experiences, the efficacy of pulmonary rehabilitation as perceived by patients with chronic obstructive pulmonary disease (COPD) and their rationale for improvements in health. 23 patients participated in a daily, three-month home-based pulmonary rehabilitation. A pre-post self-perceived assessment of efficacy was conducted. Semi-structured interviews, illness narratives and participant-observation provided a "dense description" of patients' lived-experience before and after the program. Interviews and narratives were tape-recorded, transcribed and coded. Qualitative data was subjected to "thematic content analysis" and "contextualized semantic interpretation". Patients compare functional status before and after falling ill, experience loss, stigma and depression, describe health improvements and judge the pulmonary rehabilitation's efficacy. Giving voice to chronically-ill patients, as individuals, is needed. To reduce clinical conflicts, health professionals should encourage illness narratives and value their patients' lived-experience.

Comparison of the effects of pulmonary rehabilitation with chest physical therapy on the levels of fibrinogen and albumin in patients with lung cancer awaiting lung resection: a randomized clinical trial.

BACKGROUND: Systemic inflammation plays an important role in the initiation, promotion, and progression of lung carcinogenesis. In patients with non-small cell lung cancer (NSCLC), fibrinogen levels correlate with neoplasia. Here we compared the effects of pulmonary rehabilitation (PR) with chest physical therapy (CPT) on fibrinogen and albumin levels in patients with LC and previous inflammatory lung disease awaiting lung resection. METHODS: We conducted a randomized clinical trial with 24 patients who were randomly assigned to Pulmonary Rehabilitation (PR) and Chest Physical Therapy (CPT) groups. Each group underwent training 5 days weekly for 4 weeks. All patients were assessed before and after four weeks of training through clinical assessment, measurement of fibrinogen and albumin levels, spirometry, 6-minute Walk Test (6MWT), quality of life survey, and anxiety and depression scale. PR involved strength and endurance training, and CPT involved lung expansion techniques. Both groups attended educational classes. RESULTS: A mixed between-within subjects analysis of variance (ANOVA) revealed a significant interaction between time (before and after intervention) and group (PR vs. CPT) on fibrinogen levels (F(1, 22)=0.57, p<0.0001) and a significant main effect of time (F(1, 22)=0.68, p=0.004). Changes in albumin levels were not statistically significant relative to the interaction effect between time and group (F(1, 22)=0.96, p=0.37) nor the main effects of time (F(1, 22)=1.00, p=1.00) and group (F(1, 22 )=0.59, p=0.45). A mixed between-within subjects ANOVA revealed significant interaction effects between time and group for the peak work rate of the unsupported upper limb exercise (F(1, 22)=0.77, p=0.02), endurance time (F(1, 22)=0.60, p=0.001), levels of anxiety (F(1, 22)=0.60, p=0.002) and depression (F(1, 22)=0.74, p=0.02), and the SF-36 physical component summary (F(1, 22)=0.83, p=0.07). CONCLUSION: PR reduced serum fibrinogen levels, improved functional parameters, and quality of life of patients with LC and inflammatory lung disease awaiting lung resection. TRIAL REGISTRATION: Current Controlled Trials RBR-3nm5bv.

Illness experiences of persons with chronic obstructive pulmonary disease: self-perceived efficacy of home-based pulmonary rehabilitation / Experiência da enfermidade de pessoas com doença pulmonar obstrutiva crônica: eficácia autopercebida de um programa de reabilitação pulmonar domiciliar / Experiencia de la enfermedad de personas con enfermedad pulmonar obstructiva crónica: eficacia auto-percibida de un programa de rehabilitación respiratoria

This qualitative study explores the illness experiences, the efficacy of pulmonary rehabilitation as perceived by patients with chronic obstructive pulmonary disease (COPD) and their rationale for improvements in health. 23 patients participated in a daily, three-month home-based pulmonary rehabilitation. A pre-post self-perceived assessment of efficacy was conducted. Semi-structured interviews, illness narratives and participant-observation provided a “dense description” of patients' lived-experience before and after the program. Interviews and narratives were tape-recorded, transcribed and coded. Qualitative data was subjected to “thematic content analysis” and “contextualized semantic interpretation”. Patients compare functional status before and after falling ill, experience loss, stigma and depression, describe health improvements and judge the pulmonary rehabilitation’s efficacy. Giving voice to chronically-ill patients, as individuals, is needed. To reduce clinical conflicts, health professionals should encourage illness narratives and value their patients’ lived-experience.

Este estudo qualitativo explora as experiências com a enfermidade, a eficácia da reabilitação pulmonar percebida por pacientes com doença pulmonar obstrutiva crônica (DPOC) e sua racionalidade sobre a melhora da saúde. Vinte e três pacientes participaram de um programa de reabilitação pulmonar de três meses, diário, em domicilio. Foi realizada uma pré e pós-avaliação de sua eficácia. Entrevistas semiestruturadas, narrativas de enfermidade e observação participante forneceram uma “descrição densa” da experiência vivida pelos pacientes antes e depois do programa. As entrevistas e narrativas foram gravadas, transcritas e codificadas. Os dados qualitativos foram submetidos à “análise temática de conteúdo” e “interpretação semântica contextualizada”. Os pacientes comparam o seu estado funcional antes e depois da doença, a experiência perdida, o estigma e a depressão, descrevem a melhora da saúde e julgam a eficácia da reabilitação pulmonar. É necessário dar voz aos pacientes crônicos como pessoas. Os profissionais de saúde devem obter narrativas da enfermidade e valorizar suas experiências de vida.

Este estudio explora las experiencias con la enfermedad, la eficacia de la rehabilitación respiratoria percibida por los pacientes con enfermedad pulmonar obstructiva crónica (EPOC) y su racionalidad para la mejoría en salud. Veintitrés pacientes participaron en un programa de rehabilitación respiratoria domiciliaria durante tres meses. Fue realizada una pre- y pos- evaluación auto-percibida de la eficacia del programa. Entrevistas semiestructuradas, relatos sobre la enfermedad y una observación participativa proporcionaron una “descripción densa” de la experiencia vivida por los pacientes antes y después del programa. Las entrevistas y relatos fueron grabados, trascritos y codificados. Los datos cualitativos fueron sometidos a un “análisis temático de contenido” e “interpretación semántica contextual”. Los pacientes compararon su estado funcional antes y después de la enfermedad, la experiencia perdida, el estigma y la depresión, describen mejorías en la salud y juzgan la eficacia del programa. Es necesario dar voz a los pacientes crónicos en este sentido.

[Social support network and health of elderly individuals with chronic pneumopathies]. / Rede de apoio social e saúde de idosos pneumopatas crônicos.

This study sought to analyze characteristics of the social support network of the elderly with chronic pneumopathies, establishing links with health maintenance/rehabilitation. The assumptions of Social Network Analysis (SNA) methodology were used, addressing the social support concept. A questionnaire and semi-structured interviews, both applied to 16 elderly people attended by a public hospital in Fortaleza-CE, were used for data collection. Quantitative data were processed using the UCINET 6.123, NetDraw 2.38 and Microsoft Excel software programs. In the qualitative analysis, the body of material was subjected to interpretations based on relevant and current theoretical references. Each informant brought an average of 10.37 individuals into the network. Among the 3 types of social support, there was a predominance of informational support given by health professionals. The importance of reciprocity in providing/receiving social support was also noted, as well as the participation of health professionals and the family functioning as social support. The conclusion reached was that the network of the elderly with pneumopathies is not cohesive, being restricted to the personal network of each individual, and that even so, the informants recognize and are satisfied with the social support it provides.

Rede de apoio social e saúde de idosos pneumopatas crônicos / Social support network and health of elderly individuals with chronic pneumopathies

Esse estudo objetivou analisar características estruturais da rede de apoio social de idosos pneumopatas crônicos, traçando relações com a manutenção/recuperação da saúde. Utilizou-se dos pressupostos da metodologia de Análise de Redes Sociais (ARS), focando o conceito de apoio social e suas dimensões. Na coleta dos dados, foram empregados questionário e entrevista semiestruturada, aplicados a 16 idosos assistidos por um hospital público de Fortaleza-CE. Os dados quantitativos foram processados com auxílio dos softwares UCINET 6.123, NetDraw 2.38 e Microsoft Excel. Na analise qualitativa, o corpus constituiu material submetido a interpretações apoiadas em referencial teórico pertinente e atual. Cada informante trazia para a rede uma média de 10,37 indivíduos. Dentre os três tipos de apoio social, houve predominância daquele de informação com procedência nos profissionais de saúde. Ainda se observou a importância da reciprocidade no fornecimento/recebimento de apoio social, o qual funciona com a participação dos profissionais de saúde e da família. Conclui-se que a rede do idoso pneumopata crônico é pouco coesa, restringindo-se à rede pessoal de cada um, e que, mesmo assim, os informantes reconhecem e estão satisfeitos com o apoio social proporcionado por ela.

This study sought to analyze characteristics of the social support network of the elderly with chronic pneumopathies, establishing links with health maintenance/rehabilitation. The assumptions of Social Network Analysis (SNA) methodology were used, addressing the social support concept. A questionnaire and semi-structured interviews, both applied to 16 elderly people attended by a public hospital in Fortaleza-CE, were used for data collection. Quantitative data were processed using the UCINET 6.123, NetDraw 2.38 and Microsoft Excel software programs. In the qualitative analysis, the body of material was subjected to interpretations based on relevant and current theoretical references. Each informant brought an average of 10.37 individuals into the network. Among the 3 types of social support, there was a predominance of informational support given by health professionals. The importance of reciprocity in providing/receiving social support was also noted, as well as the participation of health professionals and the family functioning as social support. The conclusion reached was that the network of the elderly with pneumopathies is not cohesive, being restricted to the personal network of each individual, and that even so, the informants recognize and are satisfied with the social support it provides.

Cuidado e doença crônica: visão do cuidador familiar no Nordeste brasileiro / Care and Chronic Illness: Family Caregiver's Viewpoint in Northeast Brazil

O cuidado causa estresse na dinâmica cotidiana da família levando a complicações físicas, mentais e emocionais ao cuidador, perda da liberdade e/ou sobrecarga de cônjuges. Entre março e novembro de 2006, esta pesquisa antropológica examinou o cuidado familiar no contexto da Doença Pulmonar Obstrutiva Crônica (DPOC). Utilizando entrevista etnográfica, narrativa da enfermidade e observação participante objetivou-se descrever a reorganização e a convivência familiar com a evolução e a experiência com a DPOC, a percepção de cuidadores familiares sobre as dificuldades e as limitações vivenciadas junto ao doente e as estratégias de enfrentamento da enfermidade. Participaram do estudo seis cuidadores familiares de baixa renda residentes em bairros urbanos pobres da periferia de Fortaleza, Ceará, Brasil. Da Análise de Conteúdo emergiram as categorias: "dividindo sofrimentos" e "atitudes e comportamentos percebidos e vivenciados pelos cuidadores". As narrativas profundas mostraram a afetação significativa entre os enfermos e seus cuidadores familiares. Apesar da pobreza, violência estrutural, desemprego, preconceito social e baixos salários endêmicos no nordeste brasileiro, os cuidadores descobrem maneiras efetivas de lidar com a cronicidade além de criar estratégias para amenizar o sofrimento causado pela doença.

The provision of care causes stress in everyday family dynamics leading to physical, mental and emotional complications in caregivers and spouses' loss of liberty and/or overwork. Between March and November 2006, this anthropological research examined family caregiving in the context of Chronic Obstructive Pulmonary Disease (COPD). By means of ethnographic interviews, illness narratives and participant observation, the scope was to describe family reorganization and coexistence with the disease and its evolution, caregiver perceptions about patient difficulties and limitations experienced and strategies employed to tackle their illness. Six low-income family caregivers, living in poor, urban areas in the outskirts of the capital city, Fortaleza, Ceará, Brazil, participated in the study. From the Content Analysis, two categories arose: "sharing suffering" and "attitudes and behavior perceived and experienced by caregivers." In-depth narratives revealed marked affection between patients and their family caregivers. Despite poverty, structural violence, unemployment, social prejudice and low salaries endemic in the Northeast of Brazil, the caregivers find effective ways to cope with chronic illness besides creating strategies to diminish suffering caused by the illness.

[Care and chronic illness: family caregiver's viewpoint in northeast Brazil]. / Cuidado e doença crônica: visão do cuidador familiar no Nordeste brasileiro.

The provision of care causes stress in everyday family dynamics leading to physical, mental and emotional complications in caregivers and spouses' loss of liberty and/or overwork. Between March and November 2006, this anthropological research examined family caregiving in the context of Chronic Obstructive Pulmonary Disease (COPD). By means of ethnographic interviews, illness narratives and participant observation, the scope was to describe family reorganization and coexistence with the disease and its evolution, caregiver perceptions about patient difficulties and limitations experienced and strategies employed to tackle their illness. Six low-income family caregivers, living in poor, urban areas in the outskirts of the capital city, Fortaleza, Ceará, Brazil, participated in the study. From the Content Analysis, two categories arose: "sharing suffering" and "attitudes and behavior perceived and experienced by caregivers." In-depth narratives revealed marked affection between patients and their family caregivers. Despite poverty, structural violence, unemployment, social prejudice and low salaries endemic in the Northeast of Brazil, the caregivers find effective ways to cope with chronic illness besides creating strategies to diminish suffering caused by the illness.

Evaluación de la ca lidad de vida relacionada con la salud en pacientes confibro mialgia / Assessment of quality of life related to health in patients with fibromyalgia

Determinar el impacto que la fibromialgia tiene sobre la calidad de vida; comparar la calidad de vida de pacientes fibromiálgicos con la población española sana; y conocer la correlación y sensibilidad de dos instrumentos de calidad de vida en la fibromialgia. Método: Estudio transversal y observacional. Participaron 27 sujetos (25 mujeres y 2 hombres) con una media de edad de 50,5 años (SD 7,9) pertenecientes a la Asociación Salmantina de Fibromialgia y Fatiga Crónica. Se utilizaron las versiones españolas del Perfil de Salud Nottingham (NHP) y el cuestionario de Salud del SF-36 (SF36) para estudiar La calidad de vida (CV). Resultados: Se obtivieron altas puntuaciones en las dimensiones, Energía, Dolor, Sueño y Movilidad física del NHP y bajas puntuaciones em las dimensiones del SF36, Problemas físicos, Dolor, Vitalidad y Percepción de La Salud General. Se han encontrado diferencias estadísticamente significativas en todas lãs dimensiones con la población española sana. Las seguintes dimensiones se correlacionaron negativamente estadísticamente: Energía (NHP) - Vitalidad (SF-36); Dolor(NHP)- Función física, Dolor y Vitalidad (SF-36); Movilidad física (NHP)-Función física y Problemas físicos (SF-36), Reacciones emocionales (NHP)- Salud mental, Problemas emocionales y Percepción de la salud general (SF-36). Resulta más sensible al deterioro de la Fibromialgia el cuestionario SF36. Conclusiones: La fibromialgia produce un importante deterioro de la calidad de vida que puede ser valorada por las dimensiones de los cuestionarios NHP y SF36.

To determine the impact that fibromyalgia (FM) has on quality of life; to compare the quality of life of patients with fibromyalgia with the healthy Spanish population and to know the correlation and sensibility of two instruments of quality of life in FM. Method: A cross-sectional and observational study. Twenty-seven subjects joined in (25 women and 2 men) with a mean age of 50.5 years (SD 7.9), belonging to the Salmantina Association ofFibromyalgia and Chronic Fatigue. The Spanish versions of the Nottingham Health Profile (NHP) and the the Short-Form 36 (SF36) were used to study quality of life. Results: High scores were obtained in the Energy, Pain, Sleep and Physical mobility dimensions of the NHP and low scores in the Physical problems, Pain, Vitality and General health perception dimensions of the SF-36. Statistical significant differences were found in all dimensions comparing to the healthy Spanish population. The following dimensions were negatively statistically correlated: Energy(NHP)-Vitality (SF-36); Pain(NHP)- Physical function, Pain and Vitality (SF-36); Physical mobility (NHP)- Physical function and Physical problems (SF-36); Emotional reactions (NHP)- Mental health, Emotional problems and General health (SF-36). The SF-36 is more sensitive than the NHP to evaluate the deterioration of the fibromyalgia. Conclusions: The fibromyalgia produces a significant deterioration in quality of life that can be assessed by the dimensions of the NHP and the SF-36.

[Breath of life: experience with chronic obstructive pulmonary disease in the context of urban poverty in Fortaleza, Ceará State, Brazil]. / Sopro de vida: experiência com a doença pulmonar obstrutiva crônica na pobreza urbana de Fortaleza, Ceará, Brasil.

This is an anthropological study on the experience of living with chronic obstructive pulmonary disease (COPD) for low-income individuals in the city of Fortaleza, Ceará State, Brazil. From March to November 2006, we conducted case studies of six patients, using ethnographic interviews, illness narratives, and participant-observation during hospital treatment and home visits. Thematic context analysis and contextualized semantic analysis were used to link individual experience to system of significance, actions taken, and structural constraints. Based on the findings, COPD provokes subjective sensations, signs, and meanings. The diagnosis "smothers" patients, provoking hardships and limitations in their manual, sexual, domestic, family, and leisure activities. Lay strategies used to confront acute shortness of breath and low self-esteem include: avoiding direct contact with the patient's "phlegm", quitting or reducing smoking, treating symptoms with home remedies and popular body therapies, remaining calm during attacks, rejecting imposed therapies, and surrendering one's self to spiritual powers. Thus, the subjectivity of illness cannot be excluded from the measurement of the "global burden of disease" in Northeast Brazil.

Sopro de vida: experiência com a doença pulmonar obstrutiva crônica na pobreza urbana de Fortaleza, Ceará, Brasil / Breath of life: experience with chronic obstructive pulmonary disease in the context of urban poverty in Fortaleza, Ceará State, Brazil

Trata-se de estudo antropológico de pessoas com a doença pulmonar obstrutiva crônica vivenciada na pobreza urbana de Fortaleza, Ceará, Brasil. De março a novembro de 2006, conduzimos com seis pacientes o estudo de casos, a entrevista etnográfica, a narrativa da enfermidade, e a observação participante no atendimento hospitalar e visitas domiciliares. Utilizamos a análise de conteúdo temática e a interpretação semântica contextualizada para interligar a experiência individual aos sistemas de significação, ações tomadas e condicionantes estruturais. Conclui-se que a doença pulmonar obstrutiva crônica provoca sensações, sinais e significados subjetivos. O diagnóstico torna a vida "um sufoco", surgindo limitações e privações de atividades laborais, sexuais, domésticas, familiares e de lazer. Evitar o contato direto com "o catarro" do doente, deixar de fumar ou diminuir a freqüência e evitar fumaça, tratar os sintomas com remédios caseiros e terapias corporais populares, manter a calma durante as crises, rejeitar restrições categóricas e impostas e entregar-se às forças espirituais são estratégias leigas para enfrentar o cansaço, a crise e a baixa auto-estima. A subjetividade da enfermidade, portanto, jamais pode ser excluída na medição da "carga global da doença" no nordeste brasileiro.

This is an anthropological study on the experience of living with chronic obstructive pulmonary disease (COPD) for low-income individuals in the city of Fortaleza, Ceará State, Brazil. From March to November 2006, we conducted case studies of six patients, using ethnographic interviews, illness narratives, and participant-observation during hospital treatment and home visits. Thematic context analysis and contextualized semantic analysis were used to link individual experience to system of significance, actions taken, and structural constraints. Based on the findings, COPD provokes subjective sensations, signs, and meanings. The diagnosis "smothers" patients, provoking hardships and limitations in their manual, sexual, domestic, family, and leisure activities. Lay strategies used to confront acute shortness of breath and low self-esteem include: avoiding direct contact with the patient's "phlegm", quitting or reducing smoking, treating symptoms with home remedies and popular body therapies, remaining calm during attacks, rejecting imposed therapies, and surrendering one's self to spiritual powers. Thus, the subjectivity of illness cannot be excluded from the measurement of the "global burden of disease" in Northeast Brazil.

A influência das técnicas de liberação miofascial e do nervo frênico na função diafragmática / The influence of the myosfascial liberation and the phrenic nerve techniques in the diaphragm function

A Terapia manual (TM) consiste em utilizar as mãos para tratar com intenção terapêutica, promovendo o retorno à função normal de seus sistemas. As técnicas de TM têm sido descritas por melhorar a mobilidade da caixa torácica, costelas e coluna torácica; a função pulmonar e qualidade de vida. Tendo o diafragma como principal músculo da respiração, o objetivo do estudo foi avaliar a influência das técnicas de liberação miofascial e do nervo frênico na função diafragmática. Estudo do tipo quantitativo, intervencionista e transversal, realizado no setor de Fisioterapia do Núcleo de Atenção Médica Integrada. Foi composto por 10 indivíduos na faixa etária entre 20 e 30 anos. Após a avaliação inicial, foi realizado um único atendimento com o protocolo específico constando de 5 técnicas de TM, tendo duração média de 40 minutos, seguido de uma avaliação final com os mesmos critérios iniciais. identificamos nos resultados, aumento dos valores médios da PImáx de 83,2 + 10,91cmH2O para 98,6 + 10,66 cmH2O, PEmáx de 89,7 + 9,41 cmH2O para 100,1 + 9,21 cm cmH2O, CVF antes de 92,4 + 3,65% para 94,9 + 12,83% , VEF1 de 90,8 + 4,80% para 94,0 + 4,06% e índice de Tiffenau de 101,3 + 2,93% para 102,0 + 2,52%. Portanto, os resultados sugerem que o protocolo utilizado a partir de técnicas da terapia manual influencia na função diafragmática, pois revelaram aumento dos valores médios obtidos na manovacuometria e espirometria, apesar de não serem estatisticamente significantes.

Qualidade de vida do cuidador de crianças com paralisia cerebral / Quality of life of caregivers of children with cerebral palsy

Objetivo: Compreender a qualidade de vida do cuidador de crianças com paralisia cerebral. Métodos: Pesquisa qualitativa realizada no Núcleo de Tratamento e Estimulação Precoce (NUTEP), com oito cuidadoras de crianças com paralisia cerebral de moderada a grave. A coleta dos dados deu-se por meio de entrevistas semi-estruturadas; sendo estas gravadas a transcritas, depois codificadas, analisadas e interpretadas de acordo com a análise de conteúdo. Resultados: As principais categorias identificadas foram: dificuldades enfrentadas (transporte, recursos financeiros, saúde), vida social (lazer), projetos de vida e estratégias de enfrentamento (religiosidade). Conclusão: A qualidade de vida das cuidadoras estudadas pode ser compreendida como insatisfatória. Porém, mesmo diante das dificuldades, elas encontram estratégias de enfrentamento para o ato de cuidar, como a religiosidade; sendo isso um pilar para sustentar suas vidas. (AU)

Qualidade de vida de crianças e adolescentes com distrofia muscular de Duchenne / Quality of life in adolescents and children with Duchenne muscular dystrophy

Objetivo: realizar uma revisão de literatura sobre qualidade de vida (QV) em crianças e adolescentes com distrofia muscular de Duchenne (DMD), doença caracterizada por fraqueza muscular generalizada e progressiva que leva à perda da marcha entre os 8-12 anos e ao óbito, geralmente no final daadolescência...