Health needs and nursing care. / Necessidades de saúde e o cuidado de enfermagem.

OBJECTIVE:: to present the concept of needs according to different approaches to discuss the possibility of health care that incorporates a broader view of human vulnerabilities in health services. METHODS:: the arguments are founded on nursing theorists who worked on the construction of frameworks relevant to care, based on needs and on philosophers who show the possibility of identifying the vulnerabilities of human beings, defending art as a therapeutic instrument that can promote health care. CONCLUSION:: although care can acquire a new dimension with the introduction of art, according to certain perspectives, philosophical studies on ethics and aesthetics should be resumed to identify human vulnerabilities that can in fact be compensated by sensible understanding of the outer world. To incorporate art in nursing care requires studies from theorists to be recovered, deepening concepts and working on empirical investigations for their adequate use.

Necessidades de saúde e o cuidado de enfermagem / Necesidades de salud y cuidado de enfermeira / Health needs and nursing care

RESUMO Objetivo: apresentar os conceitos de necessidades em distintas vertentes para discutir a possibilidade de um atendimento que incorpore, no serviço de saúde, uma visão mais abrangente das vulnerabilidades humanas. Método: os argumentos se pautam em teoristas de enfermagem que trabalharam na construção de referenciais pertinentes ao cuidado fundamentado em necessidades e em filósofos que apresentam uma possibilidade de identificar vulnerabilidades do ser humano defendendo a arte como instrumento terapêutico que pode favorecer o cuidado à saúde. Conclusão: embora sob algumas perspectivas o cuidado possa adquirir uma nova dimensão com a introdução da arte, é necessário retomar os estudos filosóficos em ética e estética para identificar as vulnerabilidades humanas que possam, de fato, ser compensadas pela apreensão sensível do mundo exterior. Incorporar a arte ao cuidado de enfermagem requer resgatar os estudos de teoristas, aprofundar conceitos e trabalhar em investigações empíricas para seu uso adequado.

RESUMEN Objetivo: presentar en diferentes abordajes los conceptos de necesidades para discutir la posibilidad de una atención que incorpore, en el servicio de salud, una visión más integral de las vulnerabilidades humanas. étodo: los argumentos se basan en teóricos de enfermería que trabajaron en la construcción de referenciales pertinentes al cuidado fundamentado en necesidades y en filósofos que presentan una posibilidad de identificar vulnerabilidades del ser humano, defendiendo la arte como instrumento terapéutico que puede favorecer el cuidado de salud. Conclusión: aunque en algunas perspectivas el cuidado pueda ganar una nueva dimensión con la introducción del arte, se debe retomar los estudios filosóficos en ética y estética para identificar las vulnerabilidades humanas que puedan realmente ser compensadas por la aprehensión sensible del mundo exterior. Incorporar el arte en el cuidado de enfermería demanda rescatar los estudios de teóricos, profundizar conceptos y trabajar en investigaciones empíricas para su uso adecuado.

ABSTRACT Objective: to present the concept of needs according to different approaches to discuss the possibility of health care that incorporates a broader view of human vulnerabilities in health services. Methods: the arguments are founded on nursing theorists who worked on the construction of frameworks relevant to care, based on needs and on philosophers who show the possibility of identifying the vulnerabilities of human beings, defending art as a therapeutic instrument that can promote health care. Conclusion: although care can acquire a new dimension with the introduction of art, according to certain perspectives, philosophical studies on ethics and aesthetics should be resumed to identify human vulnerabilities that can in fact be compensated by sensible understanding of the outer world. To incorporate art in nursing care requires studies from theorists to be recovered, deepening concepts and working on empirical investigations for their adequate use.

Atenção às necessidades espirituais na prática clínica de enfermeiros / Attention to Spiritual Needs in Clinical Nursing Practice / Atención a las necesidades espirituales en la práctica clínica de enfermeros

Ao considerar a integralidade do cuidado, é necessário que os enfermeiros sistematizem o cuidado espiritual e proponham intervenções nessa dimensão aos seus pacientes. Objetivo: analisar a compreensão do enfermeiro acerca do cuidado espiritual e a sua experiência na promoção desse cuidado aos pacientes na prática clínica. Método: pesquisa descritiva, com análise qualitativa dos dados, desenvolvida com 17 enfermeiros. A coleta de dados foi realizada por meio de entrevistas semiestruturadas, as quais foram analisadas mediante análise de conteúdo qualitativa. Resultados: os enfermeiros identificaram a necessidade de intervenção na dimensão espiritual dos seus pacientes e consideraram importante atender a essa necessidade, porém eles apresentaram dificuldades em oferecer esse cuidado. Falta de conhecimento e organização do processo de trabalho foram dificuldades citadas para a não realização do cuidado espiritual e para a priorização dos cuidados físicos. Aponta-se, ainda, que o cuidado espiritual, quando oferecido, não foi sistematizado. Conclusão: esta pesquisa apresenta potencial para suscitar discussões quanto à formação do enfermeiro para o oferecimento do cuidado espiritual, além de demonstrar suas dificuldades e facilidades para a prestação de tal cuidado no cotidiano do trabalho da enfermagem.

When looking at comprehensive care, nurses need to systematize spiritual care and propose these kinds of interventions for their patients. Objective: Analyze nurses' understanding of spiritual care and their experience in encouraging this type of attention for patients in clinical practice. Method: This is a descriptive study featuring a qualitative analysis of data. The sample included 17 nurses. The data were collected through semi-structured interviews and examined via qualitative content analysis. Results: The nurses who participated in the study indicated there is a need for intervention to attend to the spiritual needs of patients and felt it is important to address this dimension of health care. However, they have difficulty in providing spiritual care. Lack of know-how and the way their work is organized were cited as obstacles to providing spiritual care, as was the priority on physical care. The nurses in the sample also noted that spiritual care, when offered, is not systematized. Conclusion: The research in question has the potential to encourage discussion on how nurses can be trained to offer spiritual care. It also demonstrates the difficulties they encounter and the kind of facilities or conditions they require to provide spiritual care in everyday nursing practice.

Al considerar la integralidad del cuidado, es necesario que los enfermeros sistematicen el cuidado espiritual y propongan intervenciones en esta dimensión a sus pacientes. Objetivo: analizar la comprensión del enfermero acerca del cuidado espiritual y su experiencia en la promoción de este cuidado a los pacientes en la práctica clínica. Método: investigación descriptiva, con análisis cualitativo de los datos, desarrollada con 17 enfermeros. Se recolectaron los datos por medio de entrevistas semiestructuradas, analizadas mediante análisis de contenido cualitativo. Resultados: los enfermeros identificaron la necesidad de intervención en la dimensión espiritual de sus pacientes y consideraron importante atender a esta necesidad; sin embargo, ellos presentaron dificultades en brindar este cuidado. Falta de conocimiento y organización del proceso de trabajo fueron dificultades citadas para la no realización del cuidado espiritual y la priorización de los cuidados físicos. Se señala, aun, que el cuidado espiritual, cuando fue ofrecido, no fue sistematizado. Conclusión: esta investigación presenta potencial para despertar discusiones en cuanto a la formación del enfermero para el ofrecimiento del cuidado espiritual, además demuestra sus dificultades y facilidades para la ejecución de tal cuidado en la cotidianidad del trabajo de enfermería.

Espiritualidade e religiosidade na perspectiva de enfermeiros / Spirituality and religiosity in the perspectives of nurses / Espiritualidad y religiosidad en la perspectiva de los enfermeros

Ao considerar o ser humano como uma unidade formada por corpo, mente e espírito, é importante que os enfermeiros avaliem a necessidade de intervenção no campo espiritual. Este estudo objetiva descrever a compreensão do significado de espiritualidade e religiosidade para enfermeiros inseridos numa instituição hospitalar. Esta é uma pesquisa exploratória, de abordagem metodológica qualitativa, desenvolvida com 17 enfermeiros. A coleta de dados foi conduzida por meio de entrevista semiestruturada, a qual foi examinada através de análise de conteúdo. Os resultados demonstram que os enfermeiros identificam as particularidades envolvidas nos conceitos de espiritualidade e religiosidade, da mesma forma que reconhecem a articulação entre eles. A aplicabilidade desses termos na prática clínica do enfermeiro sofre influência direta da sua própria espiritualidade e religiosidade, da sua formação acadêmica e do receio de repercussão negativa consequente da abordagem direta desses aspectos aos pacientes.

Considering the human being as a unit composed of body, mind and spirit, it is important that nurses evaluate the need for spiritual intervention. This study aims to describe the understanding of nurses about the meaning of spirituality and religiosity at a hospital. This is an exploratory and qualitative research that was carried out with 17 nurses. Data were collected through semistructured interview and analyzed using content analysis. Results show that nurses identify the particularities involved in the concepts of spirituality and religiosity and recognize the link between them. The applicability of these terms in nurses' clinical practice is directly influenced by their own spirituality and religiosity, by their academic training and their fear of negative repercussions resulting from the direct approach of these issues with patients.

Al considerar el ser humano como una unidad formada por cuerpo, mente y espíritu, es importante que los enfermeros evalúen la necesidad de intervención en el campo espiritual. Este estudio describe la comprensión del significado de la espiritualidad y la religiosidad de los enfermeros que actúan en hospitales. Esta es una investigación exploratoria y cualitativa y fue desarrollada con 17 enfermeros. La recolección de datos fue realizada con entrevistas semiestructuradas y analizadas a través de análisis de contenido. Los resultados muestran que los enfermeros identifican las particularidades involucradas en los conceptos de espiritualidad y religiosidad, así como reconocen el vínculo entre ellos. La aplicabilidad de estos términos en la práctica clínica de los enfermeros es influenciada directamente por su propia espiritualidad y religiosidad, su formación académica y el miedo de las repercusiones negativas derivadas de la aproximación directa de estas cuestiones con los pacientes.

Spiritual support for people living with HIV/AIDS: a Brazilian explorative, descriptive study.

In this exploratory and descriptive research, we identified the meaning of religion and spirituality in the experience of patients at a public health service for treatment of HIV/AIDS in a Brazilian upcountry town. Eight participants were selected through theoretical sampling. Data were collected through semistructured interviews, and analyzed by means of qualitative content analysis. The emerging themes were religion: a path to support, and God is everything. Religion, as a path that leads patients to different sources of support, included exploration of different churches, acknowledgment of guilt, and finding strength to cope with the disease, rationalization of the disease process, meeting other churchgoers, and finding God and faith. God, an important source of support, was present in prayers, in the belief in healing through faith, and in the feeling of comfort and relief. Because spirituality and religion were seen as important sources of support, in this study we that health professionals include these aspects in care planning.

Apoio social para pessoas vivendo com AIDS / Social support for people living with AIDS / Apoyo social para las personas que viven con el AIDS

Objetivo: identificar e categorizar os apoios sociais relatados por pessoas vivendo com aids, considerando que a aids hoje se caracteriza por ser uma doença crônica, para a qual os apoios sociais são essenciais. Método: estudo qualitativo com oito pessoas vivendo com aids, usuários de serviço de referência em um município de pequeno porte no interior do Estado de Minas Gerais, Brasil . Para análise das entrevistas foi utilizada a codificação inicial e focalizada. O estudo foi aprovado pelo Comitê de Ética da UNIFRAN (0018/2010). Resultados: a família, especialmente as mães, e profissionais de saúde foram as principais fontes de apoio emocional. Cônjuges, amigos e instituições constituíram fontes de apoio emocional e instrumental. Internet, grupos de adesão e autoajuda ofereceram apoio informativo. Benefícios previdenciários e políticas governamentais foram identificados como apoio instrumental. A espiritualidade e a religião apareceram como apoio emocional e informativo. Autoajuda foi caracterizada como apoio de reforço. Conclusão: a identificação das fontes de apoio é importante para facilitar o estabelecimento de estratégias de integração desses indivíduos na sociedade, minimizando riscos de exclusão social e danos à saúde.(AU)

Objective: to identify and categorize social support reported by people living with aids, given that aids today is characterized as a chronic disease, for which social supports are essential. Method: qualitative study with eight people living with aids, users of reference service in a small city in the state of Minas Gerais, Brazil. In data analysis, initial and focused coding was used. The study was approved by the Research Ethics Committee of the UNIFRAN (0018/2010). Results: the family, especially mothers, and health professionals were the main source of emotional support. Spouses, friends and institutions were sources of emotional and instrumental support. Internet, support and selfhelp groups offered informative support. Social security benefits and public policies were identified as instrumental support. Spirituality and religion appeared as emotional and informational support. Self-help was characterized as reinforcement support. Conclusion: the identification of sources of support is important to facilitate the establishment of strategies for integration of individuals into society, minimizing risks of social exclusion and health damage.(AU)

Objetivo: identificar y clasificar el apoyo social reportado por las personas que viven con sida, teniendo em cuenta que hoy en día el sida se caracteriza por una enfermedad crónica, por lo que los apoyos sociales son esenciales. Método: estudio cualitativo de ocho personas que viven con el SIDA, usuarias del servicio de referencia en una pequeña ciudad en el estado de Minas Gerais, Brasil. Para el análisis de las entrevistas se utilizó la codificación inicial y centralizada. El estudio fue aprobado por el Comité de Ética de Unifran (0018/2010). Resultados: la familia, especialmente las madres y profesionales de la salud fueron la principal fuente de apoyo emocional. Los cónyuges, amigos e instituciones constituyeron fuentes de apoyo emocional e instrumental. Internet, grupos de adhesión y autoayuda ofrecieron apoyo informativo. Beneficios de seguridad social y las políticas gubernamentales fueron identificados como apoyo instrumental. Espiritualidad y religión aparecieron como apoyo emocional e informativo. La autoayuda se caracterizó como apoyo de refuerzo. Conclusión: la identificación de las fuentes de apoyo es importante para facilitar el establecimiento de estrategias para la integración de estos individuos en la sociedad, minimizando los riesgos de exclusión social y daños a la salud.(AU)

Renal replacement therapy for children: a family decision.

Although Anne had many complex health issues and experienced considerable support from her extended family, she wanted freedom from the restrictions posed by peritoneal dialysis. Her quality of life changed after transplantation, with more opportunities to engage in leisure activities, ability to travel, a less restricted diet, and an improved self-image. She required fewer treatments, surgeries, and hospitalizations. She left behind the role of sick child and took up a role more like a healthy child. During the disease and decision-making process, Anne learned coping mechanisms, allowing her to gain autonomy to make decisions. The case study illustrates both the need to listen to children as well as to care for the entire family. The nursing management of this child and her family was continually changing, and multiple strategies were used to support the family. The nurse came to understand the roles of family members in constant change, the sources of their resources, and foci of tensions. Based on this knowledge, the nurse can act by mobilizing resources, strengthening the confidence of family members, and helping them develop coping mechanisms. In conclusion, care of the ill child must be family-centered. Stresses on the family have an impact on the child and vice versa. The potential to influence the quality of life of both the child and the family is considerable.

Promoting health in families of children with type 1 diabetes mellitus.

This paper presents a study of families of children with type 1 diabetes mellitus, emphasizing the identification of social supports and networks to strengthen interventions aimed at health promotion. The approach selected was a qualitative research, using a case study design. Four families of children with diabetes type 1 were studied, totalling seven participants. Data were collected between April and June 2007, through in-depth interviews and the construction of a genogram and an ecomap. The results presented the families' characterization and testimonies grouped in the following categories: social support, social networks and family roles. To promote care in practice, there is a need to identify the characteristics of each family and resources available that provide better living conditions. We concluded that identifying supports and social networks allows for more personalized care delivery to each family with a view to health promotion.

[The art of clown theater in care for hospitalized children]. / A arte do teatro clown no cuidado as crianças hospitalizadas.

Hospitalization can be a very traumatic experience for children and their family members. The purpose of this study was to explore the experience of using clown theater art in the care for hospitalized children, starting with an activity developed by undergraduate students in the healthcare area. Data were obtained by observing 20 children and 11 students, characters in the clown theater interacting in the pediatric clinic in a school hospital in the state of São Paulo. The empirical data were analyzed with the thematic content analysis, which were grouped around the following themes: artistic expressions as a form of communication, participation of the binomial child and accompanying partner, and the clown as a therapeutic resource. The results show that this experience was a concrete intervention, emphasizing the children's development process, since it opens up a space for fantasy, laughter, happiness and the appropriation of the hospital routine; it is an example of widening the diagnostic and therapeutic process with the incorporation of intervention focusing on the affective, emotional and cultural necessities of the child and the family, in the search for non-traumatic care.

A arte do teatro Clown no cuidado às crianças hospitalizadas / The art of Clown theater in care for hospitalized children / El arte del teatro Clown en el cuidado de niños hospitalizados

A hospitalização pode ser uma experiência traumática para as crianças e seus familiares. O objetivo deste estudo foi explorar a experiência da utilização da arte do teatro clown no cuidado as crianças hospitalizadas, a partir de uma atividade desenvolvida por alunos de cursos de graduação da área da saúde. Os dados foram obtidos mediante observação de 20 crianças e 11 alunos, personagens do teatro clown em interação na clínica pediátrica de um hospital-escola do interior do estado de São Paulo. Os dados empíricos foram analisados segundo a análise temática de conteúdo, os quais foram agrupados ao redor dos seguintes temas: expressões artísticas como forma de comunicação, participação do binômio criança e acompanhante e o clown como recurso terapêutico. Os resultados indicaram que esta experiência constituiu-se em uma intervenção concreta que valoriza o processo de desenvolvimento infantil, pois abre espaço para a fantasia, o riso, a alegria e a apropriação do cotidiano hospitalar; é um exemplo de ampliação do processo diagnóstico e terapêutico com a incorporação de intervenções que privilegiem as necessidades afetivas, emocionais e culturais da criança e sua família, na busca do cuidado atraumático.

Hospitalization can be a very traumatic experience for children and their family members. The purpose of this study was to explore the experience of using clown theater art in the care for hospitalized children, starting with an activity developed by undergraduate students in the healthcare area. Data were obtained by observing 20 children and 11 students, characters in the clown theater interacting in the pediatric clinic in a school hospital in the state of São Paulo. The empirical data were analyzed with the thematic content analysis, which were grouped around the following themes: artistic expressions as a form of communication, participation of the binomial child and accompanying partner, and the clown as a therapeutic resource. The results show that this experience was a concrete intervention, emphasizing the children's development process, since it opens up a space for fantasy, laughter, happiness and the appropriation of the hospital routine; it is an example of widening the diagnostic and therapeutic process with the incorporation of intervention focusing on the affective, emotional and cultural necessities of the child and the family, in the search for non-traumatic care.

La hospitalización puede ser una experiencia traumática para los niños y sus familiares. El objetivo de este estudio fue explorar la experiencia de la utilización del arte del teatro clown en el cuidado de niños hospitalizados, a partir de una actividad desarrollada por alumnos de cursos de graduación del área de la salud. Los datos fueron obteni-dos mediante la observación de 20 niños y 11 alumnos, personajes del teatro clown en interacción en la clínica pediátrica de un hospital escuela del interior del estado de San Pablo. Los datos empíricos fueron analizados según el análisis temático del contenido, los cuales fueron agrupados alrededor de los siguientes temas: expresiones artísticas como forma de comunicación, participación del binomio niño y acompañante y el clown como recurso terapéutico. Los resultados indicaron que esta experiencia se constituyó en una intervención concreta que valoriza el proceso de desarrollo infantil, ya que abre espacio para la fantasía, la risa, la alegría y la apropiación de lo cotidiano en el hospital; además es un ejemplo de ampliación del proceso diagnóstico y terapéutico con la incorporación de intervenciones que privilegian las necesidades afectivas, emocionales y culturales del niño y su familia, en la busca del cuidado sin traumas.

[Religion and spirituality: the experience of families of children with Chronic Renal Failure]. / Religião e espiritualidade: experiência de famílias de crianças com Insuficiência Renal Crônica.

OBJECTIVE: To describe the manifestations of religiosity and spirituality in families of children with Chronic Kidney Failure undergoing peritoneal dialysis. METHODS: This qualitative research is a case study with multiple subjects. Meaningful content analysis was adopted, using the thematic type, in the framework of family nursing in health promotion. RESULTS: Four families participated in the study, totaling fourteen participants. Religion and spirituality appear as important resources for family members in coping with the chronic disease, mainly in view of threatening prognoses. CONCLUSION: It is important for nurses to understand the family's religious and spirituality in the disease process, with a view to their work in health promotion.

Religião e espiritualidade: experiência de famílias de crianças com Insuficiência Renal Crônica / Religiosidad y espiritualidad: la experiencia de familias de niños con Insuficiencia Renal Crónica / Religion and spirituality: the experience of families of children with Chronic Renal Failure

OBJETIVO: Descrever as manifestações de religiosidade e espiritualidade de famílias de crianças com Insuficiência Renal Crônica em diálise peritoneal. MÉTODO: Trata-se de uma pesquisa qualitativa, com a característica de estudo de caso com múltiplos sujeitos. A análise de conteúdo adotada foi a de significados, optando-se pelo tipo temático, tendo como referência a promoção de saúde em enfermagem familiar. RESULTADOS: Participaram do estudo quatro famílias, totalizando quatorze participantes. A religião e a espiritualidade se apresentam como recursos importantes para os familiares no enfrentamento da doença crônica, principalmente diante de prognósticos ameaçadores. CONCLUSÃO: Destacamos a importância de compreender a religião e a espiritualidade da família no processo de adoecimento, para o enfermeiro atuar na promoção da saúde.

OBJECTIVE: To describe the manifestations of religiosity and spirituality in families of children with Chronic Kidney Failure undergoing peritoneal dialysis. METHODS: This qualitative research is a case study with multiple subjects. Meaningful content analysis was adopted, using the thematic type, in the framework of family nursing in health promotion. RESULTS: Four families participated in the study, totaling fourteen participants. Religion and spirituality appear as important resources for family members in coping with the chronic disease, mainly in view of threatening prognoses. CONCLUSION: It is important for nurses to understand the family's religious and spirituality in the disease process, with a view to their work in health promotion.

OBJETIVO: Describir las manifestaciones de religiosidad y espiritualidad de familias de niños con Insuficiencia Renal Crónica en diálisis peritoneal. MÉTODOS: Se trata de una investigación cualitativa, con la característica de estudio de caso con múltiples sujetos. El análisis de contenido adoptado fue el de significados, eligiendo el tipo temático, teniendo como referencia la promoción de salud en enfermería familiar. RESULTADOS: Participaron del estudio cuatro familias, totalizando catorce participantes. La religión y la espiritualidad se presentan como recursos importantes para familiares en el enfrentamiento de la enfermedad crónica, principalmente ante pronósticos amenazadores. CONCLUSIÓN: Destacamos la importancia de comprender la religión y la espiritualidad de la familia en el proceso de adolecer, para el enfermero actuar en la promoción de la salud.

Social support and networks in health promotion of older people: a case study in Brazil.

Aim. This research aimed at identifying social support for older people and their families. Background. The Brazilian National Policy for Older People's Health, created in 1998, is based on the promotion of healthy ageing, aiming at encouraging older people to remain in their environment and independently exert their functions in society. Nursing has engaged in this process, seeking to provide integrated care to the older person and family. Method. A case study with multiple participants was carried out. The inclusion criteria were families of older people over 70 years old who attended a Family Health Unit in the interior of the State of Minas Gerais, Brazil. Data were collected between April and June, 2007. In-depth interviews, genograms and ecomaps were used to collect data, which were categorized by thematic content analysis. Results. Three families participated in this study, totalling seven participants. Conclusions. The older people's families depend on institutional networks for their health maintenance. Spirituality and religion are mixed and are very expressive sources of support. Relevance to clinical practice. Assessing social support and networks can favour nursing interventions in order to intensify social interactions, promote leisure and help the families of older people to cope with life changes.

The influence of social support on strengthening families of children with chronic renal failure.

This paper presents a study of the families of children on peritoneal dialysis, emphasizing the identification of social supports and networks to strengthen interventions aimed at health promotion. Our discussion is located in the context of inequalities between developed and developing countries. For this qualitative study, a content analysis was conducted in order to elicit themes from the raw data related to the lived experience of four families that have a child with chronic renal failure. The data were collected mainly by in-depth interviews and the construction of genograms and ecomaps. The identification and characterization of the families' social supports and networks allowed nurses and families to strengthen their coping mechanisms. Because families are dealing with severe economic problems, they need better supportive programs to guide their offspring to their full potential.

Social support and families of children with cancer: an integrative review.

This study aimed to search available evidences in literature about social support to families of children with cancer. An integrative review was elaborated and the articles were searched in PUBMED, WEB of SCIENCE, CINAHL, PsycINFO and LILACS, using the key words: social support, cancer, child and family, between 1996 and 2006. Fifteen articles were selected and the analysis of these publications allowed for the identification of three themes: social support and the trajectory of cancer, social support to healthy siblings and social support to fathers and mothers of children with cancer. Data indicated a lack of consensus among researchers about the use of the term social support and that there is a need for greater methodological rigor in the conduction of these studies. Acknowledging the clients' support needs is important to plan nursing care and guide research development, whose results can be used in practice.

The influence of social support on strengthening families of children with chronic renal failure / La influencia del apoyo social para el fortalecimiento de las familias de niños con insuficiencia renal crónica / A influência do apoio social para o fortalecimento de famílias com crianças com insuficiência renal crônica

This paper presents a study of the families of children on peritoneal dialysis, emphasizing the identification of social supports and networks to strengthen interventions aimed at health promotion. Our discussion is located in the context of inequalities between developed and developing countries. For this qualitative study, a content analysis was conducted in order to elicit themes from the raw data related to the lived experience of four families that have a child with chronic renal failure. The data were collected mainly by in-depth interviews and the construction of genograms and ecomaps. The identification and characterization of the families' social supports and networks allowed nurses and families to strengthen their coping mechanisms. Because families are dealing with severe economic problems, they need better supportive programs to guide their offspring to their full potential.

Este artículo es un estudio sobre las familias de niños con diálisis peritoneal, que destaca la identificación del apoyo y las redes sociales para fortalecer intervenciones dirigidas para la promoción de la salud, en un contexto de desigualdad entre los países desarrollados y en desarrollo. Estudio cualitativo a través del análisis de contenido, con el objetivo de identificar temas en base a datos empíricos de niños de cuatro familias con insuficiencia renal. La recopilación de datos realizada a través de entrevistas a profundidad, construcción de genogramas y ecomapas. La identificación y las características de las redes sociales y de apoyo permitieron a los enfermeros y familias mejorar su utilización y fortalecer las formas de enfrentar la situación. Como las familias tenían graves problemas económicos, necesitaban de programas de apoyo adecuados para ayudar a sus hijos a desenvolverse al máximo.

Este artigo apresenta um estudo sobre famílias de crianças em diálise peritoneal, enfatizando a identificação de apoios e de redes sociais para fortalecer intervenções que objetivam a promoção da saúde, no contexto das desigualdades entre os países desenvolvidos e em desenvolvimento. Para este estudo qualitativo, foi realizada uma análise de conteúdo, a fim de identificar temas a partir dos dados empíricos relacionados à experiência de quatro famílias que possuem uma criança com insuficiência renal. Os dados foram coletados por meio de entrevistas em profundidade, construção de genogramas e ecomapas. A identificação e a caracterização dos apoios e redes sociais permitiram às enfermeiras e às famílias melhorar sua utilização e fortalecer mecanismos de enfrentamento. Em virtude de famílias viverem em precárias condições econômicas, elas necessitam de programas adequados de apoio, para que possam conduzir seus descendentes a um potencial máximo.

Social support and social network in family nursing: reviewing concepts.

Social support and social network concepts are resources applicable to Family Nursing, as they are aimed at improving families' quality of life, and also at promoting, strengthening and maintaining their well-being. This study aimed to reflect on the main social network and social support concepts, relating them with Family Nursing, with a view to their application in nursing research and practice. We conclude that there is a lack of consensus about these concepts and that further criteria are needed for their use. In using Family Nursing, researchers must select the most relevant social network and social support concepts in literature to achieve the proposed objectives.

Social support and social network in family nursing: reviewing concepts / Red y apoyo social en enfermería familiar: revisión de conceptos / Apoio e rede social em enfermagem familiar: revendo conceitos

Social support and social network concepts are resources applicable to Family Nursing, as they are aimed at improving families' quality of life, and also at promoting, strengthening and maintaining their well-being. This study aimed to reflect on the main social network and social support concepts, relating them with Family Nursing, with a view to their application in nursing research and practice. We conclude that there is a lack of consensus about these concepts and that further criteria are needed for their use. In using Family Nursing, researchers must select the most relevant social network and social support concepts in literature to achieve the proposed objectives.

Los conceptos sobre red y apoyo social se constituyen en recursos aplicados en Enfermería Familiar, considerando que su finalidad es mejorar la calidad de vida de las familias, así como promover, fortalecer y mantener su bienestar. El objetivo del estudio fue reflexionar con respecto a los principales conceptos sobre red y apoyo social, los cuales se relacionan con Enfermería Familiar dentro de la investigación y práctica de enfermería. Se concluye que la falta de un consenso sobre estos conceptos, genera la necesidad de utilizar más criterios para su aplicación. Cuando se trabaja con Enfermería Familiar, el investigador debe seleccionar en la bibliografía los conceptos de red y de apoyo social más importante, para alcanzar los objetivos propuestos.

Os conceitos sobre apoio e rede social se configuram como recursos aplicáveis à Enfermagem Familiar, uma vez que seus objetivos visam aprimorar a qualidade de vida das famílias e, ainda, promover, fortalecer e manter seu bem-estar. O objetivo deste estudo foi refletir sobre os principais conceitos de rede e apoio social, relacionando-os à Enfermagem Familiar para sua aplicação na pesquisa e na prática de enfermagem. Conclui-se que falta consenso sobre esses conceitos e há necessidade de mais critérios ao empregá-los. O pesquisador, ao utilizar a Enfermagem Familiar, deve selecionar, na literatura, os conceitos de rede e de apoio social mais relevantes para se atingirem os objetivos propostos.

Resistance exercises for health promotion in coronary patients: evidence of benefits and risks.

Aim This review aims to search and evaluate evidence related to benefits and risks of resistance exercises for patients with coronary artery disease (CAD), post myocardial infarction (MI) and its surgical treatment or coronary artery bypass grafting (CABG). Method An integrative literature review was carried out. The guiding question of this review was: What evidence is available regarding benefits and risks of muscle resistance training for patients with CAD, post-MI or CABG? Studies from January 1997 to August 2007 were included, taken from the following electronic databases: Medline, PEDro, Cochrane Controlled Trials Database and CINAHL. Results After the selection process, 11 articles were included in the review. Five articles presented just the resistance exercises, and six combined the resistance exercises with aerobic exercise. The benefits of intervention found in the articles were the improvement of peripheral muscular strength, increase of physical capacity, improvement of emotional state and quality of life. No risks were reported in the articles related to the application of the resistance exercise. Conclusions The resistance exercises can be used as a safe and effective strategy in health promotion programmes for coronary patients, making social, physical and psychological rehabilitation easier for those people.

Promoção de saúde das famílias de docentes de enfermagem: apoio, rede social e papéis na família / Health promotion among nurding faculty members' families: support, social network and roles in the family

O objetivo deste trabalho é identificar apoios sociais, redes e papéis em famílias de docentes de enfermagem, utilizando a fundamentação teórica sobre promoção de saúde em enfermagem familiar. O cenário deste estudo constituiu-se de um Curso de Graduação em Enfermagem de uma Universidade do Brasil. Selecionaram-se como sujeitos deste estudo três famílias de enfermeiras docentes responsáveis por disciplinas do ciclo profissionalizante. A entrevista em profundidade, o genograma e o ecomapa foram usados para a coleta de dados, que foram categorizados pela análise de conteúdo, optando-se pelo tipo temático. Nas três famílias estudadas, os familiares e a família ampliada constituíram-se na principal fonte de apoio. Outras pessoas importantes foram funcionárias, sem laços de consangüinidade, as redes de apoio compostas pela escola, trabalho, igreja e locais de lazer. A identificação de papéis e apoios permitiu aos familiares fortalecerem os mecanismos de enfrentamento para lidar com os fatores estressantes cotidianos e atuarem na promoção da saúde.

This study aims to identify social support, networks, and roles in families of nursing faculty members, using the theoretical framework of health promotion in family nursing. The scenario of the study was an Undergraduate Nursing Course at a University in the interior of Brazil. Three families of nursing professors responsible for subjects in the professionalization cycle were selected as study subjects. In-depth interviews, the genogram, and ecomaps were used for data collection. Data was categorized by thematic content analysis. In the three families under study, relatives and the expanded family constituted the main source of support. Other important persons were female employees without blood relations. The social support network included the school, work, church, and leisure sites. The identification of roles and supports allowed the relatives to strengthen coping mechanisms in order to deal with the daily stress factors, as well as to act in health promotion.

La finalidad de este trabajo es identificar apoyos sociales, redes y roles en las familias de docentes de enfermería, utilizando para ello, la fundamentación teórica sobre promoción de salud en enfermería familiar. El escenario de este estudio fue un Curso de Pregrado en Enfermería de una Universidad del interior de Brasil. Como sujetos de este estudio fueron seleccionadas tres familias de enfermeras docentes, responsables por disciplinas del ciclo profesionalizante. Para la recolección de los datos se utilizó la entrevista en profundidad, el genograma y el ecomapa. Los datos fueron catalogados mediante el análisis de contenido, eligiéndose el tipo temático. En las tres familias estudiadas, los familiares y la familia ampliada se constituyeron en la principal fuente de apoyo. Fueron consideradas como importantes las funcionarias, sin lazos de consanguinidad; las redes de apoyo, compuestas por la escuela, el trabajo, la iglesia y sitios de ocio. La identificación de roles y apoyos les permitió a los familiares fortalecer los mecanismos de enfrentamiento para lidiar con los factores cotidianos estresantes y actuar en la promoción de la salud.