Healthcare providers' caring: Nothing is too small for parents and children hospitalized for heart surgery.

BACKGROUND: Parents of children with congenial heart disease (CHD) face frequent healthcare encounters due to their child's care trajectory. With an emphasis on assuring caring in healthcare, it is necessary to understand parents' perceptions of healthcare providers' actions when their child undergoes heart surgery. OBJECTIVES: To describe parents' perceptions of healthcare providers' actions when their child is diagnosed with CHD and undergoes heart surgery. METHODS: This is a qualitative study with in-depth interviews. Parents of children with CHD were interviewed twice after surgery. We analyzed data using directed content analysis guided by Swanson Caring Theory. RESULTS: Findings of the study indicate that parents perceive caring when providers seek to understand them (knowing); accompany them physically and emotionally (being with); help them (doing for); support them to be the best parents they can be (enabling); and trust them to care for their child (maintaining belief). CONCLUSIONS: Healthcare providers play an irreplaceable role in alleviating parents' emotional toll when their child undergoes cardiac surgery. Providers' caring is an integral component in healthcare.

Forças que interferem na maternagem em unidade de terapia intensiva neonatal / Fuerzas que interferen en el processo de maternidad en unidad de terapia intensiva neonatal / Forces interfering in the mothering process in a neonatal intensive therapy unit

RESUMO Objetivo: identificar as forças impulsoras e restritivas envolvidas no processo de maternagem aos recém-nascidos hospitalizados em uma unidade de terapia intensiva neonatal. Método: pesquisa descritiva e exploratória, de abordagem qualitativa, que possui como referencial a Teoria de Campo de Forças. Participaram dez mães. Os dados foram coletados de setembro a dezembro de 2014, por meio de entrevista semiestruturada, e submetidos à análise de conteúdo. Resultados: comunicação efetiva, inclusão da família no cuidado, trabalho em equipe, aprendizagem e espaço físico adequado atuaram como forças que impulsionaram a maternagem. Condutas autoritárias, estigmas relacionados à unidade de terapia intensiva neonatal, falta de assistência especializada, não realizar cuidados ao recém-nascido, cansaço físico, estresse emocional e mudanças na rotina diária atuaram como forças que restringiram a maternagem. Conclusão: identificar o campo de forças possibilitou compreender fatores e situações que influenciam a maternagem e diagnosticar as verdadeiras demandas biopsicossociais das mães dos recém-nascidos hospitalizados.

RESUMEN Objetivo: identificar las fuerzas impulsoras y restrictivas involucradas en el proceso de maternidad a los recién nacidos hospitalizados en una unidad de terapia intensiva neonatal. Método: investigación descriptiva y exploratoria, de abordaje cualitativo, como referencial la Teoría de Campo de Fuerzas. Participaron diez madres. Los datos fueron recolectados de septiembre a diciembre de 2014, por medio de entrevista semiestructurada, y sometidos al análisis de contenido. Resultados: comunicación efectiva, inclusión de la familia en el cuidado, trabajo en equipo, aprendizaje y espacio físico adecuado actuaron como fuerzas que impulsaron la maternidad. Las conductas autoritarias, estigmas relacionadas con la unidad de terapia intensiva neonatal, falta de asistencia especializada, no realizar cuidados al recién nacido, cansancio físico, estrés emocional y cambios en la rutina diaria actuaron como fuerzas que restringieron la maternidad. Conclusión: identificar el campo de fuerzas posibilitó comprender factores y situaciones que influencian la maternidad y diagnosticar las verdaderas demandas biopsicosociales de las madres de los recién nacidos hospitalizados.

ABSTRACT Objective: to identify the driving and restrictive forces involved in the maternity process for newborns hospitalized in a neonatal intensive care unit. Method: descriptive and exploratory research, with a qualitative approach, which uses the Force Field Theory as a reference. Ten mothers participated. Data were collected from September to December 2014, through a semi-structured interview, and submitted to content analysis. Results: effective communication, inclusion of the family in care, teamwork, learning and adequate physical space served as forces that fostered mothering. Authoritative behaviors, stigmas related to the neonatal intensive care unit, lack of specialized care, failure to perform care for the newborn, physical fatigue, emotional stress and changes in the daily routine acted as forces that restricted the mothering process. Conclusion: identifying the field of forces made it possible to understand factors and situations that influence mothering and to diagnose the true biopsychosocial demands of mothers of hospitalized newborns.

What Is the Added Benefit of Oropharyngeal Swabs Compared to Nasal Swabs Alone for Respiratory Virus Detection in Hospitalized Children Aged <10 Years?

We evaluated the added value of collecting both nasal and oropharyngeal swabs, compared with collection of nasal swabs alone, for detection of common respiratory viruses by reverse transcription-polymerase chain reaction in hospitalized children aged <10 years. Nasal swabs had equal or greater sensitivity than oropharyngeal swabs for detection of respiratory syncytial virus, adenovirus, human metapneumovirus, rhinovirus, and influenza virus but not parainfluenza virus. The addition of an oropharyngeal swab, compared with use of a nasal swab alone, increased the frequency of detection of each respiratory virus by no more than 10% in children aged <10 years.

Complications and associated bacterial coinfections among children hospitalized with seasonal or pandemic influenza, United States, 2003-2010.

BACKGROUND: Data on the range and severity of influenza-associated complications among children are limited. We describe the frequency and severity of complications in hospitalized children aged <18 years with seasonal influenza (during 2003-2009) and 2009 pandemic influenza A(H1N1) (during 2009-2010). METHODS: Population-based surveillance for laboratory-confirmed influenza hospitalizations was conducted among 5.3 million children in 10 states. Complications were identified by International Classification of Diseases, Ninth Revision (ICD-9) codes in medical records. RESULTS: During 2003-2010, 7293 children hospitalized with influenza were identified, of whom 6769 (93%) had complete ICD-9 code data. Among the 6769 children, the median length of hospitalization was 3 days (interquartile range, 2-4 days), 975 (14%) required intensive care, 359 (5%) had respiratory failure, and 40 (1%) died. The most common complications were pneumonia (in 28% of children), asthma exacerbations (in 22% [793/3616] aged ≥ 2 years), and dehydration (in 21%). Lung abscess/empyema, tracheitis, encephalopathy, bacteremia/sepsis, acute renal failure, and myocarditis were rare (each ≤ 2% of children) but associated with a median hospitalization duration of ≥ 6 days, and 48%-70% of children required intensive care. Bacterial cultures with positive results were identified in 2% of children (107/6769); Staphylococcus aureus and Streptococcus pneumoniae were most commonly identified. CONCLUSIONS: Complications contribute substantially to the disease burden among children hospitalized with influenza, through intensive care requirements and prolonged hospitalization, highlighting the importance of primary prevention with influenza vaccination.

Sendo-mãe de criança hospitalizada com doença crônica / Being a mother of child hospitalized with a chronic illness / Ser madre de un niño internado con enfermedad crónica

Trata-se de um estudo fenomenológico cujo objetivo foi compreender mães de crianças hospitalizadas com doenças crônicas. O acesso aos sujeitos se deu no serviço de enfermagem pediátrica de um hospital universitário do interior do estado de São Paulo, com 14 mães que estavam vivenciando a experiência, por meio de entrevista aberta com a questão norteadora "como é ser mãe de uma criança com doença crônica". Os discursos foram gravados e transcritos. A compreensão destes se deu pela descrição das experiências de acordo com a análise da estrutura do fenômeno situado. Ser mãe de uma criança com doença crônica envolve múltiplos olhares e compreensões. Do olhar para si própria evidenciando as mudanças advindas da cronicidade da doença do filho às transformações na dinâmica familiar, as mães vão caminhando por sinuosas trilhas, ora com mais otimismo, ora mais impotentes diante da facticidade da doença.

This work is a phenomenological study whose objective was to understand mothers of children hospitalized with chronic illnesses. Access to subjectswas performed at the Pediatric Nursing Unit in a university hospital in the countryside of the state of Sao Paulo, Brazil. Fourteen mothers in thissituation were interviewed by answering the open question: how is it to be the mother of a child with a chronic illness? The mothers answers wererecorded and transcribed. The understanding of these discourses was performed by evaluating the mothers descriptions of the given experiencesaccording to the analysis of the specific phenomenons structure. Being a mother of a child with a chronic illness involves multiple perspectives andunderstandings. From the mothers own introspection showing the changes resulting from the childs chronic illness to changes in family dynamics,the mothers traverse winding roads, at times more optimistically, at times powerless when facing the true reality of the disease.

Se trata de un estudio fenomenológico llevado a cabo con el objeto de comprender a madres de niños internados con enfermedades crónicas. Se realizaron entrevistas a 14 madres en los servicios de enfermería pediátrica de un hospital universitario. Se les preguntó: "cómo es ser madre de un niño con enfermedad crónica". Los discursos fueron grabados y transcritos. La descripción de las experiencias permitió entender los discursos que se analizaron según la estructura del fenómeno situado. Ser madre de un niño con enfermedad crónica involucra múltiples perspectivas y comprensiones. Desde su propia perspectiva, la madre percibe los cambios causados por la enfermedad crónica de su hijo y las alteraciones en la dinámica familiar. Las madres caminan por senderos sinuosos, algunas veces con más optimismo, otras sintiéndose impotentes ante la realidad de la enfermedad.

A comunicação da suspensão de cirurgias pediátricas: sentimentos dos familiares envolvidos no processo / La comunicación de la suspensión de cirugías pediátricas: sentimientos de los parientes involucrados en el proceso / Communicating pediatric surgery suspension: feelings of the relatives involved in the process

A hospitalização é uma experiência complexa, sendo agravada no caso de necessidade de intervenção cirúrgica, principalmente quando o paciente é criança. Quando a cirurgia é suspensa, paciente e seus familiares podem apresentar sentimentos de insegurança, angústia e ansiedade. Este estudo teve como objetivo identificar e descrever a percepção de quinze mães e/ou responsáveis por crianças de 0 a 18 anos, internadas em um hospital, após receberem a notícia de que a cirurgia de seu filho foi suspensa. É um estudo descritivo, qualitativo, que utilizou o referencial teórico da Comunicação Interpessoal e o metodológico da Análise de Conteúdo. Os resultados evidenciaram que as suspensões de cirurgias pediátricas são fatos presentes na instituição, que trazem repercussões ao paciente e familiares, e à organização institucional; que a comunicação entre profissionais da saúde, pacientes e familiares é inadequada; que a atuação do enfermeiro na notícia da suspensão da cirurgia precisa ser efetiva.

Hospitalization is a complex experience; this can be made worse if surgical intervention is required, especially when the patient is a child. When surgery is suspended, patient and family can experience feelings of insecurity, distress, and anxiety. The objective of this study was to identify and describe the perceptions of fifteen mothers or guardians of children between 0 and 18 years old admitted in a teaching hospital, after receiving news that surgery for their child was suspended. This was a descriptive qualitative study which used Interpersonal Communication as theoretical reference and Analysis of Content as the methodology. Results showed that suspension of pediatric surgery in our institution causes repercussions to patients, their families, and institution organisation; that communication between health team professionals, patients and families is inadequate; and that the nurses' participation in informing surgery suspension must be effective.

La hospitalización es una experiencia compleja, agravada en el caso de ser necesaria una intervención quirúrgica, en particular cuando el enfermo es un niño. Cuando la cirugía es suspendida, el enfermo y sus familiares pueden manifestar sentimientos de inseguridad, angustia y ansiedad. Este estudio tuve como objetivo identificar e describir la percepción de quince madres y/o responsables por niños con edades entre 0 y 18 años internados en un hospital después de recibir la noticia de que la cirugía de su hijo fue suspendida. Se trata de un estudio descriptivo cualitativo que utilizó el referencial teórico de la Comunicación Interpersonal y la metodología del Análisis de Contenido. Los resultados evidenciaron que las suspensiones de cirugías pediátricas son hechos presentes en la institución, que traen repercusiones al enfermo y familiares y en la propia organización institucional, que la comunicación entre profesionales de la salud, enfermos y familiares es inadecuada y que la actuación del enfermero en la noticia de la suspensión de la cirugía debe ser necesariamente efectiva.

A retrospective analysis of severe acute respiratory syndrome-CoV(IgG) antibody in hospitalized children during the epidemic / 解放军医学杂志

Objective To retrospectively analyze the expression of SARS-CoV (IgG) in the serum of hospitalized children who were not suffering from SARS, and retrospectively evaluate the difference of generation of the antibody between the children and adults. Methods Serum samples were collected from 85 hospitalized children, 500 health-check adults, 976 hospitalized adults, and 156 adults recovered from severe acute respiratory syndrome (SARS), and SARS-CoV (IgG) in the specimens was determined by ELISA and biologic chip. Results The level of serum SARS-CoV (IgG) in childhood patients was significantly higher than that in adult patients (17.6% vs 6.3%, P