Relação da dança com o cuidado em saúde: nexos com o estilo de vida e a saúde integral / Relationship of dance with health care: links with lifestyle and integral health

Objetiva-se analisar os significados atribuídos à dança pelas mães de crianças acometidas pelo câncer na relação com o estilo de vida e o cuidado em saúde. Estudo explicativo, qualitativo, realizado com mães de crianças com câncer, no momento da internação hospitalar para realização de quimioterapia, na pediatria do Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro. Os dados foram coletados através de formulário de identificação e caracterização do estilo de vida, além de entrevista semiestruturada em profundidade, no período de fevereiro de 2019 até março de 2020. Optou-se pelo Interacionismo Simbólico, como base referencial, juntamente com a Grounded Theory, para a produção e análise dos dados. O estudo justifica-se por ser original e inédito, também, pela transmutação que a dança realizou nas mães de crianças com câncer, refletindo novas possibilidades para cuidar de si e para cuidar do outro. Emergiram dos dados os componentes correspondentes ao modelo paradigmático, a saber: "Percebendo situações diárias desafiantes à sobrevivência: entre o real e o ideal"; "Ressignificando a percepção do agravo estereotipado através de um espaço lúdico de criação"; "Repercutindo, por meio da experiência no espaço da dança, novas possibilidades para cuidar de si e para cuidar do outro". Como categoria central, o estudo revelou: "Transmutando a energia da mãe da criança com agravo oncológico através do simbólico da dança". O estudo aponta, assim, constructos explicativos que versam sobre o fenômeno dos significados atribuídos à dança pelas mães de criança com câncer com nexo ao estilo de vida e a saúde integral, haja vista as condições intervenientes, as estratégias de ação/interação e as consequências/resultados, que implicam no cuidado em enfermagem/ saúde.

The objective is to analyze the meanings attributed by mothers of children affected by cancer to dance, in relation to lifestyle and health care. explanatory, qualitative study, carried out with mothers of children with cancer, at the time of hospitalization for chemotherapy, in the pediatrics department of the José Alencar Gomes da Silva National Cancer Institute, Rio de Janeiro.The data were collected through a lifestyle identification and characterization form and in-depth semi-structured interviews, from February 2019 to March 2020. Symbolic Interactionism was chosen as the reference base and Grounded Theory for the production and analysis of Dice. The study is justified for being original and unpublished and for the transmutation that dance performed in the mothers of children with cancer, reflecting new possibilities for taking care of themselves and for taking care of others.The components corresponding to the paradigmatic model emerged from the data, namely: Perceiving daily situations challenging survival: Between the real and the ideal, Re- signifying the perception of stereotyped grievance through a playful space of creation, Echoing through the experience in the dance space, new possibilities to take care of yourself and to take care of others. As a central category, the study highlighted: Transmuting the energy of the child's mother with cancer through the symbolic of dance.The study thus points out explanatory constructs that deal with the phenomenon of meanings attributed to dance by mothers of children with cancer related to lifestyle and comprehensive health, given the intervening conditions, action/interaction strategies, and consequences/ results, which imply for nursing/health care.

El objetivo es analizar los significados que las madres de niños afectados por cáncer atribuyen a la danza, en relación al estilo de vida y la atención a la salud. Estudio explicativo, cualitativo, realizado con madres de niños con cáncer, en el momento de la hospitalización por quimioterapia, en el departamento de pediatría del Instituto Nacional del Cáncer José Alencar Gomes da Silva, Río de Janeiro. Los datos fueron recogidos a través de un formulario de identificación y caracterización de estilos de vida y entrevistas semiestructuradas en profundidad, desde febrero de 2019 hasta marzo de 2020. Se eligió el Interaccionismo Simbólico como base de referencia y la Teoría Fundamentada para la producción y análisis de datos. El estudio se justifica por ser original e inédito y por la transmutación que la danza realiza en las madres de niños con cáncer, reflejando nuevas posibilidades de cuidarse a sí mismas y de cuidar a los demás. Los componentes correspondientes al modelo paradigmático emergieron de los datos, a saber: Percepción de situaciones cotidianas que desafían la supervivencia: Entre el real y el ideal, Re- significando la percepción del agravio estereotipado a través de un espacio lúdico de creación, Haciendo eco a través de la experiencia en el espacio de la danza, nuevas posibilidades para cuidarse y cuidar a los demás. Como categoría central, el estudio destacó: Transmutar la energía de la madre del niño con cáncer a través del simbólico de la danza. Así, el estudio señala constructos explicativos que abordan el fenómeno de los significados atribuidos a la danza por las madres de niños con cáncer relacionados con el estilo de vida y la salud integral, dadas las condiciones que intervienen, las estrategias de acción / interacción y las consecuencias / resultados que implican cuidados de enfermería/salud.

Play and Learn for Surgeons: A Serious Game to Educate Medical Residents in Uterine Artery Ligation Surgery.

Objective: Postpartum hemorrhage (PPH) is a leading cause of maternal mortality. Surgical interventions, such as uterine artery ligation and utero-ovarian arteries ligation (UAL and UOAL), are considered as effective methods to control PPH. Owing to PPH's severe outcomes, various educational tools have been developed to train surgical residents. A potential educational medium for this purpose could be serious digital games. In this pilot study, we assessed the usability and effectiveness of a serious game to promote the surgical skills of UAL/UOAL among obstetrics and gynecology (OB/GYN) residents. Methods: We designed and developed the Play and Learn for Surgeons (PLS) game to train OB/GYN residents. We assessed and compared the usability challenges of PLS before and after revising the game. To assess the effectiveness of PLS, residents were allocated randomly in control and intervention groups. Surgical skills of the residents were assessed pre- and post-test using the Objective Structured Assessment of Technical Skills checklist. Setting: This pilot study took place at the OB/GYN wards of Omolbanin Hospital (Mashhad University of Medical Sciences) and Imam Ali Hospital (Zahedan University of Medical Sciences) in Iran. Participants: Thirteen subject matter experts (nine OB/GYN experts and four senior clinical assistants) participated in the user interface design and usability assessment of PLS. Total of 46 OB/GYN residents participated in the educational effectiveness analysis of PLS. All participants were female with mean ages of 40.6, 29.9 and 28.0 years for OB/GYN experts, assistants, and residents, accordingly. Results: All participants completed the study. PLS significantly improved the skills of residents for UAL (P-value = 0.018) and UOAL (P-value <0.001) procedures. Conclusion: Serious games can be an effective and affordable approach in training OB/GYN residents for UAL and UOAL procedures. Approval number: (# IR.MUMS.fm.REC.1396.345) Trial registration number: (# IRCT2017092436366N1).

Terapia a través de la aventura para jóvenes con síndrome de Asperger / Therapy through adventure for young people with Asperger's syndrome / Teràpia a través de l'aventura per a joves amb síndrome d'Asperger

Aventúrate es el primer programa que utiliza la Terapia a través de la Aventura (TA) con jóvenes con Trastorno del Espectro Autista (TEA) en España. Un total de 15 jóvenes participaron en un programa de siete días que combina terapia grupal e individual, así como actividades varias al aire libre. El objetivo de este estudio es comprobar la efectividad de esta intervención. Los resultados muestran un tamaño del efecto que oscila entre pequeño y moderado, con mejoras más relevan­tes en la autoestima, el apego entre iguales y la reparación emocional

Aventurate is the first programme in Spain to use therapy through adventure with young people with Autism Spectrum Disorder (ASD) in Spain. A total of 15 young people participated in a 7-day programme combining group and individual therapy as well as various outdoor activities. The aim of this study is to test the effectiveness of this intervention. The results show that the effect's range is from small to moderate, and that it has more relevant improvements in self-esteem, peer bond and emotional repair

Aventúrate és el primer programa que utilitza la Teràpia a través de l'Aventura (TA) amb joves amb trastorn de l'espectre autista (TEA) a Espanya. Un total de 15 joves van participar en un programa de set dies que combina teràpia grupal I individual, així com activitats diverses a l'aire lliure. L'objectiu d'aquest estudi és comprovar l'efectivitat d'aquesta intervenció. Els resultats mostren un impacte de l'efecte que oscil·la entre petit I moderat, amb millores més rellevants en l'autoestima, l'aferrament entre iguals I la reparació emocional

Neurosensory stimulation outdoors enhances cognition recovery in cognitive motor dissociation: A prospective crossover study.

BACKGROUND: Neurosensory stimulation is effective in enhancing the recovery process of severely brain-injured patients with disorders of consciousness. Multisensory environments are found in nature, recognized as beneficial to many medical conditions. Recent advances detected covert cognition in patients behaviorally categorized as un- or minimally responsive; a state described as cognitive motor dissociation (CMD). OBJECTIVE: To determine effectiveness of a neurosensory stimulation approach enhanced by outdoor therapy, in the early phases of recovery in patients presenting with CMD. METHODS: A prospective non-randomized crossover study was performed. A two-phase neurosensory procedure combined identical individually goal assessed indoor and outdoor protocols. All sessions were video-recorded and observations rated offline. The frequency of volitional behavior was measured using a behavioral grid. RESULTS: Fifteen patients participated in this study. The outdoor group patients had statistically significant higher number of intentional behaviors than the indoor group on seven features of the grid. Additionally, for all items assessed, total amount of behaviors in the outdoor condition where higher than those in the indoor condition. CONCLUSIONS: Although preliminary, this study provides robust evidence supporting the effectiveness and appropriateness of an outdoor neurosensory intervention in patients with covert cognition, to improve adaptive goal-oriented behavior. This may be a step towards helping to restore functional interactive communication.

Conducting participatory photography with children with disabilities: a literature review.

Purpose: This review summarized studies that used participatory photography with children with disabilities, including those with communication impairments, and described modifications made to the methodology to facilitate their participation in qualitative research. Methods: In the fall of 2016, we searched Psycinfo (OVID), ERIC, CINAHL and Web of Science to identify studies that used participatory photography with children with disabilities. The search was repeated in January 2018 to retrieve any new publications. The first author extracted data that described the characteristics of each study and the modifications used. Results: Of the 258 articles identified, 19 met inclusion criteria. Participants ranged from 4-21 years old and had a variety of disabilities. Study topics included education, leisure activities and adulthood. Researchers modified participatory photography to enhance accessibility by: modifying cameras; providing individual training; teaching consent through role play; allowing children to direct adults to take photographs; including additional forms of media; using diaries and questionnaires; providing individual interviews with simplified questions; using multiple forms of communication; and modifying how photographs are shared. Conclusions: Participatory photography can be an effective method for studying the lived experiences of children with disabilities, particularly those with communication impairments. Methodological modifications can enhance the accessibility of this approach for this population. Implications for Rehabilitation Participatory photography may be an effective qualitative research method for learning about the perspectives and experiences of children with disabilities on a wide array of topics. There are many specific modifications that researchers can use to support the inclusion of children with disabilities in participatory photography research. The findings of studies that use participatory photography methodology may provide rehabilitation professionals with important insights into the lives of children with disabilities.

Intellectual engagement and cognitive ability in later life (the "use it or lose it" conjecture): longitudinal, prospective study.

OBJECTIVES: To examine the association between intellectual engagement and cognitive ability in later life, and determine whether the maintenance of intellectual engagement will offset age related cognitive decline. DESIGN: Longitudinal, prospective, observational study. SETTING: Non-clinical volunteers in late middle age (all born in 1936) living independently in northeast Scotland. PARTICIPANTS: Sample of 498 volunteers who had taken part in the Scottish Mental Health Survey of 1947, from one birth year (1936). MAIN OUTCOME MEASURES: Cognitive ability and trajectory of cognitive decline in later life. Typical intellectual engagement was measured by a questionnaire, and repeated cognitive measurements of information processing speed and verbal memory were obtained over a 15 year period (recording more than 1200 longitudinal data points for each cognitive test). RESULTS: Intellectual engagement was significantly associated with level of cognitive performance in later life, with each point on a 24 point scale accounting for 0.97 standardised cognitive performance (IQ-like) score, for processing speed and 0.71 points for memory (both P<0.05). Engagement in problem solving activities had the largest association with life course cognitive gains, with each point accounting for 0.43 standardised cognitive performance score, for processing speed and 0.36 points for memory (both P<0.05). However, engagement did not influence the trajectory of age related decline in cognitive performance. Engagement in intellectual stimulating activities was associated with early life ability, with correlations between engagement and childhood ability and education being 0.35 and 0.22, respectively (both P<0.01). CONCLUSION: These results show that self reported engagement is not associated with the trajectory of cognitive decline in late life, but is associated with the acquisition of ability during the life course. Overall, findings suggest that high performing adults engage and those that engage more being protected from relative decline.

Investigation of a Mobile "Serious Game" in the Treatment of Obsessive-Compulsive Disorder: A Pilot Study.

OBJECTIVE: Exposure and response prevention (ERP) therapy is considered a first-line treatment for obsessive-compulsive disorder (OCD). Dysregulation in the cortico-striato-thalamo-cortical (CSTC) circuit has been implicated in the pathophysiology of OCD, as have decreased functional connectivity (FC) between the dorsal anterior cingulate cortex (dACC) and the prefrontal cortex and increased FC between the dACC and the basal ganglia. We hypothesized that a new ERP-inspired mobile "serious game" would improve clinical symptoms in OCD and that symptom improvement would be associated with altered FC within CSTC. MATERIALS AND METHODS: Fifteen OCD subjects and 15 healthy controls were recruited. All subjects completed questionnaires covering demographic data, the Yale-Brown Obsessive-Compulsive Scale, the Beck Depressive Inventory, and the Beck Anxiety Inventory. In addition, all subjects were scanned at baseline to assess brain FC using resting-state functional magnetic resonance imaging. RESULTS: After 3 weeks of gameplay, FC from the left dACC seed to the right frontal precentral gyrus and from the right dACC seed to the left inferior frontal gyrus and the right middle frontal gyrus, increased in the OCD group. Responders showed increased brain connectivity from the left dACC seed to the right superior frontal gyrus compared with nonresponders. CONCLUSION: Our results suggest that serious games may improve symptoms in OCD and that this improvement may be related to increased brain connectivity between the dACC and the prefrontal cortex. Further exploration is needed to assess the potential role of serious games in OCD treatment.

Willingness to Interact After Therapeutic Recreation in a Patient With Schizophrenia.

The study aim was to describe how a patient with schizophrenia who had been in a psychiatric hospital for an extended period of time changed in his desire to interact with others after participating in the therapeutic recreation program, and to interpret his inner process based on symbolic interactionism theory. Data from a patient who showed marked changes in narratives of an interview held after the program and through observation during sessions were analyzed. The patient gained a sense of willingness, including the desire to interact with others and began to act accordingly.

Factors that bring meaning to mementos created by elders.

OBJECTIVES: Reminiscing activity groups are commonly seen in various elder care settings This study addresses the impact of reminiscence activity groups, specifically a program where group members create their own mementos, on healthy Jewish elders' sense of satisfaction and meaning. In particular, this research focused on the specific factors involved in creating the mementos themselves. METHOD: In this mixed methods study, occupational therapy graduate students synthesized relevant aspects of commonly used activity analysis forms into a matrix to analyze the activities. From a pool of 30 activities, students chose seven representing many factors and levels of complexity. With a matrix composed of a Likert scale and open-ended questions, students and Jewish elders explored the elders' perceptions of factors significantly related to their experiences when creating the seven mementos. RESULTS: Memento-making was most satisfying when elders were replicated in some way, such as with hand casting. Least satisfying activities were those that could lead to talents being appraised, such as painted self-portraits. Unanticipated factors such as social participation and educating others appeared to be as important as making the mementos themselves. CONCLUSION: While the research questions were partially answered, factors such as meaning and creativity were difficult constructs to measure because they lacked clear definitions. However, this preliminary exploration supports the concept that the use of an activity analysis matrix can enable activities directors and occupational therapists to systematically ascertain which factors positively impact well-being and social participation to meet the unique needs of aging client populations.

Effects of an Avatar-Based Anti-Smoking Game on Smoking Cessation Intent.

The purpose of this study was to compare the effects of a computer-based anti-smoking game on the intent and motivation to quit tobacco. Smokers with nicotine dependence were briefly exposed to an anti-smoking game with or without an avatar resembling the smoker's self. The computer-based anti-smoking game improved participants' immediate intent and motivation to quit smoking. Embedding an avatar resembling self into the game did not result in added benefits.

[Contributions of ludic care in nursing to chemical detoxification due to the use of crack cocaine]. / Contribuições do cuidado lúdico em enfermagem na desintoxicação química devido ao uso de crack.

OBJECTIVE: to understand the contributions of ludic care in nursing by stimulating the acceptance of chemical detoxification from crack on the perception of people in the detoxification process. METHODS: an exploratory, descriptive study with a qualitative approach, performed with five people hospitalized for chemical detoxification from crack, from March to July 2013 in a chemical detox unit of a midsize hospital in the central region of Rio Grande do Sul. Data was collected using a semi-structured interview and was subjected to content analysis. RESULTS: Two categories emerged: Ludic care in nursing as a stimulus to the acceptance of chemical detoxification; Ludic care in nursing in the promotion for healthy living after chemical detoxification. CONCLUSION: ludic care in nursing proved to enhance the acceptance of chemical detoxification from crack in the reality investigated.

Contributions of ludic care in nursing to chemical detoxification due to the use of crack cocaine / Contribuciones del cuidado lúdico en enfermería en la desintoxicación química debido al uso de crack / Contribuições do cuidado lúdico em enfermagem na desintoxicação química devido ao uso de crack

OBJECTIVE: to understand the contributions of ludic care in nursing by stimulating the acceptance of chemical detoxification from crack on the perception of people in the detoxification process. METHODS: an exploratory, descriptive study with a qualitative approach, performed with five people hospitalized for chemical detoxification from crack, from March to July 2013 in a chemical detox unit of a midsize hospital in the central region of Rio Grande do Sul. Data was collected using a semi-structured interview and was subjected to content analysis. RESULTS: Two categories emerged: Ludic care in nursing as a stimulus to the acceptance of chemical detoxification; Ludic care in nursing in the promotion for healthy living after chemical detoxification. CONCLUSION: ludic care in nursing proved to enhance the acceptance of chemical detoxification from crack in the reality investigated. .

OBJETIVO: conocer las contribuciones del cuidado lúdico en enfermería en el estímulo a la aceptación de la desintoxicación química por el uso del crack en la percepción de las personas en ese proceso. MÉTODOS: estudio exploratorio, descriptivo de abordaje cualitativo realizado con cinco personas hospitalizadas para desintoxicación química, en el período de marzo a julio de 2013, en una unidad de desintoxicación química de un hospital de mediano porte de la región central de Rio Grande do Sur. Los datos fueron recolectados por una entrevista semiestructurada y sometidos a análisis de contenidos. RESULTADOS: surgieron dos categorías: El cuidado lúdico en enfermería, como un estímulo a la aceptación y como la promoción para el vivir saludable después de la desintoxicación química. CONCLUSIÓN: el cuidado lúdico en enfermería, se mostró potenciador a la aceptación de la desintoxicación del crack en la realidad investigada. .

OBJETIVO: conhecer as contribuições do cuidado lúdico em enfermagem no estímulo à aceitação da desintoxicação química pelo uso do crack na percepção das pessoas em processo de desintoxicação. MÉTODOS: estudo exploratório, descritivo, de abordagem qualitativa, realizado com cinco pessoas internadas para desintoxicação química do crack, no período de março a julho de 2013, em uma unidade de desintoxicação química de um hospital de médio porte da região central do Rio Grande do Sul. Os dados foram coletados por meio de uma entrevista semiestruturada e foram submetidos à análise de conteúdo. RESULTADOS: emergiram duas categorias: O cuidado lúdico em enfermagem como um estímulo à aceitação da desintoxicação química; Cuidado lúdico em enfermagem na promoção para o viver saudável após a desintoxicação química. CONCLUSÃO: o cuidado lúdico em enfermagem mostrou-se potencializador para a aceitação da desintoxicação química do crack na realidade investigada. .

Participation in a social and recreational day programme increases community integration and reduces family burden of persons with acquired brain injury.

PRIMARY OBJECTIVE: To describe and evaluate a new day programme for persons living with an acquired brain injury (ABI), including persons exhibiting challenging behaviours. Activities were designed to reduce participants' social isolation, increase participation in community activities and increase social and leisure skills. It was expected that community integration would increase and challenging behaviours and family burden would decrease for day programme participants. METHODS AND PROCEDURES: Pre-post convenience sample design. Sixty-one participants and family members completed questionnaires before starting the day programme and after 6-month participation. MEASURES: Community Integration Questionnaire, Overt Behaviour Scale, Burden Assessment Scale, Goal Attainment Scaling. RESULTS: Participants had increased community integration (p = 0.000) and decreased family burden (p = 0.006). There was a trend to decreased severity of challenging behaviour. Participants and family members were very satisfied. Results suggest that the programme was effective in reducing participants' social isolation and increasing appropriate interpersonal behaviours. CONCLUSIONS: Participation increased community integration and reduced burden on family caregivers. ABI day programmes help fill the void left after other rehabilitation services end and provide survivors with opportunities to engage in a variety of activities. Persons living with ABI have need for ongoing social, recreational and life skill coaching services after formal rehabilitation has been completed.

The psychological and social impact of camp for children with chronic illnesses: a systematic review update.

Advances in medicine have reduced mortality among children with complex medical conditions, resulting in a growing number of young patients living with chronic illnesses. Despite an improved prognosis, these children experience significant psychosocial morbidity, such as depression and anxiety. Therapeutic summer recreation camps have been proposed as an intervention to enhance quality of life among these children. The purpose of this systematic review was to assess the psychosocial impact of camp for children with chronic illnesses. A systematic review of central databases was undertaken using key words, and a rating tool ­ the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies ­ was employed to rate methodological quality. 21 studies were included in this systematic review. Although overall methodological quality was weak, camp participation appeared to offer short-term psychosocial benefits on some parameters in children with a variety of chronic illnesses. There was some consistency in improved social outcomes, such as social interaction and acceptance. Based on the available evidence, it is premature to make robust claims regarding the psychosocial impact of camp as a therapeutic intervention. Theoretically informed camp programs, long-term follow-up, and incorporating camp-based messaging into routine hospital care,may enhance the utility of camp as a potential psychosocial intervention in paediatrics.

The development of a sustainable, community-supported children's bereavement camp.

This article describes the creation and development of a sustainable, community-supported children's bereavement camp. Numerous grief camps were examined prior to the project development. The project development was guided by the S.M.A.R.T. (S--Strategic/specific; M--Measurable; A--Achievable/attainable; R--Realistic; and T--Time-framed) stratagem to direct steps toward the development of the bereavement camp. Outcome measures included program participation, as well as evaluations completed by campers, family members, and volunteers. Camp attendance continues to grow, with 48 children the first year and an average of 65 the following 3 years. According to post-evaluation surveys, campers were able to integrate back into school with a decrease in stress and an increase in their ability to verbalize their grief, share feelings and begin to trust others. One child "got her sparkle back" according to her grandmother. Several campers commented that camp allowed them to see themselves as normal children. The goal of Camp Healing Hearts was that campers would laugh again, and they are.

Projeto brincar e contar: a terapia ocupacional na atenção básica em saúde / Project "play and tell?: occupational therapy in primary health care

Este artigo relata uma experiência de um grupo de contação de histórias e brincar ocorrida nas dependências de uma Unidade Saúde da Família do município de São Carlos, SP. Esse grupo foi constituído a partirda avaliação da terapeuta ocupacional no contexto da atenção básica à saúde de forma ampliada que considerou a vida cotidiana dos envolvidos: as crianças, uma usuária do serviço e a equipe de saúde. Através do olhar da terapia ocupacional para as problemáticas do território foram propostas intervenções que articulavam o cuidado individual, o cuidado coletivo e a corresponsabilização da comunidade e da equipe na busca da ressignificação do cotidiano desses atores. Trata-se de um exemplo concreto de mudança de paradigma do modelo de saúde existentepara os preceitos da Estratégia Saúde da Família com o envolvimento de usuários e profissionais de várias áreas. A terapeuta ocupacional identificou diferentes demandas do território: a necessidade de transformação do cotidiano e da rotina de uma usuária, a necessidade de espaços de lazer e brincadeiras para as crianças no território e o desejoda equipe de construir esse espaço através de uma brinquedoteca. A possível junção das realidades cotidianas da usuária, das crianças e da equipe constituiu um projeto de intervenção baseado na visão da clínica ampliada. O ?Brincar e Contar? foi capaz de transformar na prática o modelo de atenção à saúde.(AU)

This paper reports the experience of a ?storytelling and playing? group that took place in a Family Health Unit in Sao Carlos, State of Sao Paulo. The group was formed as from the evaluation of the occupational therapist in the context of Primary Health Care, which broadly considers the daily lives of the actors involved: children, one user of the system, and the health team. From the viewpoint of Occupational Therapy, with focus on the problems of the territory, interventions linking the following matters were proposed: individual care, collective care, and co-responsibility of the community and staff in pursuit of the resignificance of the everydaylives of the actors involved. This is a concrete example of paradigm shift from the existing health model to the precepts of the Family Health Strategy, with the involvement of users and professionals from various areas.The occupational therapist identified different demands of the territory: the need for transformation of daily life and routine of a user; the need for children?s leisure; and the desire of the health team to build this spacethrough a playroom. The possible combination of the user, children and the team?s everyday realities composed an intervention project based on the vision of the clinic expanded. The ?playing and storytelling? was able toactually transform the health care model.(AU)

Projeto brincar e contar: a terapia ocupacional na atenção básica em saúde / Project "play and tell": occupational therapy in primary health care

Este artigo relata uma experiência de um grupo de contação de histórias e brincar ocorrida nas dependências de uma Unidade Saúde da Família do município de São Carlos, SP. Esse grupo foi constituído a partir da avaliação da terapeuta ocupacional no contexto da atenção básica à saúde de forma ampliada que considerou a vida cotidiana dos envolvidos: as crianças, uma usuária do serviço e a equipe de saúde. Através do olhar da terapia ocupacional para as problemáticas do território foram propostas intervenções que articulavam o cuidado individual, o cuidado coletivo e a corresponsabilização da comunidade e da equipe na busca da ressignificação do cotidiano desses atores. Trata-se de um exemplo concreto de mudança de paradigma do modelo de saúde existente para os preceitos da Estratégia Saúde da Família com o envolvimento de usuários e profissionais de várias áreas. A terapeuta ocupacional identificou diferentes demandas do território: a necessidade de transformação do cotidiano e da rotina de uma usuária, a necessidade de espaços de lazer e brincadeiras para as crianças no território e o desejo da equipe de construir esse espaço através de uma brinquedoteca. A possível junção das realidades cotidianas da usuária, das crianças e da equipe constituiu um projeto de intervenção baseado na visão da clínica ampliada. O ?Brincar e Contar? foi capaz de transformar na prática o modelo de atenção à saúde.

This paper reports the experience of a "storytelling and playing" group that took place in a Family Health Unit in Sao Carlos, State of Sao Paulo. The group was formed as from the evaluation of the occupational therapist in the context of Primary Health Care, which broadly considers the daily lives of the actors involved: children, one user of the system, and the health team. From the viewpoint of Occupational Therapy, with focus on the problems of the territory, interventions linking the following matters were proposed: individual care, collective care, and co-responsibility of the community and staff in pursuit of the resignificance of the everydaylives of the actors involved. This is a concrete example of paradigm shift from the existing health model to the precepts of the Family Health Strategy, with the involvement of users and professionals from various areas.The occupational therapist identified different demands of the territory: the need for transformation of daily life and routine of a user; the need for children?s leisure; and the desire of the health team to build this spacethrough a playroom. The possible combination of the user, children and the team?s everyday realities composed an intervention project based on the vision of the clinic expanded. The ?playing and storytelling? was able toactually transform the health care model.

Health-related quality of life changes of children and adolescents with chronic disease after participation in therapeutic recreation camping program.

BACKGROUND: The principals of therapeutic recreation underpin a camping program for children and adolescents living with chronic disease. This study aimed to evaluate the campers' health-related quality of life (HRQoL) before and after the program. METHOD: We used the Hungarian version of Kidscreen-52 questionnaire to assess HRQoL. The study sample (n = 115) consisted of children and adolescents aged 10-18 (Mean Age: 13,34; SD: 2,20) collected two months before and two months after camp with the following illnesses: oncology patients (n = 32), diabetes (n = 55) and juvenile immune arthritis (JIA) (n = 28). Repeated measures of multivariate analysis of variance (MANOVA) evaluated pre and post camp changes. We used the Reliable Change Index (RCI) to calculate all the 10 subscales of clinically significant changes. RESULTS: The Self-perception subscale showed significant positive change from pre camp to post camp with small effect size. Autonomy scores showed time related decline as well as significant time and age group interaction: children under 14 years of age showed a significant moderate effect size decrease on the Autonomy subscale. 32 children (27.8%) showed clinically significant improvement (RCI > 1.96) at least on one subscale. All positive changes were independent of the type of disease, age, gender, and previous camp experience. CONCLUSION: The therapeutic recreation camping program had a positive impact on HRQoL of children and adolescents living with cancer, diabetes mellitus and JIA. The experience enhanced their self-perception in all age groups and reduced the autonomy of children under 14 years of age. This study is an innovative use of the KIDSCREEN-52 questionnaire to measure the outcome effectiveness of a psychosocial rehabilitation program and to assess and compare HRQoL of children living with different chronic diseases.

Severe pediatric rumination syndrome: successful interdisciplinary inpatient management.

BACKGROUND: Rumination syndrome is a condition that occurs when people constantly regurgitate and expel or reswallow food soon after they eat. The most severe cases of rumination syndrome can be debilitating, requiring total parenteral nutrition or enteral tube feedings. We report our experience with the treatment of children with severe rumination syndrome. PATIENTS AND METHODS: Five patients with severe rumination syndrome received a novel inpatient interdisciplinary approach, which involved pediatric psychology, pediatric gastroenterology, clinical nutrition, child life, therapeutic recreation, and massage therapy. RESULTS: Inpatient hospitalization lasted between 9 and 13 days. The treatment was successful in all 5 of the patients. They left with complete caloric intake orally. CONCLUSIONS: This treatment protocol could benefit pediatric gastroenterologists, pediatricians, and child psychologists in managing both standard and severe cases of rumination syndrome.