Experiences of siblings of children with chronic diseases revealed by the dramatic therapeutic play.

OBJECTIVE: To understand, through dramatic therapeutic play, the experiences of siblings of children with chronic diseases. METHOD: Phenomenological study, in the light of Heideggerian philosophical framework, conducted with 12 siblings of children with chronic diseases, aged between three and 11 years, accompanied in a public teaching hospital in the countryside of the state of São Paulo. The phenomenological interviews were audio-recorded and mediated by sessions of dramatic therapeutic play; later, interpreted from the Heideggerianphilosophical framework and thematic literature. RESULTS: The siblings demonstrated that they are affectively touched in the mode of sadness, longing and affection towards the sick child and, by the daily occupations imposed by the disease. CONCLUSION: The dramatic therapeutic play enabled the siblings of children with chronic diseases to expose their experiences permeated by the limitations of the child's chronic disease. Instituting actions for the inclusion of the sibling during the nursing care of the child with chronic disease is urgent to improve its quality.

Understanding the participation of mothers in the care for their children with chronic diseases in an Intensive Care Unit.

OBJECTIVE: To understand the perception of mothers of children with chronic diseases hospitalized in intensive care unitsabout their participation in the care of their children. METHOD: Qualitative study based on the premises of the Situated Phenomenon Structure Analysis, with 14 mothers, in Campinas, São Paulo. The discourseswere obtained through open interviews from November 2020 to January 2021, analyzed and discussed according to literature on the topic. RESULTS: Three thematic categories emerged - Sharing the Care with the Health Team; Wanting to be a Part of the Child's Care; Trying to Understand the Organizational Culture. FINAL CONSIDERATIONS: The mothers understand that their participation in their children care depends on the children's state of health. In addition, they highlight the importance of an effective and careful communication. It is up to health institutions to review their organizational culture, implementing the Family Focused Care.

Experiences of families of adolescents with gender incongruence in the light of the Calgary Models for Families.

OBJECTIVE: to know the experiences of family members of adolescents with gender incongruence. METHOD: this is a qualitative case study, supported by the Calgary Family Assessment and Intervention Models theoretical-methodological framework. Data collection took place through semi-structured interviews, participant observation in family groups and document analysis, with eight family members. Data analysis was performed following the precepts of content analysis. RESULTS: with family assessment, two categories emerged: "Challenges in the face of gender transition", which highlighted the problems related to the expectations created at birth, new names, pronouns and gender fluidity and the fear of prejudice, and "Supporting aspects in the face of the possibility of gender transition", which revealed family support as a strong point. CONCLUSION: knowing the experiences allowed us to understand the challenges that family members face when facing physical and emotional aspects of their children's gender transition. It was noticed that the act of seeking help and offering support is important for a healthy transition. The findings provided a better understanding of family issues and provided suggestions on how nursing can develop care for this population.

Prebriefing in clinical simulation in nursing: scoping review.

OBJECTIVE: To map the concept and structural elements of the prebriefing phase in clinical simulations in nursing. METHOD: Scoping review with searches between May and June 2021 in the databases PubMed, Virtual Health Library, EMBASE, CINAHL, SCOPUS, Web of Science, CAPES Catalog of Theses and Dissertations, Brazilian Digital Library of Theses and Dissertations and Google Scholar, in portuguese, spanish and english, without time limit. RESULTS: 24 studies were selected. In 17 articles (70.8%) the authors used the spelling prebriefing (in italics and amended), to refer to the stage that precedes the simulation, including preparatory activities and guidance. Alternative methods for prebriefing were described (reflective practices, laboratories, games and videos). CONCLUSION: There is no consensus regarding the concept and elements that constitute the prebriefing. This simulation stage contributes to participant satisfaction, participation and psychological safety, with better learning outcomes.

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

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

The act of playing as a signifier for the application of the dramatic Therapeutic Toy performed by the nurse: theoretical reflection.

OBJECTIVE: To reflect on the possible contributions of the act of playing as a signifier in the use of dramatic Therapeutic Toy performed by the nurse. METHODS: Theoretical-reflexive study, based on three moments: The language of the unconscious that emerges as a signifier when playing; How the dramatic Therapeutic Toy is used by the nurse; and the act of playing as a signifier during the application of the dramatic Therapeutic Toy: contributions to nursing practice. RESULTS: Through the intervention of the nurse in the sessions, the act of playing mediated by the dramatic Therapeutic Toy provides the child with the opportunity to elaborate on signifier elements that had not been meant by him. FINAL CONSIDERATIONS: Through the dramatic Therapeutic Toy, the articulation of the child's organism with his reality in the formation of the self constitutes an advance for the production of knowledge and nursing assistance to the child, enabling complete care and allowing the elaboration of their anxieties, which collaborates so that the child constitutes himself as a subject.

[The toy library as a possibility to unveil the daily life of children with cancer under outpatient treatment]. / A brinquedoteca como possibilidade para desvelar o cotidiano da criança com câncer em tratamento ambulatorial.

The purpose of this study is to learn the meaning of being-a-child with cancer submitted to ambulatory treatment and using the toy library as a possibility to enable their expression about their world. Participants were seven children of ages 3 to 9 years, who had been diagnosed with some kind of childhood cancer. With the objective of learning about the meaning of these experiences to children with cancer, an analysis of these data was performed based on Martin Heidegger's existential phenomenology. The child-with-cancer showed a movement that was permeated sometimes by authenticity, when the child assumed the disease and their being-toward-death and also by the lack of authenticity, when they were influenced by the decadence attitude of their relatives and health team members. Playing provided a rich contact with the existence of these severely ill children.

Growing up (being) without a mother: children's experiences during maternal imprisonment.

OBJECTIVE: to understand, through dramatic therapeutic play, children's experiences during maternal imprisonment. METHODS: this is a phenomenological study in the light of Winnicott's theoretical framework carried out in a philanthropic assistance center in the capital of São Paulo, with eight children aged three to ten who participated in an interview mediated by dramatic therapeutic play session. RESULTS: two categories emerged: Children being without a mother: a storm with lightning and thunder and Children growing up without a mother: drizzle, heavy rain and some rays of sun. FINAL CONSIDERATIONS: children revealed that, even in the absence of their mothers, it is possible to continue being and growing. Therapeutic play allowed children to give voice to their experiences, surrounded by concerns and limitations, in addition to unveiling an unknown social context.

From despair to hope: copying of relatives of hospitalized children before bad news report.

OBJECTIVE: to understand the experiences of relatives of critically ill children before bad news report. METHOD: a phenomenological study based on Heidegger's philosophical framework. Data collection was carried out from October 2018 to March 2019, through phenomenological interviews with 15 relatives of children hospitalized in a Pediatric Intensive Care Unit. RESULTS: relatives, in their existentiality, experience the facticity thrown into unpredictable situations, regardless of their choices and are faced with feelings of shock, despair and fear before bad news. After emotional impact, especially regarding the possibility of death, relatives reveal hope as a mechanism for coping with the situation. FINAL CONSIDERATIONS: solidarity and sensitivity by health professionals, especially nurses, are essential in understanding the existential dimension of relatives who experience such an experience, understanding the several facets of their existence and offering them opportunities to project themselves.

Embracement of the person with mental illness at an emergency hospital service: a qualitative research.

OBJECTIVES: to understand actions of nurses who care for people person with mental illness at a Referenced Emergency Unit in a university hospital. METHODS: a qualitative research based on Alfred Schütz's social phenomenology. Data collection was performed between December 2015 and January 2016 through phenomenological interviews with 13 nurses from an Emergency Unit. RESULTS: nurses embrace according to their previous experiences. They easily identify biological complaints and, when they recognize psychiatric signs and symptoms, refer them to the psychiatrist. They raise doubts about what to do, so they expect to be qualified for such action, believing that a protocol could help as well as they need more time. FINAL CONSIDERATIONS: the understanding of the lived type of nurse who embraces people with mental distress made possible in this study need recognition for research and interventions that focus on biological, psychic and social dimension articulation at embracement.

Using the instructional therapeutic play during admission of children to hospital: the perception of the family.

OBJECTIVE: To understand, from the family's perspective, the meaning of admitting the child in the hospital with the use of the instructional therapeutic play. METHOD: A phenomenological research with 12 families of children aged four to nine years old, recently admitted to a public and teaching hospital, in the inland of the state of São Paulo, from October to December 2016. They participated in an instructional therapeutic play session focusing on the procedures performed at hospital admission: weight, height, and vital sign measurements and test collection. The families, in turn, were invited to participate in a phenomenological interview the day after the session. RESULTS: The instructional therapeutic play collaborated in the therapeutic procedures by understanding and modifying the child's behavior. Also stressed by the families was the need for the toy to be incorporated as nursing care. CONCLUSION: Given the benefits to the child, the family believes that this strategy should be performed as a routine nursing care and, therefore, performed systematically during child hospitalization.

Mothers mothering in prison: an experience report of the nursing care project.

OBJECTIVES: to report the experience of designing and implementing the nursing care project with mothers and babies in prison. METHODS: this is an experience report about the nursing care project with mothers and children in prison, having as a guiding axis Winnicottian concepts about the mother-baby relationship. RESULTS: nursing consultations were held in childcare, thematic conversation circles and the manufacture of artifacts to encourage child development, as well as women's health care. The positive impact of the project has made it a health education program. FINAL CONSIDERATIONS: elaborating the nursing care project encouraged other ways of providing care and implementing it, using Winnicottian concepts. It is recommended that training institutions consider the prison and the individuals there as a field in the learning process of health professionals.

The meaning of the care of hospitalized children: experiences of nursing professionals.

OBJECTIVE: to understand the meaning of the care of hospitalized children for the nursing professionals of a pediatric unit. METHOD: phenomenological study, based on the existential phenomenology of Martin Heidegger. Ten nursing professionals were interviewed with the guiding question: "What is the care of hospitalized children for you? Tell me, in detail, your experience with taking care of hospitalized children." RESULTS: the meaning of the care of hospitalized children materializes between the profession and the various ways of preoccupation. By engaging in/worrying about the ways of being of everyday life, the professionals tend to improperness when trying to mediate and level all possibilities of being. However, when they extrapolate reassurance and do not get caught up in themselves, they achieve empathy, respect, and indulgence. FINAL CONSIDERATIONS: it is necessary to reassess the teaching and practice of care, so that authentic care is offered to children and their families in the context of hospitalization.

El tiempo de juego del niño se revela durante una sesión de juego dramático terapéutico / O tempo da brincadeira da criança revelado durante sessão de brinquedo terapêutico dramático / Child's playtime revealed during therapeutic dramatic play session

Introduction: playing, as an activity inherent to childhood, enables the child to acquire new knowledge about the world and to come across their own individuality expressing the world that is meaningful to him. The child's temporality composes his existence and drives him in the search for authentic existence. Objective: To describe the child's temporality during the stages of bonding and stopping playing in dramatic therapeutic play sessions. Method: phenomenological study in the light of the Heideggerian philosophical framework, with 12 children, aged between three and 11 years. For data collection, phenomenological interviews were conducted, mediated by the dramatic therapeutic toy. Results: the following thematic axis emerged: - The child's play time: being open. Conclusion: play reveals existential aspects of the child in chronological time and it fosters the sharing of new possibilities of relationship, in a free way, with the world. However, playing time might be elastic and negotiable according to individual need, so that all the expressions of the child becoming in their facticity during play would be considered. Therefore, regardless of the way and time they play, this study highlights the importance of respecting the child's existence at that moment.(AU)

Introducción: el juego, como actividad inherente a la infancia, permite al niño adquirir nuevos conocimientos sobre el mundo y encontrarse a sí mismo con su propia individualidad, expresando el mundo que le es significativo. La temporalidad del niño compone su existencia y lo impulsa en la búsqueda de la existencia auténtica. Objetivo: describir la temporalidad del niño durante las etapas de creación de vínculo y de cese del juego en sesiones de juego dramático terapéutico. Método: estudio fenomenológico a la luz del marco filosófico heideggeriano, con 12 niños, con edades entre tres y 11 años. Para la recolección de datos se realizaronentrevistas fenomenológicas, mediadas por juguetes dramáticos terapéuticos. Resultados: surgieron los siguientes ejes temáticos: El tiempo dejuego del niño: estar en apertura. Conclusión: el juego revela aspectos existenciales del niño en el tiempo cronológico y favorece compartir nuevas posibilidades de relación, libremente, con el mundo. Sin embargo, el tiempo dedicado al juego podría ser elástico y negociable según las necesidades individuales, de modo que todas las expresiones del devenir del niño en su facticidad durante el juego podrían ser consideradas. Por ello, independientemente de la forma y el momento en que jueguen, este estudio resalta la importancia de respetar la existencia del niño en ese momento.(AU)

Introdução: o brincar como atividade inerente à infância, possibilita quea criança adquira novos conhecimentos sobre o mundo e se depare com a própriaindividualidade, expressando o mundo que lhe seja significativo. A temporalidade da criança compõe seu existir e a impulsiona na busca pela existência autentica. Objetivo: descrever a temporalidade da criança durante as etapas criandovínculo e parando de brincar em sessões de brinquedo terapêutico dramático. Método: estudo fenomenológico à luz do referencial filosófico heideggeriano, com 12crianças, com idades entre três e 11 anos. Para a coleta de dados foram realizadasentrevistas fenomenológicas, mediadas pelo brinquedo terapêutico dramático.Resultados: emergiu o seguinte eixo temático: O tempo de brincar da criança:sendo em abertura. Conclusão: a brincadeira revela aspectos existenciais da criança no tempo cronológico e, favorece o compartilhar de novas possibilidades derelação, de modo livre, com o mundo. No entanto, o tempo que brinca pôde serelástico e negociável mediante a necessidade individual, para que fossem consideradas todas as expressões da criança vir a ser na sua facticidade durante a brincadeira. Portanto, independentemente do modo e do tempo que brinca este estudodestaca a importância de se respeitar a existência da criança nesse momento.(AU)

Experiences of siblings of children with chronic diseases revealed by the dramatic therapeutic play / Experiencias de hermanos de niños con enfermedades crónicas reveladas por eljuego terapéutico dramático / Vivências de irmãos de crianças com doenças crônicas reveladas pelo brinquedo terapêutico dramático

ABSTRACT Objective To understand, through dramatic therapeutic play, the experiences of siblings of children with chronic diseases. Method Phenomenological study, in the light of Heideggerian philosophical framework, conducted with 12 siblings of children with chronic diseases, aged between three and 11 years, accompanied in a public teaching hospital in the countryside of the state of São Paulo. The phenomenological interviews were audio-recorded and mediated by sessions of dramatic therapeutic play; later, interpreted from the Heideggerianphilosophical framework and thematic literature. Results The siblings demonstrated that they are affectively touched in the mode of sadness, longing and affection towards the sick child and, by the daily occupations imposed by the disease. Conclusion The dramatic therapeutic play enabled the siblings of children with chronic diseases to expose their experiences permeated by the limitations of the child's chronic disease. Instituting actions for the inclusion of the sibling during the nursing care of the child with chronic disease is urgent to improve its quality.

RESUMEN Objetivo Comprender, a través del juego dramático terapéutico, las experiencias de los hermanos de niños con enfermedades crónicas. Método Estudio fenomenológico, a la luz del referente filosófico heideggeriano, realizado con 12 hijos de niños con enfermedades crónicas, de edades comprendidas entre los tres y los 11 años, acompañados en el hospital público de enseñanza, en el interior del estado de São Paulo. Las entrevistas fenomenológicas fueron grabadas en audio y mediadas por sesiones de juego terapéutico dramático; luego, interpretada desde el marco filosófico heideggeriano y la literatura temática. Resultados Los hermanos demostraron que están tocados afectivamente en el modo de la tristeza, la añoranza y el afecto en relación con el niño enfermo y, por las ocupaciones diarias impuestas por la enfermedad. El brinco terapéutico dramático permitió que los hijos de los niños con enfermedades crónicas expusieran su vida a las limitaciones de la enfermedad crónica del niño. Conclusión Es urgente instituir medidas para la inclusión del hermano durante la asistencia de enfermera al niño con enfermedades crónicases urgente para mejorar su calidad.

RESUMO Objetivo Compreender por meio do brinquedo terapêutico dramático, vivências de irmãos de crianças com doenças crônicas. Método Estudo fenomenológico heideggeriano, realizado com 12 irmãos de crianças com doenças crônicas, com idades entre três e 11 anos, acompanhadas em hospital público de ensino, no interior do estado de São Paulo. As entrevistas fenomenológicas foram audiogravadas e mediadas por sessões de brinquedo terapêutico dramático; posteriormente, interpretadas a partir do referencial filosófico hedeggeriano e literatura temática. Resultados Os irmãos demonstraram que são tocados afetivamente no modo da tristeza, saudade e carinho em relação à criança doente e, pelas ocupações diárias impostas pela doença. Conclusão O brinquedo terapêutico dramático possibilitou que os irmãos de crianças com doenças crônicas expusessem suas vivências permeadas pelas limitações da doença crônica da criança. Instituir ações para a inclusão do irmão durante a assistência de enfermagem à criança com doença crônica faz-se urgente para melhoria da sua qualidade.

[Practical application of the nursing process in an adolescent suffering from a chronic disease]. / Aplicaçã o prática do processo de enfermagem a uma adolescente portadora de doenca crônica.

The purpose of this case study was to apply nursing diagnoses and interventions based on the North American Nursing Diagnosis Association (NANDA) Taxonomy of Nursing Diagnoses and the Nursing Interventions Classification (NIC) on an adolescent with secondary mellitus to cystic fibrosis and on her caretaker in order to provide them full care and guidelines. The nursing interventions were based on the following diagnoses: ineffective confrontation and stress syndrome due to alterations. These references helped us develop effective nursing interventions that provided a framework for individualized care, in addition to promoting a standardized nursing language.

O brincar de crianças com doenças crônicas durante a pandemia na percepção da família / Families' perceptions of how children with chronic diseases played during the pandemic / El juego de los niños con enfermedades crónicas durante la pandemia en la percepción de la familia

Objetivo: compreender as vivências de familiares de crianças com doenças crônicas sobre o brincar durante a pandemia. Método: estudo qualitativo fundamentado nos pressupostos da Análise da Estrutura do Fenômeno Situado, com 14 familiares que convivem com crianças com doenças crônicas, hospitalizadas em um hospital universitário localizado em Campinas, São Paulo. Os discursos foram obtidos, após aprovação do Comitê de Ética, por meio de entrevista aberta, de julho a setembro de 2021 e analisados segundo o referencial de Martins e Bicudo. Resultados: emergiram três categorias, brincando em outro lugar - as mudanças espaciais; brincando com (sem) outras pessoas ­ as mudanças interacionais e brincando diferente - as mudanças comportamentais. Conclusão: as mudanças ocorreram por necessidade de confinamento nos domicílios, fechamento dos espaços públicos e obrigatoriedade do distanciamento social. Houve aumento maciço do uso das telas pelas crianças, sem controle do tempo de utilização.

Objective: to understand the experiences of relatives of children with chronic diseases as regards playing during the pandemic. Method: this qualitative study of 14 family members living with children with chronic diseases, admitted as inpatients to a university hospital in Campinas, São Paulo, drew on the assumptions of Situated Phenomenon Structure Analysis. After approval by the research ethics committee, open interviews were conducted from July to September 2021 and the resulting data were analyzed with Martins and Bicudo as the frame of reference. Results: three categories emerged: Playing somewhere else ­ spatial changes; Playing with (without) other people ­ interactional changes; and Playing differently ­ behavioral changes. Conclusion: the changes resulted from confinement at home, the closure of public places, and mandatory social distancing. Children's screen use increased massively, with no control of use time.

Objetivo: comprender las experiencias de familiares de niños con enfermedades crónicas sobre el juego durante la pandemia. Método: estudio cualitativo basado en los supuestos del Análisis Estructural del Fenómeno Situado, con 14 familiares que viven con niños con enfermedades crónicas, hospitalizados en un hospital universitario ubicado en Campinas, São Paulo. Las declaraciones fueron obtenidas, previa aprobación del Comité de Ética, a través de entrevista abierta, de julio a septiembre de 2021 y analizadas según la referencia de Martins y Bicudo. Resultados: surgieron tres categorías: Jugando en otra parte ­ los cambios espaciales; Jugar con (sin) otras personas - los cambios en la interacción y; Jugar de manera diferente - los cambios en el comportamiento. Conclusión: los cambios ocurrieron por la necesidad de confinamiento en los hogares, cierre de los espacios públicos y distanciamiento social obligatorio. Hubo un aumento masivo en el uso de pantallas por parte de los niños, sin control sobre el tiempo de uso.

Visita à criança hospitalizada em terapia intensiva: vivências de irmãos reveladas por meio do brinquedo terapêutico dramático / Visita al niño hospitalizado en terapia intensiva: vivencias de hermanos revelado por el juego terapéutico dramático / Visiting a hospitalized child in intensive care: experiences of siblings revealed through the dramatic therapeutic play

Resumo Objetivo: compreender, por meio do brinquedo terapêutico dramático, o significado, para o irmão, de visitar a criança hospitalizada em terapia intensiva. Método: pesquisa qualitativa, modalidade fenomenológica, que utilizou o brinquedo terapêutico dramático para acessar às experiências dos irmãos. Foi realizada em Unidade de Terapia Intensiva Pediátrica do interior do estado de São Paulo, Brasil. Participaram das sessões de brinquedo terapêutico 11 irmãos menores de 10 anos, as quais foram analisadas à luz da Teoria do Amadurecimento. Resultados: os irmãos, tendo um lugar para brincar, dramatizaram situações, anteriormente, vividas, de seu cotidiano e da visita à criança hospitalizada. Ao viver, criativamente, revelaram que brincar é fazer a integração das experiências do "eu", favorecendo o continuar a ser diante da situação vivida. Conclusões e implicações para a prática: o Brinquedo Terapêutico Dramático compreendido à luz de um referencial teórico possibilitou que o irmão significasse a visita como uma experiência de integração do "eu", revelando emoções, desejos e preferências do cotidiano. Nesse sentido, o cuidado ao irmão da criança hospitalizada define-se pela oferta do brincar livre, para que ele demonstre o sentimento de continuar a ser em suas interações com o mundo, no qual o contexto hospitalar tornou parte da realidade.

Resumen Objeto: Comprender por medio del juego terapéutico dramático el significado, para el hermano, de la visita al niño hospitalizado en Terapia Intensiva Pediátrica. Método: Investigación cualitativa, modalidad fenomenológica, que utilizó el juego terapéutico dramático para comprender la experiencia del hermano. Se realizó en Unidad de Terapia Intensiva Pediátrica del interior del Estado de São Paulo, Brasil. Participaron de las sesiones de juego terapéutico 11 hermanos con menos de 10 años, quienes fueron analizados a la luz de la Teoría de la Maduración. Resultados: Los hermanos, al tener un lugar para jugar, dramatizaron situaciones anteriormente vividas, de su cotidiano y de la visita al niño hospitalizado. Al vivir de forma creativa, revelaron que jugar es permitir la integración de las experiencias del "yo", lo que favorece el concepto de seguir siendo, ante la situación vivida. Conclusiones e implicaciones para la práctica: El Juego Terapéutico Dramático comprendido a la luz de un referencial teórico hizo posible que el hermano entendiera la visita como una experiencia de integración del "yo", revelando emociones, deseos y preferencias cotidianas. En este sentido, el cuidado del hermano del niño hospitalizado se define por la oferta de juego libre, para que pueda demostrar su sentimiento de seguir siendo en sus interacciones con el mundo, en el que el contexto hospitalario se ha convertido en parte de la realidad.

Abstract Objective: to understand, by means of dramatic therapeutic play, the meaning, for the sibling, of visiting the child hospitalized in intensive care. Method: a qualitative research, phenomenological modality, which used the dramatic therapeutic play to access the siblings' experiences. It was carried out in a Pediatric Intensive Care Unit in the countryside of the State of São Paulo, Brazil. Eleven siblings under ten years of age participated in the therapeutic play sessions, which were analyzed in the light of the Theory of Maturation. Results: the siblings, having a place to play, dramatized previously lived situations, from their daily life and from the visit to the hospitalized child. By living creatively, they revealed that playing is to integrate the experiences of the "I", favoring the continuity of being in the face of the situation lived. Conclusions and implications for practice: the Dramatic Therapeutic Play understood in the light of a theoretical framework allowed the sibling to mean the visit as an experience of integration of the "I", revealing emotions, desires and preferences of daily life. In this sense, the care for the brother of the hospitalized child is defined by the offer of free play, so that he demonstrates the feeling of continuing to be in his interactions with the world, in which the hospital context has become part of reality.

Percepção materna sobre a participação do pai na hospitalização do filho em unidade intensiva pediátrica / Percepción materna sobre la participación del padre en la hospitalización del hijo en la unidad de cuidados intensivos pediátricos / Maternal perception of the father's participation in the child's hospitalization in a pediatric intensive care unit

RESUMO Objetivo: compreender a percepção materna sobre a participação do pai durante a hospitalização do filho em Unidade de Terapia Intensiva Pediátrica. Métodos: pesquisa qualitativa de inspiração fenomenológica, cujo referencial metodológico para análise dos discursos, advindos de 12 entrevistas com mães de crianças hospitalizadas no interior do estado de São Paulo, foi a análise da estrutura do fenômeno situado. Resultados: emergiram três categorias temáticas: Participando do processo de adoecimento do filho - a essencialidade da presença do pai; Sofrendo pelo filho - o pai sendo afetado pela hospitalização; Não podendo estar com o filho - o pai sendo impedido de ser acompanhante durante a hospitalização. As mães reconhecem a participação dos pais durante hospitalização do filho por meio de apoio, compartilhamento de atividades e na importância para a recuperação da criança. Contudo, o sofrimento advindo do adoecimento e da hospitalização, a necessidade de se dedicar ao trabalho, questões organizacionais do hospital e a ausência de legislações trabalhistas impedem a permanência dos pais no serviço de saúde. Conclusão: as unidades pediátricas precisam modificar as normas institucionais, acolhendo mãe e pai, oferecendo condições de permanência e apoiando-os durante a hospitalização do filho. É mister que a área de Enfermagem familiar discuta a participação do pai na vida do filho, em especial no ambiente hospitalar e de cuidados intensivos, de modo a impulsionar a elaboração de leis que garantam a manutenção do emprego em caso de acompanhamento do filho durante a hospitalização.

RESUMEN Objetivo: comprender la percepción materna sobre la participación del padre durante la hospitalización del hijo en la Unidad de Terapia Intensiva Pediátrica. Métodos: investigación cualitativa de inspiración fenomenológica, cuyo referente metodológico para el análisis de los discursos provenientes de 12 entrevistas con madres de niños hospitalizados en el interior del estado de São Paulo, fue el análisis de la estructura del fenómeno situado. Resultados: surgieron tres categorías temáticas: Participar en el proceso de enfermedad del hijo - la esencialidad de la presencia del padre; Sufrir por el hijo - el padre afectado por la hospitalización; No poder estar con el hijo: el padre impedido de ser acompañante durante la hospitalización. Las madres reconocieron la participación de los padres durante la hospitalización del hijo mediante el apoyo, compartir actividades y la importancia para la recuperación del niño. Sin embargo, el sufrimiento derivado de la enfermedad y la hospitalización, la necesidad de dedicarse al trabajo, los problemas de organización de los hospitales y la falta de leyes laborales impiden que los padres sigan en el servicio sanitario. Conclusión: las unidades pediátricas necesitan modificar las normas institucionales, acogiendo a la madre y al padre, ofreciendo condiciones de permanencia y ayudando durante la hospitalización del hijo. Es fundamental que el área de Enfermería de la familia discuta la participación del padre en la vida del hijo, especialmente en el ambiente hospitalario y de cuidados intensivos, para incentivar el desarrollo de leyes que garanticen el mantenimiento del empleo en el caso de acompañar a um hijo durante la hospitalización.

ABSTRACT Objective: to understand the maternal perception of the father's participation during the child's hospitalization in the Pediatric Intensive Care Unit. Methods: this is a qualitative research of phenomenological inspiration, whose methodological reference for the analysis of the speeches was the analysis of the structure of the situated phenomenon, arising from 12 interviews with mothers of hospitalized children in the countryside of the state of São Paulo. Results: three thematic categories emerged: Participating in the child's illness process - the essentiality of the father's presence; Suffering for the child - the father affected by the hospitalization; Not being able to be with the child - the father prevented from being a companion during hospitalization. Mothers recognize the fathers' participation during the child's hospitalization through support, sharing activities, and the importance of the child's recovery. However, the suffering resulting from illness and hospitalization, the need to dedicate themselves to their jobs, organizational issues at the hospital, and the absence of labor laws prevent parents from staying in the health service. Conclusion: pediatric units need to modify institutional norms, welcome mother and father, offer permanence conditions, and support them during the child's hospitalization. The Family Nursing area must discuss the father's participation in the child's life, especially in the hospital and intensive care environment, to promote the elaboration of laws that guarantee the maintenance of the job in case of accompanying the child during the hospitalization.

Understanding the participation of mothers in the care for their children with chronic diseases in an Intensive Care Unit / Entendiendo la participación de madres en el cuidado de niños con enfermedades crónicas en la unidad intensiva / Compreendendo a participação de mães no cuidado aos filhos com doenças crônicas em unidade intensiva

ABSTRACT Objective: To understand the perception of mothers of children with chronic diseases hospitalized in intensive care unitsabout their participation in the care of their children Method: Qualitative study based on the premises of the Situated Phenomenon Structure Analysis, with 14 mothers, in Campinas, São Paulo. The discourseswere obtained through open interviews from November 2020 to January 2021, analyzed and discussed according to literature on the topic. Results: Three thematic categories emerged - Sharing the Care with the Health Team; Wanting to be a Part of the Child's Care; Trying to Understand the Organizational Culture. Final considerations: The mothers understand that their participation in their children care depends on the children's state of health. In addition, they highlight the importance of an effective and careful communication. It is up to health institutions to review their organizational culture, implementing the Family Focused Care.

RESUMEN Objetivo: Comprender cómo las madres de niños con enfermedades crónicas hospitalizados en una unidad de cuidados intensivos perciben su participación en el cuidado infantil. Método: Estudio cualitativo basado en los supuestos del Análisis de la Estructura del Fenómeno Situado, con 14 madres, en Campinas, São Paulo. Los discursos se obtuvieron a través de entrevistas abiertas, de noviembre de 2020 a enero de 2021, analizadas y discutidas a partir de la literatura temática. Resultados: Surgieron tres categorías temáticas: compartiendo la atención con el equipo de salud; deseando ser incluida en el cuidado del niño; y buscando comprender la cultura organizacional. Consideraciones finales: Las madres reconocen que la participación en el cuidado de los niños depende del estado de salud del niño y enfatizan la importancia de una comunicación eficiente y cautelosa. Corresponde a las instituciones de salud revisar la cultura organizacional, implementando la Atención Centrada en la Familia.

RESUMO Objetivo: Compreender a percepção de mães de crianças com doenças crônicas hospitalizadas em unidade intensiva quanto a sua participação no cuidado ao filho. Método: Estudo qualitativo fundamentado nos pressupostos da Análise da Estrutura do Fenômeno Situado, com 14 mães, em Campinas, São Paulo. Os discursos foram obtidos por meio de entrevista aberta, de novembro de 2020 a janeiro de 2021, analisados e discutidos a partir da literatura temática. Resultados: Emergiram três categorias temáticas - compartilhando o cuidado com a equipe de saúde; desejando ser incluída no cuidado do filho e; buscando compreender a cultura organizacional. Considerações finais: As mães reconhecem que a participação no cuidado aos filhos depende do estado de saúde da criança e destacam a importância da comunicação ser eficiente e cautelosa. Cabe às instituições de saúde reverem a cultura organizacional, implementando o Cuidado Centrado na Família.