A experiência dos avós de crianças hospitalizadas em Unidade de Terapia Intensiva Pediátrica

Objective: To understand the experience of grandparents of children hospitalized in pediatric intensive care units. Method: This was a qualitative study based on the symbolic interactionism theoretical framework and the grounded theory as methodological framework carried out with grandparents of children hospitalized in the pediatric intensive care unit of a teaching hospital in a city in the state of São Paulo. Data were collected by means of participatory observation and semi-structured interviews, and analyzed following the open and axial codification stages of grounded theory. Results: Nine grandparents were interviewed. Two phenomena were identified: “finding themselves inside a storm” and “fighting to be the anchor of the family”, which explain the suffering experienced and support role developed by grandparents during the hospitalization period. Conclusion: Grandparents develop an important family support role during the crisis. Therefore, family care strategies must be developed to include this generation of the family, who are increasingly present and participatory in several healthcare settings

The grandparents' experience of children in pediatric intensive care unit

Orientador: Ana Márcia Chiaradia Mendes-CastilloDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de EnfermagemResumo: A admissão de uma criança em unidade de terapia intensiva impõe uma sobrecarga sobre os pais, irmãos e outros membros familiares. O estresse é vivenciado por todos, e interfere tanto nas relações pessoais quanto pode gerar mudanças nas rotinas familiares, tanto pela doença como pelo ambiente da terapia intensiva. Enfermeiros que trabalham com crianças sabem que o fornecimento de apoio e informação para os pais é importante, mas ainda são tímidos em considerar as necessidades dos avós, que também precisam de apoio e precisam ser considerados pelos profissionais, uma vez que a participação dos avós no cuidado tem sido cada vez mais presente nas famílias brasileiras. Em nossa realidade, ainda é pequeno o movimento dos pesquisadores em abordar a terceira geração familiar quando uma criança está doente. Diante disso, o objetivo deste estudo é compreender, a partir da perspectiva dos avós, a experiência de ter um neto hospitalizado em unidade de terapia intensiva pediátrica. Trata-se de um estudo qualitativo, que utilizou o referencial teórico do Interacionismo Simbólico e os pressupostos da Teoria fundamentada nos dados como referencial metodológico. Foram entrevistados nove avós de crianças hospitalizadas em UTI pediátrica de um hospital escola de uma Universidade do interior de São Paulo. Os dados foram coletados por meio de observação participante e entrevistas semi-estruturadas. As entrevistas foram gravadas e transcritas na íntegra logo após a sua realização, e analisadas de forma comparativa e constante, conforme preconizado pela Teoria Fundamentada nos dados. Através do processo de análise, realizado por meio das etapas de codificação aberta e axial, foi possível identificar dois fenômenos: Percebendo-se envoltos em uma tempestade, que compreende o sofrimento intenso e multiplicado vivenciado pelos avós, e representa as demandas dos avós em meio à doença crítica do neto; o segundo, Lutando para ser a âncora da família, representa a resposta dos avós diante do primeiro fenômeno, engloba o papel que os avós atribuem a si, de sustentação e estabilização da família, bem como o movimento deles para reunir forças e recursos para conseguir desempenhar esse papel. Os avós carregam um fardo durante a experiência de hospitalização do neto, evidenciado pela sua necessidade de demonstrar força, mantendo um papel de sustentação e de não partilhar do próprio sofrimento com outros membros da família, para não sobrecarregar os outros que já estão sofrendo, mas, dessa forma, sobrecarregando a si próprios. Padecem de recursos externos para atender as próprias demandas, que quando não atendidas ameaçam o papel desempenhado. É necessário que os profissionais adotem o conceito de cuidado centrado na criança e na família em sua maneira mais ampla, incluindo os avósAbstract: The admission of a child to an intensive care unit imposes an overload on parents, siblings and other family members. Stress is experienced by all, and it interferes in personal relationships and can lead to changes in family routines, by illness and by the environment of intensive care. Nurses who work with children know that providing support and information to parents is important, but they are still shy about considering the needs of grandparents, who also need support and need to be considered by professionals, since grandparents' Care has been increasingly present in Brazilian families. In our reality, there is still a small movement of researchers to approach the third generation of the family when a child is ill. Therefore, the objective of this study is to understand, from the perspective of the grandparents, the experience of having a grandchild hospitalized in a pediatric intensive care unit - PICU. This is a qualitative study that used the theoretical framework of Symbolic Interactionism and the assumptions of the Grounded Theory as a methodological framework. Nine grandparents of children hospitalized in a PICU of a school hospital of a University of the interior of São Paulo were interviewed. Data were collected through semi-structured interviews. The interviews were recorded and transcribed in full right after their completion, and analyzed in a comparative and constant analises, as recommended by the Grounded Theory. Through the process of analysis, performed through the open and axial coding, it was possible to identify two phenomena: PERCEIVING THEMSELVES INVOLVED IN A STORM, which comprehend the intense and multiplied suffering experienced by the grandparents, and represents the demands of the grandparents in amid to the grandson's critical ill. The second, STRIVING TO BE AN ANCHOR FOR THE FAMILY, represents the grandparents' response at the first phenomenon, includes the role that the grandparents attribute to themselves, the support and stabilization of the family, as well as their movement to gather strengths and resources to give to do this role. Grandparents carry a burden during the grandchild's hospitalization experience, evidenced by their need to demonstrate strength, maintaining a supporting role and not sharing their own suffering with other family members, so as not to overwhelm others who are already suffering but, thus overload themselves. Suffer by an absence of external resources to atend their own demands, Which, when left unattended, threaten the role played. Professionals need to adopt the concept of child and family-centered care in its broadest way, including grandparentsMestradoEnfermagem e TrabalhoMestra em Ciências da Saúd

A experiência dos avós de crianças hospitalizadas em Unidade de Terapia Intensiva Pediátrica

RESUMO Objetivo: Compreender a experiência dos avós de ter um neto hospitalizado em Unidade de Terapia Intensiva Pediátrica. Método: Estudo qualitativo, que utilizou o referencial teórico do Interacionismo Simbólico e, como referencial metodológico, os pressupostos da Teoria Fundamentada nos Dados, realizado com avós de crianças hospitalizadas em Unidade de Terapia Intensiva Pediátrica de um hospital-escola de uma universidade do interior de São Paulo. Os dados foram coletados por meio de observação participante e entrevistas semiestruturadas e analisados seguindo as etapas de codificação aberta e axial da Teoria Fundamentada. Resultados: Foram entrevistados nove avós. Identificaram-se dois fenômenos: “Percebendo-se envoltos em uma tempestade” e “Lutando para ser a âncora da família”, que compreendem o sofrimento vivenciado e o papel de suporte desenvolvido pelos avós durante a hospitalização. Conclusão: Os avós desenvolvem um importante papel de sustentação familiar durante a crise, portanto é essencial que se pense em estratégias de cuidado da família que envolvam também essa geração familiar, cada vez mais presente e participativa nos diferentes cenários de atenção à saúde

O processo de trabalho como determinante no processo saúde-doença

Citado nos relatos de profissionais de saúde e usuários do PSF, o trabalho mostra-se determinante no processo saúde-doença. São vários os fatores elucidados na literatura que influenciam o contexto do trabalho, seja ele saudável ou prejudicial. Nossa revisão tenta associar os estudos já realizados com as diversas opiniões relatadas pelos entrevistados. Os sujeitos do estudo foram selecionados de forma aleatória, sendo pessoas que fazem parte da equipe das USFs, quatro usuários de cada USF, sendo dois do sexo feminino e dois do masculino, adultos maiores de 20 anos, incluindo idosos e estudantes da 4ª série de medicina e enfermagem. A coleta de dados foi realizada por meio de entrevistas semi-estruturadas compostas de duas partes, englobando dados de identificação e questões norteadoras baseadas no objeto desse estudo. A análise foi realizada pela técnica de análise de conteúdo, modalidade temática. Concluiu-se que a adequação de recursos humanos e estruturais não depende apenas da organização interna do processo de trabalho da unidade de saúde, mas também de um campo mais amplo, compreendendo as políticas públicas de saúde nas três esferas do governo

Neotropical xenarthrans: a dataset of occurrence of xenarthran species in the Neotropics.

International audienceXenarthrans—anteaters, sloths, and armadillos—have essential functions forecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosys-tem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts withdomestic dogs, these species have been threatened locally, regionally, or even across their fulldistribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths.Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae(3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data onDasypus pilo-sus(Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized,but new genetic studies have revealed that the group is represented by seven species. In thisdata paper, we compiled a total of 42,528 records of 31 species, represented by occurrence andquantitative data, totaling 24,847 unique georeferenced records. The geographic range is fromthe southern United States, Mexico, and Caribbean countries at the northern portion of theNeotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regardinganteaters,Myrmecophaga tridactylahas the most records (n=5,941), andCyclopessp. havethe fewest (n=240). The armadillo species with the most data isDasypus novemcinctus(n=11,588), and the fewest data are recorded forCalyptophractus retusus(n=33). Withregard to sloth species,Bradypus variegatushas the most records (n=962), andBradypus pyg-maeushas the fewest (n=12). Our main objective with Neotropical Xenarthrans is to makeoccurrence and quantitative data available to facilitate more ecological research, particularly ifwe integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, andNeotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure,habitat loss, fragmentation effects, species invasion, and climate change effects will be possiblewith the Neotropical Xenarthrans data set. Please cite this data paper when using its data inpublications. We also request that researchers and teachers inform us of how they are usingthese data

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)