MORTE E MORRER EM UNIDADE DE TERAPIA INTENSIVA PEDIÁTRICA: PERCEPÇÃO DOS PROFISSIONAIS DE SAÚDE

The objective of this descriptive research was to investigate the perception of health care professionals who work in Pediatric Intensive Care Units in relation to the process of death and dying. The study was undertaken between June and August 2011, with data collected through structured interviews and subjected to statistical analysis. Of the 25 participants, 72% perceived death as a natural process of life, 60% felt compassion – a feeling that did not interfere in caring for the patient, 52% related that they had not received any preparation about the process of death or dying and 76% showed interest in taking a refresher course on the issue. Greater discussion is necessary about academic training, and the offer of educational activities and space for exchanging experiences, such that the workers may better understand and deal with feelings and limitations regarding death.El objetivo de esta investigación descriptiva fue conocer la percepción de los profesionales de salud que trabajan en Unidad de Terapia Intensiva Pediátrica acerca del proceso de muerte y murir. El estudio fue realizado en el periodo de junio a agosto de 2011. Los datos fueron obtenidos por medio de entrevista estructurada y sometidos al análisis estadístico. De los 25 participantes, 72% perciben la muerte como un proceso natural de la vida, 60% sienten compasión, sentimiento que no interfiere en el cuidado al paciente, 52% relataron no haber recibido preparación alguna sobre el proceso de muerte y murir y 76% manifestaron interés en realizar cursos de actualización acerca del tema. Es necesario más discusión acerca de la formación académica, y la oferta de actividades educativas y espacio para el cambio de experiencias, a fin de que los trabajadores puedan comprender mejor y lidiar con sentimientos y limitaciones delante de la muerte.O objetivo desta pesquisa descritiva foi conhecer a percepção dos profissionais de saúde que trabalham em Unidade de Terapia Intensiva Pediátrica em relação ao processo de morte e morrer. O estudo foi realizado no período de junho a agosto de 2011, os dados foram coletados por meio de entrevista estruturada e submetidos à análise estatística. Dos 25 participantes, 72% percebem a morte como um processo natural da vida, 60% sentem compaixão, sentimento que não interfere no cuidado ao paciente, 52% relataram não terem recebido preparo algum sobre o processo de morte e morrer e 76% manifestaram interesse em realizar cursos de atualização sobre o tema. É necessária maior discussão acerca da formação acadêmica, e a oferta de atividades educativas e espaço para a troca de experiências, para que os trabalhadores possam melhor compreender e lidar com sentimentos e limitações perante a morte.

Feelings of women accompanying children hospitalized in a Paediatric Intensive Care Unit

Objective: Analise feelings of women accompanying children in a paediatric intensive care unit Materials and Methods: Data were collected from August to October 2015 by the authors from individual interviews recorded with 15 women. The instrument was structured with the identification of qualitative variables, described in absolute and relative frequencies, and a guiding question. The "corpus" of each interview was electronically transcribed, floating readings were held and statements were categorized and analysed according Analise Content.  Results: 14 (93%) are biological mothers; average age 30 years; 11 (73%) have completed primary education; six (46%) have an occupation or a profession. The four themes were inferred: ambivalence of feelings and coping were related to how individuals express and deal with the hospitalized patient’s situation; empathy with the health team and the structural condition of the critical environment can also generate feelings. Nursing diagnoses were formulated from the reported feelings. Conclusion: It was observed that the feelings identified could be originated by the health-illness hospitalization process as well as the structural components of the critical environment. Keywords: Paediatric Intensive Care Units; Women; Feelings

Morte e morrer em unidade de terapia intensiva pediátrica: percepção dos profissionais de saúde

The objective of this descriptive research was to investigate the perception of health care professionals who work in Pediatric Intensive Care Units in relation to the process of death and dying. The study was undertaken between June and August 2011, with data collected through structured interviews and subjected to statistical analysis. Of the 25 participants, 72% perceived death as a natural process of life, 60% felt compassion – a feeling that did not interfere in caring for the patient, 52% related that they had not received any preparation about the process of death or dying and 76% showed interest in taking a refresher course on the issue. Greater discussion is necessary about academic training, and the offer of educational activities and space for exchanging experiences, such that the workers may better understand and deal with feelings and limitations regarding death.El objetivo de esta investigación descriptiva fue conocer la percepción de los profesionales de salud que trabajan en Unidad de Terapia Intensiva Pediátrica acerca del proceso de muerte y murir. El estudio fue realizado en el periodo de junio a agosto de 2011. Los datos fueron obtenidos por medio de entrevista estructurada y sometidos al análisis estadístico. De los 25 participantes, 72% perciben la muerte como un proceso natural de la vida, 60% sienten compasión, sentimiento que no interfiere en el cuidado al paciente, 52% relataron no haber recibido preparación alguna sobre el proceso de muerte y murir y 76% manifestaron interés en realizar cursos de actualización acerca del tema. Es necesario más discusión acerca de la formación académica, y la oferta de actividades educativas y espacio para el cambio de experiencias, a fin de que los trabajadores puedan comprender mejor y lidiar con sentimientos y limitaciones delante de la muerte.O objetivo desta pesquisa descritiva foi conhecer a percepção dos profissionais de saúde que trabalham em Unidade de Terapia Intensiva Pediátrica em relação ao processo de morte e morrer. O estudo foi realizado no período de junho a agosto de 2011, os dados foram coletados por meio de entrevista estruturada e submetidos à análise estatística. Dos 25 participantes, 72% percebem a morte como um processo natural da vida, 60% sentem compaixão, sentimento que não interfere no cuidado ao paciente, 52% relataram não terem recebido preparo algum sobre o processo de morte e morrer e 76% manifestaram interesse em realizar cursos de atualização sobre o tema. É necessária maior discussão acerca da formação acadêmica, e a oferta de atividades educativas e espaço para a troca de experiências, para que os trabalhadores possam melhor compreender e lidar com sentimentos e limitações perante a morte

Perfil dos pacientes internados em uma unidade de terapia intensiva pediátrica de um hospital escola do interior de São Paulo

The purpose of the study was to outline the profile of patients hospitalized at the Pediatric Intensive Care Unit of the Hospital das Clínicas de Botucatu - UNESP. This is a descriptive, cross-sectional and quantitative study. The data were extracted from the “Discharge, Admission and Death Register” of the unit of the patients hospitalized between January and December 2011. There was predominance of male children (54.4%) under one year of age (40,7%) were, with a mean length of stay of 5.46 days. Most of these children came from cities included in the DIR XI/SP in Botucatu (78.2%). The discharge contributed with 91.1% of the total discharges from the unit. Most admissions happened during the fall and winter, with the Immediate Post-Operative (IPO - 32.3%) and respiratory diseases (24.2%) as the most frequent causes. The profile of patients at the PICU makes it possible to elucidate individual aspects, family, social, demographic, seasonal, climatic, and, also, the clinical conditions, and, thus, comprehend the context of hospitalizations, in order to propose improvements on assistance, in an individualized and integral manner, for patients and their families.El objetivo del estudio fue definir el perfil de los pacientes ingresados en la Unidad de Cuidados Intensivos Pediátricos del Hospital de las Clínicas de Botucatu - UNESP. Se trata de un estudio descriptivo, transversal y cuantitativo. Los datos utilizados fueron extraídos del "Libro de Alta, Admisión y Óbito" que pertenece a la unidad de los pacientes ingresados de enero a diciembre 2011. Hubo un predominio del sexo masculino (54,4%), franja de edad inferior a 1 año (40,7%) y con un promedio de permanencia de 5,46 días. La mayoría de estos niños era procedente de ciudades que hacen parte de la DIR XI/SP Botucatu (78,2%). El alta contribuyó con 91,1% del total de salidas de la unidad. La mayoría de las admisiones fue durante el otoño e inverno, teniendo como causas más frecuentes el Postoperatorio Inmediato (POI - 32,3%) y enfermedades respiratorias (24,2%). El perfil de los pacientes ingresados en la UCIP permite dilucidar aspectos individuales, familiares, sociales, demográficos, estacionales, climáticos y, también, de las condiciones clínicas y, así, entender el contexto de los ingresados, con el fin de proponer mejoras en la atención prestada, de manera individualizada e integral, para los pacientes y familiares.O objetivo do estudo foi traçar o perfil dos pacientes internados na Unidade de Terapia Intensiva Pediátrica do Hospital das Clínicas de Botucatu - UNESP. Trata-se de um estudo descritivo, transversal e quantitativo. Os dados utilizados foram extraídos do “Livro de Alta, Admissão e Óbito” pertencente à unidade dos pacientes internados de janeiro a dezembro de 2011. Houve predomínio do sexo masculino (54,4%), faixa etária inferior a 1 ano (40,7%) e com uma média de permanência de 5,46 dias. A maioria dessas crianças era procedente de cidades que fazem parte da DIR XI/SP de Botucatu (78,2%). A alta contribuiu com 91,1% do total de saídas da unidade. A maioria das admissões foi durante o outono e inverno, tendo como causas mais frequentes o Pós-Operatório Imediato (POI - 32,3%) e doenças respiratórias (24,2%). O perfil dos pacientes internados na UTIP possibilita elucidar aspectos individuais, familiares, sociais, demográficos, sazonais, climáticos e, também, das condições clínicas e, assim, compreender o contexto das internações, no sentido de propor melhorias na assistência prestada, de maneira individualizada e integral, para os pacientes e familiares

New insights into the genetic etiology of Alzheimer’s disease and related dementias

Characterization of the genetic landscape of Alzheimer’s disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/‘proxy’ AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

New insights into the genetic etiology of Alzheimer’s disease and related dementias

Characterization of the genetic landscape of Alzheimer’s disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/‘proxy’ AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele