Made available in DSpace on 2016-03-15T19:40:22Z (GMT). No. of bitstreams: 1 MARIA_FELIPPE_DIST.pdf: 723435 bytes, checksum: e1e8cc5ac00609045ff26377d0bc0b77 (MD5) Previous issue date: 2006-08-24 / This research has the objective to study the problems and raise data referring to occurrence of complaints about sleep disorders in children and adolescents with visual impairment: blindness and low vision, admitted to Dorina Nowill Foundation for blind people, in São Paulo city. This is a descriptive transversal study based on quantitative method, carried through by means of data collecting of files for sample s characterization and structuralized interviews, together to subject s mother, in accordance with Scale of sleep disorders in children by Bruni et al. (1996). In this study had participated 117 subjects, with aging varying from 6 to 16 years old, divided into 3 groups: individuals with visual impairment, blindness (N=28), individuals with serious or deep low vision (N=28) and subjects from control group formed by visual impairment subjects respective brothers (N=61). The 3 groups had been matched for age and sex. All the participants with visual impairment are enrolled in elementary school and have the same social- economic level, monthly income up to 3 minimum wages. The visual impairment is frequently congenital. All the subjects with visual impairment have in their file the ophthalmologic report. Analysis of questions according to sleep disorders scale showed greater indices referring to complaints of sleeping when compared to control in the following aspects: begin and keep sleep; transition sleep/ vigil and excessive sleepiness. In the total punctuation of scale, the group with visual impairment presents complaints of sleep disorders significantly worse than control group (p < 0,001). Analysis of the 3 groups separately indicates that the group with low vision presents sleep complaints worse than control group in the following aspects: begin and keep sleep and transition sleep/ vigil. It is concluded that complaints and sleep disorders have been more frequently in population with visual impairment. Furthermore, the group with low vision showed more occurrences in sleep complaints than group with blindness. / Esta pesquisa tem o objetivo de estudar os problemas e levantar dados referentes à ocorrência de queixas de distúrbios do sono em crianças e adolescentes com deficiência visual: cegueira e baixa visão, atendidos na Fundação Dorina Nowill para Cegos, na cidade de São Paulo. Trata-se de um estudo descritivo transversal baseado no método quantitativo, realizado por meio de levantamento de dados dos prontuários para caracterização da amostra e entrevistas estruturadas, junto às mães dos sujeitos, de acordo com a Escala de Distúrbios do Sono para Crianças de Bruni et al. (1996). Participaram do estudo 117 sujeitos, com idade variando de 6 a 16 anos, divididos em três grupos: indivíduos com deficiência visual com cegueira (N=28); indivíduos com baixa visão grave ou profunda (N=28); e sujeitos do grupo controle formado pelos irmãos videntes dos próprios sujeitos com deficiência visual (N=61). Os três grupos foram pareados para idade e sexo. Todos os participantes com deficiência visual freqüentam o ensino fundamental e mesmo nível sócio econômico, com renda mensal de até três salários mínimos. A deficiência visual é mais freqüentemente congênita. Todos os sujeitos com deficiência visual possuem em seu prontuário de atendimento, o relatório oftalmológico. Análise das questões da Escala de Distúrbios do Sono revelou, de modo geral, que os sujeitos do grupo de deficiência visual apresentam maiores índices de queixa com relação ao sono quando comparados aos controles para os seguintes aspectos: Iniciar e manter o sono; Transição sono/vigília e Sonolência excessiva. Na pontuação total da Escala o grupo de deficiência visual apresenta queixas de distúrbios do sono significativamente pior do que aqueles do grupo controle (p< 0,001). Análise dos 3 grupos separadamente indica que o grupo de baixa visão apresenta queixas de sono pior do que o grupo controle para os seguintes aspectos: Iniciar e manter o sono e Transição sono/vigília. Conclui-se que as queixas e os distúrbios de sono foram mais freqüentes na população com deficiência visual. Além do mais, o grupo de sujeitos com baixa visão relatou maior ocorrência de queixa de sono do que o grupo com cegueira.

Made available in DSpace on 2016-03-15T19:40:40Z (GMT). No. of bitstreams: 1 Vania Warwar Archanjo.pdf: 491290 bytes, checksum: 8bb72efca0cd055fc2ec1956f3488ccf (MD5) Previous issue date: 2009-02-09 / This investigation conducted with people with acquired blindness sought the meaning of leisure to them, through interviews based on questionnaires compounded by an item of identification and eight questions leading to open answers. This same paper was based on Marcellino (1983, 1987, 1995, 2006) and his reflections on leisure as an experienced culture during an available time, Dumazedler (1973, 1980), focusing leisure on interests, and Blascovi-Assis (1997) who emphasizes the needed awareness of society as far as changing the universe of leisure. Making reference to visual impairment one sought to be based in authors such as Masini (1994, 2007), who discusses the importance of considering the person s perceptual referential with no sight, instead of comparing them with sighted people; on Palva (2005) and the resolution adopted by the International Council of Sidney about the related terms on visual impairment; on Farias and Buchalia (2005), who brought DSM-10 and FIC contributions (WHO 2003), complementing DSM-10 when tracing a functioning description. This work objective was to investigate the meaning of leisure to 10 people with acquired blindness and register how leisure activities have been occurring to this public, as well as verify the facilitating aspects and barriers to this experience. The guideline was analyzing if leisure activities propitiate well-being to people who acquired blindness. The interviews analysis happened in four phases: close reading of each participant s answers related to each question; classification in categories; answers categorization in charts; reflection on the data in the charts. The data analyzed showed that leisure to the subjects in the research means a possibility of well-being, by themselves or with others, once they do not feel unable to enjoy activities of such nature, since they consider the same activities as possible as they could be to the ones without visual impairment. / Esta investigação realizada com pessoas com cegueira adquirida buscou o significado do lazer para elas, por meio de entrevistas organizadas a partir de um questionário, composto de um item de identificação e oito perguntas de respostas abertas. Fundamentou-se em Marcellino (1983,1987, 1995, 2006) e suas reflexões sobre o lazer enquanto uma cultura vivenciada no tempo disponível, em Dumazedier (1973,1980), focalizando o lazer a partir dos interesses, e em Blascovi-Assis (1997) que enfatiza a necessária conscientização da sociedade no que se refere à realização de mudanças no universo do lazer. Com referência à deficiência visual buscou embasamento em autores como Masini (1994, 2007), que argumenta importância de considerar o referencial perceptual da pessoa sem a visão, em vez de compará-la com o referencial da pessoa vidente; em Paiva (2005) e a resolução adotada pelo Conselho Internacional de Sidnei sobre os termos relativos à deficiência visual; em Farias e Buchalla (2005), que trouxeram as contribuições da CID-10 e da CIF (OMS, 2003), que veio complementar a CID-10 ao delinear uma descrição de funcionalidade. O objetivo foi investigar o significado do lazer para dez pessoas com cegueira adquirida e registrar como vem ocorrendo as atividades de lazer desse público, bem como verificar os aspectos facilitadores e dificultadores nessa vivência. A linha diretriz foi a de analisar se as atividades de lazer propiciam o bem-estar às pessoas que adquiriram a cegueira. A análise das entrevistas foi realizada em quatro etapas: leitura cuidadosa das respostas de cada participante, referentes a cada pergunta; levantamento de categorias; categorização das respostas em Quadros; reflexão sobre os dados dos Quadros. Os dados analisados evidenciaram que para os sujeitos da pesquisa o lazer significa uma possibilidade de bem-estar, sozinhas ou em companhia de outras pessoas, uma vez que não se sentem incapazes para usufruir de atividades dessa natureza, já que as consideram tão possíveis para elas quanto para os que não têm deficiência visual.

A atenção conjunta é considerada, na literatura específica, como sendo uma habilidade fundamental do bebê para que este possa, a partir dela, estabelecer um conjunto de dimensões básicas no seu desenvolvimento cognitivo, social e afetivo. A atenção conjunta se refere a comportamentos como olhar na direção do olhar do outro, observar a face, a intenção e os interesses do outro, mostrar e compartilhar interativamente objetos com outros. Episódios de atenção conjunta, portanto, podem quase ser denominados de episódios de atenção visual conjunta. Esta capacidade, como dado eminentemente visual, tem sido considerada como crucialmente importante para o desenvolvimento da capacidade interativa do bebê, sendo indispensável para que este se socialize. Entretanto, ao se pensar estes processos em crianças cegas ou com deficiência visual severa, depara-se com a pouca quantidade de informação disponível em dados de pesquisas. Assim, a meta desta pesquisa foi investigar se ocorreu e como ocorreu a construção, o estabelecimento e a manutenção do processo de atenção conjunta em um bebê vidente e um bebê com deficiência visual severa, ambos em interação com os parceiros em seu entorno. Para tal, partiu-se da verificação de quais pistas sensoriais o bebê ou os parceiros circundantes se utilizam nas interações (se pistas visuais, táteis, vestibulares, auditivas, cinestésicas, olfativas ou gustativas) para iniciar, estabelecer e manter a atenção conjunta. Utilizou-se de estudo de casos múltiplos-exploratórios, envolvendo um bebê com deficiência visual severa e sua família vidente, fazendo-se um contraponto com um bebê vidente em uma família também vidente. O contraponto se mostrou importante para dar visibilidade a recursos e aspectos específicos do processo, e também preservar as características dos ambientes em que os bebês e suas famílias se encontram. A perspectiva sócio-interacionista permitiu a compreensão dos processos desenvolvimentais que ocorrem nestas situações. A construção do corpus se deu através de videogravações, posteriormente recortadas de acordo com sua relevância para a verificação da meta proposta, sendo as cenas selecionadas transcritas. Para a análise destes recortes considerou-se a abordagem microgenética, com aporte metodológico da Rede de Significações funcionando como proposta privilegiada e possibilitadora da compreensão da complexidade dos processos. Como resultados, verificou-se que para o bebê vidente, os dados encontrados confirmam o que a literatura específica indica como sendo o percurso típico para a construção da atenção conjunta. Para o bebê com deficiência visual severa, nota-se também, a partir de outras pistas que não as visuais, o estabelecimento e a manutenção do processo de atenção conjunta. Sugerem-se, entretanto, mais pesquisas a respeito destas questões, não só para se buscar mais dados a partir de outros bebês videntes e também com as mesmas características sensoriais diferenciadas da cegueira ou da deficiência visual severa, como também para contribuir com a construção de novos dados teóricos a respeito do tema. / Joint attention is considered, in specific literature, as a fundamental skill of the baby. Through this ability, the baby sets up a group of basic dimensions in his cognitive, social and affective development. Joint attention refers to behaviors like looking in the direction of someone else\'s gaze, observe the face, the intent and the interests of the other, pointing out and sharing objects interactively with other. Joint attention episodes, therefore, can almost be called joint visual attention episodes. This ability, basically as a visual fact, has been considered as crucially important for the development of the interactive capabilities of the baby, becoming essential for his socialization. However, there is few survey data about joint attention in severe visual impairment or blind children. Therefore, this research aims to investigate if occurs and how occurs the construction, establishment and maintenance of joint attention process in a seer baby, and in a severe visual impairment baby, both in interaction with surrounding partners. This work is intended to check what sensorial cues are being used, by the baby or by the surrounding partners, in their interactions (whether visual, tactile, vestibular, auditory, kinesthetic, olfactory or gustatory) to initiate, establish and maintain joint attention. It was choosen the methodology Exploratory Multiple Case Study, involving a severe visual impairment baby and its seer family, as a counterpoint to a seer baby and its seer family. This approach offered additional visibility to some specific aspects in joint attention, and, in addition, to preserving surrounding characters in which babies and their families are involved. The Social-Interactionist Perspective allowed the understanding of such developmental processes. Corpus Construction were captured on digital video recordings, subsequently prepared accordingly to the work goal and its relevancy. The selected scenes were transcribed. For the analysis of these clippings was considered a microgenetic approach. The Network of Meanings sustained the comprehension of joint attention processes and offers methodological support. As an outcome for the seer baby, this work endorses what specific literature indicates for the establishment of joint attention in a typical development child. For this baby with severe visual impairment, it was observed establishment and maintenance of joint attention process, from non visual sensory cues. However, it suggests more research on these issues to generate new contribuitions over the theme joint attention, not only to seer babies, but also to severe visual impairment babies. These future works might contribute to build new theoretical data on joint attention, in typical or even atypical sensorial conditions of development.

Orientador: Maria Aparecida Affonso Moysés / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-19T12:53:48Z (GMT). No. of bitstreams: 1 PintoeSilva_RafaelFerreira_M.pdf: 1892017 bytes, checksum: 8c5dda661c811869c486972b5e2bed56 (MD5) Previous issue date: 2011 / Resumo: Este estudo se origina da pergunta: Como pais de crianças deficientes visuais reagem diante do filho não sonhado? Com a finalidade de se aproximar dos sentimentos e expectativas de pais na primeira avaliação de seus filhos em reabilitação visual, procurando compreender afetos, emoções, expectativas e frustrações. Foram entrevistados nove mães e três pais de dez crianças com diagnóstico de deficiência visual e idade entre zero e três anos, participantes do Programa de Intervenção Precoce. Foram informados sobre a pesquisa e assinaram Termo de Consentimento Livre e Esclarecido. Este trabalho foi conduzido pela abordagem qualitativa, pelo método de estudo de caso, com ênfase no paradigma indiciário. Os dados foram coletados por entrevista semi-estruturada e análise de documentos. As entrevistas foram realizadas e transcritas; lidas, relidas, buscando definir as categorias de análise e realizar a análise de conteúdo. O número de sujeitos participantes foi definido por critério de saturação. Elencamos duas categorias de análise: Estigma e Olhar Materno. Discute-se as dificuldades enfrentadas pela criança e seus pais ao vivenciarem uma condição estigmatizante, em especial, os possíveis prejuízos para a constituição da identidade/subjetividade da criança pela ausência do espelho do olhar por sua privação de visão. Aponta-se a necessidade de adequada formação dos profissionais da saúde / Abstract: This study stems from the question: As parents of blind children react to the child does not dream? In order to get closer to the feelings and expectations of parents in the first assessment of their children in visual rehabilitation, trying to understand feelings, emotions, expectations and frustrations. We interviewed nine mothers and three fathers of ten children diagnosed with visual impairment and age between zero and three years, participants in the Early Intervention Program. Were informed about the study and signed a consent form. This work was conducted by a qualitative approach, the case study method, with emphasis on evidentiary paradigm. Data were collected by semistructured interviews and document analysis. The interviews were conducted and transcribed, read, reread, trying to define the categories of analysis and conduct content analysis. The number of participants was defined by criteria of saturation. We list two categories of analysis: Stigma and maternal gaze. It discusses the difficulties faced by children and their parents to experience a stigmatizing condition, in particular, the possible damage to the constitution of identity / subjectivity of the child by the absence of the mirror looking for its deprivation of vision. Pointed out the need for adequate training of health professionals / Mestrado / Saude da Criança e do Adolescente / Mestre em Saude da Criança e do Adolescente

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No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Vergara-Nunes-tese.pdf: 4912999 bytes, checksum: cc0ca6248d4303d00396fff2c4a68000 (MD5) Previous issue date: 2016-02-24 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Na atual sociedade do conhecimento, em que as imagens passaram a ocupar um lugar privilegiado na disseminação do conhecimento, com recursos de visualização cada vez mais presentes, é necessário encontrar um caminho de inclusão para os cidadãos cegos, a fim de que possam exercer seu direito de conhecer e apreender a realidade. Em um país onde cerca de 19% da população tem deficiência visual, com mais de 543 mil pessoas cegas, o acesso a esse tipo de material visual fica bastante prejudicado se não forem adotados recursos de acessibilidade adequados. A tecnologia assistiva chamada audiodescrição apresenta-se como possibilidade para esse acesso. Esta pesquisa, sob a ótica da teoria da enação e da externalização do conhecimento, busca verificar se tais recursos de acessibilidade são capazes de dar a esses aprendizes condições para apreenderem os conteúdos visuais e compartilharem o conhecimento neles veiculados, no contexto de aprendizagem. Com uma pesquisa qualitativa, interpretativista, valoriza-se a experiência e a subjetividade dos sujeitos, que poderão oferecer subsídios suficientes para que sejam elaboradas recomendações para apresentação de material de visualização do conhecimento para o aprendizado compartilhado com pessoas cegas. Com a questão de pesquisa “Como deve caracterizar-se a audiodescrição dos materiais escolares que permita ao aprendiz cego o acesso ao conteúdo didático visual no contexto de sala de aula?”, propõe-se um conjunto de recomendações para a elaboração de roteiros de audiodescrição com fins didáticos de imagens que veiculam conhecimento, para aprendizes cegos, com a intenção de possibilitar o aprendizado compartilhado desses sujeitos. Percebeu-se que a audiodescrição didática, utilizada com a intenção de auxiliar o aluno a aprender um conteúdo a partir de uma imagem, vai além da mera tradução visual objetiva dessa imagem; abandona a linguagem pretensamente neutra e assume seu papel de ferramenta de ensino nas mãos do professor audiodescritor, torna-se, ela mesma, um recurso didático não limitado à ferramenta intermediadora. / In today's society of knowledge, in which images came to occupy a privileged place in the dissemination of knowledge, with visualization resources increasingly present, it is necessary to find a way of inclusion for blind people so that they can exercise their right to know and grasp reality. In a country with about 19% of its population being visually impaired, more than 543,000 blind people, the access to this kind of visual material suffers great loss if adequate accessibility features are not adopted. An assistive technology called audio description is presented as one of the possibilities for such an access. This research, from the perspective of the theory of enaction and externalization of knowledge, aims to find whether these accessibility features are able to give these learners conditions to grasp the visual content and share of the knowledge served in them in the learning context. With qualitative research, interpretivist, we value the experience and the subjectivity of the subject, which may provide enough information for the drawing up of recommendations for the presentation of material for visualizing knowledge towards learning when shared with blind people. With the research question "How should one characterize audio description of school material that allows the blind learner to access visual educational content in the classroom context?" We propose a set of recommendations for the development of audio description scripts with didactic purposes of images that convey knowledge to blind learners, with the intention of enabling shared learning to these subjects. It was noticed that the didactic audio description used with the intention of helping students to learn content from an image, going beyond mere objective visual translation of this image; abandons the supposedly neutral language and assume its role as a teaching tool in the hands of the teacher-audio descriptor becomes itself a teaching resource not limited to mediating tool.

This thesis examines the belief that ideologies about blindness which have their provenance in religious, mythical and symbolic belief are 'infused into our literature and art' to become 'an important part of the way we perceive ourselves and others'. Depictions of the enduring power and influence ot symbolic belief is examined in fictional and autobiographical writings from 1600-1995. The history of theories of causation of disease in general is discussed in the first chapter. This is tollowed in the second chapter by an examination of the myths, meanings, symbols and ideologies which have become attached to blindness from pre-Christian times to the present day. The third chapter is devoted to an assessment of the influential meanings given to his own blindness by the poet John Milton and to an appraisal oi the responses, in the following century and a half, both by his adherents, notably Marveli, Dryden and the Romantic Poets, and his detractors, not least among whom was Samuel Johnson. The tollowing two chapters are given to an examination of the influence of ideology on depictions of blindness in Nineteenth and twentieth Century literature. Special attention is given to portrayals of blindness in recent works for children, in view of the belief and recommendation that writings about and for handicapped children should be realistic and tree from stereotype. Both chapters are underpinned by brief surveys of the then current social situation of the blind and of the state of medical knowledge at the time. Finally, fictional representations of blindness are compared with a number of experiental accounts taken from autobiographies of blind people written between 1870-1990.

Reklam på internet är ständigt ökande och många internetanvändare är negativt inställda till den. Därför har de utvecklat olika medvetna och omedvetna strategier för att undvika den när de ska göra något på internet. För skapare av reklam på Internet kan det vara bra att känna till hur reklamen undviks för att kunna bli bättre på att skapa effektiv reklam. Denna undersökning har baserats på intervjuer med vana internetanvändare med olika bakgrund för att få reda på hur de hanterar reklambanners samt en förståelse för hur de tänker. Intervjuerna föregicks av en videoinspelning där försöksdeltagarna fick specifika uppgifter att utföra för att eftersträva ett naturligt beteende. Resultatet av undersökningen visade att banner blindness är ett fenomen som används av många försöksdeltagare, både på ett medvetet och omedvetet plan. Det visade sig att bara några få gör något aktivt fö ratt slippa eller undvika reklambanners. Anledningarna till varför de undvek reklamen visade sig i många fall bero på tre anledningar som tas upp i Cho och Cheons (2004) teoretiska modell : reklamen stör deras uppgift; många och röriga banners samt tidigare negativa erfarenheter.

Banners är annonser som finns på de flesta webbsidor. Användare är oftast ute på Internet med syftet att leta efter specifik information. Vid informationsökning används troligen ett speciellt kognitivt schema som gör att användaren undviker att fokusera på banners eftersom informationen som eftersöks inte antas finnas i banners. Om en navigering på Internet görs för lik en banner ser inte användaren den heller. Man kan säga att banner blindness är en tendens hos användaren av webben att ignorera banners, även när de innehåller information som användaren aktivt söker. Detta examensarbete undersöker om banners lättare kan kommas ihåg när ämnet överensstämmer med webbsidans text. En experimentell studie genomfördes med två betingelser, en grupp fick kontextberoende och den andra fick kontextoberoende banners. Medelvärdena visade att det var lättare att komma ihåg kontextoberoende banners, men inget signifikant säkerställt resultat erhölls. Resultatet kan ha påverkats av att det var få försöksdeltagare

This study examines the impact of Cognitive Awareness training on transaction processing accuracy rates within the US Financial Services Industry. Grounded in the theories of Inattentional Blindness and Error Management Culture, this paper supports and extends both theories through the development of a new theoretical construct. The ACE Construct is a novel approach that combines cognitive science, organizational development, and operational efficiency practices into a single approach designed to improve transaction processing accuracy. The study involved the design and implementation of a novel training program, with performance data observations sampled over seven months, to evaluate the impact of Cognitive Awareness training on accuracy. The researcher was able to partner with a global financial services firm to conduct experiments within three of their US based locations. It involved over 150 agents as they processed live-client transactions requests in real time. The similarities between agent populations, training practices, systems and procedures, and work types, allowed for analysis and interpretation of independent variables related to gender, proficiency/experience of the agent, and location. As expected, analysis of pre-treatment conditions suggest that accuracy is largely dependent on experience. Analysis of post-treatment accuracy results favor improvement in both accuracy measures and organization climate and culture dynamics as a result of Cognitive Awareness Training. Statistically significant improvements to both accuracy and organizational climate, related to type of Cognitive Awareness treatment introduced, and tenure, were discovered in the agent populations who were present during the entirety of the study. However, there was an absence of statistical support for a direct relationship between Cognitive Awareness Training as an independent variable and accuracy improvement. Furthermore, I was unable to detect a correlation between improvements in Error Management Culture and transaction processing accuracy. The results suggest the possibility of positive effects on transaction processing accuracy in practice, and open the door for continued research in this field.

Cette thèse interroge l’usage de la contention forte lors des soins en pédiatrie. Cette problématique soulève des questions philosophiques et éthiques qui s’inscrivent dans des pratiques quotidiennes de soins. Pourtant cette pratique, à laquelle se confronte fréquemment les soignants est relativement peu interrogée, voire banalisée.En effet, l’enfant effrayé ou douloureux peut se débattre et s’agiter au décours du soin et il arrive que plusieurs adultes le maintiennent pour poursuivre le geste. Un rapport de force s’installe alors entre soignants et enfant. Dans certains cas, la contrainte physique de l’enfant lors du soin s’apparente littéralement à de la violence. Le passage de l’usage légitime de la force à la violence illégitime n’est pas systématiquement identifié.Par ailleurs le fait de contraindre l’enfant de force confronte l’infirmier à un paradoxe : celui de faire mal à l’enfant pour son bien. Cela complique la perception de l’illégitimité de certaines contentions.Difficile voire impossible de renoncer à faire le soin et pourtant regrettable d’user de la contention forte à l’encontre d’un enfant malade. Une étude qualitative ancillaire à la réflexion philosophique été menée auprès de soignants de pédiatrie. L’objectif était d’interroger cette question du point de vue des soignants pour comprendre comment l’usage de la contention lors d’un soin en pédiatrie pouvait se transformer en un usage illégitime de la force. Les résultats de cette étude ont montré que la contention était une pratique laborieuse, source de malaise mais le plus souvent vécue comme inévitable et influencée par les habitudes de l’équipe d’appartenance. (Ces résultats sont en annexe de la thèse) Le « bien de l’enfant » justifiait le recours à la force. On assistait à une hiérarchisation déontologique où la réalisation du geste technique subordonne le respect du rythme de l’enfant. L’analyse de la parole des soignants a mis en évidence : empathie et attention des soignants à l’égard de l’enfant mais à l’évocation de la contention l’enfant disparaissait du discours. Un peu comme si l’enfant disparaissait du « radar émotionnel » du soignant, le temps de la contention. Le concept de « cécité empathique transitoire » a été proposé pour caractériser le phénomène qui se produit lors d’une contention forte.La thèse explore les raisons qui conduisent les adultes qui soignent à disqualifier le refus de l’enfant en proposant une forme de réhabilitation de la parole de celui-ci. Le travail s’organise autour de développement des regards et des points de vue qui tantôt masquent tantôt rendent visibles une partie de la réalité : celle de l’enfant et celle du soignant. Les soignants sont tels les prisonniers de la caverne, otages de leurs illusions. L’espoir de maitriser l’inconstance de l’existence par la grâce de la biotechnologie semble les contraindre à sacrifier leur propre subjectivité. L’arraisonnement de l’enfant mais aussi du soignant à la technique est au cœur du débat qui émerge de la réflexion. Au fil du travail, émerge l’idée d’un entre-deux des différences, qui pourrait être un nouvel espace conceptuel où les différences entre l’enfant et les soignants se rassemblent dans l’espace de la contingence. Cet entre-deux ouvre sur de nouveaux possibles, invite à devenir prudent. La prudence aristotélicienne comme disposition pratique apporte de nouvelles perspectives à cette problématique. L’invitation à la délibération dans les soins ouvre sur une proposition concrète de déploiement de la notion de care appliquée plus spécifiquement au champ de la pédiatrie. / From transitional empathic blindness to caution during care. About physical restraint during nursing care in pediatric wardsThis thesis questions the use of strong physical restraint during pediatric care. The issue raises philosophical and ethical questions falling within daily practices of nursing acts. However, this custom to which nurses are frequently exposed is rather seldom questioned or is routinized.A child who is scared or in pain can struggle or jitter during the care and it happens that serval adults retrain the child in order to finish the treatment. It is a real power struggle between the nurses and the child. Sometimes, the child’s physical restraint is similar to violence. The step from using reasonable strength to using unfounded violence is not automatically identified.Moreover, the nurse restraining a child strongly faces a paradox: hurting a child for his wellbeing. This complicates the perception of the illegitimacy of some restraints.It is difficult if not impossible to forgo the treatment, but it is nevertheless unfortunate to use physical restraint on a sick child. A qualitative research backed by a philosophical reflection has been conducted among pediatric nurses. The aim was to probe the issue from the nurses’ point of view in order to understand how the use of physical restraint during a treatment in pediatric wards could lead to the use of unfounded strength. The result of the research highlighted that restraint was an unpleasant, cumbersome practice, but that it was often experienced as unavoidable and governed by the team’s habits. (The results of the research can be found in appendix) The “child’s wellbeing” justified the use of strength, like a kind of ethical prioritization, where achieving the technical act subordinated the respect of the child’s rhythm. Analyzing the nurses’ comments highlighted their empathy and attention to the child, but when talking about restraint, the child was no longer mentioned. It seemed the child disappeared from the nurse’s “emotional radar” during a physical restraint. The idea of “transitional empathy blindness” was suggested to characterize the phenomenon occurring during a strong physical restraint.The thesis also explores the reasons leading the adults in charge of the care to disqualify the child’s refusal by offering a means to resume the dialog with the child. The work is structured around the evolution of the attitudes and opinions that sometimes conceal the child’s and the nurse’s reality and sometimes make it visible. Nurses are like prisoners in a cave, hostages of their own illusions. The hope of mastering the fickleness of life thanks to biotechnology seems to force them to sacrifice their own subjectivity. Trying to subjugate the child but also the nurse to the technical act is food for thought. Throughout the work, the idea of an in-between differences stands out. It could lead to a new concept where the differences between the child and the nurses could meet in case of contingency. This in-between opens new possibilities and encourages caution. As practical measure, Aristotle’s principle of caution develops a new insight regarding this issue. The possibility of discussing nursing practices leads to a concrete proposal to spread the notion of care more specifically in the field of pediatrics.