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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

A sociological approach to printed information for patients

Woods, Mary Dixon January 1997 (has links)
No description available.
2

Men’s health practices within dual income families.

Laws, Thomas Alan Clifford January 2009 (has links)
The topic, Men’s health practices in dual income families, is worthy of investigation because social change continues to challenge gender roles that have been used to justify a segregation of parental responsibilities. Although child health has primarily been the responsibility of mothers, the increasing trend toward dual income families has resulted in mothers being less available for this role. An emerging substitute for maternal health care is that provided by fathers. Key researchers of fatherhood have reported that men desire more pragmatic interactions with their child, aimed at directly improving health and wellbeing (Burgess, 1990; Burgess & Ruxton, 1997; Burghes, et al., 1997). However, little is known about men’s willingness and capability in performing the range of practices necessary to effectively reduce the morbidity and mortality associated with child illness and injury (Hallberg, 2007; Laws, 2003a). This study used several methods of data collection that ultimately identified new knowledge of men’s health practices not previously recorded in the literature. Document searches, for evidence of men’s health practices, are presented as six chapters; each chapter explores a discrete category of child health or illness; Acute illness, Chronic illness, Mental health problems, Terminal illness, Health promotion and Accident and injury prevention. All six document searches revealed scant information on men’s health practices; this finding supported the need for additional methods. Focus group discussions and individual interviewsm aimed to identify men’s knowledge of child health problems, their repertoire of skills and experiences of practicing health. A questionnaire survey was distributed to households to assess respondent’s attitudes toward the concept of gender equity, shared parenting and to measure the actual health practices performed toward children. Analysis of focus group discussions and survey data revealed a) strong support for gender equity in the workplace and the home b) strong support for equitable parenting c) a repertoire of health practices and frequency of performance far in excess of that evident in the literature. These findings suggest more equitable parenting is occurring and a reclaimed fatherhood role. However, all three methods of data collection identify that men experience substantial barriers to expanding their parental role into child health care; these findings and emerging evidence indicate the need for health professionals and policy makers to develop strategies that enhance men’s inclusion, as partners, in child health practices. / Thesis (Ph.D.) -- University of Adelaide, School of Population Health and Clinical Practice, 2009
3

Health services utilization of adult dual eligible patients with mental health illness, 2011

Cancino, Ramon Samera January 2014 (has links)
Thesis (M.S.H.P.) / BACKGROUND: Dual eligible (DE) patients qualify for Medicare and Medicaid. There are approximately nine million DE patients in the United States, and healthcare costs for this population totaled 319.5 billion dollars in 2011. Behavioral health illness (BHI) is a risk factor for increased healthcare service utilization. The healthcare utilization of adult DE patients <65 years of age with BHI has been studied sparsely. This study sought to describe the adult DE patient population <65 years of age at an urban academic safety net health center and compare hospital and emergency department (ED) utilization of those with and without BHI. METHODS: The study was a secondary analysis of hospital administrative data. Inclusion criteria were patients with Medicare and Medicaid between ages 18 and 65 years, who utilized Boston Medical Center between 1/1/2011 and 1/1/2012. The independent variable was diagnosis of BHI, and the dependent variables were hospital admission and ED utilization. Chi-square and Wilcoxon rank-sum tests were used for descriptive statistics on categorical and continuous variables, respectively. Greedy propensity-score matching without replacement with a caliper distance of half of a standard deviation was used to control for confounding factors. Rate ratios (RR) and confidence intervals (CI) were determined after matching and after adjusting for those variables that remained significantly different after matching. RESULTS: Pre-propensity-score matched data showed significant differences in age, sex, race/ethnicity, marital status, education, employment, physical comorbidities, and Charlson Comorbidity Index score. Post-propensity-score matched analysis found significant differences in sex, Hispanic race, and other education and employment status. As compared to those patients without BHI, patients with BHI had RR 2.07 (CI: 1.81- 2.38) (p<.0001) of hospital admission and a RR 1.61 (CI:1.46-1.77) (p<.0001) of ED utilization. After adjustment, RR for hospital admission and ED utilization remained significantly different and even increased slightly, RR 2.14 (CI: 1.87-2.46) (p<.0001) and RR 1.64 (CI:1.49-1.81) (p<.0001), respectively. CONCLUSION: As compared to DE patients without BHI, those with BHI had significantly more hospital admission and ED utilization, even after controlling for confounding factors. Results suggest interventions for decreasing healthcare services utilization in this population should focus on those DE patients with mental health illness. / 2031-01-01
4

Beyond Parenting Practices: Family Context and the Treatment of Pediatric Obesity

Kitzmann, Katherine, Dalton, William T., Buscemi, Joanna 01 January 2008 (has links)
Many family-based treatments for pediatric obesity teach specific parenting practices related to weight management. Although youth in these programs show increases in positive health behaviors and reductions in the extent to which they are overweight, most remain overweight after treatment. A recent trend is to create tailored programs for subgroups of families. We examine the possibility of tailoring based on family context, highlighting 3 aspects of family context that have been studied in relation to pediatric obesity: parenting style, family stress, and family emotional climate. We argue that family context may moderate treatment outcomes by altering the effectiveness of health-related parenting practices and discuss the implications of this argument for designing and evaluating tailored programs.
5

Reconhecimento e enfrentamento de necessidades de estudantes com uso problemático de drogas em moradia estudantil / Recognition and dealing with the needs of students with problematic drug use in student residence

Zalaf, Marilia Rita Ribeiro 07 March 2012 (has links)
Este estudo, de caráter exploratório e descritivo, teve como objetivo geral identificar e analisar os limites e possibilidades do Serviço Social da Coordenadoria de Assistência Social da USP do Projeto Na Boca do CRUSP Prevenção e Acolhimento, quanto ao atendimento de necessidades de alunos e ex-alunos com uso problemático de álcool e outras drogas que são ou foram residentes na moradia estudantil da Universidade de São Paulo, localizado na Cidade Universitária, em São Paulo. O Projeto, cenário deste estudo, é desenvolvido pelo Serviço Social da Coordenadoria de Assistência Social. Para a produção do material empírico foi utilizada entrevista semi-estruturada com sete alunos que residem ou já residiram no CRUSP e são ou foram atendidos pelo Projeto, obedecendo todas as exigências da Resolução 196/96 do Conselho Nacional de Saúde. As entrevistas foram gravadas e transcritas, para o tratamento dos dados foi utilizada a Análise de Conteúdo com a técnica da análise temática e para análise dos resultados foram utilizadas as categorias analíticas processo saúde-doença e necessidades de saúde. Após a análise dos resultados, foi possível conformar oito categorias empíricas: 1. Ser aluno USP; 2. Problematização da doença antes do acompanhamento pelo Projeto; 3. A chegada ao Projeto; 4. Reconhecimento do Serviço pelos usuários; 5. Dependência e recaída; 6. O futuro com a doença; 7. Necessidades atendidas e 8. Demandas para aperfeiçoamento do Projeto. A análise dos dados indicou que: as intervenções promoveram melhoria na qualidade de vida do grupo estudado, viabilizando o acesso a processos potencializadores de saúde; na concepção dos alunos, o Projeto atende necessidades necessárias como casa, comida e atendimento médico; foram reconhecidas como necessidades não atendidas cobrança de resultados e assistentes sociais exclusivas para o atendimento de moradores com uso problemático de álcool e outras drogas; não foram reconhecidas necessidades que implicam em articulações com políticas públicas e envolvem educação e serviços de saúde e em autonomia. Concluiu-se que o Projeto deve propiciar reflexões críticas acerca das necessidades de transformações de condições de vida envolvendo políticas públicas e que as ações passem a considerar a autonomia como um dos conceitos fundamentais visando à recuperação do controle da própria vida e independência. O estudo permitiu a visibilização de reais possibilidades de intervenção na realidade, por meio dos pontos de vulnerabilidade identificados. A partir dos resultados encontrados, o Projeto poderá aprimorar os serviços oferecidos, além de proporcionar elementos estratégicos para outros serviços na mesma natureza. / This study, both exploratory and descriptive in character, had the general purpose of identifying and analysing the limits and possibilities of the Social Service Department of the Social Assistance Division of the University of São Paulo (USP), in the project developed in the student residence area, known as Na Boca do CRUSP Prevenção e Acolhimento (At CRUSPs Mouth: Prevention and Shelter), in relation to meeting the needs of present and former students with a problem of usage of alcohol or other drugs, in the student residence of the University of São Paulo, situated on the main university campus in São Paulo. The Project, where this study was carried out, is developed by the Social Service Department of the Social Assistance Division. For the production of the empirical materials, a semi-structured interview was used, interviews being conducted with seven students who live, or have lived, in the student residence (CRUSP) and also either are being or have been served by the Project, also complying with all the provisions of Resolution No.196 of the National Health Council (Conselho Nacional de Saúde). The interviews were also recorded and transcribed, and for treatment of data use was made of Content Analysis with the technique of thematic analysis; in order to analyse results the analytical categories of health-illness process and health needs were used. After the results were analysed, it was possible to establish eight empirical categories, as follows: 1. Being a student of the University of São Paulo (USP). 2. Problematisation of the illness before monitoring by the Project; 3. Arrival at the Project; 4. Recognition of the Services by the Users; 5. Dependency and Relapse; 6. The future with the illness; 7. Needs catered to and 8. Demand for enhancement of the Project. The analysis of the data has shown that the intervention has brought about improvement in the quality of life of the group studies, making feasible the access to health-strengthening projects; in the view of the students, the Project meets basic needs such as housing, food and medical assistance; among the needs which were not satisfied, there was the inclusion of a demand for results and also exclusive social workers to serve those residents with a problem of usage of alcohol or other drugs, there not being any recognition of any needs that involve articulation with Government policies and also involve education and health services and in a regime of autonomy. The conclusion reached was that the Project should provide critical thinking about the need for transformation of living conditions involving Government policies, and that the actions should regard autonomy as one of the fundamental concepts in seeking to regain control of the persons own life and independence. The study has also enabled the visualisation of concrete opportunities for intervention in the real situation, through the vulnerable points that have been identified. Based on the results that have been obtained, the Project can then enhance the services offered, and also provide strategic elements for other services of the same nature.
6

Sentidos de saúde/doença produzidos em grupo numa comunidade alvo do Programa de Saúde da Família (PSF). / Meanings of health/desease maked in group in a community from family health program.

Celiane Camargo Borges 07 June 2002 (has links)
O Programa de Saúde da Família (PSF) enfatiza a promoção de saúde visando à qualidade de vida das pessoas, privilegiando ações voltadas a comunidades específicas. Novos paradigmas vêm sendo pensados, numa tentativa de transformar a crise há tempos estabelecida na Saúde Pública, visando a uma produção em saúde sintonizada com a história e cultura locais. A perspectiva construcionista social, tendo em seus pressupostos a construção de sentidos sobre o mundo, na linguagem, através da relação entre as pessoas, aponta para a possibilidade de co-construção de um modelo de atenção em saúde entre profissionais e comunidade. O presente estudo, baseado nessa perspectiva, tem como objetivo: descrever sentidos de saúde/doença produzidos em grupos numa comunidade alvo de um PSF. Foram audiogravados cinco grupos de sessão única, distribuídos geograficamente pela área, realizados com pessoas dessa comunidade, convidadas a se reunirem na rua onde moram, em domicílio de um dos participantes. Foram transcritos, e junto às notas de diário de campo, constituem-se na base de dados. A análise, realizada em dois eixos, buscou tematizar: 1) Quando a questão é promover saúde – referida aos momentos em que os sentidos são produzidos pelas participantes falando do lugar de pessoas que gozam de saúde. Esse eixo foi dividido em quatro subtemas: Estar com problemas reflete na sua saúde – que trata dos momentos em que os fatores físicos, mentais e sociais são referidos como influenciadores da saúde/doença; Eu acho que tudo é tá de bem com a vida – que traz os momentos em que os conceitos sobre promoção de saúde foram tratados como fundamentais para a manutenção da saúde; Se não tiver saúde, não trabalha mesmo – que trata da relação entre trabalho e desemprego afetando o processo saúde/doença; e Ficar sem dinheiro é a pior doença – em que o dinheiro foi referido como fundamental para se estar com saúde. E o segundo eixo 2) Quando a questão é recuperar a saúde – referida aos momentos em que falam do lugar de pessoas adoecidas, necessitando de cuidados específicos em saúde. Esse eixo desdobrou-se em três subtemas: Ela tá com saúde. Tem até cartão do Posto – que analisa os momentos em que a saúde é referida como a possibilidade de acesso a serviços; Você pensa que eu tomei o remédio que a médica me deu? Ta fechadinho, em casa guardado – que trata do autocuidado na saúde caracterizado como a não-adesão a um tratamento; e A doença é bem pessoal – tratando-se da saúde/doença como um processo pessoal e singular. A análise buscou descrever o modo como estão sendo construídos os sentidos acerca das noções que vêm embasando as novas propostas em saúde, enfocando o ponto de vista da comunidade. As considerações finais deste trabalho apontam como possibilidade para transformação da crise da Saúde Pública, uma prática em saúde baseada na aproximação, conversação e negociação constante, não somente entre equipe de profissionais e comunidade, mas em todas as dimensões, desde os formuladores das políticas de saúde, até os executores e usufruidores. / The Program of Family Health (PSF) emphasizes the health promotion aiming at the quality of life of the people, privileging actions turned to specific communities. New paradigms have been thought, in an attempt to transform the crisis established for a long time in the Public Health, aiming at a production in health syntonized with the local history and culture. The social construcionist perspective, having in its estimated the construction of meanings about the world, in the language, through the relation among the people, points to a possibility of co-construction of an attention model in health between professionals and community. The present study, based on this perspective, has as an objective: to describe meanings of health/disease produced in aiming groups in a community of a PSF. Five groups of only session had been taped, distributed geographically for the area, carried through with people of this community, invited to congregate in the street where they live, in the house of one of the participants. They had been transcribed, and with the notes of the field diary, consist in the database. The analysis, carried through in two axles, attempted to focus: 1) When the question is to promote health – related to the moments where the meanings are produced by the participants speaking from the place of people who enjoy health. This axle was divided in four subjects: “Being with problems reflects in one´s health” – that deals with the moments where the physical, mental and social factors, are related as influencing the health/illness; “I think that everything is to be ok with life” - that brings the moments where the concepts on health promotion had been treated as basic for the maintenance of the health; “If you don´t have health, you do not work for sure” – that deals with the relation between work and unemployment affecting the process health/illness; and “Being without money is the worse illness” – where the money was related as basic to be with health. And the second axle 2) When the question is to recoup the health – related to the moments where they speak from the place of sick people, needing specific cares in health. This axle was unfolded in three subjects: “She`s healthy. She even has the health center card” – that analyzes the moments where the health is related as the possibility to access the services; “You think that I took the remedy that the doctor gave me? It`s well closed, in my house” – that deals with the self care in health characterized as a not adhesion to a treatment; and the “Illness is well personal” – treating the health/illness as a personal and singular process. The analysis searched to describe the ways the meanings about the notions that have been basing the new proposals in health, focusing the point of view of the community. The final considerations of this work point to possibility of a transformation of the crisis of the Public Health, a practical in health based on the approach, conversation and constant negotiation, not only between the staff of professionals and community, but in all the dimensions, since the formulators of the health politics, to the usufructuary and executors.
7

Sentidos de saúde/doença produzidos em grupo numa comunidade alvo do Programa de Saúde da Família (PSF). / Meanings of health/desease maked in group in a community from family health program.

Borges, Celiane Camargo 07 June 2002 (has links)
O Programa de Saúde da Família (PSF) enfatiza a promoção de saúde visando à qualidade de vida das pessoas, privilegiando ações voltadas a comunidades específicas. Novos paradigmas vêm sendo pensados, numa tentativa de transformar a crise há tempos estabelecida na Saúde Pública, visando a uma produção em saúde sintonizada com a história e cultura locais. A perspectiva construcionista social, tendo em seus pressupostos a construção de sentidos sobre o mundo, na linguagem, através da relação entre as pessoas, aponta para a possibilidade de co-construção de um modelo de atenção em saúde entre profissionais e comunidade. O presente estudo, baseado nessa perspectiva, tem como objetivo: descrever sentidos de saúde/doença produzidos em grupos numa comunidade alvo de um PSF. Foram audiogravados cinco grupos de sessão única, distribuídos geograficamente pela área, realizados com pessoas dessa comunidade, convidadas a se reunirem na rua onde moram, em domicílio de um dos participantes. Foram transcritos, e junto às notas de diário de campo, constituem-se na base de dados. A análise, realizada em dois eixos, buscou tematizar: 1) Quando a questão é promover saúde – referida aos momentos em que os sentidos são produzidos pelas participantes falando do lugar de pessoas que gozam de saúde. Esse eixo foi dividido em quatro subtemas: Estar com problemas reflete na sua saúde – que trata dos momentos em que os fatores físicos, mentais e sociais são referidos como influenciadores da saúde/doença; Eu acho que tudo é tá de bem com a vida – que traz os momentos em que os conceitos sobre promoção de saúde foram tratados como fundamentais para a manutenção da saúde; Se não tiver saúde, não trabalha mesmo – que trata da relação entre trabalho e desemprego afetando o processo saúde/doença; e Ficar sem dinheiro é a pior doença – em que o dinheiro foi referido como fundamental para se estar com saúde. E o segundo eixo 2) Quando a questão é recuperar a saúde – referida aos momentos em que falam do lugar de pessoas adoecidas, necessitando de cuidados específicos em saúde. Esse eixo desdobrou-se em três subtemas: Ela tá com saúde. Tem até cartão do Posto – que analisa os momentos em que a saúde é referida como a possibilidade de acesso a serviços; Você pensa que eu tomei o remédio que a médica me deu? Ta fechadinho, em casa guardado – que trata do autocuidado na saúde caracterizado como a não-adesão a um tratamento; e A doença é bem pessoal – tratando-se da saúde/doença como um processo pessoal e singular. A análise buscou descrever o modo como estão sendo construídos os sentidos acerca das noções que vêm embasando as novas propostas em saúde, enfocando o ponto de vista da comunidade. As considerações finais deste trabalho apontam como possibilidade para transformação da crise da Saúde Pública, uma prática em saúde baseada na aproximação, conversação e negociação constante, não somente entre equipe de profissionais e comunidade, mas em todas as dimensões, desde os formuladores das políticas de saúde, até os executores e usufruidores. / The Program of Family Health (PSF) emphasizes the health promotion aiming at the quality of life of the people, privileging actions turned to specific communities. New paradigms have been thought, in an attempt to transform the crisis established for a long time in the Public Health, aiming at a production in health syntonized with the local history and culture. The social construcionist perspective, having in its estimated the construction of meanings about the world, in the language, through the relation among the people, points to a possibility of co-construction of an attention model in health between professionals and community. The present study, based on this perspective, has as an objective: to describe meanings of health/disease produced in aiming groups in a community of a PSF. Five groups of only session had been taped, distributed geographically for the area, carried through with people of this community, invited to congregate in the street where they live, in the house of one of the participants. They had been transcribed, and with the notes of the field diary, consist in the database. The analysis, carried through in two axles, attempted to focus: 1) When the question is to promote health – related to the moments where the meanings are produced by the participants speaking from the place of people who enjoy health. This axle was divided in four subjects: “Being with problems reflects in one´s health" – that deals with the moments where the physical, mental and social factors, are related as influencing the health/illness; “I think that everything is to be ok with life" - that brings the moments where the concepts on health promotion had been treated as basic for the maintenance of the health; “If you don´t have health, you do not work for sure" – that deals with the relation between work and unemployment affecting the process health/illness; and “Being without money is the worse illness" – where the money was related as basic to be with health. And the second axle 2) When the question is to recoup the health – related to the moments where they speak from the place of sick people, needing specific cares in health. This axle was unfolded in three subjects: “She`s healthy. She even has the health center card" – that analyzes the moments where the health is related as the possibility to access the services; “You think that I took the remedy that the doctor gave me? It`s well closed, in my house" – that deals with the self care in health characterized as a not adhesion to a treatment; and the “Illness is well personal" – treating the health/illness as a personal and singular process. The analysis searched to describe the ways the meanings about the notions that have been basing the new proposals in health, focusing the point of view of the community. The final considerations of this work point to possibility of a transformation of the crisis of the Public Health, a practical in health based on the approach, conversation and constant negotiation, not only between the staff of professionals and community, but in all the dimensions, since the formulators of the health politics, to the usufructuary and executors.
8

EXAMINING THE WAYS MENTAL HEALTH PROFESSIONALS STRENGTHEN THEIR SKILLS AND STAY MOTIVATED WHILE PROVIDING SERVICES TO CHILDREN AND FAMILIES

Romo, Jennifer, Wener, Shamille Antoinette 01 June 2016 (has links)
The purpose of this study was to explore the ways mental health providers continue developing and strengthening their skills to have a great impact and overall beneficial effect on the families they are supporting. An interview questionnaire was created to explore participants’ experiences working with families and their children to generate an understanding of their current experiences in the mental health field. Through this study we have learned that the mental health providers are aware of the traits that they have to possess in order to provide the best care for the clients and their families. The participants in the study stay motivated by seeing the positive client outcomes and receiving feedback from their clients and families. They apply new research, go to workshops, are change agents, seek supervision, and network with other professionals for support. The qualitative design was used in order to collect the data from the participants. The study sample consisted of twelve Mental Health Providers. One‑on‑one interviews were conducted, a consent was obtained per participant, and transcribed for thematic analysis. Based on participant narratives, a key finding in this study found that there are barriers to the mental health professionals, due to cost, time restraints, lack of peer support, and supervision. A key finding was the motivation of the Mental Health Professionals to continue providing services to the families was high due to the feedback and positive client outcomes. Future research is needed to explore additional ways to better support the Mental Health Provider in the mental health field.
9

Upplevelser av att bemöta patienter med psykisk ohälsa : ett sjuksköterskeperspektiv inom vården / Experiences of encountering mental health illness in health care : A nurses perspective within the health care system

Shamshiri, Atena January 2015 (has links)
Bakgrund: Psykisk ohälsa är vanligt förekommande hos Sveriges befolkning och räknas till en av folksjukdomarna. Personer med psykisk ohälsa kan drabbas av psykiska eller fysiska besvär och söker sig då till vården där patienterna kommer att möta sjuksköterskor. Syfte: Belysa sjuksköterskornas upplevelser av att bemöta patienter med psykisk ohälsa i vården. Metod: Litteraturöversikt som bygger på åtta kvalitativa artiklar. Resultat: Tre huvudkategorier och två subkategorier skapades. Första huvudkategorin var kunskapens betydelse i vårdandet av patienter med psykisk ohälsa med subkategorierna positiva upplevelser av kunskapens betydelse och negativa upplevelser av kunskapens betydelse. Andra huvudkategorin var upplevda yrkesroll i mötet av patienter med psykisk ohälsa. Tredje huvudkategorin var upplevda känslor i mötet av patienter med psykisk ohälsa med subkategorierna positiva upplevelser och negativa upplevelser. Diskussion: Fynd i huvudkategorierna som diskuterades var sjuksköterskornas bristande kunskap och kompetens leder till att patienter med psykisk ohälsa inte erbjuds den vård de har rätt till. Okunskapen kan leda till rädsla för det okända och en känsla av att psykiatrin inte är en del av allmänsjuksköterskornas ansvar. / Background: Mental health illness is common within the Swedish population and is considered an endemic disease. People with mental health illness can suffer from psychological or physical issues and will turn to the health care system, where they will meet nurses. Aim: Shed light on nurses’ experiences of encountering patients with mental health illness in health care facilities. Method: A literature review based on eight qualitative studies. Result: Three main categories and two subcategories were created. The first main category was the importance of education in the encounter with patients with mental health illness with positive experiences in regards to the importance of education and negative experiences in regards to the importance of education as subcategories. The second main category was perceived professional role in the encounter with patients with mental health illness. The third main category was perceived feelings in the encounter with patients with mental illness. The subcategories were positive experiences and negative experiences. Discussion: Findings in the main categories were discussed, where the nurses' lack of knowledge and skills are evident. This means that patients with mental health illness are not cared for in a way they should. The lack of knowledge can lead to fear of the unknown as well as feeling like psychiatry isn't a part of the general nurses’ responsibility.
10

Significados de Saúde e Doença na Percepção de Crianças com HIV / AIDS/ Gleide de Souza da Costa

Costa, Gleide de Souza da 05 April 2010 (has links)
Made available in DSpace on 2015-05-14T13:16:35Z (GMT). No. of bitstreams: 1 parte1.pdf: 2366795 bytes, checksum: 07b0cfc9dcf61f510f55e9f9af69e63c (MD5) Previous issue date: 2010-04-05 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Relations implied in cases of infantile illness and treatment are, in most of the cases, entirely mediated by adults, usually by the mother, as if the child were not also able to inform doctors about its own condition. However, we can assume that there are existential dimensions of the disease that only the sick child is fully capable to know and to say. In order to orient adequate treatment and obtain better health results for this population, it is important to grasp the meanings attributed by the child to the illness and the beliefs, perceptions and representations created by the child about its health condition. In this sense, this study aims to apprehend the meaning of health and illness in the perception of HIV seropositive children, considering their social context and process of living with HIV. This study is based on qualitative research and was developed in two Non Governmental Organizations (NGO's), located in the city of João Pessoa (PB) and Manaus (AM), being supported by the Theory of the Social Representations. About 13 children, 07 to 10 years old, with positive diagnosis for HIV by vertical transmission, participated of the research. Data were collected through a Socio-Demographic and Clinical Questionnaire (answered by their responsible adults/caretakers) and, with the children, the technique of Drawing-story with Subject was used, requesting them to make two drawings, of a sick person and of a healthful person, and their respective stories. Children were also asked to tell which drawing they prefer and which of them they identify themselves, and a semi-structured interview concerning the meanings of health and illness among children was used, as well. The socio-demographic and clinical data have been dealt with by descriptive statistics and the interviews by Content Analysis. Drawings and stories have been submitted to procedures proposed by Coutinho (2001). Findings: In relation to clinical data, time passed since the confirmation for diagnosis varied between 03 and 08 years (M = 05 years), all the children are symptomatic, 10 of them had already been affected by opportunist illnesses (pneumonia, tuberculosis and malnutrition), 09 had already been hospitalized a number of times (from 1 week to 2 months). According to information given by caretakers, 11 of these children have got knowledge of their diagnosis of AIDS, in 09 cases communicated by a Psychologist. Mother´s (06) or father´s (03) deaths were experienced by 09 children and 10 children live in contact with other seropositive people (mother [02], father [03], both parents [03], both parents + brothers and sisters [02]. Nowadays, their caretakers are parents (02), mother (04, one of them by adoption), father (02), grandmother (03) and aunt (01). The contents of the semistructured interview and the drawing-story with subject, produced similar and complementary data about seropositive children´s perception of health, strongly associated to playing, to being joyful and to good feeding. Illness, instead, appeared associated to physical limitations for playing, symptomatology, exposition to environmental risks, infection by virus, hospitalization, and medication. Final Considerations: The findings of this study draw attention for seropositive children, in order to stimulate the people legally responsible for them, caretakers and health professionals to adopt differentiated attitudes towards children in treatment, helping them to understand what happens to them and to get better quality of life. The study also stresses the lack and need of much more research on children with HIV/AIDS, which propose actions directly related to children and teenagers and, thus, to develop public policies that would correspond to the yearnings of this population. / As relações implicadas no caso da doença infantil ainda tem sido mediadas, na maioria dos casos, pelo adulto, geralmente a mãe, como se a criança não fosse também capaz de informar ao pediatra sobre seu estado. No entanto, pode-se pressupor que existe uma dimensão vivencial da enfermidade na infância sobre a qual a criança doente é capaz de saber e de dizer. Desta forma, revela-se importante perceber os significados atribuídos à doença, ou seja, as crenças, percepções, representações criadas pela criança relativamente à sua doença, já que esta compreensão poderá permitir uma intervenção mais adequada junto desta população. Nesse sentido, este trabalho tem por objetivo apreender o significado de saúde e de doença na percepção da criança soropositiva considerando seu contexto e processo enquanto portadora do vírus HIV. Este estudo é de caráter qualitativo e utiliza como lócus duas Organizações Não-Governamentais (ONG s), localizadas na cidade de João Pessoa (PB) e Manaus (AM), subsidiado no aporte da Teoria das Representações Sociais. Participaram da pesquisa 13 crianças com diagnóstico HIV positivo por transmissão vertical, na faixa etária de 07 a 10 anos. Para a coleta de dados foi utilizado um Questionário Sociodemográfico e Clínico (respondido pelo responsável/cuidador). Com a criança utilizou-se a técnica de Desenho-Estória com Tema, com a solicitação de dois desenhos: uma pessoa doente e uma pessoa saudável e suas respectivas estórias, além do questionamento sobre qual desenho prefere e com qual se identifica, bem como uma entrevista semi-estruturada acerca dos significados da saúde e da doença. Os dados sociodemográficos e clínicos foram tratados através de estatística descritiva e as entrevistas por Análise de Conteúdo. Os desenhos e as estórias foram submetidos aos procedimentos propostos por Coutinho (2001). Os resultados indicam que em relação aos dados clínicos, o tempo de diagnóstico variou entre 3 e 8 anos (M= 5 anos), todas as crianças são sintomáticas, 10 já apresentaram doenças oportunistas (pneumonia, tuberculose e desnutrição), 9 já foram hospitalizadas acima de 6 vezes, com tempo variando de 1 semana a 2 meses). Foi informado que 11 destas crianças têm conhecimento do diagnóstico de AIDS, sendo 09 passados por uma Psicóloga. A morte da mãe (06) ou do pai (03) foi vivenciada por 09 crianças e 10 convivem com outras pessoas também soropositivas (mãe (02), pai (03), pais (03) e pais e irmãos (02). Atualmente são cuidadas por pais (2), mãe (4, sendo uma adotiva), pai (2), avós (3) e tia. Tanto a entrevista semi-estruturada quanto o desenho-estória com tema demonstraram similitude de conteúdo e complementaridade dos dados, onde a percepção das crianças soropositivas em relação à saúde se mostrou associada ao brincar, ao sentimento de alegria e a boa alimentação. A doença, por sua vez, surgiu associada às limitações físicas e do brincar, à sintomatologia, à exposição aos riscos ambientais, ao contágio por vírus, à hospitalização e à medicação. Considerações Finais: Tais resultados chamam atenção para a infância soropositiva, buscando suscitar nos profissionais de saúde, nos cuidadores e responsáveis legais uma postura diferenciada nas relações estabelecidas com as crianças em tratamento, ajudando-as a entender o que lhes acontece, e a obter qualidade de vida. Outra questão evidenciada foi a necessidade de pesquisas voltadas a essa faixa etária com HIV/AIDS, que visem a possibilitar mais ações que envolvam diretamente crianças e adolescentes e, quem sabe, assim desenvolver políticas públicas que correspondam melhor aos anseios dessa população.

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