Bakgrund: Mer än en tredjedel av världens kvinnor blir någon gång under sitt liv utsatta för våld av sin partner eller sexuellt våld av annan än partner. Tidigare forskning visar att de våldsutsatta kvinnorna upplever både positivt och negativt bemötande av hälso- och sjukvårdspersonal.  Syfte: Syftet var att beskriva sjuksköterskors upplevelser av hindrande respektive underlättande faktorer för att utföra omvårdnadsåtgärder i mötet med våldsutsatta kvinnor i nära relation.  Metod: En litteraturstudie där 11 kvalitativa artiklar har granskats och analyserats. Resultat: Fyra kategorier framkom efter analys av artiklar: kunskapsnivå bland sjuksköterskorna, arbetsmiljö och organisation, samhällets inverkan, sjuksköterskornas egna känslor och antaganden. I mötet med våldsutsatta kvinnor i nära relation upplevde sjuksköterskor både hindrande och underlättande faktorer för att utföra omvårdnadsåtgärder, vilket beskrivs i resultatets huvudrubriker. Hindrande faktorer var brist på kunskap, hög arbetsbelastning, tidsbrist och brist på stöd från verksamheten. Partner närvaro, kulturen i samhället, språkbarriärer, egna känslor och antaganden upplevdes också som hindrande faktorer. Underlättande faktorer var utbildning, kunskap, erfarenhet, tid, ökad personaltäthet, stöd från kollegor och god samverkan med andra instanser. Andra underlättande faktorer var att mötet sker i enrum, mer uppmärksamhet i samhället och utbildning i skolor, använda oberoende tolk vid språkbarriärer, skapa en god relation till kvinnan, kunna reglera och hantera egna känslor.  Slutsats: Flera faktorer har betydelse för vilka omvårdnadsåtgärder sjuksköterskor ger i mötet med våldsutsatta kvinnor. Upplevd kunskap, erfarenhet, tid, vårdsystem, kulturella aspekter och inställning påverkar vilka omvårdnadsåtgärder som ges eller inte i mötet med den våldsutsatta kvinnan. Vidare forskning behövs om utbildningsbehov hos sjuksköterskor. / Background: More than a third of the world's women are at some time during their life victim of violence by their partner, or victim of sexual violence by other person than their partner. Previous research show that women that are victims of violence experience both positive and negative treatment from healthcare professionals.  Aim: The aim was to describe the barriers and facilitating factors nurses experience to carry through nursing actions when meeting female victims of intimate partner violence.  Method: A literature study of 11 qualitative articles, those were reviewed and analyzed.  Results: Four categories emerged from the analysis: level of knowledge among nurses, the work environment and organisation, the impact of society, nurses own feelings and assumptions. During encounters with female victims of intimate partner violence, nurses experienced both barriers and facilitating factors when performing nursing actions. They are described under the main headlines in the results. Barrier factors were; lack of knowledge, heavy workload, lack of time, lack of support from employer culture in society, language barriers, own feelings and assumptions, presence of the partner. Facilitating factors were; education, knowledge, work experience, having enough time, increased personnel, support from colleagues, good cooperation with other instances. Other facilitating factors were opportunity for meetings in private, more attention in society and education in schools, using an independent interpreter when encountering language barriers, establishing a good relationship with the woman, and the ability to regulate and manage emotions.  Conclusion: Several factors for which nursing measures that are provided by nurses has meaning when meeting with the abused women. Knowledge, experience, time, care system, cultural aspects and attitude affect what nursing measures are provided or not provided when meeting with the abused women. Further research is needed about nurses’ need of education in the subject female victims of intimate partner violence.

Bakgrund: Patienter på kirurgisk vårdavdelning uttrycker ett stort informationsbehov vid utskrivning och upplever att väsentlig information saknas. Enligt patientlagen har patienter rätt till individanpassad information och delaktighet i sin vård. Högt flöde av patienter på kirurgiska vårdavdelningar och förkortade vårdtider kan medföra att patienter behöver klara av många delar av sin egenvård i hemmet efter en operation Syfte: Att undersöka hur patienter som skrivits ut från kirurgisk vårdavdelning upplever att deras informationsbehov har tillgodosetts för att klara av den första tiden i hemmet. Metod: Kvalitativ intervjustudie med ett bekvämlighetsurval. Åtta patienter som vårdats på kirurgisk vårdavdelning inkluderades. Intervjuerna analyserades med systematisk textkondensering. Resultat: Det framkom tre teman som beskriver patienternas upplevelser av hur deras informationsbehov blev tillgodosett. Patienterna beskrev upplevelser av oro och rädsla på grund av bristande information om kroppens återhämtning efter kirurgi. En kunskapsbrist hos patienter efter utskrivning bidrog till upplevelser av osäkerhet kring egenvård. Anpassad information och möjlighet att ställa frågor ansågs vara viktigt. Slutsats: Trots att patienter på kirurgisk vårdavdelning upplever att de får välanpassad och användbar information inför hemgång är det inte tillräckligt för att de ska känna sig trygga i hemmet. Avsaknad av viktig information och kunskap skapade känslor av oro och rädsla. Det är viktigt att utforma utskrivningssamtalet med fokus på patientdelaktighet och patientens individuella behov. Här finns ett område för specialistsjuksköterskan inom kirurgisk vård med sin kompetens att förbättra. / Background: Patients treated in surgical wards require self-care information at discharge. They demand information that suits their needs and express a lack of essential information. Swedish regulation states that patients have the right to get individualized information and to be able to participate in their care. Due to the large volume of patients in surgical wards and shortened length of stay, patients may be required to handle more aspects of self-care at home. Aim: The aim is to understand how surgical patients feel their information needs have been met, in order for them to confidently take care of themselves after discharge. Method: Qualitative interview study with a convenience sample of eight patients treated in surgical wards, analyzed using systematic text condensation. Findings: Three themes emerged which explained how patients felt their information needs were met. Patients describe a sense of anxiety and fear at home due to lack of information concerning recovery after surgery. A lack of knowledge after discharge led to insecurities related to self-care. Adapted information and possibilities to ask questions were perceived as important. Conclusion: Patients treated in surgical wards perceive discharge information as well-adapted and useful. However, it is perceived as not being extensive enough. A lack of essential information, coupled with a lack of knowledge led to feelings of anxiety and fear. With these results in mind, it is important to individualize the information given to patients at discharge, and to improve the patient participation during this process. This is an area that registered nurses, specialized in surgical care, have potential to improve.

The graduation theses is about urinary tract infections and the preventive care that we are able to provide within nursing care of patients with urinary catheter. The theoretical part of graduation theses includes the chapters about general introduction to nosocomial infections, as well as epidemiology, pathogenesis, diagnosis and treatment of urinary tract infections. Furthermore, it relates to their antibiotic therapy and resistence to antibiotics. The main task is the prevention of urinary tract infections. Generally I have focused on the methods of urinary catheterization and their correct indications, the materials and design of urinary catheters, as well as on nursing care of urinary catheters. The thesis includes research aimed at providing preventive measures that are implemented in practice, comparing them to each other and comparison with the current studies and recommendations.. This research provides both positive and negative results. Some of the recommendations for preventive care of urinary tract infections are being followed, other are being omitted. There are also differences between respondents from different departments as well as among the departments. Nursing care procedures are not unified despite of presence of guidelines and standard procedures. keywords: nosocomial...

Introduction: The thesis "Alzheimer's disease and department of intensive care" deals with the specifics and difficulties of nursing care for patients with this chronic and degenerative disease in intensive care units (ICUs). The number of patients with Alzheimer's disease is constantly growing and caring for them in such specific wards is extremely demanding. The purpose of this thesis was to map the most problematic areas in the care provided and propose their solution. Methods and results: The empirical part presents the results of a conducted qualitative research which took place in the form of interviews with 10 general nurses who have experience with such patients. Following a word-for-word transcription of the obtained interviews, the results are summarized in a final discussion. They show that when caring for a patient with dementia, general nurses see the main problems in his decreased ability to cooperate, behavioral changes, which often appear as a result of environment change, and difficult communication. They consider the patient's confusion, his negativism, and the inability to find the right words to be communication barriers. This results in enormous demands on the caring staff's patience. The interviewed general nurses however approach patients with dementia generally positively...

Identifikační záznam: ŠEBESTOVÁ, Marcela. Náhlé příhody břišní v gynekologii pohledem sestry v intenzivní péči. [Acute Severe Abdominal Pain in Gynaecology from the Point of View of a Nurse in the Intensive Care Unit]. Praha, 2011. 68 s., 10 příl. Diplomová práce (Mgr.). Univerzita Karlova v Praze, 1. lékařská fakulta, Ústav teorie a praxe v ošetřovatelství. Vedoucí práce Mgr. Kulhavá, Miluše. Abstrakt Diplomová práce je zaměřena na náhlé příhody břišní v gynekologii pohledem sestry intenzivní péče. Teoretická část je věnována anatomii a fyziologii ženského reprodukčního systému. Velkou část práce zaujímají náhlé příhody břišní v gynekologii a to především mimoděložní těhotenství, tedy stav, se kterým se může setkat každá žena ve svém reprodukčním období. Empirická část práce je věnována kvalitativnímu výzkumu se zaměřením na zjištění spokojenosti respondentek s poskytovanou ošetřovatelskou péčí po operaci mimoděložního těhotenství. Pohled na hospitalizaci ze strany pacientek je velice cenný, protože dokládá výsledky zdravotnické, v tomto případě ošetřovatelské práce jinak, než běžné statistiky. Výzkumný soubor je tvořen pěti ženami v reprodukčním věku, které byly hospitalizovány na gynekologicko-porodnické klinice s diagnózou ektopická gravidita. Práce shromažďuje co nejvíce informací o mimoděložním...

Bakgrund: Patienter med drog- och alkoholmissbruk riskerar många komplikationer till följd av missbruket. Missbruket leder till många dödsfall varje år och är en stor kostnad för samhället. Patienter med missbruksproblematik upplever att de behandlas orättvist i omvårdnaden. Sjuksköterskor anser att omvårdnaden av den här patientgruppen är komplex. Syfte: Syftet är att sammanställa forskning om sjuksköterskors inställning och upplevelser av att vårda patienter med drog- och alkoholmissbruk inom både somatisk och psykiatrisk vård. Metod: En litteraturstudie, med 16 vetenskapliga artiklar, 12 med kvalitativ metod och fyra med kvantitativ metod. Resultat: Resultatet presenterades i olika kategorier som var: ”Att vara osäker”, ”Att känna sig otillräcklig”, ”Att känna sig inkompetent i sin roll”, ”Att kommunicera med patienten” samt ”Att vara ensam eller i team”. Sjuksköterskorna upplevde svårigheter i omvårdnaden med den här patientgruppen. Kunskapsbrist beskrevs i samband med omvårdnaden samt känslor som ångest och stress. En del relationer mellan sjuksköterska och patient baserades på misstro och några sjuksköterskor uttryckte en vilja att förbättra omvårdnaden med den här patientgruppen. Slutsats: Utifrån denna litteraturstudie kan slutsatsen dras att sjuksköterskor kan uppleva brister i omvårdnaden av patienter med drog- och alkoholmissbruk. Bristerna visar sig genom osäkerhet, otillräcklighet, känsla av inkompetens, i kommunikationen med patienten och samverkan i teamet. Utbildning, kunskap, samverkan och engagemang visar sig vara viktiga faktorer som kan påverka kvaliteten på omvårdnaden av den här patientgruppen. Det innebär således att det finns ytterligare behov av att utveckla både kunskapsläget och rutinerna när det kommer till denna typ av vård. / Background: Patients with drug- and alcohol abuse risk various complications related to the misuse. Drug- and alcohol abuse leads to a high yearly rate of death and an important social cost. Patients with drug- and alcohol abuse experience that they are treated unfairly in the care. Nurses consider the nursing care of this patient group to be complex. Aim: The aim of this study was to describe nurses’ experiences in the care for patients with drug- and alcohol abuse, both in somatic and psychiatric wards. Method: A literature review including 16 scientific articles, 12 with qualitative method, 4 with quantitative method. Results: The result is presented in different themes: “To be unsure”, “To feel inadequate”, “To feel incompetent”, “To communicate with the patient” and “To work alone vs in a team”. The nurses experienced difficulties in the care. A lack of knowledge was described and also emotions like anxiety and stress. Many relationships were based on distrust. Some of the nurses expressed a will to ameliorate the care for this patient group. Conclusion: The conclusion of this literature review is that nurses can experience deficits in the care of patients with drug- and alcohol abuse. The deficits manifest through insecurity, insufficiency, a sense of incapacity, in the communication with the patient and in the interplay inside the team. Education, knowledge, teamwork and commitment show to be important factors that can affect the quality of the care for this patient group. This implies that there are additional needs to evolve the knowledge and routines concerning this type of care.

Syftet med studien var att beskriva upplevelsen från vård- och återhämtningstiden hos patienter som vårdats på intensivvårdsavdelning. Metoden som används hade en kvalitativ ansats. Data samlades in via intervjuer med 11 patienter som vårdats på intensivvården från två sjukhus i Sverige. Materialet analyserades genom kvalitativ innehållsanalys. Resultatet blev fyra kategorier och 14 subkategorier. Kategorin Känna trygghet bestod av subkategorierna: Bli väl omhändertagen i vården, Få information och Vikten av stöd. Kategorin Förlust av kontroll innefattade: Sakna vetskap och förståelse, Fragmenterade minnen från vårdtiden, Overklighetsupplevelser samt Känna rädsla, obehag och smärta. Kategorin Stärkas av egna resurser inkluderade subkategorierna: Vikten av positiv inställning, Hoppas och drivas av framsteg samt Bra fysiska förutsättningar och intressen som drivkraft. Kategorin Erfara förändring bestod av subkategorierna: Känna fysisk svaghet, Komplikationer som påverkar ens tillvaro, Vilja leva som tidigare och Tankar kring livet.  Slutsatsen var att god omvårdnad inkluderade patienters behov av att bli sedda, behandlade med omsorg samt minnas och förstå vad som sker. Förståelse bygger på information om den egna sjukdomsbilden, komplikationer och återhämtning. Dessa behov belyser vikten av att i omvårdnaden utgå från patienterna och att integrera dem i vården.   Som vårdpersonal bör vi sträva efter att stärka patienters känsla av sammanhang vilket förutsätter att de är väl insatta i sin sjukdom, vård och behandling samt konsekvenser av det de går igenom.  Personcentrering är viktigt för patienters känsla av sammanhang och därmed deras hälsa och livskvalité under och efter sjukhusvård. / The aim of this study was to describe the experience from the hospital stay and time of recovery in patients admitted to intensive-care unit. The method used had a qualitative approach. Data was collected through interviews with 11 patients who had received intensive-care from two hospitals in Sweden. Data was analyzed with qualitative content analysis. The result was four categories and 14 subcategories. The category To feel secure included the subcategories: Good patient care, Receive information and The importance of support. The category Loss of control comprised of the subcategories: Lacking knowledge and understanding, Fragmented memories of the hospital stay, Experiences of unreality and To feel fear, pain and discomfort. The category Strengthen by their own resources included the subcategories: Importance of positive attitude, To hope and be driven by success and also Good physical conditions and activities as the driving force. The category Experience changes contained the subcategories: Feel physical weakness, Complications that affects your life, Wish to live as before and Thoughts about life.  The conclusion was that good nursing care included patient’s needs to be seen, treated with care and remember and understand what was happening. Understanding was based on information about their own illness, complications and recovery. These needs highlights the importance of basing nursing care on the patient and to integrate them in their own care and treatment. Health professionals should strive to strengthen the patient’s sense of coherence which implies that they are well versed in their illness, care and treatment and consequences of what they are going through. Person-centering is important for the patient’s sense of coherence and thus their health and quality of life during and after hospitalization.

Children heart diseases can be divided into congenital and acquired heart defects. The acquired heart defects can be further divided into acquired heart defects, heart rhythm disorders, including hypertension, inflammatory heart diseases and heart failure. Children heart diseases can occur at any age, even if it is a congenital heart defect that is less severe. The goal of this thesis was to find out the specifics of nursing care of children with heart diseases who are hospitalized at ICU and to find out the most common nursing diagnoses according to NANDA II taxonomy, and their treatment in case of children with heart diseases who are hospitalized at ICU. During the realization of the research part, a qualitative research survey was conducted using semi-structured interviews with the nurses, participant observation and the method of content analysis, which provide a more complex view of the composition of the children with heart disease hospitalized at ICU. The interviews were conducted with the nurses at the children's ICU, where the participant observation and the method of content analysis took place as well. The results of the research show that nursing care differs in the case of cardiologic disordered children and otherwise disordered children in some areas, as well as the needs. In the research part it was found out what the most frequent nursing interventions in case of these children are and how much they differ from the interventions of children with other diseases, who are also hospitalized at ICU. Furthermore, the research shows that nurses have a negative opinion on nursing diagnoses, although they are used in the documentation. This was found not only in the semi-structured interviews with the nurses, but also during the participated observation and the content analysis of the documentation. The research also revealed that some nursing diagnoses are specific to cardiologic disordered children, but, for example, the nursing diagnosis of the risk of infection associated with invasive entry is used in case of all children hospitalized at ICU. The diploma thesis should inform nurses about nursing care in case of children with heart disease hospitalized at ICU.

Introdução: O enfermeiro é um dos profissionais presentes em todos os níveis de atenção à saúde e que participa da maioria das ações desenvolvidas na Atenção Primária à Saúde (APS), o que lhe confere papel estratégico na inovação, reestruturação de serviços e na implementação de atividades dentro do sistema de saúde. Segundo a World Health Organization (WHO), a cada ano cerca de 40 milhões de pessoas necessitam de Cuidados Paliativos (CP); voltado para pacientes com condições crônicas progressivas desde o diagnóstico, e caminhando em conjunto com as terapias modificadoras da doença ou potencialmente curativas, este tipo de cuidado deveria ser ofertado principalmente pelos profissionais que atuam na APS. Objetivos: Propor um rol de ações básicas de enfermagem em Cuidados Paliativos, considerando a integralidade e a longitudinalidade na assistência às condições crônicas de saúde, na Atenção Primária à Saúde, e classificar as ações de enfermagem em Cuidados Paliativos, segundo os níveis de competência básico e especializado. Método: Considerando a inexistência de consensos para a classificação dos níveis de complexidade das ações de enfermagem nos CP, o estudo utilizou a Técnica Delphi com um painel de enfermeiros de CP. Resultados: Das quarenta e oito ações de enfermagem em CP, vinte e três foram classificadas como ações de nível básico e foram subdivididas em quatro categorias, considerando as necessidades de saúde em foco. A discussão dos achados foi realizada sob o prisma do princípio da integralidade do SUS e o atributo da longitudinalidade da APS tomados como marco referencial deste estudo. Considerações finais: A proposição das ações de enfermagem em CP para APS propõe um horizonte para que os enfermeiros da APS possam lidar melhor com a demanda por cuidados paliativos que já está no território, com uma melhor utilização dos recursos e respeitando o princípio da integralidade e o atributo da longitudinalidade. / Introduction: Nurses are professionals present to all levels of health care and which take part in most of the actions developed in Primary Health Care (PHC), which gives them a strategic role in innovation, service restructuring and implementation of new activities within the health system. According to the World Health Organization (WHO) every year about 40 million people need Palliative Care (PC); aimed at patients with progressive chronic conditions since diagnosis, and going along with disease-modifying or potentially curative therapies, this type of care should be offered mainly by professionals working in PHC. Aims: To offer a list of basic nursing actions in Palliative Care, considering integrality and longitudinality in the assistance of chronic health conditions in PHC and to classify nursing actions in Palliative Care, according to the levels of basic and specialized competence. Method: given the lack of consensus on the classification of nursing actions complexity levels in PC, the study used the Delphi Technique with a panel of PC nurses. Results: Of the forty-eight nursing actions in PC twenty-three were classified as basic level actions and were subdivided into four categories, considering the health needs in focus. The discussion of the findings was performed under the SUS (National Health System) integrality principle aspect and the PHC longitudinality attribute taken as the reference framework of this study. Final considerations: Considering that the basic actions in PC were understood in this study, as actions that are of scope of all nurses, this includes the PHC professionals and thus it seems possible to propose a list of nursing actions in PC for PHC, considering the integrality and longitudinality in attending to chronic health conditions.

Estudo exploratório e descritivo de abordagem qualitativa sobre a utilização da CIPESC® nas consultas de enfermagem, como ferramenta para reconhecimento e enfrentamento das necessidades em saúde das crianças. Ancorado na Teoria da Intervenção Práxica da Enfermagem em Saúde Coletiva e nos conceitos de necessidades em saúde sob a perspectiva do materialismo histórico e dialético. Objetivou conhecer as possibilidades e limites da CIPESC® para reconhecer e enfrentar as necessidades de saúde da população infantil; descrever o perfil demográfico e epidemiológico da população curitibana com destaque para os indicadores relativos às crianças, seu crescimento, desenvolvimento e ocorrência de violência infantil; identificar as políticas e os programas de saúde adotados pelo município e o sistema de informação em saúde; analisar o potencial da nomenclatura CIPESC® Curitiba no reconhecimento e enfrentamento das necessidades em saúde, a partir dos diagnósticos e intervenções; verificar as potencialidades e os limites do uso da CIPESC® na consulta de enfermagem à criança. O cenário de estudo foi o município de Curitiba-PR. Os dados foram coletados em fontes primárias e secundárias. Para a coleta dos dados primários utilizou-se da técnica de estudo de caso. Os sujeitos da pesquisa foram 28 enfermeiros da atenção básica do município, que aceitaram participar do estudo por meio de instrumento de coleta de dados pela web, disponibilizado em página própria, desenvolvido em linguagem ASP.NET, com Framework 3.5 e o banco de dados utilizado foi o MySQL 5.1.30. Os resultados mostraram que as condições demográfica, de saneamento básico, educação e políticas de saúde são favoráveis à superação dos agravos à saúde. A organização da atenção à saúde tem alcançado bons indicadores epidemiológicos, mas ainda está pautada em referenciais de risco, na contra-mão do que propõe a saúde coletiva e a epidemiologia social, com consultas individualizadas e focadas nas questões biológicas do sujeito. A CIPESC® mostrou potencialidades para o reconhecimento de necessidades a partir dos diagnósticos e intervenções de sua nomenclatura mas a base representa apenas parte das necessidades expressas pelos indivíduos, não abrangendo uma abordagem integral dos processos de desgaste e fortalecimento. A discussão dos dados possibilitou identificar possíveis causas para os limites da CIPESC® como a adoção da teoria das necessidades humanas básicas como organizadora da nomenclatura, a assistência pautada em referenciais de risco e a formação dos profissionais direcionada ao modelo biomédico de atenção à saúde. A atenção às necessidades em saúde da população infantil ainda permanece como um desafio e um caminho que está sendo trilhado, em passos tímidos, sendo primordial que os processos de trabalho se ajustem às necessidades em saúde da população, utilizando-se da intersetorialidade, interdisciplinaridade, trabalho em equipe; buscando a efetiva transformação da realidade e superação de contradições e tendo as necessidades e vulnerabilidades como objetos de assistência. Todos esses aspectos devem fazer parte do cotidiano dos profissionais de saúde, com práticas consolidadas e direcionadas às transformações que a realidade precisa sofrer. / This exploratory, descriptive and qualitative study on the use of CIPESC® in nursing consultation, as a tool for recognizing and addressing child health needs and was based on the Theory Nursing Praxis Interventions in Collective Health and on the concepts of health needs under the perspective of historical and dialectical materialism. The study aimed to understand the possibilities and limits of CIPESC® (International Nursing Practice Classification in Collective Health) to recognize and address the health needs of the child population; to describe the demographic and epidemiological profile of the population from Curitiba with emphasis to indicators related to children, their growth, development and the occurrence of child violence; to identify health policies and programs adopted by the city and the health information system; to analyze the potential of the nomenclature CIPESC® Curitiba in recognizing and addressing health needs, from diagnosis and interventions; to determine the potentialities and limits of using CIPESC® in nursing consultation to child. The study was carried out in Curitiba, state of Paraná, Brazil. Data were collected from primary and secondary sources. Case study was used to collect primary data. Subjects were 28 nurses from the citys basic health care system, who agreed to participate in the study through a web-based data collection instrument, available at a specific webpage, developed using ASP.NET with Framework 3.5 and using MySQL 5.1.30 database. Results showed that the demographic, sanitation, education and health policies conditions are favorable to overcoming health problems. The organization of health care has achieved good epidemiological indicators, but it is still grounded on risk references, in counter to what is proposed by public health and social epidemiology, with individual consultations and focused on subjects biological issues. CIPESC® showed potential for the recognition of needs from diagnosis and interventions of its nomenclature, but the ground represents only part of the needs expressed by individuals, not encompassing a comprehensive approach of the processes of wear and strengthening. The discussion of data enabled to identify possible causes for the limits of CIPESC®, such as the adoption of the theory of basic human needs as the organizer of the nomenclature, care grounded in risk referencials and training of professionals guided by the biomedical health care model. The attention to child health needs remains as a challenge and a path that is being tread, at timid steps, in great need that the work processes fit the health needs of the population, using intersectoral and interdisciplinary arrangements, teamwork, seeking the effective change of reality and overcome of contradictions, with needs and vulnerabilities as objects of care. All these aspects should be part of health professionals daily practice, with consolidated practices which are directed to the changes needed in reality.