Pediatric anxiety disorders characterized as Generalized, Separation, and Social Anxiety Disorders, are chronic debilitating conditions that leave children feeling tense and isolated, both physically and emotionally. Selective serotonin reuptake inhibitors (SSRIs) are a classification of antidepressants that can be prescribed to children diagnosed with these disorders. SSRIs have been shown to be effective in treating anxiety disorders in children. The purpose of this literature review was to examine and determine if there are more risks or benefits associated with SSRIs, as well as evaluate teaching and education regarding anxiety disorder medication compliance in both children and parents. A secondary purpose of this research was to provide recommendations in nursing practice to allow children to feel more involved in their medical regimen. The following databases were used for the search: CINAHL, Academic Search Premier, and Web of Science. Key terms used in the search include but are not limited to: child* and anxiety, not autism, and selective serotonin reuptake inhibitors, OR SSRI*, OR adolsecen*, not med*, pediatric*, OR side effects. The results suggest that the benefits of SSRI therapy in children with anxiety disorder, when taken on a regularly scheduled basis, outweigh the risks, however more research aimed at compliance with SSRI therapy in children and parents is necessary. Further research analyzing children with anxiety disorders is needed to assess SSRI usage based specifically on their developmental age, and the inclusion of appropriate teaching and explanation related to their diagnoses to identifying stressors that can include behavioral therapy as well.

Background: Psychiatric hospitalization of children and adolescents can be carried out either voluntarily or involuntarily. The aim of this form of inpatient hospitalization is to provide treatment for those who cannot manage the symptoms of their mental illnesses on their own. However, psychiatric hospitalizations of children and adolescents are costly and could lead to outcomes such as worsened mental state in former patients and distrust of the system in caregivers. It is crucial to have a solid understanding of specific components that lead to the hospitalization. Purpose: To identify potential trends in patient admission data through the analysis of admission characteristics in children and adolescents placed under involuntary and voluntary status in a psychiatric facility. Methods: An extensive literature review was conducted using the CINAHL, MEDLINE, and APA PsycINFO databases. Articles that were eligible for inclusion in this review of literature were those written in English, published from 2000-2024, and contained a population of subjects aged 3-17. A total of nine articles were utilized for the review after the search was completed. Results: Of the nine articles, a majority of them found correlations between involuntary admission and psychotic symptoms and disorders, manic behaviors, older age, female gender, and psychosocial burden. As for voluntary admission, behavioral or mood disorders, symptoms of depression and suicidal thoughts, and younger age were found to be primary contributing factors. Conclusion: More research should be completed on patient demographics that are lesser noted, such as sexual orientation, race, and ethnicity, in order to enhance the quality of care children and adolescents receive under inpatient psychiatric hospitalization. Additionally, with the identification of these trends related to legal placement status, future research should be conducted on long-term outcomes of and satisfaction with psychiatric hospitalization in former patients with the aforementioned demographics.

Bakgrund: Den pediatriska omvårdnad som specialistsjuksköterskan bedriver bör utgå från ett familjecentrerat förhållningssätt där familjens behov, delaktighet och åsikter tas hänsyn till. En validerad, nationell utvärdering av pediatrisk vårdkvalité saknas idag i Sverige. Australian Hospital Patient Experience Question Set-Parent (AHPEQS-P) är en engelskspråkig enkät som undersöker vårdkvalité ur ett föräldraperspektiv. Enkäten har översatts till svenska men är inte utvärderad i svensk kontext, vilket bör göras för att säkerställa en korrekt utvärdering av vårdkvalitén. Syfte: Syftet var att bedöma ytvaliditeten av den svenska versionen av AHPEQS-P. Metod: En kvalitativ studie med deduktiv ansats genomfördes där kognitiva intervjuer i tre fokusgrupper genomfördes. Urvalet bestod av elva föräldrar till barn med varierande erfarenhet av slutenvård. Analysen utgick från kvalitetsbegreppen relevans, nytta, lämplighet och konstruktion. Resultat: Resultatet visade att enkäten uppfyllde sitt syfte och att enkätfrågorna till största del var lätta att förstå och ansågs relevanta för utvärdering av vårdkvalitén. Vissa ord tolkades olika och alternativa varianter föreslogs för att förtydliga och förbättra språket. Slutsatser: Efter en viss modifiering bedöms ytvaliditeten av AHPEQS-P vara tillräcklig för att gå vidare till nästa fas av implementeringen. Enkäten anses mäta vårdkvalité ur ett familjecentrerat perspektiv och att lyssna till familjen är en viktig aspekt i specialistsjuksköterskan profession. / Background: Pediatric care should be based on a family-centered approach where the family's needs, participation and opinions are accounted for. Yet there is no validated, national survey that measures quality of pediatric care in Sweden. The Australian Hospital Patient Experience Question Set-Parent (AHPEQS-P) is a questionnaire in English that examines quality of care from a parental perspective. The survey is translated into Swedish but has not been evaluated in Swedish context, which should be done to ensure a correct evaluation of the quality of care. Purpose: The purpose was to assess the face validity of the Swedish version of AHPEQS-P. Method: A qualitative study with a deductive approach was conducted. The Swedish version was evaluated through cognitive interviews in three focus groups. The sample consisted of eleven parents to children with varying experiences from inpatient care. The analysis was based on the quality criteria relevance, utility, appropriateness and construction. Results: The results showed that the survey fulfilled its purpose, the questions were mostly easy to understand and were considered relevant for evaluation of the quality of care. Single words were discussed, and alternative versions were suggested to clarify and improve language. Conclusions: After some modification, the face validity of the AHPEQS-P is assessed to be adequate to proceed to the next phase of implementation. The survey measures quality of care from a familycentered perspective and listening to the family is an important aspect of the specialist nurses’ profession.

Det övergripande syftet med avhandlingen är att beskriva långvarigt sjuka barns upplevelser av tröst samt vilka och vad som tröstar barn, föräldrar och en sjuksköterska. Avhandlingen omfattar fyra delstudier. Långvarigt sjuka barn, föräldrar och en sjuksköterska har intervjuats och barnen har ritat teckningar.I delstudie I var syftet att undersöka vad barn med långvariga sjukdomar berättar muntligt och i teckningar om sina upplevelser av att bli tröstade. Sju barn i åldern 4-10 år, med olika långvariga sjukdomar, beskrev under intervju sina upplevelser av tröst och ritade teckningar. Intervjuerna analyserades med innehållsanalys, vilket utmynnade i fyra teman: att vara fysiskt nära sin familj, att känna sig trygg och säker, att sjuksköterskor finns till hands för barnen och att barnen finns till hands för sina föräldrar och syskon. Resultatet visar att barnen litade på sjuksköterskors kunskap och yrkeskunnande, vilket var en förutsättning för att kunna känna sig trygg och hemma på sjukhus. Att vara nära sin familj upplevdes än mer betydelsefullt för att uppleva tröst. I delstudie II var syftet att beskriva föräldrars upplevelser av vad som tröstar dem när deras barn insjuknat i cancersjukdom. Nio föräldrar till barn i åldern 3-9 år, som var inlagda på vårdavdelning och hade genomgått sin första behandling, intervjuades. Innehållsanalys utmynnade i fem teman: att uppleva tröst genom att vara nära sitt barn, att uppleva tröst genom barnets styrka, att uppleva tröst genom att känna sig hemma på vårdavdelningen, att uppleva tröst genom att vara en familj och genom att vara hemma samt att uppleva tröst genom stöd från sociala nätverk. I kommunion, en djup känsla av gemenskap med barnet och personer i sociala nätverk, upplevde föräldrarna en ny vardag som kännetecknades av att känna sig trygg i livet trots alla svårigheter och de upplevde stunder av hopp. I delstudie III var syftet att beskriva upplevelser av vad som tröstar ett allvarligt sjukt och senare döende barn, berättat av barnet, hans mamma och hans sjuksköterska. Barnet ritade teckningar. Fältanteckningar, teckningar och intervjuer analyserades med innehållsanalys, vilket utmynnade i fyra teman: att uttrycka känslor och bli redo för tröst, att vara i kommunion, att skifta perspektiv och att finna tröst genom att vara hemma. Resultatet visar att tröst för det svårt sjuka, senare döende barnet, innebar att barnet kunde uttrycka sina känslor som barnet ville, att familjen fanns nära och var involverade i omvårdnaden av barnet, att barnet kunde vårdas hemma och att barnet upplevde en förtroendefull relation med sin sjuksköterska. I delstudie IV var syftet att beskriva vem och vad som tröstar föräldrar, syskon, sjuksköterska och andra personer som tröstade ett svårt sjukt och senare döende barn, beskrivet av mamman och barnets sjuksköterska. Intervjuer från delstudie II analyserades med innehållsanalys och utmynnade i tio teman. Resultatet visar en bild av samverkande nätverk som kan finnas runt ett svårt sjukt barn. Den svåra situationen innebar att barnets familj bar en tung börda, men omgivna av ett tröstande nätverk som de kunde luta sig mot och dela lidande och ansvar med, kunde de finna tröst och trösta varandra. Resultatet i avhandlingen visar att de långvarigt sjuka barnen och föräldrarna fann tröst i att kunna dela lidande med varandra. Föräldrar och sjuksköterska fann tröst i att kunna dela lidandet och ansvaret med personer i sina sociala nätverk. Modellen om tröst (Norberg m fl, 2001) kunde användas för att ge struktur till diskussionen. / The overall aim of the thesis was to describe experiences of comfort for children with chronic illnesses, and who and what comforted children, parents and one nurse. The thesis comprises four studies and is based on interviews with sick children, parents and one nurse. The children also made drawings. In study I the aim was to examine how children with chronic illnesses narrate their experiences of being comforted in the hospital. Seven children 4-10 years old described in interviews their experiences of comfort and made drawings. Thematic content analysis revealed four themes: being physically close to one’s family, feeling safe and secure, staff being there for the children, and children being there for parents and siblings. The findings suggest that trusting the staff’s knowledge and professional skills is a prerequisite for children to feel "at home", and safe in hospital. Being close to one’s family was essential for feeling comforted. In study II the aim was to describe what parents narrate as comforting them when their child was suffering from cancer. Interviews were performed with nine parents, eight mothers and one father, of children aged 3-9 years, who were admitted to a pediatric oncology ward and had undergone their first treatment. Content analysis revealed five themes: experiencing comfort from being close to the child, deriving comfort from the child’s strength, from feeling at home on the ward, from being a family and being at home, and deriving comfort from support of social networks. In communion with the child and others, the parents built a new normality perceived as being at home in life, despite all their difficulties. Within the frame of communion the parents experienced moments of hope. In study III the aim was to describe what comforted a seriously ill and finally dying child, as revealed by the child, his mother and his nurse. Field notes, drawings and interviews were analyzed using content analysis that revealed four themes: expressing feelings and becoming ready for comfort, being in communion, shifting perspective and finding comfort in feeling at home. Based on the findings, comfort for an ill and finally dying child was interpreted as being about having opportunities to express feelings in the way the child chooses, the family being close and involved in care, and achieving feelings of being at home and having a trustful relationship with a special nurse. In study IV the aim was to describe who and what comforted the comforters of a seriously ill and ultimately dying child as described by the child’s mother and nurse. Interviews with a mother and a nurse from study III were analyzed by content analysis and a sociogram was outlined. The findings provided a picture of interacting social networks that can exist around a seriously ill child. The difficult situation meant that the child’s family carried a heavy burden. However, surrounded by a comforting network with which they could share both suffering and responsibility, they were able to find comfort and comfort each other. The findings from this thesis show that chronically ill children and parents found comfort from sharing suffering with one another. The parents and the nurse found comfort in sharing suffering and responsibility with persons in their social networks. The model of consolation (Norberg et al, 2001) could be used to give structure to the discussion.

A dor é um evento estressante para crianças e adolescentes e pode ter consequências negativas fisiológicas, psicológicas e comportamentais ainda mais quando é acompanhada por uma doença crônica, sem possibilidades de cura. Nesse sentido, o Cuidado Paliativo Pediátrico é uma filosofia de cuidado que deve ser instituída desde o diagnóstico da doença até que esta não responda mais às intervenções curativas. Assim, o foco do cuidado passa a ser a maximização da qualidade de vida que a criança e o adolescente e seus familiares necessitam, enquanto o sofrimento e a dor são minimizados. Considerando-se o caráter único da experiência de dor da criança e do adolescente, em cuidados paliativos, optou-se por desenvolver um estudo com abordagem qualitativa. Utilizamos como referencial teórico a Teoria de Desenvolvimento Cognitivo de Piaget e, como referencial metodológico, a História Oral. Tais referenciais são fundamentais para ancorar os resultados encontrados neste estudo e responder ao objetivo geral de conhecer a experiência da criança e do adolescente em cuidados paliativos no manejo diário da dor e aos objetivos específicos de conhecer como a criança e o adolescente em cuidados paliativos descrevem a intensidade, a qualidade e a localização da dor e de conhecer como a criança e o adolescente em cuidados paliativos manejam a dor em seu cotidiano. Permitem, igualmente, que crianças e adolescentes, de 6 a 17 anos 11 meses e 29 dias, portadores de uma doença crônica que causava dor e que estavam em cuidados paliativos e matriculados em um Ambulatório de Dor e Cuidados Paliativos de um Hospital Escola Pediátrico de caráter público de nível terciário tenham voz. Crianças em idade escolar descreveram sua dor a partir de componentes sensoriais e avaliativos. Os adolescentes, por outro lado, expressaram sua dor utilizando componentes sensoriais, avaliativos, afetivos e de miscelânea. Dos seis colaboradores deste estudo, cinco ainda frequentam a escola e relacionam-se com crianças e adolescentes da mesma faixa etária. Todos os colaboradores fazem uso de medicamentos e de alternativas não farmacológicas para o alívio da dor, como massagem, hidroterapia, acupuntura e crioterapia, constatando melhora em sua dor. Alguns colaboradores precisam lidar com sua aparência física prejudicada pela doença. Apesar da dificuldade de se entrevistar crianças e adolescentes, percebemos que eles têm muito a dizer e a nos ensinar, principalmente como eles lidam com a dor em seu cotidiano. Este trabalho é importante para que os profissionais de saúde compreendam que, com um adequado manejo da dor, crianças e adolescentes conseguem ter uma vida mais próxima da normalidade, reduzindo seu sofrimento. / Pain is a stressful event for children and adolescents and can have negative consequences - physiological, psychological and behavioral ones even more when it is accompanied by a chronic disease with no possibility of cure. In this context, the Pediatric Palliative Care is a philosophy of care that must be instituted from the diagnosis until the illness no longer responds to curative interventions. Therefore, the focus of care is to provide the highest quality of life possible to children and adolescents and their families while minimizing suffering and pain. Considering the uniqueness of the experience of pain in children and adolescents in palliative care, we chose to develop a qualitative study. We used the Theory of Cognitive Development Piaget as theoretical framework and the Oral History as the methodological one. Such references are essential to support the results found in this study and to address the overall objective of knowing the experience of the child and adolescent in palliative care for the daily management of pain as well as the specific goals of knowing how the children and adolescents in palliative care describe the intensity, quality and location of pain and of knowing how children and adolescents in palliative manage pain in their daily lives. Moreover, these frameworks allow that children and adolescents (from 6 to 17 years 11 months and 29 days), suffering from a chronic disease that caused pain and in palliative care and who were enrolled in an Outpatient Pain and Palliative Care of a public tertiary Pediatric Teaching Hospital character, have a voice. School children described their pain using sensory and evaluative components. Teenagers, on the other hand, expressed their pain using sensory, evaluative, affective and miscellaneous ones. Of the six collaborators to this study, five are still in school and relate to children and adolescents of the same age. All collaborators use drugs and non-pharmacological alternatives for pain relief such as massage, hydrotherapy, acupuncture and cryotherapy, reporting improvement in their pain. Some collaborators need to deal with their physical appearance which is affected by the disease. Despite the difficulty of interviewing children and teenagers, we have realized that they have a lot to say and to teach us, especially with regard to how they deal with pain in their daily lives. The present work is important for health professionals to understand that, with adequate pain management, children and adolescents can live a life as normal as possible, thus reducing their suffering.

Introdução: O relacionamento estabelecido entre profissionais de saúde, criança e família durante os cuidados de final de vida é complexo e multidimensional. Poucas evidências mostram como os relacionamentos são estabelecidos no contexto de final de vida da criança e influenciam no luto após a morte de um filho. Objetivo: Interpretar a experiência de pais sobre os relacionamentos estabelecidos com os profissionais de saúde durante o final de vida da criança com câncer no hospital. Método: Trata-se de uma pesquisa qualitativa, guiada pela hermenêutica filosófica de Gadamer. A coleta dos dados foi realizada por meio de observações de campo em um hospital oncológico pediátrico com famílias de crianças hospitalizadas em situação de final de vida, entrevista com pais enlutados pelo menos 6 meses após o óbito da criança e análise de prontuários. Para a análise dos dados, o processo de transcrição, leitura e releitura dos dados, revisão das notas de campo e reflexão sobre os dados com outros pesquisadores ajudaram na compreensão do fenômeno para a geração de interpretações. Para tanto, foram identificadas unidades de significados nos dados que, posteriormente, foram agrupadas por similaridade para a formação indutiva de temas. Resultados: Os relacionamentos entre pais e profissionais da saúde no final de vida da criança com câncer hospitalizada desvelam fenômenos do encontro e da interação interpessoal presentes na situação de doença, morte e perda. Esses relacionamentos são permeados pela presença de valores humanos e são estabelecidos de forma dinamica com vínculos diversos. Existem componentes evidentes no relacionamento durante o final de vida da criança no hospital, tal como o amparo, o silêncio, a deterioração, a tolerância, a hierarquia, o compartilhamento e a confiança, bem como, fatores internos e externos que influenciam nas interações. Por meio dos relacionamentos, os pais reavaliam o próprio papel, enquanto vivenciavam a experiência inesperada de perder um filho e significados atribuídos à doença e à perda são associados aos encontros mesmo anos após a morte do filho. Considerações finais: Os relacionamentos servem de base para fortalecer e suportar os pais a exercerem o papel de cuidadores para garantir a excelência no cuidado do filho. A qualidade dos relacionamentos entre pais e profissionais da saúde torna-se uma lembrança marcante no processo de luto e estabelecem uma conexão permanente com o filho falecido. Um olhar para o relacionamento entre familiares e profissionais integrando a ciência do cuidado proporciona a base de paradigmas não positivistas, que são urgentes nas situações de final de vida. Este estudo pode contribuir com as políticas de enfermagem na consolidação de futuras diretrizes sobre a qualidade na prática do cuidado de final de vida da criança, facilitando para as famílias manter vínculos significativos durante o processo de doença, perda e luto. / Introduction: The relationship established between family and healthcare providers during the childs end-of-life care is complex and multidimensional. There are few evidences which explore how these relationships during the childs last hospitalization influence familial adaptation after loss. Objective: To interpret parents experience in their relationship with healthcare providers during the childs end-of-life with cancer in the hospital. Methods: This is a qualitative research, guided by Gadamers philosophical hermeneutics. Data collection was through field observations conducted in a pediatric oncology hospital with hospitalized families in end-of-life situation, interviews with bereaved parents at least 6 month after the childs death and medical records analysis. For the data analysis, the process of transcription, reading and re-reading the data, reviewing field notes and reflection on the data with other researchers helped understand the phenomenon to generate interpretations. Therefore, units of meaning emerged from the data were grouped, and themes were inductively determined and submitted to an interpretation process. Results: Relationships between parents and healthcare providers during a childs end-of-life process unveil the encounters and interpersonal interactions phenomena in illness and loss trajectory. These relationships are permeated with human values and are established in a dynamic way with various bondings. There are evident components in a child´s end-of-life context, such as presence, silence, deteriorations, tolerance, hierarchy, collaboration and trusting, as well as internal and external factors which influence the interactions. Through relationships, parents reevaluate their own role, while they live the unexpected experience of losing a child and attribute meanings to the loss. Final considerations: Relationships serve as a basis for strengthening and supporting parents in providing excellence in the child\'s care. The quality of the relationship between parents and healthcare providers is a remarkable memory of the child\'s life during the bereavement process. Looking into the relationship between parents and providers integrating it with caring science provides a basis for non-positivist paradigms which are urgent in end-of-life situations. This study aims to contribute to end-of-life nursing policies in recognizing the components to improve the quality of the relationships as a starting point for care which will allow families to have a safe base while experiencing the child\'s illness and the bereavement process.

Made available in DSpace on 2016-01-26T12:51:21Z (GMT). No. of bitstreams: 1 tamaraveigafaria_diseert.pdf: 284212 bytes, checksum: 883fa3baa2cf059a3f82f421937e30ac (MD5) Previous issue date: 2009-06-09 / Historicamente, o câncer é associado a experiências malditas, de infortúnios fisicos, mentais e sociais, sendo visto como uma doença cruel, intratável e misteriosa. A apresentação do diagnóstico é a mais delicada no processo de tratamento oncológico, pois envolve a apresentação de um diagnóstico que traz consigo uma grande carga de preconceito pela maioria dos pacientes, agregado ao medo, incertezas sobre o futuro e imagens pré-concebidas do tratamento oncológico. Sabe-se que o envolvimento do paciente no tratamento é fundamental e que, portanto para que ele decida sobre sua terapêutica será necessário que ele conheça seu diagnóstico. A quimioterapia, uma opção terapêutica para o câncer, também évista como sendo muito assustadora, pois muitas pessoas têm idéias preconcebidas sobre ela e principalmente quanto seus efeitos colaterais. Com isso, defmimos como objetivo geral deste estudo "Correlacionar o conhecer o diagnóstico de doença oncológica e as experiências durante o tratamento" Trata-se de uma pesquisa qualitativa na qual a amostra constou 6 pacientes sendo que 3 tinham conhecimento do diagnóstico e 3 o desconheciam. Os dados foram coletados por meio de entrevistas semi-estruturadas e de observações dos participantes no contexto sociocultural hospitalar e domiciliar. A análise dos dados foi realizada segundo a análise de conteúdo de Bardin. As unidades de significados foram: A descoberta da doença, a indicação e início do tratamento, os efeitos colaterais e a importância das informações de enfermagem e os sonhos. Com as experiências relatadas pelos informantes foi possível compreender que a principal influência no tratamento quimioterápico depende das características pessoais, culturais e sociais que cada paciente traz consigo. O conhecimento do diagnóstico oncológico faz com que o paciente tenha mais esperança e mais força para enfrentar a doença. Nota de Resumo No entanto o paradoxo da pesquisa foi que aqueles que não conhecem o diagnóstico seguem melhor as orientações dadas durante a consulta de enfermagem, porém apresentam-se fragilizados muitas das vezes e com dúvidas constantes sobre o tratamento. A pesquisa realça a necessidade de o profissional mudar sua linguagem no momento da revelação do diagnóstico, pois a utilização de alguns termos pode contribuir para atribuição de significados diferentes da realidade.

Family-centered care (FCC) is important within the practice of pediatric oncology nurses. Such nurses face challenges and barriers when attempting to provide FCC. The purpose of this study was to understand the experiences of pediatric oncology nurses in relation to FCC; identify how pediatric oncology nurses implemented FCC into their practice; identify what facilitated and enabled pediatric oncology nurses to implement FCC; and discern the barriers and challenges that were present in their setting when implementing FCC. A qualitative approach utilizing person-centered interviewing was used to collect data. Nurses (N=20) from the Alberta Children‟s Hospital were recruited through purposeful convenience sampling and were then interviewed. Five major themes were identified from the data set: ACH support f FCC, How participants defined FCC, Establishing FCC, Enhancing FCC, and Barriers and Challenges to providing FCC. Recommendations for future research and implications for practice and education are offered. / xii, 191 leaves ; 29 cm

Bakgrund: Sjuksköterskor på neonatalavdelningar arbetar ofta i nära relation med föräldrar till för tidigt födda barn. Föräldrars delaktighet i omvårdnaden av sitt barn kan påverka förälderns psykiska hälsa, anknytning till barnet samt påverka barnets välmående och möjlighet till utveckling. Syfte: Beskriva barnsjuksköterskors upplevelser av att optimera föräldrars delaktighet i omvårdnaden av sitt för tidigt födda barn. Metod: Kvalitativ studie med induktiv ansats. Genom ett bekvämlighetsurval rekryterades åtta kvinnliga barnsjuksköterskor vid två jämförbara neonatalavdelningar i södra Sverige att delta vid semistrukturerade intervjuer. Intervjuerna bearbetades genom en kvalitativ innehållsanalys. Resultat: Studiens resultat presenteras utifrån två kategorier med nio underkategorier: 1) Svårigheter, innefattande fem underkategorier: Föräldrars olika medverkan i omvårndaden, Föräldrars reaktioner, Kommunikationssvårigheter, Relationen föräldrar-barnsjuksköterska samt Organisatoriska hinder 2) Framgångsfaktorer innefattande fyra underkategorier: Gynnad anknytning, Samspel mellan föräldrar och barn, Professionellt bemötande samt Utbildning till föräldrar och personal. Diskussion/Slutsats: Föräldrars insatser i omvårdnaden av sitt barn, barnsjuksköterskornas sätt att involvera dem och samspelet mellan båda parter leder till att föräldrars delaktighet kan optimeras eller missgynnas. Föräldrars rädslor är ett hinder för optimerad delaktighet som behöver uppmärksammas och ges utökade resurser för att hantera. Fortbildning till vårdpersonal på neonatalavdelningar skulle kunna förbättra barnsjuksköterskornas professionalitet i bemötande och omhändertagande av rädda och oförberedda föräldrar. / Background: Nurses working on neonatal wards often work closely to parents of premature born babies. Parents’ participation in the care of their baby can affect their mental health, their connection to the baby and influence the well-being and opportunities for development for the child. Aim: To describe pediatric nurses’ experiences of optimizing the participation of parents in the care of their premature born babies. Method: A qualitative study was conducted. Eight female pediatric nurses from two comparable neonatal wards in Southern Sweden were interviewed with semi-structured questions. A qualitative content analysis was conducted. Findings: The result of the study was represented by two categories and nine subcategories: 1) Challenges, containing five subcategories: Variation in parent participation, Parental reactions, Communication issues, Relationship between the parents and the pediatric nurse and Organizational obstacles 2) Factors for progress, containing four subcategories: Favored attachment, Interaction between parents and the child, Professional treatment, and Education of parents and staff. Conclusion: Parental contributions in the care of their newborn, the pediatric nurses’ ways of involving the parents and the interaction between the two can determine if the parental involvement becomes optimized or is disadvantaged. Parents fear represent one of many obstacles for optimized participation and could be given further attention and increased resources. Educating the pediatric staff could also improve the quality of care when working with parents reactions and fear in the unthought-of situation.

Esta pesquisa teve com objetivo compreender o que é ser familiar de uma criança com aids à luz da filosofia de Martin Buber. Para tanto, desenvolveu-se um estudo qualitativo com abordagem existencial-fenomenológica. O cenário em que o estudo se desenvolveu foi o Ambulatório de Pediatria de um Hospital Universitário e teve, como informantes, sete familiares cuidadoras de crianças com aids. Para a coleta das informações, utilizou-se a entrevista fenomenológica proposta por Carvalho (1987). A interpretação das informações fundamentou-se na Filosofia Hermenêutica de Ricoeur, por meio da utilização do modelo proposto por Crossetti (1997) e Motta (1997). O estudo obteve parecer favorável do Comitê de Ética em Pesquisa da instituição. Dos discursos emergiram três temas, quais sejam: Desvelando os Modos de Ser-no-Mundo do EU Familiar; Relações ‘entre’ o EU Familiar e o TU Criança com aids; e, Diálogos ‘entre’ o EU Familiar e o TU-Eterno. O primeiro tema desvelou os seguintes sub-temas: existencialidade do EU familiar ao conviver com a aids; vivenciando o medo e as perdas; vivências em com-unidade familiar; necessidades experienciadas pelo EU familiar; EU familiar como um ISSO; e, EU familiar na vivência da aceitação e luta. O segundo tema apresentou os seguintes sub-temas: experienciando mudanças e dificuldades existenciais; o TU criança percebido como não diferente; relação EU familiar e TU criança com aids; e, diálogos para a revelação do diagnóstico de aids à criança. O terceiro tema revelou os seguintes sub-temas: esperanças na vivência do EU familiar; e, dialogando com o TU-Eterno. As apropriações do estudo possibilitaram compreender que ser-familiar de uma criança com aids traz repercussões para sua existencialidade e para a relação com a criança, além de revelar os diálogos existenciais com o TU-Eterno. Como recomendações, ficam propostas ações de cuidado, bem como questões relativas às áreas da pesquisa, do ensino, da extensão e do cuidado em Enfermagem. / This research aimed at understanding what a familiar being of a child with AIDS means in the light of Martin Buber’s philosophy .Therefore, a qualitative study with a phenomenological-existential approach was performed. The scenario where the study took place was the University Hospital Pediatric Outpatient Unit using information from seven family members of children with Aids. To gather information, a phenomenological interview proposed by Carvalho (1987) was used. The information interpretation was based on Ricouer’s Hermeneutic Philosophy through a model proposed by Crossetti (1997) and Motta (1997). The study was well accepted by the Institution Research Ethics Committee. Three themes came up from the discourses: Revealing the Ways of Being in the World of the Familiar I; Relationship ‘between’ the Familiar I and the YOU Child with aids and Dialogues between the Familiar I and the Eternal-YOU. The first theme revealed the following sub-themes: Familiar-I existentiality while living with aids; living fear and losses; living in a familiar comm-unity; necessities experienced by Familiar I; Familiar I as an IT, and Familiar I in living with acceptance and struggle. The second theme presented the following sub-themes: experiencing changes and existential difficulties; the YOU child perceived as not different; the relationship familiar I and child YOU with aids; and dialogues to reveal the aids diagnosis to the child. The third theme revealed the following sub-themes: hope in the Familiar I living; and maintaining a dialogue with the YOU- Eternal. The study appropriation made possible the understanding that the familiar being of a child with aids have repercussion on his/her existentiality and on the relationship with the child besides revealing the existential dialogues with the YOU-Eternal. As recommendation, proposals are given in the research, teaching and extension areas and in nursing care. / Esta pesquisa tuvo como objetivo comprender lo que significa ser familiar de un niño con sida a la luz de la filosofía de Martín Buber. Para tanto, se ha desarrollado un estudio cualitativo con un abordaje existencial fenomenológico. El escenario en que se desarrolló el estudio fue el Ambulatorio de Pediatría de un Hospital Universitario y tuvo, como informantes, a siete familiares cuidadores de niños con sida. Para la recolección de las informaciones, se utilizó la entrevista fenomenológica propuesta por Carvalho (1987). La interpretación de las informaciones se fundamentó en la Filosofía Hermenéutica de Ricoeur, utilizando el modelo propuesto por Crossetti (1997) y Motta (1997). El estudio obtuvo el parecer favorable del Comité de Ética en Pesquisa de la institución. De los discursos emergieron tres temas, que son: Develando los modos de ser en el mundo del YO Familiar; Relaciones ‘entre’ el YO Familiar y el TU Niño con sida; y, Diálogos ‘entre’ el YO Familiar y el TU-Eterno. El primer tema develó los siguientes subtemas: existencialidad del YO familiar al convivir con el sida; vivenciando el miedo y las pérdidas; vivencias en com-unidad familiar; necesidades experienciadas por el YO familiar; YO familiar como un ESO; y, YO familiar en la vivencia de la aceptación y la lucha. El segundo tema presentó los siguientes subtemas: experienciando cambios y dificultades existenciales; el TU niño percibido como no-diferente; relación de cuidado entre YO familiar y TU niño con sida; y, diálogos para la revelación del diagnóstico de sida al niño. El tercer tema develó los siguientes subtemas: esperanzas en la vivencia del YO familiar; y, dialogando con el TU-Eterno. La apropriación del estudio posibilitó la comprensión de que ser familiar de un niño con sida trae repercusiones para su existencialidad y para la relación con el niño, además de revelar los diálogos existenciales con el TUEterno. Como recomendaciones, queda la propuesta de acciones de cuidados, bien como cuestiones relativas a las áreas de la pesquisa, de la enseñanza, de la extensión y del cuidado en Enfermería.