Thesis (M.S.)--University of Wisconsin, School of Nursing. / eContent provider-neutral record in process. Description based on print version record.

<p> Parents' participation in the care of their hospitalized child is an integral part of pediatric nursing practice and is considered to be beneficial for children and parents. However, parents may not discuss their participation with nurses and instead base their activities on their perceptions of nurses' assumptions and expectations regarding parents' participation in care. Nurses may assume a gate keeping role regarding parents' participation, deciding what parents will do and then monitoring these activities. Nurses' heavy workloads may preclude the teaching necessary for parents to participate in certain aspects of care. As a result, parents' actual participation in care may be more or less than their desired level of participation. Measuring actual participation alone may thus give an incomplete picture of a family's situation.</p> <p> To date, no attempt has been made to measure the difference between parents' actual and desired participation in care. A cross-sectional, descriptive design was used to measure parents' actual level of participation in care and their desired level of participation in care, and to describe the congruency between them. Parents of children admitted to medical and surgical units in a tertiary care children's hospital (N = 191) completed two instruments measuring desired and actual participation in care as well as providing demographic data. Study results indicate a difference between parents' actual and desired participation, with the majority of parents expressing a desire to increase their participation. Parents' care activities included providing comfort, assisting with activities of daily living, assisting with mechanical care and advocating for the hospitalized child. Recommendations are made for nursing practice at the bedside, for nursing administration and for future research. Measuring congruency between actual and desired levels of participation can contribute to our understanding of parents' experiences of their child's hospitalization and may provide a unique perspective on parental participation in care.</p> / Thesis / Doctor of Philosophy (PhD)

Thesis (M.S.)--University of Wisconsin--Madison, School of Nursing, 1968. / Typewritten. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 87-92).

Thesis (M.S.)--University of Wisconsin--Madison, School of Nursing, 1967. / Typewritten. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 48-49).

Thesis (M.S.)--University of Wisconsin--Madison, 1968. / Typewritten. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 86-89).

Crianças e adolescentes podem fornecer informações importantes para a melhoria dos serviços de saúde, por exemplo, no que se refere à comunicação com a equipe de enfermagem e à qualidade da assistência recebida durante a hospitalização. Podem, ainda, dizer a respeito de sua relação com a equipe multidisciplinar, em particular com os enfermeiros, pois identificam o que os torna bons profissionais. Sendo assim, o presente estudo tem como objetivo compreender as perspectivas de crianças e adolescentes hospitalizados sobre o que significa ser um bom enfermeiro. Considerando o objeto e objetivo do estudo, optamos por adotar o referencial da Grounded Theory ou Teoria Fundamentada nos Dados. O estudo, desenvolvido na unidade de pediatria de um hospital universitário do estado de São Paulo, teve a participação de 17 crianças e adolescentes, com idades entre 5 e 17 anos. Os dados foram coletados por meio de entrevista intermediada por estratégias lúdicas de comunicação, complementada por informações clínicas dos prontuários. A análise dos dados seguiu as recomendações da Teoria Fundamentada nos Dados e permitiu a elaboração de três categorias temáticas: enfermeiro ou enfermeira: as questões de gênero no trabalho da enfermagem; a comunicação como instrumento de trabalho do enfermeiro no cuidado a crianças e adolescentes hospitalizados e competências do enfermeiro diante da realização de procedimentos dolorosos na assistência a crianças e adolescentes hospitalizados. As questões de gênero no trabalho da enfermagem foram observadas quando os participantes, embora tenham mencionado a presença ainda discreta de homens na profissão, reconheceram que todos eram enfermeiros e que, desde que realizassem o cuidado corretamente, não deveria haver distinção. A comunicação desses profissionais foi considerada essencial durante a hospitalização e um importante atributo para o bom enfermeiro, sendo esta uma estratégia capaz de tornar o ambiente hospitalar mais acolhedor, amenizando o sofrimento provocado pelo período de hospitalização. As competências do enfermeiro diante da realização de procedimentos dolorosos também foram apontadas como atributo de um bom profissional. Os participantes destacaram a punção venosa como fonte de desconforto e dor, os quais poderiam ser amenizados mediante aprimoramento profissional, paciência, interação do enfermeiro com o paciente durante a realização deste procedimentos e tempo de experiência prática. Os resultados deste estudo preenchem uma lacuna na literatura brasileira sobre a temática, pois evidenciam implicações para a prática do enfermeiro e contribuem para a compreensão das experiências de crianças e adolescentes hospitalizados sobre a qualidade dos cuidados de saúde e o processo de hospitalização. Destaca, ainda, que crianças e adolescentes demonstram entendimento acerca dos cuidados realizados, sendo capazes de apontar o que esperam de um bom enfermeiro e de expressar suas perspectivas / Children and adolescents can provide important information for the improvement of health services, such as communication with the nursing team and the quality of care they receive during hospitalization. They can also say about their relationship with the multidisciplinary team, in particular with the nurses, they know, for example, what makes them good professionals. Thus, the present study aims to understand the perspectives of hospitalized children and adolescents about what it is to be a good nurse. Considering the object and purpose of the study, we rely on Grounded Theory. The study was carried out in a university hospital in the state of São Paulo, in the pediatric unit, with the participation of 17 children and adolescents, aged between 5 and 17 years. The data were collected through an interview intermediated by playful communication strategies and complemented by clinical information obtained in the medical record. Data analysis was performed according to the recommendations of the Grounded Theory. From the analysis of the empirical material, three thematic categories emerged: nurse: gender issues in nursing work, communication as a nurses work tool in the care of the hospitalized child and adolescent, and nurses competencies in the face of painful assistance procedures hospitalized child and adolescent. Gender issues in nursing work have implications when children and adolescents have pointed out the discreet presence of men in the profession, but that all are nurses and that by doing the right care there should be no distinction. The nurses communication was considered essential during hospitalization and an important attribute for the good nurse, being this a strategy to make the hospital environment more welcoming, alleviating the suffering caused by the hospitalization period. The nurses\' competences regarding painful procedures were also pointed out as an attribute of the good professional. The participants emphasized venous puncture as a source of discomfort and pain, which could be softened by professional improvement through study, patience, interaction of the nurse with the patient during the performance of the procedures and their time of practical experience. The results of this study fill a gap in the Brazilian literature on the subject, identifying implications for the practice of nurses and contributing to the understanding of the experiences of hospitalized children and adolescents about the quality of health care and the hospitalization process. It is also worth noting that children and adolescents demonstrate an understanding of the care they perform, being able to point out what they expect from a good nurse, as well as express their perspectives

Passamos por um período de grandes descobertas para a ciência, mas o homem ainda continua sem desvendar o processo de morte e morrer. A morte ainda é um grande mistério que o amedronta; é vista como um tabu, tema interditado e fracasso profissional. Partindo do pressuposto de que os profissionais de enfermagem têm preparo insuficiente para lidar com pacientes em iminência de morte, traçamos como objetivo desse estudo: investigar como os profissionais de enfermagem vivenciam o processo de morte e o morrer das crianças/adolescentes hospitalizados, onde buscam preparo e apoio para enfrentar essa perda e identificar que tipo de apoio eles oferecem à família durante o processo de morte e morrer de seus filhos. Pela natureza dos objetivos propostos, este estudo é de natureza qualitativa. Os participantes são enfermeiros, auxiliares e técnicos de enfermagem que trabalham em clínicas com leitos pediátricos de um hospital-escola do interior do estado de São Paulo, que tenham vivenciado o processo de morte e morrer das crianças/adolescentes que estiveram sob seus cuidados. Os dados empíricos foram coletados mediante entrevista e organizados em três temas: enfrentando a morte, estratégias de apoio e luto da equipe. Os resultados indicam que os profissionais de enfermagem negam a morte nos hospitais e acreditam que sua função é salvar vidas; oferecem apoio afetivo e emocional às famílias; buscam apoio principalmente na equipe de trabalho e na família e vivem o luto pela morte de seus pacientes. Concluímos, a partir desses resultados, que os profissionais de enfermagem estão necessitando de suporte emocional e educacional para lidarem com a morte de forma mais harmoniosa e assistirem às reais necessidades das crianças e adolescentes que estão em iminência de morte. Recomendamos que seja incluído nos currículos o tema da morte e que as instituições hospitalares busquem a educação permanente como estratégia para promover mudanças de posturas dos profissionais junto ao paciente que está morrendo. / We are in a period of great advancements in science, but men are still seeking to understand the process of death and dying. Death is a great scary mystery, it is seen as a taboo, a theme that we must no approach and considered a professional failure. Basead on the presupposition that the nursing professional is not well prepared to cope with patients tha are dying, the goals of this study were: to investigate how nursing professionals experience the process of death and dying of hospitalized children and adolescents, to verify where they find preparation and support to face this loss and to identify what kind of support they offer to the families during the process of death and dying of their child/adolescent. Due to the nature of the objectives proposed, this study is considered qualitative. Subjects were nuses, nursing auxiliaries and technicians who work in pediatric wards at a university hospital in the state of São Paulo, Brazil and who had experienced the process of death and dying of children/adolescents that were receiving the care provided by them. Empirical data were collected through interviews and were organized in there themes: facing death, support strategies and team mourning. Results indicated that nursing professionals deny death in the hospitals and believe that their function is to save lives; they offer affective and emotional support to families; they look for support mainly within the working team and family and they experience the mourning due to the death of their patients. Author concluded, based on these results that the nursing professionals need emotional and education support in order to cope with death in a more natural way and to assit the children and adolescents’ real necessities whwn they are dying. The author recommends the inclusion of the theme “death" in the curricula and also that hospitals must for permanent education as a strategy to promote changes in posture of the professionals that provide care to patients who are dying.

A hospitalização institui uma crise na vida da criança e afeta tanto seu lado orgânico como o psíquico, determinando distúrbios comportamentais diversos e interrompendo seu desenvolvimento normal. Assim, o trabalho junto às crianças hospitalizadas torna-se fundamental para amenizar os efeitos negativos da doença, hospitalização e tratamento, que ameaçam seu desenvolvimento psicossocial normal. A arteterapia, meio de expressão e criação, restabelece uma maneira natural da criança comunicar-se com as outras pessoas; através dela a criança amplia seu conhecimento sobre o mundo e se desenvolve emocional e socialmente, motivo pelo qual não deve faltar na vida de qualquer criança, especialmente daquelas hospitalizadas. O objetivo deste trabalho é analisar os efeitos da utilização da arteterapia com crianças hospitalizadas. Trata-se de uma pesquisa com a abordagem quase-experimental, baseada em estudos quantitativos, fundamentados na mudança de comportamento e desenvolvimento das crianças hospitalizadas, bem como das imagens configuradas. Participaram do estudo 20 crianças, distribuídas em dois grupos: grupo experimental (n=10) e grupo controle (n=10). Crianças pertencentes ao grupo experimental submeteram-se às intervenções em arteterapia, sendo avaliadas através de instrumentos preestabelecidos, antes e após as intervenções em arteterapia, enquanto as do grupo controle também foram avaliadas no mesmo período, porém sem as referidas intervenções. A análise dos dados mostrou que as crianças do grupo experimental melhoraram seu comportamento, desenvolvimento plástico e produções plásticas, ao contrário das do outro grupo, que permaneceram com desempenhos mais uniformes. A arteterapia constituiu-se num excelente meio para canalizar, de maneira positiva, as variáveis do desenvolvimento da criança hospitalizada e neutralizar os fatores de ordem afetiva que, naturalmente, surgem, além de expor potenciais mais saudáveis da criança, por vezes pouco estimulados no contexto da hospitalização. / Hospitalization establishes a crisis in children’s lives and affects both their organic and mental realms, thus determining various behavioral disorders and interrupting normal development. Therefore, working with hospitalized children is fundamental in order to alleviate the negative effects of the disease, hospitalization and treatment which threaten their normal psychosocial development. Art therapy, a means of expression and creation, re-establishes the child’s normal form of communication with other people; through it the child expands his/her knowledge about the world and develops both mentally and socially, and for this reason, it must be present in all children’s lives, particularly of those who are hospitalized. This work aimed at analyzing the effects of using art therapy with hospitalized children. It is a study with a quasi-experimental approach based on quantitative analyses of behavioral and developmental changes in hospitalized children as well as of the configured images. Twenty children participated in the study and they were distributed into two groups: experimental group (n=10) and control group (n=10). The children comprising the experimental group were submitted to art therapy interventions and were evaluated through pre-established instruments prior to and after the interventions. Those in the control group were also evaluated in the period; however, the interventions were not used. Data analysis showed that the children in the experimental group improved their behavior, plastic development and plastic production in opposition to those in the control group, who maintained more uniform behaviors. Art therapy constituted an excellent means to positively guide the hospitalized child’s development variables as well as to neutralize the naturally arising affection-related factors, in addition to exposing the child’s healthiest potentials which are seldom stimulated in the hospitalization setting.

Social work in health care is a field in which health care blends with social care and represents inseparable part of curing and nursing process. There is not given enough attention and importance to this field, which it should deserve. The role of a social worker in the care of a hospitalized child is not sufficiently surveyed and defined, and therefore it became the theme of this dissertation. The main objective of this research was to look into the role of a social worker in the care of a hospitalized child. These partial goals were set for the survey: 1. To find out the subjective perception of the role of a social worker in the care of a hospitalized child from the point of the social workers themselves. 2. To find out what goal the operation of social work in the care of a hospitalized child is to achieve. 3. To look into what position in the medical team the social worker has in the framework of the care of a hospitalized child. 4. To find out what methods of social work are the most frequently used by social workers in the care of a hospitalized child. The theoretical part of the dissertation deals with social work in hospital. Following chapters describe social workers in hospital including their approaches to clients and theoretical definition of their role. Chapters dealing with children in hospital, social work with them and the whole family also represent a significant part of the theory. A qualitative survey using the method of making inquires was chosen for the purposes of the dissertation. The survey was carried out in a semi-conducted interview, which was divided into several fields enabling deeper insight into this specific profession and more concrete characteristics of the role held by the social worker in the care of a hospitalized child. A surveyed specimen consisted of female social workers in hospitals working within the framework of their field work with hospitalized children and their families. The selection of the surveyed specimen was intentional. For the sake of the survey ten interviews with social workers were carried out. Thanks to the opinions of the social workers the role of the social worker in the care of the hospitalized child can be, expressed with the aid of several graphs, which serve for clear and lucid orientation in results brought by this survey. Based on the survey results following hypotheses were defined: H 1: Social workers in the care of the hospitalized child most frequently hold the role of an advisor. H 2: The position of the social worker in the medical team is not equal. H 3: Dialogue is the most frequently used techniques in the social work with the child and their family. The survey reveals the importance of the role of the social worker in the care of the hospitalized child. The dissertation should mainly serve for opening the discussion about the role of the social worker in the hospital, in this case in the care of a hospitalized child.

Passamos por um período de grandes descobertas para a ciência, mas o homem ainda continua sem desvendar o processo de morte e morrer. A morte ainda é um grande mistério que o amedronta; é vista como um tabu, tema interditado e fracasso profissional. Partindo do pressuposto de que os profissionais de enfermagem têm preparo insuficiente para lidar com pacientes em iminência de morte, traçamos como objetivo desse estudo: investigar como os profissionais de enfermagem vivenciam o processo de morte e o morrer das crianças/adolescentes hospitalizados, onde buscam preparo e apoio para enfrentar essa perda e identificar que tipo de apoio eles oferecem à família durante o processo de morte e morrer de seus filhos. Pela natureza dos objetivos propostos, este estudo é de natureza qualitativa. Os participantes são enfermeiros, auxiliares e técnicos de enfermagem que trabalham em clínicas com leitos pediátricos de um hospital-escola do interior do estado de São Paulo, que tenham vivenciado o processo de morte e morrer das crianças/adolescentes que estiveram sob seus cuidados. Os dados empíricos foram coletados mediante entrevista e organizados em três temas: enfrentando a morte, estratégias de apoio e luto da equipe. Os resultados indicam que os profissionais de enfermagem negam a morte nos hospitais e acreditam que sua função é salvar vidas; oferecem apoio afetivo e emocional às famílias; buscam apoio principalmente na equipe de trabalho e na família e vivem o luto pela morte de seus pacientes. Concluímos, a partir desses resultados, que os profissionais de enfermagem estão necessitando de suporte emocional e educacional para lidarem com a morte de forma mais harmoniosa e assistirem às reais necessidades das crianças e adolescentes que estão em iminência de morte. Recomendamos que seja incluído nos currículos o tema da morte e que as instituições hospitalares busquem a educação permanente como estratégia para promover mudanças de posturas dos profissionais junto ao paciente que está morrendo. / We are in a period of great advancements in science, but men are still seeking to understand the process of death and dying. Death is a great scary mystery, it is seen as a taboo, a theme that we must no approach and considered a professional failure. Basead on the presupposition that the nursing professional is not well prepared to cope with patients tha are dying, the goals of this study were: to investigate how nursing professionals experience the process of death and dying of hospitalized children and adolescents, to verify where they find preparation and support to face this loss and to identify what kind of support they offer to the families during the process of death and dying of their child/adolescent. Due to the nature of the objectives proposed, this study is considered qualitative. Subjects were nuses, nursing auxiliaries and technicians who work in pediatric wards at a university hospital in the state of São Paulo, Brazil and who had experienced the process of death and dying of children/adolescents that were receiving the care provided by them. Empirical data were collected through interviews and were organized in there themes: facing death, support strategies and team mourning. Results indicated that nursing professionals deny death in the hospitals and believe that their function is to save lives; they offer affective and emotional support to families; they look for support mainly within the working team and family and they experience the mourning due to the death of their patients. Author concluded, based on these results that the nursing professionals need emotional and education support in order to cope with death in a more natural way and to assit the children and adolescents’ real necessities whwn they are dying. The author recommends the inclusion of the theme “death” in the curricula and also that hospitals must for permanent education as a strategy to promote changes in posture of the professionals that provide care to patients who are dying.