O cuidado compartilhado entre mães e educadoras de um centro municipal de educação infantil: uma pesquisa-ação

O cuidado à criança envolve a identificação e o atendimento às necessidades de modo a oferecer-lhe atenção como pessoa em contínuo processo de crescimento e desenvolvimento. Contudo, o cuidado oferecido à criança que convive em instituição escolar está permeado por conflitos que fragilizam a relação família-escola, não sendo estimulada a articulação desses atores no que refere ao cuidar da criança. Diante dessa problemática, objetivou-se analisar a construção de um pacto do cuidar entre mães e educadoras de crianças que frequentam um Centro Municipal de Educação Infantil. Trata-se de um estudo qualitativo, tendo como método a pesquisa-ação. Envolveu doze mães e oito educadoras de uma instituição de educação infantil de Cidade Nova, no município de Natal, no período de abril a novembro de 2013. Os dados foram coletados através de entrevista grupo focal, observação participante, seminários e diário de campo. Os resultados foram analisados seguindo o direcionamento da análise temática freireana. Na etapa do diagnóstico situacional, que investigou a realidade vivenciada pelas participantes do estudo, percebeu-se que as educadoras não se sentem preparadas para lidar com aspectos de saúde-doença da criança e recusam as ações de cuidado como desempenho de suas funções, interpretada como uma atitude que ultrapassa sua competência profissional. Os pais, por sua vez, apresentaram dificuldade de entendimento e clareza da sua função e relação com a instituição e executam as ações de saúde sem associá-lo à promoção e prevenção, além de realizarem com conhecimento empírico. Vista a necessidade de mudança das ações de saúde prestadas à criança, decidiu-se conjuntamente, através de uma roda de conversa, realizar capacitações sobre higiene e limpeza, medidas caseiras no cuidado à criança e primeiros socorros. Na etapa de implementação da ação coletiva as participantes consideraram as atividades úteis no cuidado prestado à criança e perceberam a importância do cuidado compartilhado para o desenvolvimento infantil. Com o desenvolvimento das capacitações, as participantes sentiram a necessidade de sistematizar as atividades prestadas à criança nos problemas de saúde e, para tanto, foram construídos, conjuntamente, protocolos e procedimentos operacionais padrão para a formalizar as ações. Na etapa de avaliação dos encontros, constatou-se que há expectativas positivas para a continuidade do cuidado em comunhão entre pais e educadores, pois foram construídas novas percepções em relação ao cuidado da criança. Percebeu-se mudança considerável nas mães assíduas ao estudo quanto ao cuidado e interesse, no entanto tornaram-se evidentes as fragilidades no processo de trabalho do CMEI, pois emergiram a dificuldade existente nos membros que compõe a instituição de educação infantil de articular o cuidado à educação. Como principal dificuldade, elenca-se o alto índice de mães faltosas e a dificuldade de articular com outros profissionais de saúde para as atividades. Considera-se que o pacto de cuidar não foi implantado integralmente, pois partilhar cuidados sugere o encontro de pais e educadores que podem ter aspectos divergentes sobre necessidades infantis e desenvolvimento, o que requer constante negociação entre as partes. Nesse sentido, constitui-se em um processo contínuo de aperfeiçoamento entre família e instituição de educação infantil

Ações de cuidado nas relações intrageracionais em crianças em acolhimento institucional

According to the Statute of Children and Adolescents (1990) children and adolescents are conceived as subjects of rights, with absolute priority and development peculiar condition. Thus, if these rights were violated or threatened, will be applied protection measures. Within these measures, in that Statute, the foster institutional is proposed, with transitional and exceptional character. When the child goes out from family and community life, and she is upheld in an institution, the child is placed in a new development context, therefore, with new people, new places, and new relationships. According with Socio-Historical Psychology, theoretical support of this study, each context presents specific demands of socialization that influence child development and her subjectivity is constituted through the relations that the subject establishes in each context. These contexts bring challenges and proposals for the child and she needs to respond these. Then, whereas he is in relation to the other, in this moment, the subject is constituted, the interactions established during the foster institutional will be of paramount importance to the child. Among these interactions, we can cite situations involving aspects of moral development, specifically those that can ask (or not) the exercise of the virtues. About the intersection between these actions can then arise care actions beyond those involving the attending of an emerging need. The objective of this study is to investigate the presence of relation everyday permeated by care actions among children in foster institutional. For the scope of the objective three children were participated, with three years old and in foster care measure. The research is qualitative and the procedure for building the corpus was, mainly, the participant observation. Procedures with video and history in books were also used as supplementary procedures. The analysis of the corpus was made through Thematic Content Analysis, the episodes were grouped into analysis categories pre-and post-established. The preestablished were care actions related to body care, care actions related to socio affective aspects, and care actions related to body care and socio affective aspects simultaneously. The two post-established categories were dismemberment of the preceding categories, called care actions developed in child-child interaction, without the intervention of an adult, and care actions developed in child-child interaction, with direct intervention of the educator. The analysis indicated that in the everyday interaction between foster children, they identify the physical and emotional needs of each other foster member, and they are willing to help them in whatever way they can, emphasizing the importance of play and playful moments like mediators about these interactions. The care actions observed are based on children´s concepts and interpretations made from their experiences and largely refer to maternal care. The condition of being away from their family life can be an element that enables these actions. Finally, this study reaffirms the importance of designing the foster institution as a socialization and care space. It follows the importance of valuing and strengthening the positive aspects that arise in the relationships established by the children in this context, including the care actions, the research objective, which are components of the subjectivity of these children

Processo de cuidar de crianças hospitalizadas com câncer

The objective was to understand the process of care in the perception of hospitalized children with cancer. This is a descriptive study of qualitative approach. Data were collected between the months of October 2013 and January 2014, through photographic records and semi-structured interview consisting of questions relating to the identification of age, sex, diagnosis and length of stay and a script of questions related to the recorded pictures. Eight children were included aged between six and twelve who were admitted to a pediatric oncology sector, located in the city of Natal / RN. The criteria used in the sample were: being hospitalized for cancer treatment; and present favorable physical conditions for carrying out the data collection. For the treatment of collected material was used content analysis, thematic modality. The study followed the ethical and legal principles governing scientific research with human beings and took place with the approval of the project by the Ethics and Research Committee of the Northern League Riograndense against Cancer, with opinion registered under number 329 015 and CAAE 16097613.9.0000.5293. According to the results it was found that, for the child, the care happens through technical activities, such as making procedures and the use of personal protective equipment, as well as through the dialogic relationship, which favors the establishment of confidence in care professional. Caring also means developing activities that promote well-being, the fun and the social and cognitive development, highlighting thus the playful, during hospitalization, as an auxiliary tool in the care process. During hospitalization, the child identifies two individuals responsible for their care, accompanying family and professional, and nursing professionals the most cited in moments of care. , Also of note, the promotion of care, in the perception of the child related to the infrastructure of the institution, environmental cleaning, personal hygiene, the medicalization and the food. It is concluded that care understood by the child, whilst still maintaining relations with the biomedical model, points to a new perspective that should consider the biological, social and psychological of acquiring cancer without unlink them of the development child. 9 Moreover, we see the child as an active social actor in this process, and therefore needs to be heard and answered their needs

Crianças com infecções respiratórias agudas: como são cuidadas em casa?

Objetivou-se, neste estudo exploratório/descritivo, identificar conhecimentos e necessidades dos cuidadores da criança com Infecção Respiratória Aguda (IRA) através de uma amostra de 129 crianças atendidas no serviço de crescimento e desenvolvimento de uma unidade de saúde. Foram aplicados formulários junto aos cuidadores, em seu domicílio, nos meses de fevereiro e março de 2002. Os cuidadores eram do sexo feminino, a maioria jovem, com ensino fundamental incompleto e com renda de 1 a 2 salários. Em relação aos primeiros cuidados com a criança doente, 48,2% dos cuidadores procuram o médico, 36,6% medicam por conta própria e 13,2% utilizam fitoterápicos. Como medidas de prevenção contra pneumonia em crianças com IRA leve, os cuidadores utilizam medidas de senso comum e sabem reconhecer sinais de gravidade das doenças, por experiências anteriores, revelando uma lacuna do conhecimento dos principais sinais e sintomas de doenças graves do trato respiratório

Avaliação do desempenho funcional de crianças com paralisia cerebral de acordo com níveis de comprometimento motor

Contextualization: Several studies have examined the mobility of this group of children, however little is known about the impact of motor function in activities of daily living, considering the seriousness of their neuromotor damage. Objective: Identify the functional differences of children with Cerebral Palsy with different levels of motor dysfunction and correlate these differences with the areas of mobility, self-care and social function in functional ability and caregiver´s assistance of these children. Methods: An l analytical cross-section search was developed, which were part 70 children / families aged from 4 to 7.5 years, in the Rehabilitation Center for Children. As tools were used the Pediatric Evaluation Disability Inventory (PEDI) and the Gross Motor Function Classification System (GMFCS). Data analysis was performed by ANOVA and Pearson's correlation tests. Results: The results show the functional variability of children CP in different severity levels of motor disfunction This variation was observed in the areas of mobility, self-care and social function. The results also showed a strong correlation between the domains mobility and self-care, mobility and social function. Conclusions: The variability shown by the children with CP, suggests the use of PEDI and GMFCS as this association appears to increase the understanding of how the gross motor functions are related to activities of daily living, describing the best commitments and their degree of impact on functional activities. This correlation demonstrates how mobility is crucial to evaluate the performance and guide the therapeutic practice, to develop the children´s potencial, and guide the caregiver in stimulation

IgA sérica, secretora, IgE total e estado nutricional em crianças com infecções por enteroparasitas

Infections for intestinal parasites are one of the main morbidade causes in humans and, its relationships with socioeconomic levels and hygiene conditions in countries in development are already very established. Many works, even so, they are being accomplished to elucidate the complex interactions among nutrition, these infections and answer imunológica, because it is seen that malnutrition commits the immunity increasing the susceptibilidade for infectious diseases and these for its time can harm the state human nutricional. It is known that sponge helmínticos they stimulate synthesis of IgE so much policlonal as specific for the same ones and that IgA secretora, main imunoglobulina of defense of the mucous ones, can act against protozoa as the Giardia lamblia and against helmintos as Trichuris tichiura and Strongyloides stercorales. Some studies show that the malnutrition energy protéica influences in the production of these answers, but some authors show results divergentes. In this work it was evaluated the levels of total IgE, IgA sérica and secretora, contagem of sanguine eosinófilos, levels of proteins séricas and state nutricional, in 103 children of low socioeconomic level, to discover a correlation between those and infection for enteroparasitas. They participated in the study children of both sexes, with age of 3 to 6 years, visitors of the same creche and residents in a neighborhood with precarious hygiene conditions and basic saneamento, in the city of Christmas. The obtained results showed that the faulty environmental and socioeconomic conditions favored to a high infection frequency for enteroparasitas, mainly Trichuris trichiura and Ascaris lumbricoides between the helmintos and Endolimax sleep and Giárdia lamblia among the protozoa. Light malnutrition without deficit protéico was observed in 30% of the children, which didn't also present significant deficiencies of IgA sérica and secretora. The sponged children

O processo de trabalho e a composição técnica do trabalho do enfermeiro no cuidado à saúde da criança em unidades de saúde da familia

With the trajectory that the problems related to child health are taking in our society, particularly with regard to infant mortality, beyond the process of decentralization of health and the implementation of the Family Health Strategy in the cities, where it has increased considerably performance of nursing staff in Primary Health Care, they can be considered essential factors for reflections on the care of nurse dispenses the health of these children. In order to check how it is organized the working process of the nurse in caring for these children in USFs as well as the difficulties found in the dynamics of this work, this research aimed to analyze the work processes of nurses in care Child Health in USFs, with emphasis on technologies used in producing care. This is a research exploratory and descriptive with qualitative approach, based on the theoretical reference in about Work Process and Composition Technique of Work. The data were collected through semi-structured interviews of 11 nurses who, at the moment, perform their functions for more than 01 year at USF. The guiding questions were based at theoretical reference. To analyze the results, was used the referential of content analysis, and was refer to thematic analysis. In situations that were involved closed questions of the interview, was used the aid of SPSS 15.0 program for Windows. The results indicated that the process of nurse work in health care of children, focuses on the preventive character, whose focus of the actions are healthy children, following the routines and protocols established by the Ministry of Health with a view to maintaining health them. When analyzing the data through theoretical references of Composition Technique of Work found that the core technologies of daily tasks of the nurse are directed for the use of technology soft-hard and hard, and the reason established between the Dead Working and Alive Working, there is prevalence of the first against the second in the production of this care. These situations contribute to the explanation of the emergence problems related to adhesion of mothers / caregivers to monitoring the CD, due to character prescriptive and normalizer of actions. The results also suggested the presence of "vanishing lines" in the make of nurses, confirming the self-governance of health professionals in daily work. These "vanishing lines" express the own execution of the Work Live in action, guided by the use of soft technologies, however, was not characterized as a process of technology transition. So, to get a better resolution to the problems related to child health, the nurse has reorganize your work process by focusing on the execution of work live in action.

Práticas populares de cuidado à criança: o saber/fazer de cuidadoras

Popular practices correspond to the resources used by households, lay people and popular therapists, whose perception of knowledge is constructed in the everyday. In this context, the sick child can become vulnerable to be dependent on a family caregiver, who often decide to employ popular practices. Thus, the child care should be shared between carer and health professional. However, they know little about the resources that the family uses to detect a grievance in infant. Therefore, the present research aimed to analyse the use of popular practices by caregivers of children with zero to five years old. We conducted an exploratory and descriptive study with a qualitative approach, together with 15 caregivers of children who were treated at the Joint Unit Felipe Shrimp, located in Natal, Rio Grande do Norte, Brazil. To select the participants, they should be age and above 18 years; be caregivers of children up to five years of age; and reside in the area ascribed the Joint Unit Felipe Shrimp. The data collection took place between September and October 2013, through in depth interview. This step was preceded by the approval of the Health Department of the city of Natal; the direction of the Joint Unit Felipe Shrimp; as well as, the Committee on Ethics in Research from the Federal University of Rio Grande do Norte with Certificate of Presentation and Consideration Ethics, No 15467013.8.0000.5537. Furthermore, the interviewees formally authorized their participation in the research by signing the consent form. The data were treated according to the technique of content analysis in the form of thematic analysis according to Bardin. This process, four categories emerged: "Types of popular practices used in the care of the child"; "Source of information of popular practices"; "Results obtained with popular practices"; "Factors that hinder the adoption of common practices." The results showed the use of popular practices by caregivers in the case of illness to children such as the homemade preparations with medicinal plants and folk healers. The family environment was referenced as the main learning space and spread of popular practices, which are influenced by cultural relations present in this context. As to the results obtained with popular features, the caregivers said to be satisfactory, and this triggers a feeling of confidence and acceptability of such measures. It is concluded that the use of popular practices in child care persists in everyday most of the participants, despite the hegemony of allopathic therapy. The caregivers stated that such practices are effective and easy to obtain, being secured in context by popular culture. In addition, health professionals, especially nurses, were seldom mentioned by the caregivers as to the information concerning popular resources used by them, which suggests the weakness in dialogic process of negotiating practices between both of them

Atividades educativas na rede pública de ensino: efeitos sobre a higiene oral e o nível de informação em Saúde Bucal

The contents introduction concerning the individual health cares reveals important since the school education. In this direction, the present study objectified to know an effect of Oral Health education intervention in the oral hygiene and in the schools children information level, of 4º e 5º basic education years. The study was composed by two groups, chosen of random form: control group (n = 115) and experimental group (n = 132), with 247 public net school children in total sample. The experimental group participated of some educative activities in Oral Health, with biweekly frequency, during the 4 months period, given for a surgeon-dentistry. Both the groups were submitted to a clinical examination for a previous verification of the Plaque Index (PI) and of Loe Silness Gingival Index (GI). A questionnaire with closed questions on Oral Health was applied before and after to verify the school children rightness index. After the intervention, the final data, represented for the PI, GI and Rightness Index verification, has been collected for statistical analyses through the chi-square test to a 95 % of reliable level, using the SPSS 10,0 software. The PI and GI were categorized in high and low on the initials index basis medium; already the Rightness Index was categorized in inadequate (< 50%) and adequate (≥ 50%). It was verified that the PI (p = 0,014; IC 0.24-0.86) and the GI (p = 0,013; IC 0,28-0,84) presented differences statistically significant, after the education activities, when compared to with the control, favoring the experimental group. It was verified too the experimental group got greater rightness index, presenting difference highly significant (p<0,0001; IC 3,73-26,81). It was still observed that there was no association between the oral hygiene indicators and the school children information level. Ahead the results, it can been concluded that education activities related in the school routine were capable to give positives effects in the oral hygiene control and in the information level about Oral Health, however, not necessarily, the individual with bigger information is that one who has practiced an oral hygiene more adjusted. One become necessary, however, that the education in Oral Health occurs of permanent and integrated form with others school actors, for the positive effect does not lose the student s life longterm

Avaliação clínica da saúde bucal de crianças com neoplasias malignas atendidas no Hospital Infantil Varela Santiago em Natal-RN

The childhood cancer is characterized by a predominance of hematogenic and lymphatic system neoplasm, although a fTequency of the central nervous system tumors and sarcomas are widely common. Particularities of many childhood cancers and the adverses effect of the antineoplastic agents can change radically the oral environrnent and predisposes to the risk of oral complications. This study assessment clinically the oral health of 40 children on treatment for different types of malignant neoplasm with age range of O to 1S years old (Group I) and compared to 38 nonnal children in the same age range (Group lI). The results shown that nonnal patients had a gingival bleeding index (GBI) and caries experience minar than patients of Group lI, the visivel plaque index (VPI) was lightly higher in patients of Group 1. There was not difference statistically significant in the variables. Sixteen patients of Group I developed together 61 oral complications with predominance of mucositis, followed by spontaneous oral bleeding, candidiasis and xerostomy, that complication were most commons in patients with systemic neoplasm. Its was concluded that patients submitted to antineoplastic therapy with poor oral health had a higher risk to develop oral complications

A percepção das características da face infantil por adultos e crianças sob uma perspectiva evolucionista

Child facial cues evoke attention, parental care behaviors and modulate for infant- caretaker interactions. Lorenz described the baby schema ( Kindchenschema ) as a set of infantile physical features such as the large head, round face, high and protruding forehead, big eyes, chubby cheeks, small nose and mouth. Previous work on this fundamental concept was restricted to positive perception to infant face, and did not show consistent results about the development individuals perceptions, regarding the physical attributes that worked as markers of cuteness. Here, we experimentally tested the effects of baby schema on the perception of cuteness of infant faces by children and adults. We used 60 none graphically manipulated photos of different stimulus children faces from 4 to 9 years old. In the first task for the adults experimental subjects, ten stimulus photos were shown, whereas for children experimental subjects, four stimulus photos were shown at a time, with a total of six rounds. The second task involved only adults, who indicated the motivation of affective behaviors and care directed to children through a Likert scale. Our results suggest that both participants judged similarly the cuteness of children's faces, and the physical features markers of this perception were observed only for younger stimulus children. Adults have attributed more motivations of positive behaviors to cuter stimulus children. The recognition of the baby schema by individuals of different ages and genders confers the universality and power of children's physical attributes. From the evolutionary perspective the responsiveness to baby schema is significant to ensure aloparental and parental investment, and the consequent children survival

Acolhimento institucional e desenvolvimento moral: a generosidade em crianças de quatro a seis anos de idade em situação de abrigo

This research has as main proposal to verify how the virtue of generosity, considered as one of the important aspects of moral development on children, shows itself in children between four and six years old in institutional welcome condition. Toward this aim, knowledge in Human Development Psychology, specifically Jean Piaget and his contemporary collaborators, were associated to philosophic knowledge, with emphasis in Kant and Aristotle. The research took place in an institutional welcome service in the town of Natal-RN, between February and May of 2009, witch is responsible to offer care to children from zero till six years old. As procedure were used: the rulebased game Memory Game ; the childhood story One note fight ; and observations of the institution s everyday. The corpus analysis was done by the Thematic Content Analysis method. In general, in the daily observations, children showed themselves more co-operative and generous than in the executed procedures, mainly when the matter subject was other´s well-being. The duty, Kantian perspective, was overcome by the Aristotelian sumo bem, classified as generous act of afford to other what is not posted as right, however guaranteed by solidarity

Contando histórias de cuidado à infância em unidade de terapia intensiva pediátrica

The tales of children's literature, in their plots, mark existential dilemmas belonging in human‟s lives, such as death, situations of separation, loss, abandonment, fear, challenges, achievements and other elements that make them suitable material to assist children in their developmental process. Such elements, present in children‟s storybooks, are close to the experiences lived by the children in the context of hospitalization in a special manner. With that said this study focus on the understanding of the therapeutic possibilities of the tales of children's literature in the care of hospitalized children in Pediatric Intensive Care Units (UTIPED) based on the Heidegger's concept of Care and adopting the Phenomenology as the method. The UTIPED of a state public hospital located in the municipality of Natal/RN was elected as the study site and four hospitalized children aged between six and nine years, all males, presenting different clinical conditions were selected to participate in the study following age and clinical conditions as the selective criteria. The procedure of corpus construction included eight individual sessions of storytelling accompanied by the use of ludic resources. The phenomenological understanding about the therapeutic possibilities of tales was structured under three main elements: (1) the ludic axis; (2) the reflective axis; and (3) the affective axis. The appropriateness of the proposed therapy in the context of the UTIPED and the potential of the tales as a protection factor to the child was evident. The storytelling activity framed a scenario of care unusual in the context of intensive care units, establishing a symbolic space for children‟s expression. Therefore, this study indicates this therapeutic proposal for children‟s care in the UTIPED that considers their evolutionary stage, their clinical conditions at the time and especially their emotional needs during their immersion in a diverse and foreign environment which is filled with potentially harmful elements to their full development.

O psicólogo e os serviços de acolhimento institucional para crianças e adolescentes

The Shelters are responsible for caring for children and adolescents whose families or guardians are temporarily unable to fulfill his role as care and protection. The activities to be developed by psychologists in these services are greatly important for the elaboration and development of political- pedagogical project of the same, and for reasons pertaining to the present and future of children and adolescents received judgments. The psychologist puts up the challenge of contributing to a better care of children, also cooperating with the implementation of the new care standards of childcare. The aim of this study was to investigate the role of the professional psychologist in assistance to children and adolescents in 13 Shelters in the Metropolitan Region of Natal/RN. For both set out to make visits to the institutions to know how it is organized the field work of the psychologist, his routine work and activities developed. Nine psychologists interviewed according to a semi-structured interview script. The data analysis is supported by the theoretical aspects of dialectical materialism historical and theme content analysis was used. Results were presented from three angles: psychologists and institutional framework; activities, resources and methods of work; psychologists and legal frameworks of the Institutional Hospitality. The study points out the recent entry of the psychologist in Shelters, combined with considerable turnover of these professionals. This work has been organized through the Individualized Service Plan, prioritizing the return to family of origin. Moreover, in general, perform joints with the service network, reporting, individual consultations and follow-adoption processes . Staff members, however, feel a lack of specific and continuing training on special protection, including due to the distance between the proposed theory and practice. It was thus observed a movement of psychologists distance themselves from welfare or repressive practices, however the structural difficulties of services and lack of continuing education appear to limit the development of a performance focused on the transformation of the reality of children and adolescents treated and their families

Crianças com infecções respiratórias agudas: como são cuidadas em casa?

Objetivou-se, neste estudo exploratório/descritivo, identificar conhecimentos e necessidades dos cuidadores da criança com Infecção Respiratória Aguda (IRA) através de uma amostra de 129 crianças atendidas no serviço de crescimento e desenvolvimento de uma unidade de saúde. Foram aplicados formulários junto aos cuidadores, em seu domicílio, nos meses de fevereiro e março de 2002. Os cuidadores eram do sexo feminino, a maioria jovem, com ensino fundamental incompleto e com renda de 1 a 2 salários. Em relação aos primeiros cuidados com a criança doente, 48,2% dos cuidadores procuram o médico, 36,6% medicam por conta própria e 13,2% utilizam fitoterápicos. Como medidas de prevenção contra pneumonia em crianças com IRA leve, os cuidadores utilizam medidas de senso comum e sabem reconhecer sinais de gravidade das doenças, por experiências anteriores, revelando uma lacuna do conhecimento dos principais sinais e sintomas de doenças graves do trato respiratório