RESUmo Este estudo teve como objetivos avaliar a reprodutibilidade interavaliadores do ins-trumento para a classificação de pacientes pediátricos portadores de câncer; verificar se o instrumento de classificação de pa-cientes é adequado a pacientes pediátri-cos portadores de câncer e elaborar uma proposta de modificação do instrumento, permitindo a adaptação para pacientes pediátricos oncológicos. Foram avaliados, na unidade de internação pediátrica de um Hospital de câncer, 34 pacientes pe-las equipes de médicos, enfermeiros e técnicos de enfermagem. Para a avaliação do grau de concordância entre os escores obtidos pelos avaliadores foi utilizado o coeficiente Kappa, que revelou um valor intermediário/alto nas classificações ob-jetivas, e um valor baixo nas subjetivas. Conclui-se que o instrumento é confiável e reprodutível, porém, para classificação do paciente pediátrico oncológico, sugere-se a complementação de itens para atingir um resultado mais compatível com a realidade dessa população. dEScRiToRES Criança Neoplasias Classificação Enfermagem pediátrica AbSTRAcT The objectives of this study were to assess the interrater reproducibility of the instrument to classify pediatric patients with cancer; verify the adequacy of the patient classification instrument for pediatric patients with cancer; and make a proposal for changing the instrument, thus allowing for the necessary adjustments for pediatric oncology patients. A total of 34 pediatric inpatients of a Cancer Hospital were evaluated by the teams of physicians, nurses and nursing technicians. The Kappa coefficient was used to rate the agreement between the scores, which revealed a moderate to high value in the objective classifications, and a low value in the subjective. In conclusion , the instrument is reliable and reproducible , however, it is suggested that to classify pediatric oncology patients, some items should be complemented in order to reach an outcome that is more compatible with the reality of this specific population. dEScRiPToRS Child Neoplasms Classification Pediatric nursing RESUmEn Estudio que objetivó estimar la reproduc-tibilidad inter-evaluadores del instrumento para la clasificación de pacientes pediá-tricos portadores de cáncer; verificar si el instrumento de clasificación de pacientes es adecuado para pacientes pediátricos portadores de cáncer y elaborar una pro-puesta de modificación del instrumento, permitiendo su adaptación para pacientes pediátricos oncológicos. Fueron evaluados 34 pacientes en la unidad de internación pediátrica de un Hospital oncológico por parte de los equipos de médicos, enferme-ros y técnicos de enfermería. Para estimar el grado de concordancia entre los punta-jes obtenidos por los evaluadores, se utilizó el coeficiente Kappa, que expresó un valor entre intermedio y alto en las clasificacio-nes objetivas, y un valor bajo en las sub-jetivas. Se concluye en que el instrumento es confiable y reproducible, aunque para la clasificación del paciente pediátrico on-cológico se sugiere la implementación de ítems p...

Patient classification is essential for managing a hospital unit. Literature, however, does not present conceptualizations of pediatric patient categories. The objectives of this study were to define and validate pediatric patient care categories, according to the level of dependency of the nursing team. The care categories were defined based on a literature review, and the content of the proposed categories was validated by a group of judges involved in managing and providing care in a pediatric unit, and by judges involved in pediatric education and research as well as in the construction of patient instruments. Five care categories were established and validated: Minimal, Intermediate, High dependency, Semi-intensive and Intensive. The validation of the care categories were the basis for constructing a system for the classification of pediatric patients, that may contribute with the decision making process of nurses working in management and health care.

Objective: To construct a tool for classification of pediatric patients, validate its content, and assess the interrater reliability. Methods: This is a quantitative study in which a mixed method was used. Validity of its content was assessed through a descriptive exploratory design using the Delphi technique. Inter-rater reliability was then assessed with a correlational design. Results: After four stages of use of the Delphi technique, the instrument was composed of 11 care demand indicators. Each of them comprised one-to-four situations of graded complexity, that reflected increasing intensity of nursing need. The reliability levels as optimal, good, and weak were obtained for five, five, and one indicators, respectively. Conclusion: The content of the instrument was constructed and validated with satisfactory reliability to classify pediatric patients into five healthcare categories. ResumoObjetivo: Construir, validar o conteúdo e verificar a confiabilidade interavaliadores de um instrumento para a classificação de pacientes pediátricos. Métodos: Estudo misto com referencial quantitativo, sendo o delineamento descritivo exploratório para a validação do conteúdo do instrumento realizado pela Técnica Delphi seguido por desenho correlacional para avaliar a confiabilidade interavaliadores. Resultados: Após quatro fases da Técnica Delphi, o instrumento ficou constituído por 11 indicadores de demanda de cuidado e cada um por quatro situações graduadas refletindo o aumento da necessidade de enfermagem. Obteve-se nível de confiabilidade ótimo para cinco indicadores; bom para cinco e apenas um indicador com fraco nível de confiabilidade. Conclusão: Foi construído e validado o conteúdo do instrumento para classificar pacientes pediátricos em cinco categorias de cuidados com confiabilidade satisfatória.

OBJECTIVES: to assess the construct validity and reliability of the Pediatric Patient Classification Instrument. METHODS: correlation study developed at a teaching hospital. The classification involved 227 patients, using the pediatric patient classification instrument. The construct validity was assessed through the factor analysis approach and reliability through internal consistency. RESULTS: the Exploratory Factor Analysis identified three constructs with 67.5% of variance explanation and, in the reliability assessment, the following Cronbach's alpha coefficients were found: 0.92 for the instrument as a whole; 0.88 for the Patient domain; 0.81 for the Family domain; 0.44 for the Therapeutic procedures domain. CONCLUSIONS: the instrument evidenced its construct validity and reliability, and these analyses indicate the feasibility of the instrument. The validation of the Pediatric Patient Classification Instrument still represents a challenge, due to its relevance for a closer look at pediatric nursing care and management. Further research should be considered to explore its dimensionality and content validity.

Background: The daily family life of a child with chronic disease changes according to the illness's demands. The siblings of these children may receive less attention from both parents, as well as from the rest of the family, who may focus more on the sick child and not in a similar way on the healthy sibling. Objectives: To compile perceptions of siblings of children hospitalized due to chronic disease. Methodology: Siblings of children diagnosed with chronic diseases, aged between 8 and 16 years, participated in the study. We used open interviews, recording, transcribing, and submitting them to analysis. Results: We were able to interview only four siblings. In the interviews' analysis, four categories of results (Coping with the sibling's disease; Family restructuring; Experiences resulting from the sibling's hospitalization; and Experiences of exclusion) emerged. Conclusion: The siblings of children with chronic diseases live in a situation of vulnerability and exclusion, demonstrate difficulties in dealing with their perceptions and feelings, which proves it is essential to involve the sibling in the nursing process.