Objective: To analyse the context in which the diagnosis of autism is revealed and the impact of this revelation on family relationships. Methods: This is a qualitative study with 10 families of autistic children assisted at the Psychosocial Care Centre for Children and Youths in a municipality of Paraíba. Data were collected between July and August 2013 through semi-structured interviews and interpreted using thematic content analysis. Results:The identified Main Unit of Analysis and the respective categories were: the impact of disclosing the diagnosis of autism to the family; characteristics of diagnosis disclosure: the place, time, and the dialogic relationship between the professional and the family; changes in family relationships and the mother's burden when caring for the autistic child. Conclusions:The health professionals who report autism should better prepare the family to cope with the difficulties of this syndrome and autonomously care for the autistic child.Keywords: Autistic disorder. Diagnosis. Family relations. RESUMO Objetivo: Analisar o contexto da revelação do diagnóstico do autismo e o impacto deste nas relações familiares. Métodos: Trata-se de um estudo qualitativo, realizado com 10 familiares de crianças autistas, assistidas no Centro de Atenção Psicossocial Infanto Juvenil em um município da Paraíba. A coleta ocorreu entre julho e agosto de 2013 por meio de entrevista semiestruturada cujos dados foram interpretados pela análise de conteúdo na modalidade temática.Resultados: Identificou-se uma Unidade Temática Central com respectivas categorias: o impacto da revelação do diagnóstico de autismo para a família; características da revelação do diagnóstico: o local, o tempo e a relação dialógica entre o profissional e a família; alteração nas relações familiares e a sobrecarga materna no cuidado à criança autista. Conclusões:Há necessidade do profissional de saúde que noticiará o autismo saber preparar melhor a família para enfrentar as dificuldades impostas pela síndrome e para conquistar a autonomia no cuidado ao autista. Palavras-chave: Transtorno autístico. Diagnóstico. Relações familiares. RESUMENObjetivo: Analizar contexto de revelación del diagnóstico de autismo y el impacto de esto en las relaciones familiares. Métodos: Se trata de un estudio cualitativo con 10 familiares de niños autistas que reciben asistencia en el Centro de Atención Psicosocial para Niños y Jóvenes en un municipio de Paraíba. Los datos fueron recolectados entre julio y agosto de 2013 a través de entrevistas semiestructuradas y los datos fueron interpretados por el análisis de contenido en la modalidad temática.Resultados: Se identificó una Unidad Temática Central con respectivas categorías: el impacto de revelar el diagnóstico de autismo para la familia; la divulgación de las características de diagnóstico: el lugar, la hora y la relación dialógica entre el profesional y la familia; cambios en las relaciones familiares y la sobrecarga ,manterna en el cuidado del niño autista.Conclusiones: Existe la necesid...

RESUMO Objetivo:Identificar alterações desencadeadas no cotidiano da família que vivencia a experiência de doença crônica na infância. Métodos: Pesquisa qualitativa do tipo exploratória descritiva. Realizou-se o trabalho de campo em um hospital escola do Estado da Paraíba envolvendo como sujeitos, seis acompanhantes das crianças hospitalizadas por doença crônica. A técnica de coleta dos dados foi a entrevista semi-estruturada. Na análise dos dados foram observados os princípios da análise temática. Resultados: As alterações mais relevantes vivenciadas pelas famílias incluem as dificuldades financeiras, para atender as novas demandas da criança, e de acesso a serviços de saúde. Sentimentos como medo, dúvidas e insegurança compuseram o cenário familiar. Conclusão: Destaca-se que as famílias demonstraram interesse em ser incluídas no cuidado e em falar de seus sentimentos, ressaltando-se a importância da escuta sensível. Estabelecer vínculos e formar parcerias é um dos caminhos para a reconstrução humanizadora das práticas em saúde. Descritores: Criança hospitalizada; Doença crônica; Enfermagem pediátrica; Família ABSTRACT Objective: To identify, in the family, the daily changes unleashed by experiencing a chronic disease on infants. Methods: Is a qualitative research, descriptive and exploratory. The field work was conducted in a teaching hospital in the State of Paraiba, the research was performed on six companions of children hospitalized for chronic illness. Data were collected through a semi-structured interview and analyzed using the principles of thematic analysis. Results: The most significant changes experienced by families include financial difficulties to meet the new demands of the child, and the access to health services. In the home environment were found feelings of fear, doubt and insecurity. Conclusion: We highlight that families showed interest in being included in the care and in talking about their feelings; stressing the importance of a sensitive listening. One of the ways to rebuild humanizing health practices is to establish linkages and the construction of alliances. Keywords: Child, hospitalized; Chronic disease; Pediatric nursing; Family RESUMEN Objetivo: Identificar alteraciones desencadenadas en lo cotidiano de la familia que vivencia una enfermedad crónica en la infancia. Métodos: Investigación cualitativa del tipo exploratoria descriptiva. Se realizó el trabajo de campo en un hospital escuela del estado de Paraíba, envolviendo como sujetos a seis acompañantes de niños hospitalizadas por enfermedad crónica. La técnica de recolección de datos fue la entrevista semiestructurada. En el análisis de los datos fueron observados los principios del análisis temático. Resultados: Las alteraciones más relevantes experimentadas por las familias incluyen las dificultades financieras para atender las nuevas demandas del niño, y las de acceso a los servicios de salud. Sentimientos como miedo, dudas e inseguridad compusieron el escenario familiar. Conclusión: Se destaca que las familias demostraron in...

The aim of this study was describing and reflecting about the aspects related to the social history and public policies for the children's health assistance in Brazil. A brief historical contextualization was realized concerning changes on the way the society views the child in Brazil and around the world, also perspectives considering public policies for the children's health in the national context were presented. It was possible to identify that the historical evolution of the child participation in the society is linked to the changes in the assistance public policies, which were demonstrated in the child death decrease and associated to challenges, like the morbimortality reduction caused by perinatal injuries and avoidable causes. The advances and conquers in the child's health are evolved in a paradigmatic change movement into a model of a net formation and a comprehensiveness care. This context requires the human resources preparation for such area, based on the health promotion and prevention, as well as a better quality of life of the population.

This research aimed to verify at what moment, in what kinds of care and in what way mothers are included in care to the hospitalized child and to verify how care is negotiated between nursing team and mothers. The field research was carried out through participant observation of everyday care at a pediatric hospital unit, as well as interviews with mothers and the nursing team. The inclusion of the mother in care has taken place in a subtle way. The mother has taken on procedures that had been part of nursing competence before, concentrating information on the therapeutic process. The lack of a collective therapeutic project from the perspective of family-centered care is one of the obstacles to the involvement of mothers in care. Results demonstrate that the relation between mothers and the nursing team reveal to be complex and influenced by the exercise of power, which results in the need to construct shared care.

OBJECTIVE To evaluate the continuity of care for children and adolescents with chronic diseases in the health care network. METHODS This qualitative study was conducted between February and October 2013 with 12 families, six health managers, and 14 health professionals from different health care services in a municipality of the state of Paraíba, Brazil, using focal groups, semi-structured interviews, and medical record consultation. The data were analyzed by triangulation and thematic analysis. RESULTS Two categories were created: “health care management” and “(dis)continuity of care.” We found gaps in the system, including poor data recording aimed to facilitate follow-up and guide the planning actions as well as sporadic and discoordinate services with a limited flow of information, which hinders follow-up over time. CONCLUSION Continuity of care in the health care network is limited and creates the need to develop strategies to improve these services.

This study aims to reflect on humanization in health care, recovering the history of understanding about mankind, the human and humanity, until humanization in humanity and health. We discuss the national humanization program in hospital care and reflect on this proposal and on the issue of humanization in Brazilian health care nowadays. Communication is indispensable to establish humanization, as well as technical and material conditions. Both users and health professionals need to be heard, building a network of dialogues to think and promote singular humanization actions. For this process to take effect, there is a need to involve the whole that makes up the health service. This group involves different professionals, such as managers, public policy makers, professional councils and education institutions.

RESUMO:Pesquisa qualitativa, exploratório-descritiva, que objetivou compreender a percepção da família acerca do impacto do diagnóstico de paralisia cerebral e identificar estratégias de enfrentamento. Os dados foram coletados em uma Clínica-Escola de Fisioterapia de João Pessoa-PB com sete famílias de crianças com paralisia cerebral, entre março e abril de 2009, por meio de entrevista semiestruturada. A análise seguiu os princípios da interpretação temática. Os resultados demonstraram que o impacto desse diagnóstico é um momento difícil, gerando sentimentos de culpa nos pais. A família vivencia o medo frente ao desenvolvimento motor do filho e mudanças na dinâmica cotidiana. A fé e o amor ao filho influenciam no modo como as mesmas buscam se adaptar à nova situação. A família precisa de uma rede de apoio e atenção especial dos profissionais de saúde que devem ser sensíveis para promover escuta atentiva, minimizando o impacto do diagnóstico e contribuindo no enfrentamento.DESCRITORES: Paralisia cerebral. Família. Cuidado da criança. IMPACT OF A CEREBRAL PALSY DIAGNOSIS ON THE FAMILYABSTRACT: The objective of this qualitative, exploratory-descriptive study was to better understand family perceptions concerning the impact of a cerebral palsy diagnosis and to identify confronting strategies. Data was collected in a Clinical School of Physiotherapy in João Pessoa, Brazil from seven families with children with cerebral palsy between March and April of 2009 through semi-structured interviews. Data analysis followed the principles of thematic interpretation. The results showed that the impact of this diagnosis is a difficult time and generates feelings of guilt in the parents. The family experiences fear regarding the motor development of the child and changes in their day-to-day dynamic. Faith and love for the child influence the way with each they seek to adapt to these new circumstances. The family needs a support network and special attention from health care professionals that must be sensitive in order to promote attentive listening, minimizing the impact of the diagnosis and contributing to their coping. DESCRIPTORS: Cerebral palsy. Family. Child care. EL IMPACTO DEL DIAGNÓSTICO DE PARÁLISIS CEREBRAL PARA LA FAMILIA RESUMEN:Investigación cualitativa, exploratorio-descriptiva, con el objetivo de comprender la percepción de la familia acerca del impacto del diagnóstico de parálisis cerebral de un hijo e identificar estrategias para hacer frete a la situación. Los datos fueron recolectados en una Clínica Escuela de Fisioterapia de una Universidad en João Pessoa, Paraíba, Brasil, con siete familias de niños con parálisis cerebral, de marzo a abril de 2009, mediante entrevistas semiestructuradas. El análisis siguió los principios de la interpretación temática. Los resultados mostraron que el impacto de ese diagnóstico es un momento difícil y genera sentimientos de culpa en los padres. La familia siente miedo ante el desarrollo motor del hijo y se verifican cambios en la vida cotidiana. La fe y el amor al hijo ejercen...

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