"Mas eu sabe tudo"

Abstract

The changing epidemiology of childhood diseases, influenced by an improvement of the living conditions and health , the scientific progress , and the technology aggregated to the diagnostic techniques have led to profound transformation in the pediatric population served by health services . These changes have increased the need for more complex care, human resources and materials, technology diagnostic and therapeutic, concerns with humanization, besides the intensive care units. The pediatric intensive care units (PICU) were created with the goal of providing optimal care to critically ill children, such to facilitate the healing of diseases and promote growth toward a quality of life with the full development of their potential. In spite of that, the PICU are considered stressful environments, affecting the child emotionally. In this context, the therapeutic play (TP), whose purpose is to enable the understanding of the child's own feelings and emotional reactions by the healthcare team, as well as to prepare them for unpleasant procedures, emerges as an essential strategy to the child, because playing is an integral part of a healthy infant development, even when it is in hospitalization. The objective of this study was to understand the experiences of preschool children hospitalized in the Pediatric Intensive Care Unit through the dramatic therapeutic play as an instrument of access to the life/world of the children. This is a phenomenological study with eight children who participated in a dramatic therapeutic play sessions at the PICU and, after the medical discharge from this unit, at the Pediatric Care Unit. The playing with the children, was recorded in digital audio and transcribed in full, and the notes in the field journal composed the phenomenological discourse.The analysis of the structure of the phenomenon occurred in the light of the theory the maturing of Winicott and revealed three themes: experiencing the hospitalization, recalling its history beyond the hospitalization and growing mature with playing. The playing was revealed to be necessary even when the clinical conditions more adverse because the need to externalize and understand new experiences and limitations remains present, being the TP an adequate technology. The life/world experience revealed itself by means of integrating new experiences vii with those already known, ranging from dependence stages of the maternal figure, revealing the complexity of the PICU without the presence of the mother, enabling the understanding of how the experience of hospitalization is the cause of suffering in an intensive care unit.