Playful intervention with chronically-ill children: promoting coping

Abstract

Chronic diseases can adversely aff ect the development process of children. This qualitative, action-research study had the aim to analyze the eff ects of activities in the manual "Como Hóspede no Hospital" (As a patient in the hospital) on the coping process of children with chronic diseases. Study participants included six children and adolescents aged seven to 13 years, who suff ered from a chronic disease. Data were collected in the pediatric clinic of a public hospital in the Brazilian state of Paraíba, through participant observation and individual sessions with activities from the manual. Data interpretation followed the principles of thematic analysis. The activities from the manual encouraged participants' search for information about their disease and treatment, and increased their interest and participation in their health care process, thereby contributing to better coping. The study points to the need for comprehensive care for children with chronic diseases. Descriptors: Chronic disease. Child. Comprehensive health care. RESUMOAs doenças crônicas podem gerar consequências adversas ao processo de desenvolvimento infantil. O estudo teve por objetivo analisar os efeitos da realização de atividades do manual "Como Hóspede no Hospital" sobre o processo de enfrentamento de crianças afetadas por doenças crônicas. Pesquisa qualitativa do tipo pesquisa-ação. Participaram do estudo seis crianças e adolescentes, entre 7 e 13 anos, com doenças crônicas. Os dados foram coletados na clínica pediátrica de um hospital público do estado da Paraíba, por meio de observações participantes e sessões individuais com a aplicação de atividades do manual. A interpretação dos dados seguiu os princípios da análise temática. As atividades do manual estimularam a busca de informação sobre a doença e o tratamento, e aumentaram o interesse e a participação das crianças e dos adolescentes em envolver-se no cuidado à saúde, contribuindo para um melhor enfrentamento. Aponta-se a necessidade de cuidados integrais às crianças com doenças crônicas. Descritores: Doença crônica. Criança. Assistência integral a saúde. RESUMENLas enfermedades crónicas pueden tener consecuencias adversas para el proceso de desarrollo del niño. El estudio tuvo como objetivo analizar los efectos de la realización de actividades del guía "Cómo huésped en el Hospital" en el proceso de enfrentamiento de los niños afectados por enfermedades crónicas. Investigación cualitativa del tipo investigación-acción. El estudio incluyó a seis niños y adolescentes de 7 a 13 años con enfermedades crónicas. Los datos fueron recogidos en la clínica pediátrica de un hospital público en el estado de Paraíba a través de la observación participante y sesiones individuales con la aplicación de las actividades del guía. La interpretación de los datos siguió los principios de análisis temático. Las actividades del guía alientan la búsqueda de información sobre la enfermedad y el tratamiento y aumentaron el interés y la participación de los niños y adolescentes en involucrarse...

The use of children’s stories in nursing care for the child: an integrative review

“…Ludic and educational interventions are important in the comprehensive care for the child's and the adolescent's health, since they increase the care and promote autonomy. These are actions that go beyond providing instructions on the conduct with the treatment to be fulfilled (6) .…”

“…The study emphasized that the knowledge of the child's cognitive development phase in the planning of the activity is fundamental for the success of this technology (18) . A7 (6) showed how a manual called "Como Hóspede no Hospital", created to address recurrent hospitalizations in chronic disease, assisted in understanding the health-disease process and in the child's participation in the therapeutic process. Children were well accepted for hospital activities and were able to talk about living with chronic illness and hospitalization, promoting the acquisition of coping strategies (6) .…”

“…They have been extensively studied, both as free play and the relationship with health promotion and development, as well as interventions that have improved. Among them, the use of stories and therapeutic play (TP) stand out as strategies capable of interfering in a positive way in the child's perception about the health-disease process and about nursing care (2)(3)(4)(5)(6)(7) . TP is classified in instructional, physiological and dramatic functions (2) , and can be used in different care settings, allowing the child to better express their perceptions and needs (3) .…”

“…Stories as a mediating intervention in the care process may be only a recreational reading, boosts the imagination and helps the child to mitigate the treatment consequences, but can also be used as a therapeutic and structured reading, in order to intervene in part of the care. In this case, it can bring to nursing, child and family, the improvement in the acceptance of painful procedures, understanding of the health-disease process, trust in the professional, acceptance of treatments and serves as a tool for the health and research (4)(5)(6)(7) . The success of this intervention depends on adequate planning and the professional's ability to use the technique.…”

Participación social y salud: una experiencia colaborativa sobre la enfermedad renal crónica

“…17 En este contexto, llama la atención la casi nula producción de estudios participativos sobre esta enfermedad crónica en Latinoamérica. Dos trabajos realizados en Brasil parecen ser la excepción: el de Cesarino y Casagrande, 18 quienes identificaron de forma colaborativa las necesidades de aprendizaje de los enfermos en hemodiálisis, y elaboraron un plan de enseñanza, lo implementaron y lo evaluaron, y el de Moura y colaboradores, 19 quienes, por su parte, analizaron los efectos de la implementación de las acciones sugeridas en un manual para afrontar dicha enfermedad.…”