ABSTRACT
Introdução: O câncer merece destaque entre as doenças que causam transtornos em adultos e crianças, pois continua sendo um diagnóstico dos mais temidos da atualidade. Vincula-se a um estigma de sofrimento, mutilação e morte, envolvendo uma série de ameaças e dificuldades, que afetam não só a criança, mas sua família como um todo, ao longo do processo de diagnóstico e tratamento Objetivo: Comparar os comportamentos de crianças durante a quimioterapia endovenosa antes e após a aplicação do brinquedo terapêutico instrucional (BTI). Materiais e Métodos: Pesquisa não controlada do tipo "antes e depois", realizada na oncopediatria de um hospital público. Foram avaliadas 10 crianças submetidas a quimioterapia endovenosa. Na coleta de dados, utilizou-se um questionário com questões sociodemográficas, clínicas, comportamentais e reações esboçadas durante o tratamento, antes e após a sessão de BTI. A análise de dados foi feita no programa SPSS, sendo realizado o teste de Mc Nemar, considerando um intervalo de confiança de 95%. Resultados: O câncer infantil mais frequente foi a Leucemia Linfoide Aguda (40%). Dos comportamentos analisados, percebeuse redução significativa após o uso do BTI do comportamento "postura retraída". Conclusão: O BTI representou uma ferramenta importante no controle da ansiedade e sofrimento gerado pelo tratamento quimioterápico endovenoso.
Introduction: Cancer plays a notable role among diseases that afflict adults and children. Its diagnosis is still much feared and connects to a stigma of suffering, mutilation and death. It is related to difficulties and treats that affects not only the child but also his whole family during the long process of diagnosis and treatment. Objective: to compare the behaviors of children during intravenous chemotherapy before and after the application of therapeutic instructional toy (BTI). Materials and methods: Uncontrolled search such as "before and after", held in oncopediatria of a public hospital. Ten children were evaluated, subjected to intravenous chemotherapy. For collection, it was used a questionnaire asking for sociodemographic, clinical and behavioral questions, as well as issues and reactions outlined during treatment, before and after the session of BTI. The data analysis was done in SPSS program, being carried out the Mc Nemar test, assuming a confidence interval of 95%. Results: the most frequent childhood cancer was Acute Lymphoblastic leukemia (40%). Among the behaviors examined, it was significantly reduced after the use of BTI "retracted posture" behavior. Conclusion: the BTI represented an important tool in the control of anxiety and suffering generated by intravenous chemotherapy treatment.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Play and Playthings , Child, Hospitalized/psychology , Drug Therapy/psychology , Emotions , Neoplasms/drug therapy , Ovarian Neoplasms/drug therapy , Infusions, Intravenous/psychology , Leukemia, Myeloid, Acute/drug therapy , Punctures/psychology , Child Behavior/psychology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Kidney Neoplasms/drug therapyABSTRACT
The safe and effective treatment of uncooperative or combative preschool children with extensive dental needs is one of pediatric dentist's ongoing challenges. The traditional methods of behavior management are no longer acceptable to parents as they are not ready to spare more time for dental treatment of their children. Keeping this in mind, the present study was designed and carried out to evaluate the sedative effects of oral ketamine and oral midazolam prior to general anesthesia. Twenty uncooperative children in the age-group of 2-6 years were selected after thorough medical examination and investigations. Informed consent was obtained from the parent. This was a randomized double-blind study. An anesthesiologist administered either 0.5 mg/kg midazolam or 5 mg/kg ketamine orally. The heart rate, respiratory rate, and oxygen saturation were recorded at regular intervals. The sedation and anxiolysis scores were also recorded. The parents were asked to answer a questionnaire at the follow-up session the next day on the surgical experience of the parent and the child and side effects experienced, if any. When the data was subjected to statistical analysis, it was observed that both drugs resulted in adequate sedation at the end of 30 min, with oral midazolam providing significantly better anxiolysis. The heart rate and respiratory rate were marginally higher with oral ketamine. The questionnaire revealed a better response with oral midazolam; side effects were more prominent with oral ketamine.
Subject(s)
Administration, Oral , Anesthesia Recovery Period , Anesthesia, Dental , Anesthesia, General , Anxiety, Separation/psychology , Attitude to Health , Child , Child Behavior/drug effects , Child, Preschool , Cooperative Behavior , Dental Anxiety/psychology , Dental Care for Children , Double-Blind Method , Follow-Up Studies , Heart Rate/drug effects , Humans , Hypnotics and Sedatives/administration & dosage , Infusions, Intravenous/psychology , Ketamine/administration & dosage , Masks , Midazolam/administration & dosage , Oxygen/blood , Respiration/drug effectsABSTRACT
El uso de la comunicación terapéutica contribuye para la calidad de la atención de enfermería, sobre todo en los procedimientos que causan miedo y ansiedad en el paciente, tales como la instalación de venoclisis. El objetivo de este estudio fue evaluar la percepción de enfermeras sobre una comunicación terapéutica durante la instalación de venoclisis, mostrada en una simulación filmada. Se realizó estudio descriptivo-exploratorio en una ciudad de México; la población fue de 30 enfermeros y 12 docentes. Los pasos metodológicos fueron: Construcción y validación de un contenido de texto; Filmación del contenido de texto con actores y validación; Presentación del video y aplicación de cuestionario semiestructurado para identificar as técnicas de comunicación terapéutica presentes en la simulación; la percepción de la calidad de la comunicación enfermero-paciente; la percepción de similitudes entre su práctica y la simulación; y las dificultades para utilización de estas técnicas en la práctica cotidiana. Los participantes consideraron "buena" la relación interpersonal mostrada; identificaron técnicas de comunicación terapéutica, que en su mayoría correspondieron a la categoría de descripción de la experiencia y expresión de pensamientos y sentimientos; no se encontraron diferencias sustanciales entre docentes y personal asistencial. La dificultad más referida para utilizar técnicas comunicativas fue el problema del paciente para relacionarse.
The use of therapeutic communication contributes to nursing care quality, mainly in procedures that cause fear and anxiety in patients, such as the installation of endovenous therapy. This study aimed to identify how nurses perceive therapeutic communication during the installation of endovenous therapy, as shown in a filmed simulation. This exploratory-descriptive and comparative study was developed in a Mexican city and involved 30 clinical nurses and 12 nursing faculty. The methodological process was: Construction and validation of textual content; Filming textual content with actors and validation; Presentation of the video to nurses and faculty and application of the semistructured questionnaire to identify therapeutic communication techniques in the simulation; perception of nurse-patient communication quality; perception of similarities between care practice and simulation; and difficulties to use these techniques in daily practice. Participants perceived the interpersonal relationship shown as "good"; they identified therapeutic communication techniques, which mostly corresponded to the description of the experience and expression of thoughts and feelings; no substantial difference was found between the perceptions of educational and care personnel. The most frequent difficulty to use communicative techniques was attributed to patients' problems to establish relations.
O uso da comunicação terapêutica contribui para a qualidade da assistência de enfermagem, sobretudo nos procedimentos que causam medo e ansiedade ao paciente, como a instalação de terapia endovenosa. O trabalho buscou identificar a percepção de enfermeiras sobre uma comunicação terapêutica, durante a instalação de terapia endovenosa, apresentada em uma simulação filmada. Este estudo descritivo-exploratório foi realizado em uma cidade do México com 30 enfermeiros assistenciais e 12 docentes de enfermagem. Os passos metodológicos foram: Construção e validação do texto; Filmagem do texto com atores e validação; Apresentação do vídeo aos enfermeiros e aos docentes e aplicação de questionário semi-estruturado para identificar as técnicas de comunicação terapêutica presentes na simulação; a percepção da qualidade da comunicação enfermeiro-paciente; a percepção de semelhanças entre a sua prática e a simulação; e as dificuldades para utilização destas técnicas na prática cotidiana. Os participantes consideraram como "bom" o relacionamento interpessoal apresentado; identificaram as técnicas de comunicação terapêutica que majoritariamente correspondem à descrição da experiência e expressão de pensamentos e sentimentos; não foram encontradas diferenças substanciais entre docentes e enfermeiros. A dificuldade mais freqüente para utilizar técnicas comunicativas foi atribuída aos problemas do paciente para se relacionar.