Bárbara Radieddine Guimarães

Objectives: to analyze appreciation and coping strategies of children hospitalized for COVID-19 and their primary caregivers during the illness and hospitalization process. Methods: a qualitative and exploratory study, based on the McCubbin & McCubbin model (1993), with 25 participants: ten children hospitalized for COVID-19 and 15 primary caregivers. A semi-structured interview was used, and data were subjected to reflective thematic analysis. Results: children reported a predominantly negative appreciation of hospitalization, marked by fear, homesickness, pain, and discomfort with hospital routine. Their coping strategies included play, electronic devices, hygiene, and adherence to treatment. Caregivers also expressed negative assessments related to fear of death, isolation, and distress. Their strategies involved spirituality, religiosity, love for their children, and support from professionals and family members. Final Considerations: coping strategies differed between children and caregivers, highlighting the importance of care sensitive to the dyad’s needs.

RESUMO Objetivos: analisar a apreciação e as estratégias de coping de crianças hospitalizadas por COVID-19 e de suas cuidadoras primárias durante o processo de adoecimento e internação. Métodos: estudo qualitativo e exploratório, baseado no modelo de McCubbin &, McCubbin (1993), com 25 participantes: dez crianças hospitalizadas por COVID-19 e 15 cuidadoras primárias. Utilizou-se entrevista semiestruturada cujos dados foram submetidos à análise temática reflexiva. Resultados: as crianças relataram apreciação predominantemente negativa da hospitalização, marcada por medo, saudade, dor e desconforto com a rotina hospitalar. Suas estratégias de coping incluíram brincadeiras, dispositivos eletrônicos, higiene e adesão ao tratamento. Cuidadores também expressaram avaliações negativas relacionadas ao medo de morte, isolamento e angústia. Suas estratégias envolveram espiritualidade, religiosidade, amor pelos filhos e apoio de profissionais e familiares. Considerações Finais: as estratégias de coping diferiram entre crianças e cuidadores, ressaltando a importância de cuidados sensíveis às necessidades da díade.

O objetivo da presente pesquisa foi analisar as fraquezas e ameaças para a implementação das atividades de vacinação de alta qualidade, por estado, no Brasil. Trata-se de uma análise qualitativa de conteúdo direta das fraquezas e ameaças identificadas por 17 estados brasileiros, a partir da matriz Forças, Oportunidades, Fraquezas e Ameaças (FOFA), no período de 24 de novembro de 2023 a 17 de janeiro de 2024. Emergiram quatro temas empíricos principais: processo de trabalho, recursos humanos; organização do território; e sistemas de informação e comunicação. Destaca-se que as fraquezas e ameaças se sobrepuseram, sendo as principais: dificuldades na organização e ações do microplanejamento; monitoramento; qualificação da equipe; participação de atores externos à equipe; número de profissionais; estrutura física; e reconhecimento de populações vulneráveis e da situação vacinal. A utilização da matriz FOFA mostrou-se relevante para a identificação de fraquezas e ameaças na implementação do microplanejamento.

Objective: To analyze problem-solving and coping strategies of parents of children with Down Syndrome in family adaptation. Method: This is a qualitative research that used the Resiliency Model of Family Stress, Adjustment, and Adaptation. Participants were mothers and/or fathers from 40 families of children aged 1 to 7 years diagnosed with DS. Directed content analysis was performed, supported by software and considering a code dictionary. Results: Problem-solving and coping proved to be a set of actions, behaviors, efforts, and communications that contributed to family adaptation and favored balance between the demands imposed by Down Syndrome and the acquisition of resources by the family. Conclusion: In the first moment, which corresponds to the time of news or diagnosis of the syndrome and the first days after birth, internal and external resources, which represent coping, are developed to accept and refocus ideas and feelings towards Down Syndrome. Over time these resources have an effect and cause changes in family functioning patterns and in the relationship of these families with the outside world, as they seek child development.

Objectives: to identify predisposing and enabling factors as well as the health needs associated with the discontinuance of outpatient follow-up of newborns who were hospitalized at neonatal intensive care unit. Methods: cross-sectional study, using the behavioral model of health services use. The study was composed of 358 mothers and newborns referred to the outpatient follow-up after discharge. Characterization, perception of social support, postnatal depression, and attendance to appointments data were collected, analyzed by the R software (3.3.1). Results: outpatient follow-up was discontinued by 31.28% of children in the first year after discharge. In multiple regression analysis, the chance of discontinuance was higher for newborns who used mechanical ventilation (OR = 1.68; 95%CI 1.04-2.72) and depended on technology (OR = 3.54; 95%CI 1.32-9.5). Conclusions: predisposing factors were associated with the discontinuance of follow-up; enabling factors and health needs did not present a significant association. Children with more complex health conditions require additional support to participate in follow-up programs, thus ensuring the continuity of care.

Objective: to identify aspects that contribute to the discontinuation of outpatient follow-up of newborns from Neonatal Intensive Care Units (NICU) from the perspective of mothers. Method: exploratory, qualitative study, whose theoretical framework was Symbolic Interactionism. Fifteen mothers of children with NICU who discontinued outpatient follow-up in Belo Horizonte-MG were included in a semi-structured interview. Data were analyzed based on the proposal of Hsieh and Shannon. Results: distance from the health service, absence of family support, difficulty in leaving work, maternal health status, organization of the health service itself and deficiency of public transportation were predisposing factors for outpatient abandonment. Mothers understand that their children do not need differentiated care of children at usual risk. Conclusion: service organization, socioeconomic status of the family and social support perceived by mothers were related with the lack of compliance with outpatient follow-up.