Supported self-care for children and adolescents with chronic disease and their families

Factors related to quality of life in children with chronic illness from their own perspectives: A cross-sectional study

PURPOSE

This study aims to explore the demographic, clinical, and psychological factors that influence the quality of life in children with chronic illnesses.

DESIGN AND METHODS

A descriptive, cross-sectional study was conducted between February and July 2023. The sample consisted of 120 pediatric patients, aged 7 to 18 years, diagnosed with chronic illnesses and treated in outpatient and inpatient wards. Participants were selected using purposive sampling based on specific inclusion and exclusion criteria. Data were collected using 11 validated questionnaires covering demographic, clinical, and psychological factors, as well as the Pediatric Quality of Life Inventory (PedsQL). Data were analyzed using t-tests, ANOVA, and multivariate linear regression to identify the most influential factors on children's quality of life, with a significance threshold set at p < 0.05.

RESULTS

Gender, age, duration of illness, disease symptoms, and pain level were significantly correlated with children's quality of life (p < 0.05). Another factors like self-efficacy, self-concept, and role function had a strong positive impact (p < 0.01), while coping mechanisms, resilience, self-esteem, and family support showed no significant effect. Duration of illness was the most influential factor (B = 0.969).

CONCLUSIONS

Children's quality of life is strongly influenced by factors like gender, age, illness duration, symptoms, self-efficacy, self-concept, and role function, with illness duration having the greatest impact.

PRACTICE IMPLICATIONS

Healthcare providers should take a holistic approach, addressing clinical, demographic, and psychosocial factors, with special attention to children with longer illness durations, as this greatly affects their quality of life.

Taking care of myself in a different and broken world: self-care practices of adolescents on dialysis

PURPOSE

Being on dialysis is a traumatic situation particularly during adolescence. Therefore, adolescents must have self-care support according to their special needs. The goal of this study was to describe the adolescents´ self-care practices when they are on dialysis. This paper reports only the adolescents´ selfcare practices based on the health care team guidelines but adjusted to their beliefs and habits.

METHODS

The methodology of the study was interpretive phenomenology. In-depth interviews were conducted with 15 adolescents; Smith´s IPA procedure was used for data analysis.

RESULTS

Being on dialysis meant to the adolescents living in a different and broken world. Self-care practices included: 1) coexisting with the dialysis slavery or being attached to a machine day or night, 2) struggling with the maddening thirst experience, 3) Deciding what, when and how much food to eat, 4) taking care of an alien that helps to survive, 5) taking the medicines when feeling in need of them.

CONCLUSION

The adolescents tried to care for themselves adjusting their care activities to the health team´s recommendations. However, they also adjusted those practices to their beliefs and habits, which allows them to live with dialysis in a less traumatic way.

Quality of child and adolescent care transitions considering the presence of chronic disease

OBJECTIVES

to analyze the quality of child and adolescent care transitions from hospital to home, considering the presence of chronic disease.

METHODS

quantitative, cross-sectional study, carried out from February to September 2019 in two hospitals in the south of Brazil. We used an instrument to characterize participants and the Care Transitions Measure (CTM-15) for the legal tutors of children and adolescents that were discharged from the institutions.

RESULTS

the general mean of the quality of transition of care was 87.9 (SD=13.4), in a scale from 0 to100). We found a significant difference in the quality of transition of care when comparing patients with and without chronic disease (90.0 and 84.3; p=0.001).

CONCLUSIONS

we found the quality of the transition of care to be satisfactory, with better results for patients with chronic disease. This can help understand the most impactful aspects in the transition of care, especially in regard to children health.

Health care network (dis)articulation in late and moderate prematurity

OBJECTIVE

to analyze the Health Care Network (dis)articulation of late and moderate premature infants in the first year of life.

METHOD

a qualitative study with semi-structured interview, which addressed the care network constitution in a municipality in southern Brazil. Fifteen mothers of infants participated. Thematic content analysis and flowchart were used to describe networks and services.

RESULTS

first contact in Primary Health Care is a decisive factor for the recognition and articulation of neonates/infants in the network and enables resolution, especially in childcare demands. Secondary and hospital care services support isolated acute events or chronic conditions, without articulation between levels of care and in a uniprofessional way.

FINAL CONSIDERATIONS

attention to health conditions is organized and structured in a uniprofessional, fragmented and disjointed way, which makes it impossible to form a Health Care Network premature infants' perspective.

Family management ofchildren who experience sickle cell disease: a qualitative study

OBJECTIVE

to know the family management experience of children with sickle cell disease in the light of the Family Management Style Framework.

METHODS

a qualitative case study carried out between September/2015 and July/2016 with 12 members of eight families registered in a blood center in Minas Gerais. The semi-structured interviews were recorded, and the data were analyzed and interpreted by the hybrid model thematic analysis.

RESULTS

three management styles were identified: five families in the accommodating style; two families in the struggling style; and only one family in the enduring style.It was noted that empowerment was paramount in the acquisition of skills and abilities to care for these children.

FINAL CONSIDERATIONS

family management knowledge of children with sickle cell disease provided a reflection on nurses' role in supporting, orienting and encouraging the empowerment of these families aiming at the search for comprehensive care.

Social network of children with cronic disease: knowledge and practice of nursing

OBJECTIVES

To identify the knowledge and practice of primary care nurses about the social network approach for families of children with chronic diseases.

METHODS

Qualitative research, conducted by means of interviews with 23 family health nurses, from one municipality in Paraíba and one in Rio de Janeiro, from June to July of 2017. The data were interpreted using thematic analysis.

RESULTS

Social network meant institutional support offered by services outside the unit, and socioeconomic problems involved the family context. In practice, nurses find it difficult to provide comprehensive care and establish ties with families. When referring to other professionals, a weakness in the counter-referral to the family health unit is found.

FINAL CONSIDERATIONS

Some gaps were found regarding the knowledge and practice of nurses regarding the social network approach, which requires professional training to strengthen social relationships and the necessary support for families of children with chronic diseases.

SUPPORTED SELF-CARE ACTIONS FOR CHILDREN AND TEENAGERS WITH CHRONIC DISEASES

ABSTRACT Objective: to analyze actions of Primary Health Care teams from the perspective of supported self-care for children and adolescents with chronic diseases. Method: a qualitative study, conducted between April and August 2016, with 11 primary care professionals from a municipality of Paraíba, Brazil. A semi-structured interview supported data collection; and a thematic analysis backed interpretation, which categorized the actions according to the 5 A ́s methodology (Evaluation, Guidance, Agreement, Assistance, Follow-up). Results: there were insufficient actions in the specific care plans. Isolated interventions are performed including: assessment of barriers to self-care and emotional state of the individual; provision of information on signs, symptoms of disease and treatment; stimulating the search for community resources; actions inherent to professional training; and follow-up by active search and home visits. Conclusions: actions in Primary Health Care do not yet value the active and co-responsible role of the individual in the control of their disease, with gaps to be overcome in the five pillars of supported self-care. Intervention studies are recommended that train professionals regarding supported self-care of these individuals.

Nurses' perspective on health education in Diabetes Mellitus Care

ABSTRACT Objective: to grasp the perspective of nurses on health education in the process of caring for people with Diabetes Mellitus in Primary Care. Method: a descriptive study of a qualitative nature carried out with 13 nurses from the Family Health Strategy in Southern Brazil. The data were collected in November and December of 2017, through recorded interviews, which were submitted to content analysis, thematic modality. Results: three categories emerged, which show from the perspective of nurses, the influence of structural and assistance characteristics in the development of educational actions; outcomes of these actions, and possibilities to increase their quality as central to the nursing action. Final considerations: there are still gaps in the structuring of public health policies, especially in the process of managing and caring for people with diabetes, which limits quantitatively and qualitatively the development of educational actions in Primary Care.