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Objective: To evaluate the effect of the application of a warm compress in association with the prescribed antipyretic drug compared to the effect of the prescribed antipyretic alone, in reducing fever in hospitalized children. Method: This is a pilot randomized clinical trial performed in pediatric units of a secondary-level hospital. The convenience sample consisted of 33 children with axillary temperature greater than or equal to 37.8°C (100°F), randomized to the control group (antipyretics) or intervention group (antipyretics + warm compresses). Temperature was monitored in both groups for 3 hours and data were collected using standardized instruments, analyzed using Mann Whitney, Fisher’s Exact, Chi-Square, and ANOVA tests. Results: The control group consisted of 17 children and the intervention group of 16 children. The temperature of all children decreased over time, with progressive attenuation, with a lower final mean in the control group (p=0.035). In the intervention group, irritability and crying were observed in 12.5% of the children. Conclusion: The application of warm compresses in association with antipyretics was not effective in reducing fever in hospitalized children compared to the use of pharmacological measures alone. Clinical trial registration protocol: UTN-U1111-1229-1599. RESUMEN Objetivo: Evaluar el efecto de la aplicación de compresa tibia en la asociación al antitérmico prescripto en comparación al efecto aislado del antitérmico prescrito, en la reducción de la fiebre en niños hospitalizados. Método: Ensayo clínico aleatorizado del tipo piloto, realizado en unidades pediátricas de un hospital de nivel secundario. La muestra, de conveniencia, fue compuesta por 33 niños con temperatura axilar superior o igual a 37,8°C, aleatorizados para el grupo control (antitérmicos) o grupo intervención (antitérmicos + compresas tibias). La temperatura fue monitoreada en ambos grupos durante 03 horas y los datos fueron recolectados a través de instrumentos padronizados y analizados por medio de las pruebas Mann Whitney, Exacta de Fisher, Chi-Cuadrada y ANOVA. Resultados: El grupo control fue compuesto por 17 niños y el grupo intervención por 16 niños. La temperatura de todos los niños bajó con el tiempo, con atenuación progresiva, con promedio final inferior en el grupo control (p=0,035). En el grupo intervención se observó irritabilidad y lloro en el 12,5% de los niños. Conclusión: La aplicación de compresa tibia en asociación al antitérmico no se mostró eficaz en la reducción de la fiebre en niños hospitalizados en comparación al uso de medidas farmacológicas aisladas. Protocolo de registro de ensayos clínicos: UTN-U1111-1229-1599. RESUMO Objetivo: Avaliar o efeito da aplicação da compressa morna em associação ao antitérmico prescrito em comparação ao efeito isolado do antitérmico prescrito, na redução da febre em crianças hospitalizadas. Método: Ensaio clínico randomizado do tipo piloto, realizado em unidades pediátricas de um hospital de nível secundário. A amostra, de conveniência, foi composta por 33 crianças com temperatura axilar maior ou igual a 37,8°C, randomizadas para o grupo controle (antitérmicos) ou grupo intervenção (antitérmicos + compressas mornas). A temperatura foi monitorada em ambos os grupos durante 03 horas e os dados foram coletados por meio de instrumentos padronizados e analisados por meio dos testes Mann Whitney, Exato de Fisher, Qui-Quadrado e ANOVA. Resultados: O grupo controle foi composto por 17 crianças e o grupo intervenção por 16 crianças. A temperatura de todas as crianças diminuiu com o tempo, com atenuação progressiva, com média final menor no grupo controle (p=0,035). No grupo intervenção observou-se irritabilidade e choro em 12,5% das crianças. Conclusão A aplicação de compressa morna em associação ao antitérmico não se mostrou eficaz na redução da febre em crianças hospitalizadas em comparação ao uso de medidas farmacológicas isoladas. Protocolo de registro do ensaio clínico: UTN-U1111-1229-1599.

To learn about the adaptation process of family members when experiencing their child's hospitalization in an Intensive Care Unit.A qualitative, descriptive and exploratory study conducted at the Pediatrics Unit with family members of children from the Pediatric Intensive Care Unit. The thematic analysis technique was used.Thirteen (13) family members, 12 mothers and one father participated. The following categories emerged from the results: Family impact on children's hospitalization in a Pediatric Intensive Care Unit and Mechanisms for adapting family members to hospitalization in a Pediatric Intensive Care Unit.The mechanisms adopted by the family in the process of adapting the child to admission to the Pediatric Intensive Care Unit were: positive thinking, understanding the treatment and the operation of the unit. Health professionals can offer strategies to the family in order to make hospitalization less traumatic, making it possible to share experiences and expand the knowledge of those involved.Conhecer o processo de adaptação de familiares ao vivenciar a internação da criança em uma Unidade de Terapia Intensiva.Pesquisa qualitativa, descritiva e exploratória, realizada na Unidade de Pediatria, com familiares de crianças provenientes da Unidade de Terapia Intensiva Pediátrica. Utilizou-se a análise temática.Participaram 13 familiares, 12 mães e um pai. Dos resultados emergiram as categorias: Impacto da família frente à internação infantil em Unidade de Terapia Intensiva Pediátrica e Mecanismos de adaptação de familiares à internação em uma Unidade de Terapia Intensiva Pediátrica.Os mecanismos adotados pela família no processo de adaptação da criança a internação na Unidade de Terapia Intensiva Pediátrica foram: pensamento positivo, entendimento do tratamento e de funcionamento da unidade. Os profissionais de saúde podem oferecer estratégias à família a fim de tornar a internação menos traumática, possibilitando o compartilhamento das experiências e a ampliação do conhecimento dos envolvidos.Conocer el proceso de adaptación de familiares que vivencian el internamiento del niño en una Unidad de Terapia Intensiva.Investigación cualitativa, descriptiva y exploratoria, realizada en la Unidad de Pediatría, con familiares de los niños provenientes de la Unidad de Terapia Intensiva Pediátrica. Utilizó se el análisis temático.Participaron 13 familiares, 12 madres y 1 padre. De los resultados emergieran las categorías: Impacto de la familia frente al internamiento infantil en una Unidad de Terapia Intensiva Pediátrica y Mecanismos de adaptación de los familiares al internamiento en una Unidad de Terapia Intensiva Pediátrica.Los mecanismos adoptados por la familia en el proceso de adaptación del niño en la Unidad de Terapia Intensiva Pediátrica fueran: pensamiento positivo, entendimiento del tratamiento y del funcionamiento de la unidad. Los profesionales de la salud pueden ofrecer estrategias a la familia para tornar el internamiento menos traumático, posibilitando el compartiendo de las experiencias y la ampliación de lo conocimiento de los participantes envueltos.

Objective:to describe the behavior of children during the instructional session of therapeutic play (ITP) in the preoperative period and to verify the behavior presented by them during the perioperative period. Methods: Exploratory descriptive study with a quantitative approach, developed in a large private hospital in Sao Paulo, in which the behaviors presented by 30 children between three and five years old, undergoing minor surgery were seen at the hospital during the session of TP and in the surgical center, from admission to awaken from anesthesia. Results: Most children participated in the ITP session (21; 70%), entered the surgical room spontaneously (22; 73.3%) without resisting mother separation (24; 80%), collaborating with the anesthetic procedure (16; 53.3%) and quietly awakening from anesthesia (26; 87%). Conclusion: The use of ITP led the child to understand the surgical procedure, making it less traumatic. Objetivo:Describir el comportamiento de los niños durante una sesión de juego terapéutico instruccional en el periodo preoperatorio y verificar el comportamiento mostrado en el periodo intraoperatorio. Método: Estudio descriptivo, exploratorio, de abordaje cuantitativo, desarrollado en un hospital privado en la ciudad de São Paulo. Se observaron los comportamientos de 30 niños entre los 3 y los 5 años sometidos a cirugías menores durante la sesión de juego instruccional realizada en la unidad de internación y en el quirófano, desde su admisión en el hospital hasta el despertar de la anestesia. Resultados: La mayoría de los niños participaron efectivamente de la sesión de juego terapéutico instruccional (21; 70%), el 73% entró espontáneamente en el quirófano, el 80% no se resistió a la separación de la madre, el 53,3% colaboró con el procedimiento anestésico y el 87% despertó tranquilamente de la anestesia. Conclusión: El uso del juego terapéutico instruccional ayudó a los niños a entender el procedimiento quirúrgico, haciéndolo menos traumático.

The purpose of the present study was to identify, according to the mothers' perspective, the benefits related to her permanence and participation in the care for her child hospitalized at a Pediatric Intensive Care Unit (PICU). The theoretical framework was Cross-cultural Nursing Theory, and the methodological framework was the assistant convergent research approach. Data was collected from six mothers of children hospitalized at a PICU of a University Hospital, in the period from January to May 2007, through interviews and active observation. Analysis was conducted following four generic processes: collection, synthesis, theorization and application. The results evidenced that the mothers' presence and care increased the attachment between mother and child, increased mothers' confidence, and made the child calmer. This produced positive feelings such as joy and satisfaction for being able to care for their child. Nurses should review their behavior toward the mothers accompanying their child at the hospital, and adopt attitudes that support her participation in the care for her hospitalized child.

The objective of this study was to understand the vulnerability experienced by the family of children hospitalized in a Pediatric Intensive Care Unit (PICU). The Symbolic Interactionism and the Concept of Family Vulnerability were the frameworks used to understand this experience. Qualitative Content Analysis was used. Data was collected through interviews and observation with 11 families of children hospitalized in a PICU of a university hospital in São Paulo. Six analytical categories regarding the family experience emerged. The categories were compared to the conceptual categories of Family and Vulnerability, and revealed the elements that defined the concept within this context. The child's hospitalization in a PICU triggers intense suffering within the family, as it refers to the possibility of losing their child. Thus, the power and the autonomy of the family in relation to their child are reduced, intensifying the feeling of vulnerability.

This study has the objective of understanding the existential experience of mothers of children hospitalized in an intensive pediatric care unit (IPCU). It is a qualitative-based research grounded on the humanistic nursing theory. The investigation scenario was the IPCU of a public hospital. Five mothers of children who were hospitalized in the referred unit participated in the investigation. Data were analyzed from the standpoint of the five phases of the phenomenological nursing. The following issues emerged from the collected statements: the relationship between mothers and nursing professionals at the moment of admission and throughout the child's hospitalization period in the IPCU; and mothers who experience fear, despair and loneliness in face of the child's disease. The present study highlights the complexity of a mother-centered approach and subsidizes a new look at the field of the care, teaching and nursing research.

The objective of this study was to describe scholars' feelings in terms of hospitalization, and discuss on their perception about hospitalization. It is a qualitative study performed using semi-structured interviews and recordings based on the following atopic for analysis: feelings and perceptions reported by scholars during hospitalization. It was found that the feelings reported by scholars during hospitalization are those of restriction, fear, pain, preoccupation, missing home and others, and anxiety. Most scholars see hospitalization as something negative, though they also report positive aspects such as receiving exclusive affection from their mothers, having access to foods they usually do not have at home and compensations they receive for being ill. Playing emerged as an important activity that alleviates the negative aspects of hospitalization. In conclusion, despite having negative feelings, scholars are able to realize that hospitalization is important for their recovery.

Childhood is a phase that requires much attention from the family and the health service, because family members, besides depending on relatives, are vulnerable to the environment. The objective of this study was to describe the experiences of relatives of children hospitalized in an emergency care service, discuss on how those experiences affect the everyday life of the family and report the aspects that interfere in the nursing care. This descriptive study was performed using a qualitative approach, and was developed in a private emergency hospital. Interviews were performed with ten family members to obtain the data. The data was submitted to thematic analysis, and three categories were elaborated: experiences of the family member, changes in the everyday life of the family, the faith of the family and their closeness as facilitating agents. In conclusion, the person accompanying the patient goes thorough adaptations, whilst experiencing hospitalization, with changes to the routine of the family. However, because of the conflicts experienced by the family member, nursing should see them as a subject of the extended care.

The objective of this qualitative study was to understand the perception that families of hospitalized children with chronic illness about their being away from the process of education. The empirical material was produced by means of interviews performed with families of hospitalized children with chronic illness. The data was analyzed based on the principles of thematic analysis. Among other aspects, the data showed the lack of systematized pedagogical actions in the studied hospital, in a way that the educational activities that were developed were seen as a moment of leisure. We understand that the hospital class is becoming an important health care technology for hospitalized children. Therefore, it requires support, especially from the Departments of Education, in terms of providing the necessary human resources, funding and materials. This is a pioneer study, capable of helping improve the quality of life of children with chronic illness.

The objective of this study was to learn about the experience of suffering in hospitalized school-aged children. The methodological strategy used was narrative inquiry, and the Model of Suffering as the theoretical framework. Participants were 14 children. Data collection was performed using semi-structured interviews, guided by the following question: Tell me your story about getting sick and coming to the hospital. Results show that hospital events comprise the child's experience of suffering, represented by five categories: knowing the suffering caused by the disease; enduring to survive the experience of being ill, relaxing from enduring to free their emotions, living the suffering, and floating between enduring and suffering. The suffering or enduring of the child is determined by the context of the experience and by the support or interactions that surrounds them. In conclusion, nurses have the duty to offer children opportunities to express themselves and make the suffering bearable.

This study presents a qualitative approach, and used the method of Simple Observation. It was carried out with eight children who were hospitalized in two pediatric units of a school hospital in São Paulo. Its purpose was to learn the stimulating elements for the development of a child in a hospital environment. Besides, it aimed at motivating nursing professionals to adapt the hospital environment to the child. After the analysis of the collected data, categories were organized as: stimulating objects and situations, procedures and inter-relationships. The conclusion is that the nursing team performs an important role as one of the stimulating elements in the hospitalized child care, since they are aware of this role.

Care for the emotional needs of hospitalized children has had the attention of nursing professionals in Brazil, although not as a general rule. The chance to play is known as a relief from suffering, especially in childhood, which justifies the importance of this theme. This study had the objective of analyzing Brazilian nurses' academic production on the use of toys during the attention to children in hospitals in strictu sensu Graduate programs. Data were taken from Portal CAPES, CEPEn, IBICT and papers' references. Of the 15 theses/dissertations found in the literature only 14 are available; they were analyzed and comprise the corpus of this study. It was found that toys have been used mostly in pre and postsurgery, by Nursing professors, with preschool and school age children, parents and nurses. All of the works reinforce the positive results of toys' use. We recommend to pediatric nurses the use of toys in all institutions where children need care.

Hospitalization may have negative effects on child development and behavior. Thus the aim of this work was to evaluate the behavior during the hospitalization of 7- to 10-year-old children, before and after art therapy intervention. It was proposed a quasi-experimental plan with a control group (n=10) and a group that was submitted to art therapy intervention (n=10). Results show that these interventions were effective in improving the behavior of the children. Hospitals can also be stimulating environments for children if they offer them health care practices that go beyond the disease.

In this paper we present a report of a clinical situation in which we identified the vulnerability of the family, propitiating to pediatric nurses the use of this concept in their practice and intervention with families. The study was carried out with a family that was going through a situation of a child illness and hospitalization. The vulnerability was identified in the interactions of family members with the illness, with other family members and with the health staff, and served as a guide for planning the nursing assistance. The interventions led to the strengthening of the family to face the situation and, for pediatric nurses, the recognition of the importance of using the results of theoretical research in their professional practice.

This study was aimed at comprehending the meaning of being hospitalized for pre-school children. The theoretical references were the Symbolic Interactionism and Vygotsky's theory on the child's symbolic play. The methodological referential was the Theory Based on Data. Eleven children between the ages of 3 and 6 took part in the survey. The strategies for data collection were: participative observation, interviews with the children mediated by the Therapeutic Toy, and interviews with the mothers. The analysis of the data made possible the construction of the technical model Growing up with the mother's protective presence, which puts in evidence the vulnerability, the child's force and the protection given by the mother to face the mystery and the fear of hospitalization.

The study had as objective to identify the hospitalized children's perception, in school age, about the accomplishment of exams. The research of descriptive nature was used, prevailing the investigation of qualitative character. The results revealed that the children cooperate with exams despite the fear. The fear was related to the dread of the physical pain, being hurt, or even the unknown. It is considered that the child notes the exam accomplishment as part of his/ her treatment and he/she would like to receive explanations about the procedure.

The factors that do or don't support the permanence of accompanying mothers in a pediatric unit were evaluated. Six interviews were held with the mothers and analyzed according to the themes. The factors that support the accompanying mother are: count on presence of other family members (mainly the child's father), the possibility of free meals at the hospital; trust the hospital team and being heeded by this team. The factors that don't support the mother are: child's illness; worry about other responsibilities (other children and house chores) impossibility to sleep and rest; lack of attention from the hospital team and the impossibility to receive visits.

This study was conducted with live-in mother in university hospital. The objectives were as follows: to understand the experienced interactions, to identify the meanings that a family attribute to the experience of going through the child's hospitalization, to identify what the experience of hospitalization provokes in the family life and construct a model theory representative of the experience. Reference Theory the Symbolic Interactionism and Reference Methodology Grounded Theory had been utilized. From results appeared the phenomenon Going in search of solution and Going through a difficult situation. Through these phenomena, the main category Experiencing a difficult and revealing passage with her child was identified.

Playing is one of the essential activities for the physical, emotional and social development to the child. Although the recognized importance of this activity, during the hospitalization process it is little value, so it is not find out between the foreseen therapeutic actions that are preview. The goal of this paper is discuss the theory and practice principles to subsidize the utilization of play in the aid to the hospitalization children. The empiric data collection was realized through the participant observation of 11 children who were intern in a pediatric unit of a teaching hospital of State of São Paulo up country. We identify that the act to play has repercussions in the child, nurse and hospital. To the child it is not obstruct the development; help it in the understanding about what is occurring with itself and discharge fear, tension, anxiety and frustration; promote satisfaction, funny and spontaneity and allows it transforms experiences that should support inactive in active discharge. To the nurse it is a tool of intervention and a way of communication, that allows detect the uniqueness of each child. Related to the hospital, change the current view that is only a pain and suffering place.

This study was intended to analyse the experience of the father who have a child in an Intensive Care Unit, by applying the qualitative research under the phenomenological perspective of Martin Heidegger, it was to identify three themes which figured that experience: Transforming the fear into hope, Perceiving himself as the person who decides and Acting for his child benefit. These themes unveiled the phenomenon SEARCHING A CHANCE FOR THE CHILD TO BECOME, who reveals that submits his child to risks and to essential treatments while continuously unchanging overcomes his own feelings in order to offer to his child an opportunity of full living.

This study review the of role the caretaker at the pediatric unit while the child is in hospital. The opinions of caretaker and nurses were surveyed as for the role that the participating family member would have during their stay along with the child in hospital. Data were gathered between April and June 1997 in units allowing for children to stay together with caretaker, at state hospitals. The interviews with the groups were separated by meas of the stafement analysis, based on the studies by COSTA (1992), and FRIEDMAN (1986), which allowed us to determine six categories: SecurityProtection, Caretaking, Recovery, Knowledge, Supervision and Guidance, which in turn allowed us to study, although in a modest fashion, the agreements and disagreements regarding how our interviews perceive the role of the caretaker.

The aim of this study was evaluate the utilization of tools for pain perception assessment in 41 hospitalized pre-school children submitted to painful procedures: care of wounds or blood extraction. The utilized tools were the faces scale, behavioral indicators and words which describe the pain. Most of the pre-schoolers understood and correctly answered to the faces scale, which can be noticed by the crescent movement 0 (no pain) 4 (maximum pain) during the choice of faces before and after the painful procedure. Crying, immortality and forehead wrinkling were the predominant behavioral indicators, intensified during the procedure. Pre-schoolers verbalizations about their pain showed up to be concrete terms or evaluative-indicative nature, resulting in variable or weakly precise concepts.

This study describes a phenomenological analysis of a nursing under graduated student's discourse, who used the therapeutic play for caring a hospitalized child. The goal of the study was to understand the meaning of the experience for this student.

This work focus the importance of the relationship existent between the multiprofessional staff, the hospitalized child and the responsible. The authors identify and comment about the positive and negative points of the pediatric units studied, as well as the orientations given by the staff and assimilated by the children and responsibles. Multiprofessional relationship X child X responsible: challenge to the staff.

The present work reports an initial process of nursing assistance systematization developed in a Pediatric Unit of a medium size hospital in São Carlos-SP, considering the actual human resources and the type of approach adopted by the institution on the assistance given to the hospitalized child. A Routine Manual was elaborated based on the literature and with the staff participation, and after that, a training was realized with these employees, starting from routines previously sketched, using groupal dynamics that looked forward to rescue the knowledge that they already had about the themes. The work considered the employees opinion about their participation in the systematization process.

The objective of this work is to describe the effect of massage done by parents on the reaction to venous puncture of preschooler and school age child hospitalized. Children's reactions were evaluated through the data of vital parameters, non-verbal communication and verbalization. The results obtained indicated that massage had significant effect in non-verbal reactions, especially those related to muscular relaxation. Effects on the reaction of vital parameters showed no difference between the two procedures, with and without massage, realized on the same child.

In this paper the author presents the essentials of the psychologically preparation of the child and his family for surgical procedures, discussing as well other relevant factors, such as: what to consider to make an appropriate preparation; necessary resources to implement it; when, where and how to do it, and also what to expect from the appropriately prepared child.

This study, was accomplished with 20 school-age children hospitalized in pediatric units. The goals were: how children expressed their perception of the illness and the hospitalization; what sources were available to obtain knowledge about their experience of illness and hospitalization and what were their interest and concerns.

This work describes the realization and the results of one experimental research accomplished with children from 3 to 5 years of age, recently-hospitalized using the therapeutic-play. The results showed that it helped children behave more according to what is expected of this 3-5 age group, as well as show signs that they had adapted or presented ego strength.