O cuidado da família à criança em uso de cânula de traqueostomia no domicílio: as vozes dos familiares cuidadores

• Autor(a) principal: Bossa, Priscila Machado de Araujo
• Data de Publicação: 2017
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/11432
• topic: Pediatric Nursing; Child Health; Tracheostomy; Caregivers; Enfermagem Pediátrica; Saúde da Criança; Traqueostomia; Cuidadores; CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM

The child with a tracheostomy tube shows an inherent fragility originated from the exposure of the lower airways through the stoma and the constant presence of the tube, and when, at home, requires continued monitoring and, above all, specific care on the part of the family caregivers with the purpose of preserving life and providing welfare for their children. Study object: the care of the family to the child with a tracheostomy tube at home. Objectives: to describe the care related to the maintenance of life held by the family caregivers to the children with tracheostomy tubes at home; to identify the challenges faced by relatives to care for the child with a tracheostomy tube; to analyze the strategies used by the family caregivers to overcome these challenges. Methodology: it is a descriptive study with a qualitative approach. The scenario was a pediatric outpatient facility that assists children in chronic conditions in the city of Rio de Janeiro, and the participants were 8 family caregivers of children with tracheostomy tubes, aged between 3 and 9. Data were collected through semi-structured interviews, from January 2015 to May 2016, analyzed according to the content analysis proposed by Bardin, and then interpreted in the perspective of the conceptions of care prescribed by Collière. The results gave rise to two categories: The care developed by the family caregivers to the child with a tracheostomy tube and The challenges and strategies of the family caregivers in relation to the care of the child with a tracheostomy tube . The first category includes: the care during bath; the care related to the maintenance of the tracheostomy tube and the care held for the aspiration of the airways. The second encompasses: the challenges of dealing with the new; in the care of the child; in the acquisition of materials and challenges related to leisure. The demands for care of the child with a tracheostomy tube are complex, with significant repercussions on the family routine, but they enable the preservation of the permeability of the airways of their children, thereby avoiding possible obstructions and injuries caused by the constant moisture of the skin with presence of pulmonary mucus in contact with the fixative lace. As for the challenges, these were related to the new condition of the child, the handling of the device, the lack of structure for the development of care, the frequent presence of tracheal secretion, the concern about the tube removal, mainly at the time to switch the fixative lace, as well as the fear of obstruction of the tracheostomy tube. In order to confront the challenges in the home environment, the family caregivers reinvent the care strategies with the purpose of preserving the life of the child. Nevertheless, the care actions are sometimes inappropriate, which jeopardizes the health of their children. Conclusion: the nursing staff needs to rethink and articulate its daily practice in order to redirect its praxis and actions, in the holistic sense, where the health of the child is seen in the family and community environment, thereby developing educational actions appropriate to the actual needs of the child and of its family and involving it in the care process.