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Introdução: compreender como profissionais da Estratégia Saúde da Família percebem a intoxicação infantil e as práticas de cuidado desenvolvidas em comunidade em situação de vulnerabilidade social. Métodos: pesquisa de abordagem qualitativa baseada no referencial dialógico de Paulo Freire. Foi desenvolvida por entrevistas face a face, com 15 profissionais integrantes de equipes da Estratégia Saúde da Família de um município do Noroeste do Paraná, Brasil. As entrevistas foram áudio gravadas, transcritas e submetidas à Análise de Conteúdo de Bardin. Resultados: as percepções foram articuladas em três categorias temáticas: Intoxicações infantis e o ambiente domiciliar: como os acidentes ocorrem; Prática profissional para atendimento, encaminhamento e prevenção das intoxicações infantis; e Limites para a prática de promoção e prevenção das intoxicações infantis no território. Conclusão: as percepções revelam os profissionais não considerarem a família inserida em um contexto sociocultural como centro da ação profissional, poucos referiam ao cuidado no contexto da promoção da saúde e prevenção.

Resumo Introdução A avaliação de programas pode nortear a tomada de decisão de gestores. Objetivo Analisar o Índice de Implementação (II) da Rede Mãe Paranaense (RMP). Método Pesquisa quantitativa retrospectiva realizada em três Regionais de Saúde (RS) do Paraná, Brasil, totalizando 55 municípios. Construíram-se indicadores de avaliação antes (2010-2011) e depois (2012-2013) da implementação da Rede. Estabeleceram-se cinco domínios com variáveis coletadas no Sisprenatal, Sinasc, SI-PNI, SIM e informações nas RS. Para cada domínio, avaliou-se a influência das variáveis do II (adequado e inadequado). Utilizou-se do programa XLStat2014® e aplicaram-se os testes de Shapiro-Wilk, regressão logística, análise da variância fatorial e Monte Carlo, com nível de significância p < 0,05. Resultados O II antes (2010-2011) e depois (2012-2013) da RMP, nas três RS, apresentou diferença estatística significativa (F6,156 = 129,14; p = 0,000). Em 2010, todas as RS foram estatisticamente semelhantes (p > 0,05), demonstrando equivalência nos municípios; em 2010-2011, o II da 10ª RS foi maior que da 9ª RS; em 2011-2012, os valores da 10ª e da 17ª RS foram estatisticamente superiores aos da 9ª RS (p < 0,05); em 2012-2013, a 10ª RS apresentou elevado crescimento, semelhante ao da 17ª RS (p > 0,05) e superior ao da 9ª RS (p < 0,05). Conclusão O II para avaliar o desempenho da Rede nas três RS se mostrou adequado à avaliação dos indicadores.

Objetivo: Compreender os critérios utilizados pela equipe de enfermagem para avaliar a dor da criança hospitalizada em uma UTIP. Metodologia: Estudo qualitativo, tendo como público alvo a equipe de Enfermagem de uma UTIP de um Hospital Regional do Interior do Estado de São Paulo. Foram realizados grupos focais alternando em dias ímpares e pares. Analisou-se os dados utilizando Análise Temática proposta por Bardin. Resultados: A análise resultou em duas categorias, sendo a primeira: “Vivenciar a multidimensionalidade da dor da criança: projeções e sentimentos” e a segunda: “Avaliação da dor pediátrica: um cuidado a ser aprimorado”. Conclusão: Conclui-se que as entrevistadas compreendem de forma subjetiva o conceito de dor e que as mesmas não utilizam critérios padronizados para a avaliação da dor, o que gera uma assistência não sistematizada diante do manejo da dor da criança hospitalizada.

ABSTRACT Objective: To analyze the knowledge and practices of education of Family Health Strategy professionals regarding child intoxication for the autonomy and empowering of the families. Methods: Qualitative research, carried out through semistructured interviews with 50 professionals from the Family Health Strategy of a city in the Northwest of Paraná. Data was problematized using Paulo Freire’s sociocultural approach and its concepts of dialogism and autonomy. Results: The statements showed the many ways in which the care for child intoxication is perceived and their relations with educational action, but these were traditional educational practices, with elements focused on the dissemination of information about health-disease, probably because the dialogic approach is still abstract and has no interface with the concrete practices. Final considerations: The education knowledge and practices of the professionals for the autonomy and empowering of families suggested that there is a transition stage between the biomedical model, focused on a cure, and the dialogical one.

This is a descriptive, quantitative and cross-sectional study to analyze the knowledge of child education and health professionals about chickenpox, previous to a health education workshop they attended. Data were collected through self-completion questionnaires and analyzed using the Epi Info® software, considering 5% statistically significant level. There were 92 participants from eight Child Day Care Centers and two Basic Health Care Centers in Londrina – PR. More than 52.0% of health professionals and 74.0% of child education professionals didn’t know the disease. To 76.0% of child education professionals and 38.1% of health professionals, chickenpox does not present complications and its viral etiology was reported in 75.0% and 50.0% of professionals, respectively. Chickenpox is a disease that can still be prevented, little known among these two categories of professionals, and requires adequate assistance and reductions of transmissibility through health education programs, besides immunization.

The objective was to analyze childhood mortality at a regional health department in the State of Paraná before and after the implementation of the Rede Mãe Paranaense program. The descriptive and retrospective method was used with secondary data from the Information System of the State Secretary of Health, using data from children younger than one year and causes of death, between 2009 and 2014. It was observed that, in the early neonatal period, the population size increased from 15,000 to 50,000, from 31% to 36% of deaths after the implementation. Despite the implementation of the program to improve women’s health during pregnancy and birth and infant health, the avoidable deaths remained high, i.e. 63% before and 51% after the implementation. The results did not evidence a significant reduction in childhood mortality after the implementation of the program, but its implementation is still recent, demanding further time for the cities to adapt to the program and invest in the training of the professionals involved

Objective to evaluate pain in children undergoing transplantation of hematopoietic stem cells.Methods longitudinal and analytical research with children hospitalized for transplant of hematopoietic stem cells with Faces Pain Scale Revised, every four hours from hospital admission to hospital discharge analyzed with relative absolute frequency and chi-square test.Results nine children aged four to nine years old were evaluated, totaling 1,095 ratings in 23.4% were reported with some pain score; of these, 38.9% were in hypo pharynx region; 78.8%, moderate pain. The chi-square showed significance between pain scores weeks post-transplantation and pain existence among the analyzed children.Conclusion although the pain has not affected large proportion of children, moderate and strong pain covered around 80.0% of complaints along the hematopoietic stem cell transplantation process. Thus, it is suggested that the evaluation of pain is one of the signs to be inserted in the protocols of nursing interventions in this context of caring.

Objective: to analyze the care of the child and the use of alternative therapies by mothers in the first 42 days postpartum. Method: quantitative descriptive cross-sectional study carried out in a low-risk public maternity ward, with a home visit at 42 days postpartum, between July 2013 and January 2014, in Londrina-PR. The Fischer Exact and Chi-Square Tests were used considering a 95% confidence interval. Results: among the 357 puerperal women, 50.7% were aged ≤24 years, 69.2% multiparous, 75.4% had ≥8 years of schooling and 49% an income ≥2 minimum salaries. Complementary therapy was predominantly suggested by the grandmothers, used in the child’s bath (97=27.2%), on the umbilical stump (143=39.9%), for conjunctivitis (108=81.0%) and for jaundice (56=34.6%). The social class was significant (p=0.005) with age, education, income and use of teas. Conclusion: maternal practices are maintained between generations, some indiscriminately, with it being necessary for the health team to prevent injuries and promote health considering the cultural aspects of the family.

Objective: to grasp the every day of the professionals in the primary care health service in the cases of violence against children. Methods: this is a qualitative study conducted in nine Basic Health Units. For analysis of the material, the Content Analysis was used, specifically thematic analysis. Results: the speeches of professionals allowed the construction of two themes: Professionals facing cases of violence against children: between reason and emotion; Integration of health services, education, justice, and community: opportunities and challenges for addressing violence against children. Conclusion: the facilities to cope with the violence against children were much smaller than the difficulties, especially those related to absence family protocols and lack of in-service training.

The primary attention is considered the first contact of individuals, their families and the population with the health system. As you approach the individuals and the community, your power to interact with the population can increase. It features four key attributes: first contact access, longitudinality, comprehensiveness and coordination, and three derivatives: family counseling, community orientation, and cultural competence. The family orientation consists in the knowledge of family factors related to the origin and care of diseases and community orientation on recognizing the needs in the community through epidemiological data and direct contact. The aim of the study was to evaluate the principles of family and community orientation of primary child health in primary health care units in Londrina, Paraná. A descriptive, quantitative, held on 39 basic units of the urban area, between August 2012 and January 2013 through an evaluation tool called PCATool Brazil-child version. A total of 609 interviews were answered by parents or primary caregivers of children under twelve, who used the service at least three times for consultation with a pediatrician or nurse. The score value for family counseling was 5.082 and community orientation 5.462, not reaching the ideal score (6.6). It was concluded that both attributes need to be developed, with improvement or installation of new measures, which may assist in improving the quality of primary care of the child.

Primary Care is a set of universally accessible services that promotes and protects health and prevents and treats diseases, and it is considered the initial access to the Health System. Four main essential attributes are present: accessibility, continuity, integrality and coordination. The coordination is the network of several health related services and actions that must be synchronized and continuous regardless of the location in which they occur. The goal of this study was to evaluate this coordination principle in Primary Care provided to children in 39 UBS (tr. From Basic Health Unit) in the urban area of the city of Londrina. The research is multicentric (Londrina, Cascavel and João Pessoa), descriptive and quantitative – with use of PCATool-Brasil for children. In this instrument, coordination is subdivided in integration of care (which refers to the relation between Basic Health Care and specialties) and the information system (which evaluates the health data and file availability). Amongst the 609 subjects submitted to interview, only 29.2% reported that a specialist examined the child. The coordination-integration of care score was 7.393 and the coordination-information system score was 7.620. From the eight questions concerning the coordination attribute that can be numeric-evaluated, three had scores below 6.6. The score should be higher than that to meet the concept of Primary Care. The conclusion is that the coordination attribute had a high score despite the three questions with a low score.

RESUMO Objetivo: Descrever o coeficiente de mortalidade neonatal por sepse e outras causas, além das características maternas, gestacionais, do parto, do recém-nascido e do óbito em Londrina, Paraná. Métodos: Estudo transversal e de séries temporais. Foram estudados óbitos neonatais que continham, em qualquer campo da declaração de óbito, registro de sepse neonatal, entre 2000 e 2013. Os anos foram agrupados em biênios e realizou-se cálculo do coeficiente de mortalidade neonatal e por causas específicas, segundo 10ª revisão da Classificação Internacional de Doenças (CID-10). Para a análise bivariada, considerou-se p

Ao ministrar a disciplina de saúde mental, torna-se necessário compreender o imaginário dos discentes sobre pessoas com sofrimento psíquico. Teve-se como objetivos: delinear o perfil de graduandos de enfermagem cursando a disciplina de psiquiatria e saúde mental; analisar a dimensão imaginativa de graduandos de enfermagem sobre pessoas com sofrimento psíquico. Utilizou-se o método sociopoético, em 2014, em Universidade do Rio de Janeiro-Brasil, junto a 24 estudantes. Aplicou-se a vivência de lugares geomíticos, análise categorial e o estudo transversal. Constatou-se que 92%, 88% e 71% dos alunos são, respectivamente, mulheres, de etnia branca, de 20 a 29anos. Quanto ao imaginário, os dados produzidos pelo grupo pesquisador possibilitaram a delimitação das seguintes categorias temáticas: Múltiplas direções na vida; Difícil acesso na solidão; Metamorfose deambulante; Aridez em vida. Concluiu-se que a compreensão da dimensão imaginativa dos graduandos revelou uma ancoragem no imaginário social referente à loucura ao perceber as pessoas com aparência estigmatizada e aterradora. ABSTRACT Lecturing in mental health requires an understanding of students’ imaginaries regarding people with psychological distress. This study aimed to profile undergraduate nursing students enrolled in the discipline of psychiatry and mental health, and to examine the imaginative dimension in their views of people with psychological distress. The socio-poetic method was used with 24 students at a university in Rio de Janeiro, in 2014. The techniques applied were the experience of geo-mythical places, category analysis and cross-sectional study. The students were found to be 92% women, 88% Caucasians, and 71% 20-29 years old. As for their imaginaries, from the data produced by the research group it was possible to delimit the following thematic categories: multiple directions in life; difficult access in solitude; aimless metamorphosis; and barren lives. It was concluded that this understanding of the imaginative dimension in the students revealed it to be anchored in the social imaginary of madness in that such people are perceived as appearing stigmatized and terrifying. RESUMEN Al impartir la asignatura de salud mental, se hace necesario comprender el imaginario de los estudiantes acerca de las personas con trastornos psíquicos. Tuvo como objetivos: describir el perfil de los estudiantes de enfermería que cursan la asignatura de psiquiatría y salud mental; analizar la dimensión imaginativa de los estudiantes de enfermería sobre personas con trastornos psíquicos. Se utilizó el método sociopoético, en 2014, en una Universidad de Río de Janeiro, Brasil, junto a 24 estudiantes. Se aplicó la experiencia de lugares geomíticos, el análisis categórico y el estudio transversal. Se encontró que el 92%, 88% y 71% de los estudiantes son, respectivamente, mujeres, caucásicos y tienen entre 20 y 29 años. En cuanto al imaginario, los datos producidos por el grupo investigador hicieron posible la delimitación de las siguientes categorías temáticas: múltiples direcciones en la vida; difícil acceso en la soledad; metamorfosis ambulante; aridez en vida. Se concluyó que la comprensión de la dimensión imaginativa de los estudiantes mostró un anclaje en el imaginario social referente a la locura al ver a las personas con apariencia estigmatizada y aterradora. DOI: http://dx.doi.org/10.12957/reuerj.2015.10514

Aim: to raise awareness about the perception that people accompanying children have on storytelling during hospitalization. Method: qualitative research with eight people accompanying children in the pediatric unit. Data were collected through semi-structured interviews and analyzed using thematic analysis. Results: two categories emerged: Story time: fun in the hospital and A journey to the world of fantasy: no room for pain. Final Considerations: telling stories in the hospital setting is a strategy that should be used for the child's recovery, control of pain and reduction of stress and trauma resulting from hospitalization for both the child and accompanying persons

In spite of the many methods used by the Neonatal Intensive Care Unit workers to stimulate the breastfeeding of premature babies, some cases are unsuccessful. It was noticed that both time and effort spent in this process may generate a feeling of frustration not only to the mothers, but also to the health care professionals. This research aims to reveal experiences lived by the health care staff in situations of unsuccessful breastfeeding of preterm newborns. Following a semi-structured script, staff members of the Neonatal Intensive Care Unit of the school public hospital, Londrina–PR, in 2012. Their quotes were transcribed and analyzed according to the Content Analysis method. Four categories were identified through the previous process: Frustration arising from the failure of the process of breastfeeding; Feeling of “duties fulfilled”; Maternal factors influencing the outcome of breastfeeding: the professionals' opinion; Physical and external factors influencing negatively the process of breastfeeding. While some workers deal easily with the negative outcome, some resent the unsuccessful process for a while and question their own abilities. Maternal cooperation with the staff and the existence of an environment more conducive to breastfeeding were considered in determining outcome. As researchers, we can not act on the infrastructure, but we suggest holding meetings for discussions about breastfeeding families and professionals, and groups of milking mothers to maintain milk production.

This study aimed to understand the meaning that mothers of premature attributed to their experience with the use of the technique of translactation. A qualitative study, which interviewed five mothers of premature infants less than 32 weeks gestation and / or less than 1,500 grams, six months after discharge from the hospital, in the period of collection from July to September 2011. These mothers participated in the integrated project "A support network to premature family". The inclusion criteria: mothers of premature infants admitted to the neonatal unit; that during the hospitalization of their baby, performed the technique of translactation, and their babies were discharged from the hospital for at least six months at the time of data collection and articipation in the project. Exclusion criteria were being younger than 18 years and not residing in Londrina. Two categories emerged: Breast milk to premature: essential for healthy growth and development and Translactation as a resource for successful breastfeeding. The analysis method used was the theme proposed by Bardin. The translactation proved to be a good strategy to promote breastfeeding. A health service prepared with multidisciplinary and interdisciplinary support for the management and encouragement of breastfeeding during hospitalization in neonatal care unit is required.

This study aimed to characterize the surgical procedures performed in children hospitalized in the pediatric unit of a hospital public school. It is a quantitative, descriptive and cross-sectional study conducted in the city of Londrina, Paraná, from January 2007 to December 2009. Data were collected from the hospital's statistical department database record, assessing medical records of patients. During the three years of study, 2360 procedures were performed, of these 56.7% were in children who lived in the city itself. There were predominance of males (62.0%) and age group between 1 and 3 years old (30.0%). The larger amount of procedures was performed by the pediatric surgery clinic (54.6%), followed by orthopedics (14.8%) and hematology (12.1%). The most frequent procedures were appendectomy, liquor puncture and orthopedic fracture correction. Congenital malformations correction amounted 10.8% and procedures resulting from external causes 16%. Only one death occurred during the intraoperative period in three years of study. The results allowed to characterize the performed surgeries' profile, providing subsidies for improving specific techniques for management and pre-and postoperative preparation to ensure better care for child and family and reduction of possible traumas during hospitalization

This study aimed to analyze the perception of the nursing team regarding the assessment and management of pain performed in a pediatric unit. This is a qualitative, observational, prospective, and cross-sectional study. Data were collected through semi-structured interviews with the nursing team from a pediatric unit of an university hospital in the city of Londrina - Paraná, in the period from June to August 2009, and analyzed according to Mayan. In total, 31 professionals of the nursing team participated in this study, 4 nurses and 27 from other nursing categories. It was verified that less than half of the professionals attended training courses for pain assessment often carried out in this hospital. However, most stated to perform the assessment of pain as the 5th vital sign for all children. The facial scale is the most used by the team, although only 44% had correctly described the technique of use. Other professionals also reported that they did not use any scale to assess pain. The main difficulty pointed by the nursing team was regarding assessment of pain in infants. Regarding the unit's assessment of pain in general, most of the professionals think that they need to improve, reporting that other professionals do not assess pain all the times, or do it incorrectly. Nevertheless, everyone considered pain assessment of major importance in childcare. It is concluded that there is still a lack of knowledge and awareness about child's pain in the nursing team.

RESUMO Objetivo: compreender as ações de cuidado do enfermeiro a partir do Programa Rede Mãe Paranaense (PRMP). Métodos: estudo qualitativo alicerçado na fenomenologia social de Alfred Schütz. Participaram oito enfermeiros dos municípios da 10ª Regional de Saúde do Paraná. Realizouse entrevista semiestruturada de agosto a dezembro de 2014. Resultados: identificaram-se três categorias: conhecimento sobre o PRMP; ações de cuidado do enfermeiro no PRMP; e expectativas quanto ao PRMP. O enfermeiro conhece os objetivos, os compromissos e os indicadores do PRMP. Desenvolve ações de captação precoce; estratificação de risco habitual, intermediário e alto risco e encaminhamentos conforme o risco. Proporciona cuidado qualificado à gestante, à parturiente, à puérpera e à criança. A partir das ações de cuidado, vislumbram qualificar ainda mais as ações de cuidado a essa população. Conclusão: as ações da equipe multidisciplinar poderão contribuir de forma eficaz na redução da morbimortalidade materna e infantil. Faz-se necessário mais investimento nos programas de saúde para o alcance da excelência nas ações de cuidado.

A quantitative, retrospective and cross-sectional study to define the characteristics of pediatric hospitalization in a Burn Treatment Center between 2007 and 2011. There were 248 children burn victims hospitalized, of which 65.7% were male and 50.4% younger than three years of age. Approximately 58.0% of accidents occurred in autumn/winter. The main causative agent for those younger than three years was scalding (72.1%), and for those between 4 and 12 years old, direct flame contact (52.5%). 86.0% of burns were classified as second and third degree, predominately on upper limbs, torso and head. Mean hospitalization time was 14.8 days. Patients were discharged with improvement in 58.0% of cases, 38.0% were referred to rehabilitation and 4.0% died. Burns among the pediatric population can be avoided by investing in prevention campaigns, aimed especially at bringing awareness to families about the risk of child morbimortality and repercussions due to burns. doi: 10.5216/ree.v16i3.21968.

The aim of the study was to analyze the guidelines considering breastfeeding given by health professionals to women during prenatal care, delivery and postpartum care. Quantitative and descriptive work developed at Regional Pinheiros, Maringá-PR, from the registry in SisPreNatal, from May to August 2009. Data were collected through interviews conducted with parents at home, using a structured instrument. Participants were 36 mothers, most of whom received counseling for breastfeeding during prenatal (58.3%), maternity (87.6%) and in nursing visits to newborn (84.6%). The prevalence of exclusive breastfeeding was 37.5%, even with the end of maternity leave. The rate is still below the recommended by the World Health Organization for exclusive breastfeeding. The present results may contribute to the monitoring of health actions and development of new strategies in the maintenance of exclusive breastfeeding.

The present quantitative and descriptive study aimed at characterizing the hospitalization of children with cancer, from 2005 to 2009, in Londrina, Parana. 52.2% of the patients were male and 43% had between one and four years of age. The most frequent type of cancer was leukemia and hematology the most frequent medical clinic (35.8%). In regards to mortality, leukemia was predominant (36.0%) among female patients (56.0%) and patients between one and four years of age (56.0%). The results of this study allowed characterizing the pediatric population with cancer. These data can contribute to the decision making of healthcare managers in coping and planning of care for this population group, as well as provide input to the formulation of hypotheses to be investigated in future epidemiological and foster multidisciplinary research excellence.

Objective. To present the experiences of nursing staff working with hospitalized burned children. Methodology. Qualitative study. Data were obtained from semi-structured interviews applied to 16 people of the nursing team (12 professional technicians and 4) working at a burn treatment center. For the analysis, the Method information Interpretation of the Senses was used. The theoretical basis used to support the discussion of the study was proposed by Geertz's interpretive anthropology. Results. The narratives showed that the process of care to burned children is stressful for the participants because they are psychologically involved with the tragic story of a patient who suffered burns, and therefore with the clinical situation. This allows for the development of empathy. On the other hand there cultural involvement facing and accepting the consequences of what happened to the patient, due to the change of body image stigma that the child will suffer hamper the re-socialization of the child after discharge. Conclusion. The nursing team is affected in various ways during the care of hospitalized burned children. There is need for educational programs for their preparation in the care of these patients.

Este estudo objetivou analisar a estrutura e composição das famílias com crianças com paralisia cerebral e identificar a existência de apoio e rede social que elas dispõem. Métodos: Trata-se de uma pesquisa descritiva, qualitativa, desenvolvida em um hospital universitário em Londrina-PR. Os dados foram coletados com dez famílias, no hospital e em domicílio, no período de outubro de 2011 a março de 2012, por meio de diário de campo, genograma, ecomapa e entrevista semiestruturada. Foram analisados mediante o Método de Interpretação dos Sentidos. Resultados: As famílias foram, na maioria,do tipo nuclear. Sua rede social foi composta pela família materna, profissionais de saúde e instituições religiosas, destacando a ausência dos profissionais da Estratégia Saúde da Família. Receberam apoio emocional, instrumental, informacional e cognitivo, os quais não foram suficientes e geraram sentimentos negativos. Conclusão: Cabe ao enfermeiro detectar as fragilidades na rede e auxiliar as famílias na busca e obtenção do suporte necessário.

Considerando os efeitos deletérios da dor pós-operatória na criança e seu direito a receber alívio, sentiu-se a necessidade de estudar esse tema. Pesquisa qualitativa desenvolvida na unidade pediátrica de um hospital público de Londrina - Paraná, visando investigar a percepção dos pais quanto ao manejo da dor pós-operatória pela equipe de enfermagem e seu envolvimento neste processo. Foram entrevistados 10 familiares que acompanhavam crianças submetidas a cirurgias. Os dados foram agrupados em dois temas: caracterização do manejo da dor pós-operatória e estratégias adotadas para o alívio da dor pós-operatória. A terapia farmacológica foi mencionada como principal método utilizado pela equipe para analgesia. Quanto à atuação dos pais, referiram o uso de estratégias não farmacológicas como: distração, brinquedos, entre outros. O tratamento farmacológico é supervalorizado pelos profissionais e pelos pais. Técnicas não farmacológicas são extremamente úteis, porém, é necessário incentivar os pais a participar ativamente no manejo da dor pós-operatória de seus filhos.Estudio cualitativo desarrollado en la unidad pediátrica de un hospital público en Londrina-Paraná tuvo como objetivo conocer la percepción de los padres en el manejo del dolor post-operatorio por parte del equipo de enfermería y su relación en este proceso. Fueron entrevistados 10 padres que acompañaban niños sometidos a cirugías. Los datos fueron agrupados en dos temas: caracterización del manejo del dolor post-operatorio y estrategias adoptadas para el alivio del dolor post-operatorio. La terapia farmacológica fue mencionada como el principal método utilizado para analgesia por parte del equipo de enfermería. Sobre la actuación de los padres, ellos mencionaron el uso de estrategias nofarmacológicas como: distracción, uso de juguetes, entre otros. El tratamiento farmacológico es súper valorizado por los profesionales e por los padres. Las técnicas nofarmacológicas se mostraron extremadamente útiles, sin embargo es necesario que los padres sean estimulados a participar activamente en el manejo del dolor de sus hijos.Considering the harmful effects of the postoperative pain on children and their right to get relief, there is a need to research this subject. Qualitative study developed at a pediatric unit of a public hospital in Londrina-Paraná, aims to analyze the parent's perception about the postoperative pain management by the nursing team and their involvement in this process. Ten parents of children that were submitted to surgeries were interviewed. Data were grouped in two themes: characterization of the postoperative pain management and strategies used to get relief of postoperative pain. Pharmacological therapy was considered the main method used by the nursing team to analgesia. Concerning the parent's actuation, they referred nonpharmacological strategies such as: distraction, use of toys, among others. Pharmacological treatment is overestimated by professionals and parents. Non-pharmacological techniques have proved useful. However, it is necessary to encouraged the parents to participate in the pain management of their children.

Toda cirurgia implica em lesão de tecidos, manipulação de estruturas e órgãos, sendo a dor uma conseqüência desse processo, que pode ser minimizada. Este estudo tem como objetivo caracterizar, retrospectivamente, o processo de manejo da dor pós-operatória a partir dos registros contidos em 300 prontuários de 280 crianças de 0 a 14 anos submetidas à cirurgia no ano de 2004 em três hospitais de Londrina, PR. O estudo indicou a existência de poucos registros sobre dor pós-operatória realizados por enfermeiras, sendo a maioria realizada por auxiliares ou técnicos de enfermagem. Esses achados evidenciam a necessidade de realização de pesquisas sobre manejo da dor pediátrica e os fatores que o influenciam.Toda cirugía implica en lesión de tejidos, manipulación de estructuras y órganos, siendo el dolor una consecuencia de ese proceso, que puede ser minimizada. El presente estudio tiene como objetivo caracterizar, retrospectivamente, el proceso del manejo del dolor pos operatorio a partir de los registros contenidos en 300 prontuarios de 280 niños de 0 a 14 años sometidos a cirugía el año 2004 en tres hospitales de Londrina, PR, Brasil. El estudio indicó la existencia de pocos registros realizado por enfermeras, y la mayoría fue realizada por auxiliares o técnicos de enfermería. Los resultados evidencian la necesidad de la realización de pesquisas sobre el manejo del dolor pediátrico y los factores que lo influencian.All surgical procedures involve tissue lesions, manipulation of structures and organs, causing pain which can be minimized during the process. The objective of this study is to characterize, retrospectively, the process of managing post-operative pain based on 300 medical records of 280 childre, who underwent surgery in 2004, in 3 hospitals located in Londrina, PR, Brazil. The study revealed that only a few nurses document post-operative pain, and that the majority of the records were made by nursing aides or technicians. The results have shown the need for research on pediatric pain management and the factors affecting them.

The objectives of this study were to comprehend the breastfeeding process from reports of mothers of premature babies and identify factors facilitating or complicating this process. A descriptive qualitative study regarding the family centered care. We conducted 12 interviews with mothers of six months premature babies of chronological age and we submitted data to content analysis. Four categories emerged: The previous breastfeeding experience in the process of breastfeeding the premature baby; Emotional context versus the breastfeeding process; The ability to manage breastfeeding the premature baby and, Successes and failures. We concluded that family and professional support, adequate management and the welcoming of individualized services in the prematurity context were majorly responsible for the breastfeeding success, being even able to surpass the previous maternal desire. Breastfeeding accompaniment after discharge is indispensable for its success with premature babies.

ABSTRACT Objective: Understand the experience of nurses, doctors and administrators of pregnancy-puerperal cycle care to women in the Rede Mãe Paranaense (Freely translated as Paranaense Mother Network). Method: Qualitative research according to social phenomena with 44 professionals from 10 municipalities of the Regional of Health, in Paraná State, Brazil. The testimonies were recorded until converge and were analyzed following the steps established from the background. Results: It was understood a content of meaning experienced among different professional classes. The "motives why" in which the Network was a reasoned proposal to improve the mother care quality, although there is disarticulation in the planning and application. The expectation for "motives for" proved fragility and challenges to reach the goals and aims of the Network in the Primary Health Care practice. Final considerations: The Network reorganization was carried out, but there are gaps in the reference and counter-reference system, especially for the pregnancy and high risky childbirth and puerperal cycle.

RESUMO Objetivo Avaliar o impacto das Infecções Relacionadas à Assistência à Saúde no custo da hospitalização de crianças. Método Estudo de coorte, prospectivo, quantitativo, envolvendo crianças admitidas nas Unidades de Internação e de Terapia Intensiva Pediátrica de um hospital universitário público. Os dados foram analisados por meio do software SPSS por distribuição de frequências, medidas de tendência central e dispersão. Para todas as análises foi considerado o nível de significância estatística de p