O lúdico no enfrentamento da hospitalização de crianças com doenças crônicas

Abstract

The chronic disease and hospitalization can bring negative repercussions for the child. An assistance that is based in the child s expanded necessities can minimize the harmful effects imposed by these conditions and contribute in the promotion of his development. Considering that the ludic resource can be an important tool in this process, this research had as objectives to identify how activities contained in the manual Like a Guest in the Hospital contribute for a more effective coping of the hospitalization of the child with chronic disease and evaluate the effects of the use of this manual in coping with the hospitalized child with chronic disease. It is a study of the exploratory and descriptive type, with qualitative approach, done in a Teaching Hospital of the State of Paraíba, after being approved by the Ethics Comity. The study included six children that were hospitalized in the referred institution in the period of January to April of 2009, with chronic diseases with ages between 7 and 13 years. The empiric data were collected by means of participant observation, in varied situations, that happened before and after the sessions of application of activities of the referred manual, to identify possible changes in the coping with the disease and hospitalization. All of the sessions were recorded in a MP4 equipment and the observations registered in a field diary. The data analysis followed the criteria of thematic interpretation. This way, it was possible to capture the investigated problematic through the category: Coping with the hospitalization of the child with chronic disease through interventions with a ludic health manual. The results revealed that by means of intervention some changes were observed in the children s behavior, contributing to better coping with the situation of disease and hospitalization. The changes refer to a bigger participation in his health process, becoming interested in better understanding his infirmity and the treatment; reduction of the anxiety in face of the maternal removal; improvement in the interaction with the other children and health team professionals; reduction of fear of the procedures and of death; demystification of fantasies related to the hospital; adoption of strategies to reduce the discomfort caused by longing; development of self-care abilities. In the mother s perspective, the children became calmer with the intervention. The behavior changes observed indicate positive effects in coping with the situation of disease and hospitalization, however, we must call attention to the subjective aspects inherent to the process. About this aspect we captured a great psychic suffering in the children, suffering this that had not been identified, in a simple observation, in the children s behavior, but, through an establishment of dialogue enabled by the activities of the manual, the expression of feelings proportioned a relief of tensions. We believe that changes in the way of caring can reduce the discomforts inherent to hospitalization and promote the child s development, even in view of adverse situations. We hope that the study amplifies the discussion about child health assistance by means of reflection about the resources that can contribute to a humanized integral care.