Living with the extreme premature and his family in the hospital and home context.

Abstract

The guiding subject of this study appeared, starting fro m the professional daily in an  Intensive Pediatric Therapy Unit. To find answer to this question it was aimed identifying how is the extreme premature care processed in the hospital and home context. In the methodological path an exploratory-descriptive qualitative approach was used, with three extreme prematures and their families, interned in the Unit of Neonatal Intensive Therapy, of an University Hospital, in the municipal district of Rio Grande/RS. For the collection of data three scripts had been constructed, one for the systematic observation, another one for the participant observation and the third for the half-structure interview contemplating the pre-established category: the process of care to the extreme premature. Moreover, it was used a  script of family identification  and of the child in the hospital and another one for home context . The collection was carried from October,  2005 to Augusf,2006, through the systematic observation during the hospital internment, participant observation and  half-structured interview at home.  Among the results it was observed that: the care process at home was influenced by the maternal presence during the hospitalization of the extreme premature; the family support benefitted the caretaker, making possible safety and peacefulness for the care; the biological aspects deserved, on the part of the mothers, a special prominence and they were evidenced associated with the maternal insecurity in the care; the orientations of the health team were given in isolated and sporadic way, no systematic and, therefore, not including all the cares and each child's individual need;  even so, they influenced, positively, in the home care; the care process begins in the mother's first encounters with her baby, being configured in the affectionate care; the health support services that  exist are distanced of the home context and they offer support, specifically, to the biological development, and they not possess an integral vision of these children's developments. It was evidenced that the biological , psychosocial, spiritual aspects and the care are interdependent and they are processed in continuous interaction, making possible to visualize the newly born extreme premature as a one and different human being.