Estrutura, desenvolvimento e dinâmica da família da gestante com papilomavírus humanos

Abstract

One studied Gabi's family, a young single pregnant woman with human Papilomavirus (HPV). Gabi, after discovering she was pregnant and sick went to the health service. After identifying the lesion in the external genitals she was led to specialized service where she underwent several surgical procedures for extirpation of the lesion that was quite extensive and bulky. Her family is composed by her mother, her stepfather (her mother's partner) and her brother. One proposes the theory that the family of the pregnant woman with Human Papilomavirus has its dynamics and its development modified by the appearance of the disease. The nurse's specialized care promotes healthy interactions and favorable cognitive changes to the resolution, in family, of the identified problems. The objectives were: to evaluate the structure, development and dynamics of the pregnant woman's family with diagnosis of Human Papilomavirus and to analyze the implications of the nursing care applied the family in that context. For doing so, the Calgary Model of Families Evaluation by Wright and Leahey (2002) was used. The sceneries of the research were the Institute of Cancer Prevention of Ceará, Basic Unit of Family Health (UBASF) and the pregnant woman's home (located in a critical area on the periphery of Fortaleza-Ceara-Brazil). As instmments of data collection, one used genogram, ecomap, field diary and Gabi's diary, which, at the researcher's request, was written during the period of interaction. The data collection was carried out from October, 2003 to April, 2004. The data analysis was conducted starting from the evaluation, considering the categories of the own model: structural, "developmental" and functional. This stage in the patient's and her family's life, is described in 7 events that also represent moments in which the nursing care took place dimng the implementation of the research: The involvement with the boyfriend; The experience of being a woman; The pregnancy and the disease; The insertion in the health system; Gabi's surgery; The experience of giving birth to a healthy child; Gabi's and her daughter's welcome in the family. One highlights that the nursing care contributed significantly to the invigoration of the affectionate bonds in the family, especially between mother and daughter. One emphasizes the need of the Family Health Program to incorporate the precocious reception of the pregnant women in the community, because the patient only went to the basic unit of Family Health, in the 24th week of pregnancy, already presenting the disease in advanced state. One reinforces the need of families like these, which present youngsters susceptible to offences to health due to the lifestyle they are exposed to and the environment they live in, to be accompanied, following the principles of hierarchy and integrity of the Unique System of Health and to be directed to wider systems, such as the institutions that compose the socio-sanitary and religious net of support to the families. The changes that were evidenced, especially in the cognitive dimension of the family confirm the theory.