A SIMULAÇÃO COMO ESTRATÉGIA DE LETRAMENTO EM SAÚDE PARA AS FAMÍLIAS DE CRIANES EM USO DE GASTROSTOMIA

Abstract

With technological advances in healthcare, there has been an increase in survival among children with chronic diseases who require specialized care to maintain their health. These children are known as Children with Special Health Care Needs (CSHCN) and require ongoing assistance, including the use of technological enteral devices, such as gastrostomy tubes, prescribed when there are swallowing difficulties or gastrointestinal tract anomalies. However, hospital discharge for these children using gastrostomy is challenging for families, who frequently experience fear and insecurity regarding this technology, often feeling unprepared to provide the necessary care. An emerging approach to addressing this challenge is simulation training, particularly through Rapid Cycle Deliberate Practice (RCDP), which offers a realistic experience for practice and learning. It contributes to developing knowledge and skills and can serve as a useful intervention to prepare family caregivers. This study aims to investigate how families of children using gastrostomy tubes perceive simulation as a means of training and skill development. This is an intervention study with a qualitative approach, conducted in three stages. The study included family caregivers of children aged between 1 and 11 years old who had used gastrostomy for at least six months and were followed up at a university hospital in the Central-West region, residing in Campo Grande or within a radius of up to 130 km. Families whose children stopped using the device during data collection and those who were healthcare professionals were excluded due to possible influence on care acceptance and management. The first stage consisted of contacting family caregivers to present the study and invite participation, followed by applying a semi structured questionnaire after acceptance. The second stage involved conducting the RCDP session, during which a specific day and time were scheduled with the family to apply the Gastrostomy Tube Feeding Skills Training Protocol (RTH-Gastro). In the third stage, semi-structured interviews were conducted 30 days after the training, scheduled previously and carried out at participants’ homes. The interviews were audio-recorded and transcribed verbatim, and data were analyzed through Content Analysis as proposed by Elo and Kyngäs and Bardin. Results indicate that clinical simulation significantly improves caregiver confidence, self-efficacy, and competencies, providing a realistic experience that contributes to family preparedness during the transition from hospital to home care. Families reported increased security and understanding regarding the use of technological devices, as well as reduced feelings of fear and insecurity. Clinical simulation, integrated into the Interactive Family Care Model (IFCM), demonstrated to be an essential health education tool, promoting family empowerment for safe gastrostomy device management. Expanding this practice into different care contexts is recommended, considering each family’s particularities, to strengthen family resilience and improve the quality of home care.