We get a work excuse document to show at the company, and we don't lose the day - , but the boss lets us recover the hours so as not to lose wages [ They serve us very well at the BHU; in the beginning, they even sent us to see a psychologist [ The families' narratives suggest situations in which professional care was sought across the different healthcare services such as hospitals, emergency rooms, and doctors' offices.
The route traversed by the families who sought care, especially in situations of acute child illnesses, is commonly expressed in various contexts, regardless of the disaster because it is associated with the parents' beliefs regarding the severity of their child's illness and the difficulty of accepting the help of other professionals except medical consultations to resolve the problem at the BHU Thus, it is important to consider that a mismatch often exists between the routines of the families and the BHU, which prolongs the search for care in emergency rooms and hospitals.
The observations from the mothers denoted that professional care sensitivity and, in some cases, ability, implied acceptable service to families in situations aggravated by exposure to a disaster. The narrative below describes the perception regarding the lack of professional preparedness to meet the changing needs of care after the disaster:.
We observed that when the weather was bad or when it rained more; the clinic has more people then. The people go there saying that it hurts here, it hurts there; if they start talking to these people, they realize that it is all emotional: it's fear, it's concern. There was a great increase in the number of referrals to the psychologist, mainly adults, and the use of controlled medications.
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In fact, it is necessary to find a way to treat the psyche without the person knowing that this is being done, especially for older people, you know? For example, imagine if the doctor tells you need a psychologist! He [the doctor] should ask the nurse to guide this indication; otherwise people will pass by, or they won't go. The elderly are still afraid that this [treatment] is for crazy people who have mental problems or something, so it should be a treatment in which the person gets involved without them knowing until a certain time. I think this is still missing Thus, the care and support for individuals, families, and communities should exist in throughout the whole cycle: before the disaster, during the acute phase, after the acute phase, and recovery.
Population empowerment should be a strategy for disaster preparedness that provides opportunities to understand vulnerabilities and promote cohesion and community support 20 - Perceptions regarding the health-disease process of certain family members who became ill during the disaster were interpreted with regard to the consequences of life changes and their effect on the family routine.
The health of the family is guaranteed via the promotion of routines and rituals that encourage interaction, cohesion, social participation in rights advocacy, improvements in quality of life, and the prevention of new disasters. Daily care not only encourages the development of personal skills in the interactions between parents and children but also builds healthier lifestyles through prevention and the health education of family members. The support of family healthcare staffs and the employment strategies that assist families in household health production were judged as insufficient or too distant.
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Furthermore, the system is more complex for those living in rural areas during illness situations that require care. However, these data deserve additional analysis. The results of the present study contribute to the understanding that natural disasters greatly affect healthcare routines; however, a constant family effort existed to provide the conditions needed to maintain or improve individual health, particularly for children, given their development and future health.
In addition, the families reviewed and reassessed routines and rituals based on the new care needs that arose after the disaster and within the context of individual and family development phases. Thus, the Family Routines and Rituals benchmark supports the understanding of the experiences of families in transition after disasters and helps them to interpret their care needs, using health promotion and a culturally sensitive approach.
This research should specifically explore the roles and functions of nurses in each phase, from before the disaster to the recovery phase. The theme of natural disasters should be included in the agenda of research groups, the curriculum of technical courses and nursing degrees, and continuing health education cycles where Family Health Strategy FHS professionals can exchange experiences, address technical-scientific knowledge deficiencies to work with affected populations, and develop municipal response plans to the events that characterize each region.
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