Características determinadas do envolvimento materno no tratamento fisioterapêutico de crianças portadoras de deficiência

Abstract

The technological scientific advances have led to the increase in survival of children with disorders derived from pre-natal, peri-natal and post-natal periods. However, this survival has been added by the predominance of physical, sensorial, cognitive and behavioral sequels in this population. The insufficiency in children interferes markedlyin the mother-child relationship, in family relations and in social relationships. These children's mothers are the main characters that will intermediate their children's neuropsychomotor development, the minimization of secondary effects resulting from the deficiency and the inclusion of their children in the family and social environments. The physiotherapeutic treatment, by means of early intervention in children bearing deficiency, aims at stimulating and facilitating neuropsychomotordevelopment and preventing deformities in this population. This alleged treatment in the utilization of brain flexibility mechanisms addresses children in the 0-3 years' range (extending to 5-year old children). During the early intervention sessions, the mothers are invited to participate actively in the treatment of their children, with the purpose of learning a few ways of handling, positioning and some visual and motorstimulation techniques as well as a way to promote their interaction with the child. The presence of the mothers and their participation in the physiotherapeutic treatment of their children aims primarily at the continuity and maintenance of the treatment at home in the preservation of the biomechanical alignment, the length of the soft parts and the stimulation of mother-child interaction. The perception of the difficulty of some mothers in adhering to and participating in the physiotherapeutictreatment of their children has brought about large doubts related to the benefits of home treatment, since mothers' adherence to their children's treatment is essential in the evolutive process of the children in all of its aspects. This has to do with a qualitative research performed as of semi-structured interviews, accompanied by home visits, with fifteen mothers of children bearing deficiency from APAE Itaúna andthe out-patient clinic of the University of Itaúna. In the analysis of the results, principles of the Analysis of Speech were used. The categories of the concepts studied were: mothers' reaction in light of the deficiency, attitudes of the mothers after receiving the diagnosis, expectations of the mothers relative to the evolution of the child, participation of mothers in the treatment, evaluation of the continuity of the treatment at home, perception of the mothers on the manner in which people react totheir child, further difficulties of the mothers, understanding of the diagnosis on the part of the mothers, prognosis and treatment and perception on the part of the mothers with regard to the need of physiotherapeutic treatment. Literature shows that in a social-economic situation, the mother's age, the number of children, the style oflife of the mother, social and family support, the seriousness of the deficiency, the levels of education, all of these interfere in the adherence and in the participation of the mothers in treatments of children with chronic diseases or special requirements. The results of this study show that maternal involvement in the physiotherapeutic treatment of children bearing deficiency is influenced by the acceptance of this child, by the support given to the mother by a father figure, by the family and social support, through the facilitation of treatment programs regarding schedules and prescriptions, respecting the life style of the mother, through their expectations in the child's evolution and through the quality of mother-physiotherapist and child interaction.Therefore, it is necessary to make the physiotherapeutic program viable in accordance with life situations of each mother, the creation and/or intensification of asupport effort on the part of the family, the society and the professionals to the mothers that will enable better ways of interaction between mother and child with perspectives centered not on the child's deficiency but rather on their possibilities.