The impact of pediatric liver transplantation on family relations/O impacto do transplante hepatico infantil na dinamica familiar

This study attempts to understand the impact of pediatric liver transplantation on family relations. Six mothers of two-parent families whose children had been submitted to liver transplant within the last six years participated in the study. Mothers were interviewed about family relationships in the context of pediatric liver transplantation. Qualitative content analysis of the interviews revealed that parents-child relationship was marked by fear of death, leading to permissive and overprotective attitudes in order to reduce the child's suffering. It was noted that this pattern of behavior was maintained even after transplantation and patient's recovery. Parents' relationship tended to fortify and focus on the child's transplant and illness. Parents' relationship with their healthy children was affected. These children developed feelings of abandonment, competition and rivalry. Relatives tended to become closer and played an important supportive role. The results showed that all family members were affected and needed restructuring which reinforces the importance of early and systematic psychological assistance to the families aiming at a better adaptation to the child's condition, preventing the development of emotional problems. Keywords: Pediatric liver transplant; Family relations; Psychology. O presente estudo buscou compreender o impacto do transplante hepatico infantil (THI) na dinamica familiar. Participaram da pesquisa seis maes de criancas transplantadas de figado. O tempo pos-transplante variou entre um e seis anos. As maes foram entrevistadas a respeito do relacionamento familiar no contexto do THI. Analise de conteudo qualitativa revelou que a relacao genitores-crianca doente foi permeada pelo medo da morte, levando a atitudes permissivas e superprotetoras, na tentativa de poupar o filho de mais sofrimentos, sendo que este padrao de relacionamento manteve-se presente mesmo apos o transplante e a melhora do quadro de saude dos filhos. A relacao do casal tendeu a fortalecer-se e centrar-se nas preocupacoes a respeito da doenca e do transplante, havendo mais dialogo e uniao. A relacao com os filhos sadios passou para segundo plano, surgindo sentimentos de desamparo, ciumes e rivalidade nas criancas. A familia extensiva, por sua vez, tendeu a tornar-se mais proxima e apresentou um importante papel de apoio. Os resultados apontaram que toda a familia foi afetada, havendo necessidade de reestruturacao familiar, o que reforca a importancia do acomp