GLOBAL PROTECTION OF THE CHILDREN
When a family is experiencing such a hard and demanding experience, it needs help in many ways, with our experience and the contribution of professionals in the various fields of support, we try to deal with every material and psychological aspect of our guests’ needs. . The “Daniele Chianelli” Committee finances the multidisciplinary group that works in the Department of Hematology and Pediatric Oncoematology of the Hospital S. Maria della Misericordia of Perugia, with professional figures supported by the “Daniele Chianelli” Committee for Life that integrates the health workers of the Hospital and University of Perugia thus forming an exceptional working group which “mission” is to help overcome the worst moments of the illness of children and adults.
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The Residence Daniele Chianelli is a special residence for patients in outpatient therapy (Residence Daniele Chianelli) adjacent to the Hospital Santa Maria della Misericordia of Perugia consisting of thirty apartments made available to the sick and their families at no cost to rent who find in the residence the warmth and love of a large family linked by a feeling of sharing and hope.
In the structure you have the opportunity to take advantage of the same comforts of your home: air conditioning and heating. The apartments consist of a single room for the patient with a TV and a personal bathroom, a terrace, a living room with a double sofa bed for the family with another separate bathroom and a kitchenette equipped with dishes and crockery.
The apartments are distributed over three floors. On the ground floor: the main entrance, a very spacious hall with volunteers always present and active, a gym equipped with various equipment and the support of professional physiotherapists, a games room equipped with many toys suitable for any age where there are animators ready to fulfill the desires of every child, two infirmaries and a clinic for social worker and psychologist and a school environment where to take lessons with teachers of home education or voluntary teachers for repetitions or teaching Italian. A recording room for music therapy, a room equipped with a computer and an Internet point and a small chapel where Mass is celebrated once a month and moments of prayer during the day; a meeting room for meetings of the Committee, a large functional kitchen and a spacious multi-purpose room where you can watch football games, movies or cartoons, where scientific parties and conferences take place, a colorful room where workshops of decorative techniques are carried out, etc. .
During the year 2013, about 64 families were hosted, of which 15 coming from abroad, in particular from the state of Venezuela.
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The activity of psychoneology involves the development of all its phases both within the Department of Hematology and Bone Marrow Transplantation, aimed at creating a container for the patient at 360 degrees, with the possibility of sharing, the seat of ideas, resources and strategies to help the patient regain and maintain a better quality of life, the most dignified possible in this difficult phase of life.
It is aimed at patients who are guests at Residence Chianelli, patients admitted to the Hematology and Bone Marrow Transplantation Departments, and patients who receive treatment at Day Hospital and patients’ relatives.
It takes place through individual interviews in the rooms of the departments, at the day hospital and in the study set up inside the Residence Chianelli. The service is continuous and often continues even after the remission of the disease for both the patient and the family members.
The Psycho-Psychologist coordinates and collaborates with the entire team dedicated to the “well-being of the patient as a person” made up of 2 music therapists, an art therapist, 2 educators and a trainee psychologist.
Collaborate and update constantly with doctors and head nurse and every Friday the team is confronted to create a network and a usual and appropriate container for each patient.
Organizes the group of expressive psychotherapy one day a week for patients attending the Day hospital and the Residence Chianelli and is available to support the medical-nursing team.
Once a month he organizes an interactive seminar that brings together doctors, nurses, patients and family members with the aim of informing, supporting and improving the quality of life of those who are facing the path of illness.
Together with the psychological service of pediatric oncohaematology, he is interested in the adolescent patient as a “middle ground”, through the project of creating a multipurpose room common to the two departments (adult-pediatrics) and group activities both recreational and recreational. psychological.
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The Psychological Support and Psychotherapy Service in Pediatric Oncohaematology, conducted by Dr. Cardinali Letizia, is aimed at every family unit that belongs to the ward, and is guaranteed during all phases of the care path of the little patient.
The psychologist takes care of the whole family unit already during the diagnostic process, when the suspicion of an important illness hovers in the mind and heart of the parents, the doctors and the little patient.
Thanks to the Chianelli Committee’s commitment, in fact, the Service is active every day, at the exhibit, where a special space has been set up, which guarantees users privacy, and at the Residence Chianelli.
A diagnosis of cancer in children has a strong influence on the evolution of the small patient, the general objective of psychological work is to accompany the child in exploring the dark areas of his heart, to help him get in touch with the ” open wounds “, to touch with him what is most frightening, welcoming the thoughts and emotions experienced, in order to reach a good level of acceptance of the disease and therefore of the path of treatment.
Next to the sick child there are obviously parents and often siblings, the Psychological Support Service and Psychotherapy is also addressed to them, with the aim of helping them to perform an extraordinarily difficult and tiring task.
To do this a methodology shared by the national pediatric oncohematology centers is adopted, which makes use of individual and family clinical interviews, individual and group meetings with young patients, mediated by expressive techniques (drawing / painting / photo / video / storytelling) and games of games.
Interventions are carried out in coordination with the Territorial Services of Child Neuropsychiatry, Mental Health Centers and Scholastic Institutes.
The collaboration with the Italian Universities has been consolidated for thesis projects and internship experiences, and with the Health Staff Training Agencies.
In recent years, the team has paid particular attention to improving the care of adolescent and young adult patients, who express specific needs and experiences and therefore require interventions built specifically for them. In 2014, thanks to the support of the Chianelli Committee, some pilot experiences were carried out aimed at patients of this age group, such as the experience of Montagnatherapy and participation in concerts during the Umbria Jazz event.
The work of psychological support in such a complex and delicate context is made possible by the fact that the professional figure of the psychologist is integrated with the other figures of the multidisciplinary team, in this way the psychologist is perceived by the users as one of the many allies in the path towards Life.
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PROFESSIONAL SOCIAL SERVICE
The social assistant:
It welcomes, listens and evaluates people’s problems, to identify and organize, together with patients and their families, effective and timely responses to the needs that are almost never just healthcare.
It accompanies the patients and their relatives in the moment of suffering, in which prevails pain, fear, disorientation, need to be guided along a path in search of solutions to new problems.
- Social counseling talks with patients / families to examine and define emerging issues related to the disease
- Activities of social secretariat
- Information support and orientation to access to legal benefits (Law 104/1992, Law 68/1999, Civil Disability)
- Drafting of the Social Report, necessary documentation in order to complete the process for the recognition of the state of handicap
- Search for possible solutions to particular needs for foreign patients
- Guidance and support for access to economic, housing and social benefits
- Reporting to local services (Municipality, ASL) and common management for those cases that present situations of urgency and social emergency
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The Committee for Life Daniele Chianelli also makes use of a team of physiotherapists who provide to follow the patient once discharged from the hospital and hosted within the Residence.
When the child or adult is discharged and hosted within the Residence Daniele Chianelli based on the patient’s therapeutic process, a program is personalized, revalued at each meeting, this is possible thanks to the collaboration between the medical staff of the departments and the association itself. For a good rehabilitation the performances must be constant and continuous over time, for this reason the service is carried out at least twice a week.
The users who use it are all the patients hosted in the Residence Daniele Chianelli who need this activity.
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The Committee for Life Daniele Chianelli uses the expertise of specialized figures for animation and play with young patients both in the Department and in the Residence. The game, considered the fundamental expression of the child, allows the medical and nursing staff and all the volunteers to enter into communication with the young patients, to know them, to understand them, to share their joys, fears, anxieties and problems. It is through it that the child, in addition to representing the situation that surrounds him, can also detect the way he perceives it; gaming is not simply the means to learn what is needed in everyday life, but it is one of the ways in which the child can develop his or her ability to cope with the stress and difficulties of life that beset him. It also acts as a relief valve that allows him to relive and face the fears and anxieties that can overwhelm him. Thanks to the importance of play and animation, the service performed, especially within the department, must be continuous and constant.
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The Committee for Life Daniele Chianelli avails itself of the collaboration of two qualified figures, such as that of the cultural mediator within the cultural mediation project integrated with the protocol for the activation of intercultural mediation interventions; two qualified figures to support foreign patients from Venezuela and Ukraine, together with their family members, with the task of facilitating communication between families and health personnel, facilitating the knowledge and use of services, identifying with the assistant social needs, resources, difficulties of the person and family, promoting integration and accompanying the patient in comparison with Italian customs and habits (hygiene, health, nutrition, child care ..).
When the mediation intervention within the ward is not required, further work is carried out by the mediator at the Residence Daniele Chianelli. Beginning with the reception of patients and their relatives since their arrival in Italy; facilitates the process of adaptation to new, different conditions of life, climate, nutrition. Finally, he reports cases where he considers the intervention of the psychologist necessary.
It can be said that the mediator “takes over” the family as soon as it arrives in Italy. He assists the family throughout the period of stay up to accompany it at the airport upon departure.
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Music therapy is the specialized discipline that uses music, understood in its broadest meaning of the sound universe, in a therapeutic process that facilitates communication, learning, motor skills and the expression of the whole person.
It has been present in the Santa Maria della Misericordia Hospital in Perugia for almost a decade, in the Adult and Pediatric Department of Onco-Hematology and Bone Transplantation.
As a support therapy, music therapy collaborates with the medical disciplines to encourage the activation of physical functions,
MT active – postural and kinetic activities
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and social, potential or residual, of the person, child, boy and adult, who is going through an important path of illness, suffering and estrangement from their daily reality.
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Its contribution to the cultural integration of those patients who, uprooted from their land, are facing a therapy and treatment course in a foreign country is also essential.
Steel-drum, Center-South America instrument
Music therapy works and coordinates with other supporting disciplines: psychology, physiotherapy, art therapy and educators, pursuing the common goal of global personal care.
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Examples of integration with art therapy
The therapeutic relationship based on music, production or listening, allows the patient to temporarily be distracted from the dynamics of hospitalization, but above all allows to harmonize his inner world in relation to current conditions of illness and in anticipation of the return to life of everyday.
Our biological, mental rhythms and the whole neuro-vegetative system are influenced by music that generates stimulating, relaxing, problematic or resolutive effects. Through music we can understand something about us, to express an idea or a state of mind, to move us and to free ourselves. Music contributes to the process of identifying the self and throughout the course of life accompanies us, playing a role of social and emotional integration.
CD covers elaborated within the departments
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If all this relates to the MUSIC element, MUSIC THERAPY belongs to the preciousness of the relationship, with a purely therapeutic objective that is established between therapist and patient through the musical parameter, by means of a specific methodology.
The three music therapists, currently working in the ward, meet patients in their inpatient rooms on an individual journey and, when possible, in group meetings at the Residence Chianelli.
It is not necessary for patients to have musical skills.
Timetables are updated at the beginning of the year.
To request the intervention of music therapy in the rooms of the ward you can contact the head nurse.
Furthermore, music therapists, in collaboration with the department team, periodically carry out training activities for operators, music therapists and trainees in order to promote the activity of the department, train new professionals and create a national collaboration network for the convergence of data scientific.
Pediatric onco-hematology training course, 2015
Adults onco-hematology training course, 2015
In fact, an area of interest is reserved for research. Some examples:
Study to increase the pain threshold at the time of bone marrow collection in pediatrics.
Patient-child response to different rhythmic stimuli.
The use of music in the ward, on the occasion of events and major holidays, is widely accepted, not only among patients and their families, but also among the medical-nursing staff.
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Art therapy service
The therapy support activity is aimed at patients admitted to the Department of Pediatric Oncohaematology and to patients admitted to the Bone Marrow Hematology and Transplantation departments.
ART THERAPY is defined as a set of methods that can be framed by different conceptual areas (psychoanalytic, cognitive, relational, etc.) aimed at human promotion with rehabilitative, psycho-pedagogical, psychotherapeutic and preventive purposes of any form of psychosocial distress, which envisage the systematic use of expressive practices. visual – plastic – pictorial traditionally considered artistic “(Art.2 APIAr.T). It is therefore an intervention of help and support for non-verbal mediation through the use of artistic materials and is based on the premise that the creative process put into place in making art produces well-being, health and improves the quality of life.
The art therapy in the departments in question has the function of:
- Minimize the interruptions of the psychological development of the pc. (pediatric), improving morale and supporting the healing process.
- Contributes to the improvement of the living conditions of the pc. offering a meaningful and rewarding activity during the long days spent in the room.
- It helps the patient to explore emotions, to shape painful issues, to face discomforts or emotional traumas, to integrate the experience and to express what he / she feels about illness and medical care.
- It has a liberating function and the melting of tensions.
- Ludic function: distraction from ongoing therapies.
- It allows you to work on a symbolic level to explore possible changes.
- It favors an experience of normality through artistic creation.
- It also becomes a support for families because at the time of the session they entrust their dear, they can leave the room aware that the Art Therapist is taking care of him/her, or stay and observe or even participate.
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Project of home care for children affected by oncohematological diseases treated by the Department of pediatric Oncohaematology of the Hospital of Perugia. A car, purchased with the proceeds of donations and made available for the home care service that is spread over the entire territory of the Region. An initiative of fundamental importance to eliminate the discomforts of sick children being treated at the Pediatric Day-Hospital department.