scholarly journals Nursing care in palliative care in pediatric oncology

2021 ◽  
Vol 5 (3) ◽  
pp. 91-94
Author(s):  
Joana Muniz Mendonça ◽  
Luana Luzia de Assis Arruda Corbari ◽  
Matheus Mychael Mazzaro Conchy ◽  
Renan da Silva Bentes

This research has as general theme "Nursing care in palliative care in pediatric oncology", an approach that needs to be further discussed due to the need to prepare nursing professionals working in the pediatric sector with cancer patients who are terminally. Thus, an informative text was produced with information based on authors who have already conducted research on this theme, with a qualitative approach, because this is a Bibliographic research. To guide this research, the general objective was to identify the knowledge and reactions of nursing professionals in pediatric cancer care and as specific objectives to identify the perceptions and feelings that permeate pediatric nursing practice in relation to cancer, treatment, and its implications and to know the care/care activities aimed at children hospitalized in the pediatric oncology sector. It is concluded that the courses directed to nursing need to offer disciplines that prepare these professionals to deal with pediatric patients who are in terminal state, preparing them to comfort the family in the face of the failure of the treatments that the patient underwent.

2021 ◽  
Vol 42 ◽  
Author(s):  
Tatiana Pifano da Silva ◽  
Liliane Faria da Silva ◽  
Emília Gallindo Cursino ◽  
Juliana Rezende Montenegro Medeiros de Moraes ◽  
Rosane Cordeiro Burla de Aguiar ◽  
...  

ABSTRACT Objectives: To identify the knowledge of nursing professionals about palliative care in pediatric oncology and their needs for end-of-life care. Method: A descriptive study with a qualitative approach, carried out in a federal hospital in Rio de Janeiro specialized in oncology. 29 nursing professionals from the pediatric inpatient sector participated in semi-structured interviews between July and August 2019. Data submitted to textual lexicographic analysis with Iramuteq. Results: Professionals are aware of the use of comprehensive care, centered on the family, aimed at comfort, and dignified death. They highlighted the need for psychological support for the nursing team, in addition to effective communication with a multidisciplinary team and carrying out actions for professional training in pediatric palliative care. Final considerations: A study showed care that is consistent with the precepts of palliative care and points out gaps in training, highlighting the need for professional training with a view to quality care.


2013 ◽  
Vol 21 (3) ◽  
pp. 780-786 ◽  
Author(s):  
Jael Rúbia Figueiredo de Sá França ◽  
Solange Fátima Geraldo da Costa ◽  
Maria Emilia Limeira Lopes ◽  
Maria Miriam Lima da Nóbrega ◽  
Inacia Sátiro Xavier de França

OBJECTIVE: to investigate and analyze communication in palliative care contexts from the perspective of nurses, based on Humanistic Nursing Theory. METHOD: this is a field study with a qualitative approach, in which ten nurses working in the pediatric oncology unit of a Brazilian public hospital participated. Semi-structured interviews were used to collect data. The testimonies were qualitatively analyzed using Humanistic Nursing Theory and based on the five phases of Nursing Phenomenology. RESULTS: two thematic categories emerged from the analysis of the study's empirical material: "strategy to humanize nursing care, with an emphasis on relieving the child's suffering" and "strategy to strengthen ties of trust established between nurse and child." CONCLUSION: communication is an efficacious element in the care provided to the child with cancer and is extremely important to promoting palliative care when it is based on Humanistic Nursing Theory.


2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 108-108
Author(s):  
Andrea Joan Cuviello ◽  
Andrea Beri ◽  
Renee D Boss ◽  
Nirali N. Shah ◽  
Brigitte C. Widemann ◽  
...  

108 Background: In 2015 the Psychosocial Standards of Care Project for Childhood Cancer published 15 evidence-based standards for pediatric psychosocial care for children with cancer and their families. One standard endorses incorporation of palliative care to “reduce suffering throughout the disease process, regardless of disease status”. Patients enrolling on phase I studies represent a unique cohort within pediatric oncology, as they generally represent a patient population that has not responded to standard therapies and a chance of cure is limited. Phase I trials, primarily designed to test safety and feasibility, offer a low chance of therapeutic benefit and high risk of death. This study aims to define the prevalence of palliative medicine consultation for phase I patients. Methods: A retrospective chart review of pediatric patients enrolled in a National Cancer Institute (NCI) Pediatric Oncology Branch Phase I clinical trial between 2015-present, using the NIH Biomedical Translational Research Information System (BTRIS). Palliative Care Consult Notes, Advance Directive information, diagnoses and medications were captured. Results: We reviewed the records of 126 phase I patients; 66% were male, 47% were >18 years, 67% had relapsed/refractory leukemia, and 46% are now recorded as deceased. Palliative medicine was consulted in <20% of patients; all consultations were for symptom management, primarily pain control (91%). Only 9% of patients had an advance directive prior to enrollment at the NCI. During therapy at the NCI, an additional 20% of patients completed an advance directive, just over a third (35%) of which were patients who received palliative medicine consultation. Conclusions: Palliative care was infrequently consulted in a highly vulnerable patient population where survival outcomes are poor and disease or therapy side effects are substantial. Efforts to increase the use of palliative care services in this population may improve the quality of life for children and families. Future directions include working to standardize the involvement of palliative medicine for pediatric patients enrolling onto phase I clinical trials.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19002-e19002
Author(s):  
Saten Hovhannisyan ◽  
Ruzanna Papyan ◽  
Lilit Sargsyan ◽  
Samvel Danielyan ◽  
Lala Vagharshakyan ◽  
...  

e19002 Background: In Armenia the incidence of pediatric cancer accounts for around 80-100 cases per year. This qualitative study was conducted in 2018 to evaluate the needs and challenges in a provision of pediatric cancer care in Armenia. Comparative qualitative study was conducted in 2020 to evaluate the progress in the field. Methods: Qualitative research methods were incorporated to evaluate the achievements, needs and challenges in a provision of childhood cancer care in Armenia. Semi-structured in-depth interviews were conducted with selected study participants including pediatric oncologist/hematologists, pediatric surgeons, who also treat cancer patients, and radiation oncologists. Purposive sampling technique and qualitative conventional content analysis methods were used. Results: Data collected in January 2020 has shown significant improvements in the field of pediatric oncology in Armenia. In the 2018 study, some of the major issues included lack of centralized pediatric cancer care, pediatric cancer registry, palliative care center, possibility of providing high-dose methotrexate, limited nursing training, multidisciplinary team approaches and use of central catheters. Within two years, majority of these problems were solved or are in the process. In 2019 all 3 pediatric oncology and hematology units were merged and the Pediatric Cancer and Blood Disorders of Armenia was created; with the support from charitable foundations all children with cancer receive free medical and psychosocial coverage; a 25 year data has been collected from all the possible sites, the first pediatric cancer palliative care is under construction, 4 multidisciplinary cancer teams were created, pediatric oncology and hematology fellowship was created at the Yerevan State Medical University to prepare for the first time "pediatric oncologist-hematologist" as a one profession. The existing major problems include very limited provision of pediatric cancer medications by the government, as well as lack of the official registration of the number of essential drugs included in the WHO list. Conclusions: Twinning programs, multidisciplinary team discussions with international experts, improvement in availability of several resources, professional development of the staff are major tools for the progress of pediatric oncology in Armenia. Poor provision and official registration of anti-neoplastic medications by the government still remain a major obstacle.


2021 ◽  
Vol 15 (9) ◽  
pp. 2979-2983
Author(s):  
Stephanie Hurado Hinojoza ◽  
Doris Ortiz Morales ◽  
Maria Olalla Garcia

Introduction: Currently the responsibilities and role of each nursing professional has been put to the test with the need to care for thousands of Covid-19 patients, whose demands for technical, cognitive and personal care have exceeded the capacities of many healthcare professionals. Aims & Objective: To know the perspectives of nursing professionals regarding the care of patients diagnosed with Covid-19. Material & Method: the qualitative method was applied with a phenomenological approach, with the consensual participation of 10 HANM professionals, for convenience. The information was collected through in-depth interviews and analyzed in the atlas ti software. V9, using 6 core categories and 11 subcategories with which the hermeneutical unit was built. Results: Nursing care in the time of Covid-19 has faced uncertainty and fear, not knowing accurately the procedures and treatments due to the lack of information in this regard, despite this they maintain the humanization in the treatment of the patient and the Family members, through emotional intelligence, manage their feelings and fears to provide support to their patients. Conclusions: Despite the limited accessibility to protection barriers and biosafety standards, mechanisms were established to provide comprehensive care, considering the needs of the patient and their families, and accompanying them throughout the disease process. The greatest impact for nursing professionals has been to be in constant contact with death, increasing their fear of catching it and bringing the disease to their family members. Keywords: Covid-19, nursing, care, patients.


Author(s):  
Nessa Coyle

Providing palliative care depends on the nurse having strong interpersonal skills and clinical knowledge and is informed by respect for the person and the ethical principles of autonomy, beneficence, nonmaleficence, and justice. The genuine, warm, and compassionate relationship of a nurse with his or her patient is frequently a healing relationship even in the face of death. It is a combination of state-of-the art clinical competence with fidelity to the patient, the ability to listen and remain present in the face of much suffering and distress, and effective communication. It is the nurse who provides much of the care and support to patients and families throughout a disease trajectory and the one who is more likely to be present at the time of death than any other health professional.


2020 ◽  
Vol 11 (2.ESP) ◽  
Author(s):  
Fernanda Barcellos Santiago ◽  
Ana Lúcia Abrahão Da Silva

Objetivo: Relatar a experiência da assistência de Enfermagem à primeira paciente em Cuidados Paliativos oncológicos com COVID-19, no Rio de Janeiro. Método: Trata-se de estudo descritivo do tipo relato de experiência acerca da assistência de Enfermagem à paciente com COVID-19 em instituição de referência. Resultados: Durante o levantamento de dados, constatou-se que a assistência de Enfermagem é fragmentada e sem sistematização em registros e prontuário, consistindo em: vigilância do estado geral da paciente, assistência ventilatória e risco de queda. Incluíram-se medidas para aliviar o medo frente aos sintomas físicos mais expressivos. O uso da tecnologia por videochamada foi o recurso utilizado para amenizar a ansiedade. Conclusão: A abordagem da equipe de enfermagem à paciente com doença avançada e com COVID-19 se torna peculiar pela rápida evolução desta doença, tornando a assistência de enfermagem múltipla, complexa, com cuidados biopsicossocioculturais. O rápido agravamento da doença, isolamento, ausência de cuidador/familiar e risco de contaminação da equipe frente à adequação do serviço de internação hospitalar no contexto da pandemia fizeram com que a assistência de enfermagem fosse mais específica e cuidadosa. Em meio ao caos, à mistura de sentimentos e ao medo, vivenciou-se a verdadeira essência do Cuidado Paliativo.Descritores: COVID-19; Cuidado Paliativo; Enfermagem.FIRST CASE OF COVID-19 IN AN ONCOLOGICAL PALLIATIVE CARE UNIT: EXPERIENCE REPORTObjective: To report the experience of nursing care to the first patient in palliative care oncology with COVID-19, in Rio de Janeiro. Method: This is a descriptive study of an experience report about nursing care for patients with COVID-19 in a reference institution. Results: During data collection, it was found that nursing care is fragmented and without systematization in records and medical records, consisting of: surveillance of the general condition of the patient, ventilatory assistance and risk of falling. Measures to alleviate fear in the face of the most expressive physical symptoms were included. The use of technology by video call was the resource used to alleviate anxiety. Conclusion: The nursing team's approach to patients with advanced disease and with COVID-19 becomes peculiar due to the rapid evolution of this disease, making nursing care multiple, complex, with biopsychosociocultural care. The rapid worsening of the disease, isolation, absence of caregiver / family and risk of contamination of the team in view of the adequacy of the hospitalization service in the context of the pandemic made nursing care more specific and careful. In the midst of chaos, mixed feelings and fear, the true essence of Palliative Care was experienced.Descriptors: COVID-19; Palliative Care; Nursing.PRIMER CASO DE COVID-19 EN UNA UNIDAD DE CUIDADOS PALIATIVOS ONCOLÓGICOS: INFORME DE EXPERIÊNCIAObjetivo: informar la experiencia de la atención de enfermería al primer paciente en oncología de cuidados paliativos con COVID-19, en Río de Janeiro. Método: Este es un estudio descriptivo de un informe de experiencia sobre cuidados de enfermería para pacientes con COVID-19 en una institución de referencia. Resultados: Durante la recolección de datos, se encontró que la atención de enfermería está fragmentada y sin sistematización en los registros y registros médicos, que consiste en: vigilancia del estado general del paciente, asistencia respiratoria y riesgo de caídas. Se incluyeron medidas para aliviar el miedo frente a los síntomas físicos más expresivos. El uso de la tecnología por videollamada fue el recurso utilizado para aliviar la ansiedad. Conclusión: El enfoque del equipo de enfermería para pacientes con enfermedad avanzada y con COVID-19 se vuelve peculiar debido a la rápida evolución de esta enfermedad, lo que hace que la atención de enfermería sea múltiple, compleja y con atención biopsicosociocultural. El rápido empeoramiento de la enfermedad, el aislamiento, la ausencia del cuidador / familia y el riesgo de contaminación del equipo en vista de la idoneidad del servicio de hospitalización en el contexto de la pandemia hicieron que la atención de enfermería fuera más específica y cuidadosa. En medio del caos, sentimientos encontrados y miedo, se experimentó la verdadera esencia de los cuidados paliativos.Descriptores: COVID-19; Cuidados paliativos; Enfermería. 


Rev Rene ◽  
2015 ◽  
Vol 16 (4) ◽  
pp. 593 ◽  
Author(s):  
Marcos Paulo de Oliveira Lima ◽  
Mônica Cordeiro Ximenes de Oliveira

Objective: to understand the meaning of nursing care for the family of patients in palliative care. Methods: field, descriptive, and exploratory study with qualitative approach conducted in secondary general hospital in the State of Ceará, Brazil. The participants comprised eight family members of patients in palliative care, with the conduction of semi-structured interviews and direct observation. For data analysis, we used the thematic category analysis. Results: data revealed the construction of three thematic categories. The meaning of nursing care for the family of patients in palliative care is anchored in the physical presence of these professionals, the performance of technical procedures, and teamwork. Conclusions: we verified that the nursing care highlighted by families aims at a humanistic care, established in the presence and based on human interaction.


2019 ◽  
Vol 13 (1) ◽  
pp. 126
Author(s):  
Edna Regina Verri ◽  
Natalia Aparecida Santana Bitencourt ◽  
Jéssica Aires da Silva Oliveira ◽  
Randolfo Dos Santos Junior ◽  
Hélida Silva Marques ◽  
...  

ABSTRACT Objective: to investigate the understanding and practice ofpediatric palliative care. Method: it is a qualitative, exploratory and descriptive study, in a Maternal-Infant School Hospital with 30 Nursing professionals. A sociodemographic questionnaire and semi-structured interview were used to collect data. The data was submitted to the Content Analysis technique. Results: professionals presented difficulties related to the understanding of the philosophy and objectives of palliative care and difficulties in working with pediatric patients under this care, highlighting the feelings of failure and sadness in dealing with the situation. As a coping strategy, the affective detachment of the patient and his family, the spirituality and the offer to the patient of a differentiated and humanized care are used as coping strategies. Conclusion: it is necessary to include palliative care in the academic training of professionals, favoring the knowledge of the subject and preparing the professional to deal with death and dying, as well as the need for a space in the health institutions that provide shelter for the difficulties of professionals working in this context. Descritores: Palliative Care; Pediatrics; Pediatric Nursing; Death; Adaptation, Psychological; Humanization of Assistance. RESUMOObjetivo: investigar a compreensão e a prática dos profissionais de enfermagem sobre os cuidados paliativos pediátricos. Método: trata-se de estudo qualitativo, exploratório e descritivo, em um Hospital Escola Materno-Infantil com 30 profissionais de Enfermagem. Utilizaram-se, para a coleta de dados, questionário sociodemográfico e entrevista semiestruturada. Submeteram-se os dados à técnica de Análise de Conteúdo. Resultados: apresentaram-se, pelos profissionais, dificuldades relacionadas à compreensão da filosofia e aos objetivos dos cuidados paliativos e dificuldade em atuar com pacientes pediátricos que estão sob esse cuidado, destacando-se os sentimentos de fracasso e de tristeza ao lidarem com a situação. Empregam-se, com isso, como estratégias de enfrentamento, o distanciamento afetivo do paciente e de sua família, a espiritualidade e o oferecimento, ao paciente, de um atendimento diferenciado e humanizado. Conclusão: salienta-se a necessidade da inclusão de cuidados paliativos na formação acadêmica dos profissionais, favorecendo o conhecimento do tema e preparando o profissional para lidar com a morte e o morrer, assim como a necessidade de um espaço nas instituições de saúde que proporcione acolhimento frente às dificuldades dos profissionais que atuam nesse contexto. Descritores: Cuidados Paliativos; Pediatria; Enfermagem Pediátrica; Morte; Adaptação Psicológica; Humanização da Assistência. RESUMEN Objetivo: investigar la comprensión y la práctica de los profesionales de enfermería sobre los cuidados paliativos pediátricos. Método: se trata de un estudio cualitativo, exploratorio y descriptivo, en un Hospital Escuela Materno-Infantil con 30 profesionales de Enfermería. Se utilizaron, para la recolección de datos, cuestionario sociodemográfico y entrevista semiestructurada. Se sometieron los datos a la técnica de Análisis de Contenido. Resultados: se presentaron, por los profesionales, dificultades relacionadas a la comprensión de la filosofía y a los objetivos de los cuidados paliativos y dificultad en actuar con pacientes pediátricos que están bajo ese cuidado, destacándose los sentimientos de fracaso y de tristeza al lidiar con la situación. Se emplean, con ello, como estrategias de enfrentamiento, el distanciamiento afectivo del paciente y de su familia, la espiritualidad y el ofrecimiento, al paciente, de una atención diferenciada y humanizada. Conclusión: se destaca la necesidad de la inclusión de cuidados paliativos en la formación académica de los profesionales, favoreciendo el conocimiento del tema y preparando al profesional para lidiar con la muerte y el morir, así como la necesidad de un espacio en las instituciones de salud que proporcione acogida frente a las dificultades de los profesionales que actúan en ese contexto. Descritores: Cuidados paliativos; Pediatría; Enfermería Pediátrica; Muerte; Adaptación Psicológica; Humanización de la Atención. 


2018 ◽  
Vol 22 (4) ◽  
Author(s):  
Cintia Fonseca Nunes ◽  
Liliane Faria da Silva ◽  
Fátima Helena do Espírito Santo ◽  
Fernanda Garcia Bezerra Góes ◽  
Juliana Rezende Montenegro Medeiros de Moraes

Abstract Objective: To analyze the applicability of musical dynamics for nursing students in respect to palliative care in pediatric oncology. Methods: A qualitative research using the creative and sensitive method was developed in 2016 in the School of Nursing of a federal university in Rio de Janeiro. 'Musical Body' dynamics was used with ten students in the last year of the graduation course with data being submitted to thematic analysis. Results: The dynamics favored reflection on coping strategies and improving the care provided to children besides reinvigorating the healthcare team. It prompted reflection on empathy, unpreparedness and lack of opportunity to experience pediatric oncology and mourning and was thus an approximation to practical experience. Participants emphasized the possibility of using musical dynamics in the professional setting. Conclusion: Musical dynamics proved to be a useful strategy to sensitize nursing students about palliative care in pediatric oncology.


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