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      Children and Adolescents with Cancer: experiences with Chemotherapy Translated title: Niños y adolescentes con cáncer: experiencias con la quimioterapia Translated title: Crianças e adolescentes com câncer: experiências com a quimioterapia

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          Abstract

          This study aimed to comprehend chemotherapy from the perspective of children and adolescents with cancer. Ten children and adolescents between eight and 18 years of age, in different phases of chemotherapy, participated in this exploratory, qualitative study. Data collection was carried out through semi-structured interviews and analysis of the patients’ medical records. Analysis of the empirical material followed the content analysis technique. The study allowed the comprehension that, for the children and adolescents, chemotherapy is mainly remembered for its collateral effects and suffering. After the initial impact, mainly due to physical changes, preoccupations are related to disease recovery, i.e. a cure. Over time, they also mentioned that the disease was seen as something to be overcome and, due to the chemotherapy, likely to be the outcome.

          Translated abstract

          Objetivando comprender como la terapéutica de quimioterapia es vista por los niños y adolescentes con cáncer, participaron de este estudio exploratorio de abordaje cualitativo, 10 niños y adolescentes entre ocho y 18 años, en diferentes etapas de la quimioterapia. Para la recolección de datos, utilizamos como instrumentos la entrevista semiestructurada y las fichas médicas. El análisis del material empírico siguió la técnica de análisis de contenido. El estudio permitió comprender que, para los niños y adolescentes, la quimioterapia es recordada, principalmente por sus efectos colaterales, acompañado de sufrimiento. Pasado este primer impacto, principalmente el de las alteraciones físicas, las preocupaciones se dirigen a la recuperación de la enfermedad, o sea, a la cura. Con el tiempo, relatan que la enfermedad fue vista como algo a ser vencido y, gracias a la quimioterapia, pasible de obtener ese resultado.

          Translated abstract

          Objetivando compreender como a terapêutica quimioterápica é vista pelas crianças e adolescentes com câncer, participaram deste estudo exploratório de abordagem qualitativa 10 crianças e adolescentes, entre oito e 18 anos, em diferentes momentos da quimioterapia. Para a coleta dos dados, utilizou-se como instrumentos a entrevista semiestruturada e os prontuários. A análise do material empírico seguiu a técnica de análise de conteúdo. O estudo permitiu compreender que, para as crianças e adolescentes, a quimioterapia é lembrada, principalmente, por seus efeitos colaterais, acompanhado de sofrimento. Passado esse primeiro impacto, sobretudo das alterações físicas, as preocupações dirigem-se à recuperação da doença, ou seja, à cura. Com o tempo, relatam que a doença foi vista como algo a ser vencido e, graças à quimioterapia, passível de tal desfecho.

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          Hair and cancer chemotherapy: consequences and nursing care--a literature study.

          Hair is a body appendage that throughout history has been a symbol of the social, cultural and political climate, in addition to connoting religious affiliation. Hair loss on the other hand has been associated with a loss of attractiveness, individuality, a state of disgrace and illness, in addition to the ageing process, death and a loss of sexuality. One of the most common side-effects of chemotherapy is hair loss (alopecia). Alopecia can range from sporadic thinning of the hair to complete baldness. Several factors may contribute to the severity of hair loss including drug, dose and schedule as well as hair care practices. Prevention of alopecia has been a focus in the medical and nursing literature since the late 1960s. Mechanical, physical and biological measures have been used with varying success. The goal of prevention is primarily the reduction of patient distress caused by chemotherapy-induced alopecia. Patient reactions to alopecia vary and may be dependent on the individual importance of hair, prognosis, degree of expected hair loss, the amount of information and preparation given, and physical and psychological coping mechanisms. Nurses play an important role in assisting the patient to cope with alopecia by giving the needed information and teaching self-care strategies to minimize alopecia, cope with alopecia, and protect the skin and eyes following alopecia. These interventions are aimed at helping the patient move through a potentially devastating experience to a renewed sense of well-being.
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            Crianças/adolescentes em quimioterapia ambulatorial: implicações para a enfermagem

            A hospitalização era a indicação mais comum na assistência à criança com câncer, entretanto, um grande enfoque vem sendo dado à desospitalização, viabilizada através do seguimento ambulatorial e/ou assistência domiciliar (home care). O objetivo deste trabalho é analisar as dificuldades que os pais enfrentam no ambiente domiciliar, quando seus filhos são submetidos à quimioterapia ambulatorial. Para tanto, foi realizada uma entrevista semi-estruturada com os pais, nos meses de janeiro e fevereiro de 2000, na sala de quimioterapia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, da Universidade de São Paulo. Os resultados apontam as seguintes dificuldades: alteração no cotidiano familiar; comunicação ineficiente; alteração da auto-imagem e reação adversa à quimioterapia. Este trabalho possibilitou o acesso a informações de real interesse para assistência à criança/adolescente com câncer e sua família. A partir dos dados empíricos, elaborou-se uma cartilha de orientação para o cuidado domiciliar.
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              A different perspective to approaching cancer symptoms in children.

              A sound and comprehensive knowledge base about symptoms in children experiencing cancer is necessary if health care professionals hope to effectively manage their symptoms. To date, there is still much to be discovered about how children with cancer and their families experience childhood cancer symptoms. Accordingly, a longitudinal qualitative study was undertaken between July 1998 and December 2000 to explore and describe the childhood cancer symptom course from the perspectives of children and their families. The study was conducted in three settings: the participants' homes and both an inpatient and outpatient pediatric cancer unit located in Western Canada. Thirty-nine children (4 1/2- to 18-year-old males and females) with mixed cancer diagnoses and their families (parents and siblings) participated in the study. The majority of the children were diagnosed with either leukemia or lymphoma (72%), had siblings (87%), and two parents (87.2%), and remained in remission at the completion of the study (90%). All the children received chemotherapy either alone (56%) or in combination with surgery (18%), radiation (5%), radiation and bone marrow transplant (8%), radiation and surgery (10%), and surgery, radiation, and bone marrow transplant (3%). Multiple methods of data collection were used including open-ended formal interviewing and participant observation. Interview and participant observation data were analyzed by the constant comparative method of data analysis. The creation of illness narratives added to the understanding of children's and families' experiences. In addition to providing a description of how the symptoms affected children's and families' daily living, findings related to how to health professionals can better understand and approach children's cancer symptoms emerged. When families, physicians, nurses, and other health professionals approached children's symptoms solely as side effects (e.g., nausea) or singular physical and psychological states, children provided minimal description of what they were actually experiencing. However, a greater understanding was achieved when the symptoms were approached as dynamic multidimensional experiences that occurred within a particular context. Children experienced symptoms as feeling states. Critical to children's feeling states were the meanings that children and their families assigned to the symptoms. Viewing cancer symptoms in the context of assigned meanings has implications for how symptoms are assessed and managed. The need to develop a children's symptom assessment tool based on assigned meanings is recommended.
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                Author and article information

                Journal
                rlae
                Revista Latino-Americana de Enfermagem
                Rev. Latino-Am. Enfermagem
                Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo (, SP, Brazil )
                0104-1169
                1518-8345
                October 2010
                : 18
                : 5
                : 864-872
                Affiliations
                [01] SP orgnameUniversidade de São Paulo orgdiv1Escola de Enfermagem de Ribeirão Preto Brazil
                Article
                S0104-11692010000500005 S0104-1169(10)01800505
                10.1590/S0104-11692010000500005
                21120404
                3e500390-e0d5-45e2-a263-e8727a3d5d80

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 18 July 2009
                : 03 March 2010
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 21, Pages: 9
                Product

                SciELO Revista de Enfermagem

                Categories
                Original Articles

                Neoplesias,Quimioterapia,Niño,Adolescente,Enfermería Pediátrica,Neoplasms,Drug Therapy,Child,Adolescent,Pediatric Nursing,Neoplasias,Criança,Enfermagem Pediátrica

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