The importance of communication in pediatric oncology palliative care: focus on Humanistic Nursing Theory

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Abstract

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.

Translated abstract

OBJETIVO: investigar y analizar la comunicación en los cuidados paliativos en oncología pediátrica, bajo el punto de vista de los enfermeros, con base en la Teoría Humanística de Enfermería. MÉTODO: se trata de una investigación de campo, con abordaje cualitativo, de la cual participaron diez enfermeros actuantes en oncología pediátrica en un hospital público brasileño. Para la recolección de los datos, fue utilizada la técnica de entrevista semiestructurada. Las declaraciones fueron analizadas cualitativamente, bajo el marco de la Teoría Humanística de Enfermería, y de las cinco fases de la Enfermería Fenomenológica. RESULTADOS: del análisis del material empírico del estudio, surgieron dos categorías temáticas: "estrategia para humanizar el cuidar en enfermería, con énfasis en el alivio del sufrimiento del niño", y "estrategia para fortalecer el vínculo de confianza entre el enfermero y el niño". CONCLUSÍON: la comunicación se configura como un elemento eficaz del cuidado en el niño con cáncer y es de suma importancia para la promoción de los cuidados paliativos cuando fundamentada en la Teoría Humanística de Enfermería.

Translated abstract

OBJETIVO: investigar e analisar a comunicação nos cuidados paliativos em oncologia pediátrica, sob o ponto de vista de enfermeiros, com base na Teoria Humanística de Enfermagem. MÉTODO: trata-se de pesquisa de campo, com abordagem qualitativa, da qual participaram dez enfermeiros atuantes em oncologia pediátrica, de um hospital público brasileiro. Para a coleta dos dados, foi utilizada a técnica de entrevista semiestruturada. Os depoimentos foram analisados qualitativamente, à luz da Teoria Humanística de Enfermagem, e nas cinco fases da Enfermagem Fenomenológica. RESULTADOS: da análise do material empírico do estudo, emergiram duas categorias temáticas: "estratégia para humanizar o cuidar em enfermagem, com ênfase no alívio do sofrimento da criança" e "estratégia para fortalecer o vínculo de confiança entre enfermeiro e criança". CONCLUSÃO: a comunicação se configura como um elemento eficaz no cuidado com a criança com câncer e é de suma importância para a promoção dos cuidados paliativos quando alicerçada na Teoria Humanística de Enfermagem.

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Supportive and palliative care needs of families of children who die from cancer: an Australian study.

Leanne Monterosso, Linda Kristjanson (2008)

To obtain feedback from parents of children who died from cancer about their understanding of palliative care, their experiences of palliative and supportive care received during their child's illness, and their palliative and supportive care needs. A qualitative study with semi-structured interviews. 24 parents from Perth (n = 10), Melbourne (n = 5), Brisbane (n = 5) and Sydney (n = 4). Five Australian tertiary paediatric oncology centres. Results Parents whose children died from cancer live within a context of chronic uncertainty and apprehension. Parents construed palliative care negatively as an independent process at the end of their children's lives rather than as a component of a wider and continuous process where children and their families are offered both curative and palliative care throughout the cancer trajectory. The concept of palliative care was perceived to be misunderstood by key health professionals involved in the care of the child and family. The importance and therapeutic value of authentic and honest relationships between health professionals and parents, and between health professionals and children were highlighted as a critical aspect of care. Also highlighted was the need to include children and adolescents in decision making, and for the delivery of compassionate end-of-life care that is sensitive to the developmental needs of the children, their parents and siblings. There is a need for health professionals to better understand the concept of palliative care, and factors that contribute to honest, open, authentic and therapeutic relationships of those concerned in the care of the dying child. This will facilitate a better understanding by both parents and their children with cancer, and acceptance of the integration of palliative and supportive care in routine cancer care.