By gaining knowledge and further understanding about valid coping strategies during chemotherapy treatment, health professionals can mobilize personal and material resources from the children, health teams, and institutions aiming to potentiate the use of these strategies to make treatments the least traumatic.

Children are considered competent social actors. Although they are able to express their opinions, they may have some difficulties in answering direct verbal questions, requiring researchers and health professionals to enter their world by using auxiliary resources for communication. This study presents the experience of using finger puppets as a playful strategy for improving interaction and communication with hospitalized children with cancer, aged seven to 12. It describes the strategy of making and using puppets as an auxiliary tool to communicate with children with cancer and presents the results and limitations of using puppets in clinical practice. The use of the puppets, creatively and in accordance with the children's motor, cognitive, and emotional development, showed benefits, such as allowing the children to freely express themselves; respecting their autonomy; and minimizing the hierarchical adult-child relationship. The use of puppets is an appropriate strategy to communicate with hospitalized children. This tool can also enrich clinical practice, as it encourages children with cancer to report their experience of being ill and also helps the health team during evaluation and intervention.

No abstract

Fatigue is among the most common, debilitating, and distressing symptoms associated with chronic condition in pediatric population. The purpose of this study was to identify non-pharmacological fatigue interventions in children and adolescents with cancer. For this, we carried out an integrative review of the literature from January 2000 to December 2016. A comprehensive search of four databases was conducted: Cumulative Index to Nursing and Allied Health Literature, Psychology Information, Medline via PubMed, and Web of Science. Randomized controlled trial, quasi-experimental, case-control and cohort studies were included in this review. Thirteen relevant studies were included for analysis. Seven papers reported positive outcomes for exercise, exercise plus leisure activities, healing touch and acupressure. In another six papers using exercise, exercise plus psychological intervention and massage, no effectiveness was found. Effective management of fatigue in children and adolescents is important but research in this area is limited, so the results of this review should be interpreted cautiously. Future researchers are encouraged to test the effective interventions in homogenous cancer populations and in other groups where fatigue is a common concern.

Malignancy-and cancer-related treatments lead to multiple symptoms. Although treatments focus on cure, few research studies have examined the symptoms that accompany these aggressive and complicated treatments. The purpose of the study was to evaluate the symptoms experienced by children at home. Children (n = 25) and adolescents (n = 33) diagnosed with cancer completed the Memorial Symptoms Assessment Scale during the 5 days at home after discharge from the hospital. The most frequent physical

ABSTRACT:In view of the negative impact of pain on the quality of life of cancer patients, identifying and stimulating the use of effective strategies to minimize these painful feelings is highly relevant for care. The aim of this study was to identify painful experiences of adolescents with cancer and to get to know their strategies for pain relief. This is an exploratory research, using qualitative data analysis. Semistructured interviews were held with nine adolescents with cancer, who reported on acute, recurring and chronic, physical and emotional painful experiences. To relieve these pains, they described pharmacological and non-pharmacological strategies, including: distraction, presence of relatives, bed positioning, cooperation to accomplish procedures and keeping up positive thinking. Therefore, it is essential for health professionals to know available evidence for pain relief and to develop skills to articulate this knowledge with their professional experience and with the patients' own strategies. DESCRIPTORS: O ALÍVIO DA DOR ONCOLÓGICA: ESTRATÉGIAS CONTADAS POR ADOLESCENTES COM CÂNCER RESUMO:Tendo em vista o impacto negativo da dor na qualidade de vida do paciente oncológico, identificar e estimular o uso de estratégias eficazes para minimizar essas sensações dolorosas é de grande relevância para o cuidado. Este estudo objetivou identificar experiências dolorosas de adolescentes com câncer e conhecer suas estratégias para o alívio da dor. Trata-se de um estudo exploratório, com análise qualitativa dos dados. Foram realizadas entrevistas semiestruturadas com nove adolescentes com câncer, os quais relataram experiências dolorosas agudas, recorrentes e crônicas, tanto físicas quanto emocionais. Para o alívio dessas dores, descreveram estratégias farmacológicas e não farmacológicas, tais como: distração, presença de familiares, posicionamento no leito, colaboração para realizar procedimentos e manutenção de pensamento positivo. Assim, é essencial que os profissionais de saúde conheçam as evidências disponíveis para o alívio da dor e desenvolvam habilidades para articular esse conhecimento à sua experiência profissional e às estratégias dos próprios pacientes. DESCRITORES:Adolescente. Neoplasias. Dor. Enfermagem pediátrica. EL ALIVIO DEL DOLOR ONCOLÓGICO: ESTRATEGIAS CONTADAS POR ADOLESCENTES CON CÁNCER RESUMEN:Ante el impacto negativo del dolor en la calidad de vida del paciente oncológico, identificar y estimular el uso de estrategias eficaces para minimizar esas sensaciones dolorosas es muy relevante para el cuidado. El objetivo de este estudio fue identificar experiencias dolorosas de adolescentes con cáncer y conocer sus estrategias para aliviar el dolor. Estudio exploratorio con análisis cualitativo de los datos. Fueron realizadas entrevistas semiestructuradas con nueve adolescentes con cáncer, que relataron experiencias dolorosas agudas, recurrentes y crónicas, físicas y emocionales. Para aliviar esos dolores, describieron estrategias farmacológicas y no farmacológicas, tales como: distracción; ...

Resumo OBJETIVO Descrever as experiências de pais de crianças e adolescentes com leucemia quanto à transição de cuidados do hospital para o domicílio. MÉTODO Estudo qualitativo, descritivo, realizado com nove mães e dois pais, em um hospital público pediátrico de São Paulo-SP. Os dados foram coletados por meio de entrevistas semiestruturadas, de maio de 2016 a janeiro de 2017, organizados no software Atlas.ti 7® e submetidos à análise de conteúdo indutiva. Adotou-se a Teoria das Mudanças como referencial teórico. RESULTADOS A categoria central foi “A volta para casa: apropriando-se de uma nova realidade”, composta de três subcategorias: apreensão com a nova realidade de cuidados; impacto imediato das mudanças; e implementação do plano de orientações. CONCLUSÃO A transição para o domicílio fez com que os pais tivessem que se adaptar à nova e complexa realidade de cuidados. Melhorias no planejamento e sistematização da primeira alta mostram-se necessárias.

This study aims to synthesize qualitative evidence about the bereavement experience of parents following the death of a child due to cancer. A qualitative metasynthesis was conducted from searching five databases. The search identified 650 articles that were independently assessed by two reviewers. Thirty-one articles were selected for full-text reading and assessed for eligibility; a total of 14 articles were included in the final sample and submitted to quality appraisal. The software NVivo® was used to organize the data and support the thematic analysis procedures. Two analytical themes were constructed: (1) losing a child and facing a rupture in identity and sense of life and (2) surviving grief and reengaging in life. The grief process was dynamic, continuous, and begun before the death of the child. Fathers and mothers reacted differently to the loss and experience of grief. The loss of a child definitively changed the parents’ life and caused identity crisis and loss of life’s purpose. During the process of survival, parents constructed new meanings that helped them cope with grief; they used strategies that allowed them to recover their sense of purpose in life. Synthesizing the experience of bereaved parents is essential to improve the support families of children with advanced cancer receive to better cope with their suffering and loss, before and after the child’s death.