Cuidado ao câncer e a prática interdisciplinar

Bomfim

Olson

et al. 2020

BMJ

Objective To evaluate evidence from randomised controlled trials and non-randomised controlled trials on the effectiveness of hospital clowns for a range of symptom clusters in children and adolescents admitted to hospital with acute and chronic conditions. Design Systematic review of randomised and non-randomised controlled trials. Data sources Medline, ISI of Knowledge, Cochrane Central Register of Controlled Trials, Science Direct, Scopus, American Psychological Association PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Latin American and Caribbean Health Sciences Literature. Study selection Randomised and non-randomised controlled trials were peer reviewed using the following eligibility criteria: children and adolescents who were admitted to hospital for acute conditions or chronic disorders, studies comparing use of hospital clowns with standard care, and studies evaluating the effect of hospital clowns on symptom management of inpatient children and adolescents as a primary outcome. Data extraction and synthesis Two investigators independently screened studies, extracted data, and appraised the risk of bias. Methodological appraisal was assessed by two investigators independently using the Jadad scale, the revised Cochrane risk-of-bias tool for randomised controlled trials (RoB 2), and the risk of bias in non-randomised studies (ROBINS-I) tool for non-randomised controlled trials. Results 24 studies (n=1612) met the inclusion criteria for data extraction and analysis. Most studies were randomised controlled trials (n=13). Anxiety was the most frequently analysed symptom (n=13), followed by pain (n=9), psychological and emotional responses and perceived wellbeing (n=4), stress (n=4), cancer related fatigue (n=3), and crying (n=2). Five studies used biomarkers, mainly cortisol, to assess stress or fatigue outcome following hospital clowns. Most of the randomised controlled trials (n=11; 85%) were rated as showing some concerns, and two trials were rated with a high risk of bias. Most non-randomised controlled trials (n=6; 55%) were rated with a moderate risk of bias according to ROBINS-I tool. Studies showed that children and adolescents who were in the presence of hospital clowns, either with or without a parent present, reported significantly less anxiety during a range of medical procedures, as well as improved psychological adjustment (P<0.05). Three studies that evaluated chronic conditions showed favourable results for the intervention of hospital clowns with significant reduction in stress, fatigue, pain, and distress (P<0.05). Conclusions These findings suggest that the presence of hospital clowns during medical procedures, induction of anaesthesia in the preoperative room, and as part of routine care for chronic conditions might be a beneficial strategy to manage some symptom clusters. Furthermore, hospital clowns might help improve psychological wellbeing in admitted children and adolescents with acute and chronic disorders, compared with those who received only standard care. Systematic review registration PROSPERO CRD42018107099.

Section: Introductionmentioning

confidence: 99%

Effectiveness of hospital clowns for symptom management in paediatrics: systematic review of randomised and non-randomised controlled trials

Bomfim

Olson

et al. 2020

BMJ

“…The result of these infectious and inflammatory conditions was a phenomenon known as sickness behavior (16) . The manifestations of sickness behavior may be related to tumor invasion, as well as adverse effects of treatment of some types of cancer, causing an intense discomfort to the patients and reducing their functional state, with a consequent reduction in quality of life (17)(18) . Due to the high prevalence of cancer symptom clusters in palliative care in pediatric oncology, their management is crucial in pediatric oncology and one of the essential pillars of Nursing in Oncology (16,(18)(19) .…”

Section: Introductionmentioning

confidence: 99%

“…The manifestations of sickness behavior may be related to tumor invasion, as well as adverse effects of treatment of some types of cancer, causing an intense discomfort to the patients and reducing their functional state, with a consequent reduction in quality of life (17)(18) . Due to the high prevalence of cancer symptom clusters in palliative care in pediatric oncology, their management is crucial in pediatric oncology and one of the essential pillars of Nursing in Oncology (16,(18)(19) . Patients with cancer undergoing palliative care may benefit from the use of Complementary Therapies (CT), as a support to treatment, mainly for the management of cancer symptom clusters (20)(21)(22) .…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of complementary therapies for the management of symptom clusters in palliative care in pediatric oncology: a systematic review

Urbano

Schuab

et al. 2021

Rev. esc. enferm. USP

Self Cite

Objective: To evaluate the effectiveness of complementary therapies in the management of symptom clusters in children and adolescents with cancer undergoing palliative care. Method: Systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, resorting to the databases MEDLINE, Web of Science, Central Cochrane, and PsycINFO. The identification, selection, inclusion, extraction, and methodological assessment were conducted by two independent reviewers. Results: Five quasi-experiments met the eligibility criteria. The heterogeneous characteristics of the studies made meta-analysis impossible. Two studies used therapeutic massage, one used Reiki, one used boswellic acid, and one used Cannabis sativa; three of them (therapeutic massage and Reiki) presented statistically significant results for the management of the cluster pain-anxiety-worry-dyspnea. Most studies presented a moderate risk of bias as per ROBINS-I tool. Conclusion: Therapeutic massage and Reiki may be effective for the symptom clusters management, especially the pain-anxiety-worry-dyspnea cluster in children and adolescents undergoing palliative care.

“…Todavia, em crianças com câncer, a preocupação corrente não se limita apenas à possibilidade de risco aumentado de infecção pelo Sars-CoV-2 ou à maior gravidade do desfecho clínico, mas também ao impacto da pandemia de Covid-19 no manejo e cuidado desses pacientes, principalmente no que concerne ao acesso a seus tratamentos correntes [18][19][20] . Em artigo publicado no início de maio de 2020 no The Lancet, ainda na fase inicial da pandemia, pesquisadores já reportaram consequências negativas substanciais no cuidado de crianças com câncer na América Latina 21 .…”

Section: Desenvolvimentounclassified

Covid-19 em Crianças com Câncer

Veronez

Rev. Brasileira.De.Cancerologia

2020

A Covid-19 caracteriza-se como uma infecção aguda do trato respiratório com quadros clínicos que variam desde formas leves e/ou assintomáticas até formas graves. Embora sua taxa de letalidade seja baixa, cerca de 3,7% dos casos, alguns fatores estão associados com um risco aumentado para uma evolução mais grave da doença e morte, tais como idade avançada e presença de comorbidades, como é o caso de pacientes com câncer.