Crianças/adolescentes em quimioterapia ambulatorial: implicações para a enfermagem

Abstract

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.

Children and Adolescents with Cancer: experiences with Chemotherapy

“…As much as treatment changes the daily activities of the child and adolescent, the family should seek to maintain the routine prior to diagnosis, so that the sick child will not feel incapacitated, powerless and dependent (2) , since the symptoms bring to the children the feeling that the cancer is "more real" in their lives and leads to changes in family routines, including losses and restrictions (12,15) .…”

“…I had long hair, I already cut it a lot, it is falling out a lot. The prejudice causes discomfort, because people often keep away from those that do not fit into "standards of normality", an attitude that can accentuate the feelings of isolation experienced by the children and adolescents (2) . As time passes, when they start to worry about other aspects of the treatment, they start to accept the hair loss, realizing that it is a passing, temporary event: According to the literature, alopecia has psychosocial implications, since the hair is important in social and sexual communication, being a social, cultural and political symbol.…”

“…Once considered an acute and fatal disease, cancer today has characteristics of a chronic disease and, even with a good prognosis the family and child feel threatened with death when given the diagnosis (2) .…”

“…Thus, considering chemotherapy as a source of preoccupation, questions and doubts (2) , the purpose of this study was to comprehend, from their own statements, how children and adolescents with cancer undergo this experience.…”

The meaning of neutropenia and homecare needs according to caregivers of children with cancer

“…This new demand involving daily habits generates anxiety, fear and apprehension because these are mostly situations experienced for the first time at home, as evidenced in a study that aimed to identify the general care demands of children a n d a d o l e s c e n t s a t h o m e a f t e r o u t p a t i e n t chemotherapy, though it did not exclusively focus on neutropenia (14) .…”