O itinerário terapêutico de famílias de crianças com câncer: dificuldades encontradas neste percurso

Abstract

Resumo OBJETIVO Conhecer as dificuldades encontradas pelas famílias no itinerário terapêutico de crianças com câncer. MÉTODO Pesquisa descritiva e exploratória, de abordagem qualitativa, realizada de março a novembro de 2016, através de entrevistas semiestruturadas, com 21 familiares de crianças em tratamento oncológico em um hospital universitário federal no Rio de Janeiro, cujos dados foram submetido à análise temática. RESULTADOS As dificuldades das famílias perpassam a identificação e a investigação pelos profissionais de saúde dos sinais e sintomas da criança e a passagem dos familiares por diversos serviços de saúde até a confirmação diagnóstica. CONSIDERAÇÕES FINAIS O diagnóstico precoce do câncer infantil depende de ações de instituições de saúde e de ensino para a apropriada investigação da doença pelos profissionais, entre eles o enfermeiro que atua nas classificações de risco das emergências e na atenção básica, além do adequado funcionamento do sistema de referência e contrarreferência do sistema de saúde.

Preparation of the discharge of relatives of children using antibiotics: contributions of nursing

“…14 From this perspective, it is proposed that orientation sessions take place with information on the drugs to be used after discharge. 7,11 This process of continuing education allows more time for understanding the information, clarifying doubts and understanding the necessary guidelines for the cares. 14 The speeches of the research participants regarding the role of the physician as the responsible person for the guidance in preparing relatives are in line with a study on the patient's discharge process.…”

“…Providing educational material may be useful in combination with direct counseling or other behavioral interventions, but the use of printed guidelines or educational sessions alone does not improve patient compliance with the treatment. 7,11 The nursing staff, as indicated by the participants, has no prior knowledge of the discharge of the patient or of their medication therapy at home. Corroborating these data, one study also highlighted failures in the communication among the health team members, definition of discharge on the same day and lack of multidisciplinary participation in daily patient visit.…”

“…A review study that sought evidence for the safe care of hospitalized children showed that in pediatric nursing safe care is based on several interfaces, such as quality of the records, the use of checklists in the procedures, improvements in the drug giving process and in professional training, and parental involvement in care. 6,7 Thinking about the child in transition from hospital care to home care, the occurrence of errors or failures in the therapeutic process at home, related to drug use, may result in ambulatory or emergency care and hospital readmission. In this sense, the complexity of post-discharge drug use, with a focus on patient safety, 8 stresses the need for the nursing staff to be involved in preparing the relatives for the discharge of children using antibiotics at home, especially the nurse, considering their social role as a health educator.…”

“…Although the number of studies addressing the safety of pediatric patients and the need for family involvement in the therapeutic process is increasing, researches that specifically address the preparation of families regarding home care with antibiotic therapy are incipient. 4,[6][7][8] Given the above, the following guiding question was formulated for the study: How does discharge preparation for relatives of hospitalized children happen for continuing antibiotic use at home? From this perspective, the objective was to describe the discharge preparation for relatives of hospitalized children for continuing antibiotic therapy at home, from the perspective of nursing professionals.…”

Tendência Temporal de Internações por Diagnóstico Oncológico em Crianças e Adolescentes

“…De forma inicial, um dos principais entraves no itinerário do tratamento é o diagnóstico precoce tardio 4 . Diferente dos cânceres em adultos, os fatores de risco relacionados com o estilo de vida não influenciam nas probabilidades de a criança e o adolescente desenvolverem câncer.…”