A compreensão da doença, do tratamento quimioterápico e as formas de enfrentamento de crianças com câncer
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Data
2016-08-18
Autores
Lopes, Guilherme Costa [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O diagnóstico de câncer infantil promove vivências e enfrentamentos específicos, que podem interferir na adesão aos procedimentos e expectativas de cura. Este estudo transversal, de delineamento quali-quantitativo, visou identificar como as crianças com câncer, com idade entre seis e doze anos, em tratamento quimioterápico, explicavam a causa, os sintomas, e prevenção de doenças comuns e de sua própria doença, o procedimento quimioterápico, a possibilidade de cura, assim como os comportamentos de enfrentamento (coping) que utilizavam no contexto da quimioterapia. O estudo foi realizado em dois centros de referência para o tratamento de câncer pediátrico do centro-oeste paulista. Os cuidadores forneceram os dados sócio demográficos e outros necessários para calcular o risco psicossocial da família. As crianças responderam a uma entrevista sobre causas, sintomas e tratamento das doenças em geral e sobre o câncer e tratamento quimioterápico e a um questionário sobre os comportamentos de enfrentamento utilizados para lidar com a quimioterapia. Elaboraram, também um desenho sobre sua percepção do procedimento, a partir da técnica de desenho-estória. Observou-se que a maioria das famílias se concentrava na categoria risco psicossocial alvo (moderado), especialmente as com baixa escolaridade, problemas financeiros, preocupação excessiva e percepção de que a criança estava sofrendo muito. Ao explicar a doença, as crianças tiveram facilidade em nomeá-la e diferenciar o câncer de outras doenças. A quimioterapia representava a possibilidade de cura, mas, também um procedimento doloroso, com longas esperas, enjoos e desânimo. As estratégias de enfrentamento mais utilizadas pelas crianças frente à quimioterapia foram a distração e solução de problemas. Houve diferenças nos comportamentos de enfrentamento quanto ao sexo, idade e tipos de câncer: meninas referiram buscar mais apoio nas relações interpessoais, crianças mais novas referiram comportamentos menos adaptativos que crianças mais velhas e uma porcentagem muito maior de crianças com leucemia referiu desânimo quando comparadas com crianças com tumores sólidos. As diferenças encontradas, tanto em relação à compreensão da doença e tratamento, quanto aos comportamentos de enfrentamento, sinalizam para a necessidade de intervenções personalizadas, que contemplem características específicas, para facilitar a adaptação da criança ao tratamento.
Child cancer diagnosis promotes specific livings and hardships, that may infer in the consent to the procedure and healing expectations. This qualitative and quantitative transversal study, aimed to identify how children with cancer, aging between six and twelve years old, explained the causes, symptoms, and the prevention of common diseases and their own, the chemotherapy procedure and the disease's cure possibility as well as their coping behavior inside the chemotherapy context. The study has been conducted in two reference of pediatric cancer treatment centers in São Paulo state's mid-west region. The caregivers provided social, demographic and all other important data necessary to calculate the family's psychosocial risk. Children answered to an interview about the causes, symptoms and the treatment of the diseases in general and about the cancer and its chemotherapy treatment and a questionnaire about the coping behaviors used to deal with the chemotherapy. They also elaborated a drawing based on their perception of the procedure, using the drawing-story technique. It was observed that mostly of the families were concentrated in moderate psychosocial risk, especially the ones with low education, financial problems, excessive concern and perception that the child was suffering, Children found it easy to name and set apart cancer from other diseases. Chemotherapy represented a cure possibility but also a painful procedure, with long waiting, nausea and dismay. The most coping strategies used by the children facing chemotherapy were the distraction and problem solving. There were differences in the coping behaviors regarding gender, age and cancer types: girls referred to seeking more interpersonal support, younger children referred less adaptive behavior than the older children and a much larger percentage of children with leukemia referred discouragement when compared to children with solid tumors. The differences found, regarding both the disease's comprehension and its treatment, as the coping behaviors, highlight the necessity of personalized interventions that contemplate specific characteristics, to help children's adaptation to the treatment.
Child cancer diagnosis promotes specific livings and hardships, that may infer in the consent to the procedure and healing expectations. This qualitative and quantitative transversal study, aimed to identify how children with cancer, aging between six and twelve years old, explained the causes, symptoms, and the prevention of common diseases and their own, the chemotherapy procedure and the disease's cure possibility as well as their coping behavior inside the chemotherapy context. The study has been conducted in two reference of pediatric cancer treatment centers in São Paulo state's mid-west region. The caregivers provided social, demographic and all other important data necessary to calculate the family's psychosocial risk. Children answered to an interview about the causes, symptoms and the treatment of the diseases in general and about the cancer and its chemotherapy treatment and a questionnaire about the coping behaviors used to deal with the chemotherapy. They also elaborated a drawing based on their perception of the procedure, using the drawing-story technique. It was observed that mostly of the families were concentrated in moderate psychosocial risk, especially the ones with low education, financial problems, excessive concern and perception that the child was suffering, Children found it easy to name and set apart cancer from other diseases. Chemotherapy represented a cure possibility but also a painful procedure, with long waiting, nausea and dismay. The most coping strategies used by the children facing chemotherapy were the distraction and problem solving. There were differences in the coping behaviors regarding gender, age and cancer types: girls referred to seeking more interpersonal support, younger children referred less adaptive behavior than the older children and a much larger percentage of children with leukemia referred discouragement when compared to children with solid tumors. The differences found, regarding both the disease's comprehension and its treatment, as the coping behaviors, highlight the necessity of personalized interventions that contemplate specific characteristics, to help children's adaptation to the treatment.
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Palavras-chave
Coping, Compreensão da doença, Psicologia pediátrica, Câncer infantil, Disease Comprehension, Pediatric Psychology, Child Cancer