Thesis (M. Phil.)--University of Hong Kong, 2009. / Includes bibliographical references (leaves 174-211) Also available in print.

Diss. Uppsala : Univ., 2003.

<p>The purpose of this essay is to compile interventions for parents of children with cancer in a literature review based on 13 peer-reviewed articles. The objective is twofold: to describe the aim of the interventions, and to investigate their effectiveness. Results indicate that the aim is to reduce stress, prevent the development of posttraumatisk stress, improve problem-solving skills, improve coping behaviour or increase parents’ knowledge of childcancer. Some of the interventions have intended effect, others have effect but not intended effect, and finally some show no effect at all. The main conclusion is that the forthcoming studies need to focus more on developing interventions that are flexible and can satisfy multiple needs.</p>

Cancer är en sjukdom som drabbar människor i alla åldrar. Den är fortfarande en av de vanligaste dödsorsakerna bland barn och ungdomar. Smärtan hos barn har underskattats på grund av bristfällig kunskap och därför inte alltid behandlats på ett adekvat sätt. Syftet med studien är att sammanställa och belysa forskning som beskriver huruvida rädsla kan påverka barns upplevelse av smärta vid cancerbehandling samt beskriva vilka åtgärder som kan vidtas för att minska rädslan och därmed smärtupplevelsen. Metoden som används är en litteraturöversikt som grundar sig på forskning som finns inom området. Resultatet grundar sig på 20 vetenskapliga artiklar. Avgränsningen har gjorts från år 1989-2007. Artiklarna har valts ut genom kritisk granskning. Resultatet visar att de medicinska metoderna som används för att behandla cancer ofta skapar högre nivåer av rädsla hos barn än själva cancersjukdomen i sig. Smärtan kan leda till negativa upplevelser som kan orsaka mer rädsla och smärta. Resultatet visar också att med hjälp av olika åtgärder kan rädslan minskas och därmed även smärtupplevelsen. / Cancer is a disease that affects mankind, regardless of age. It is still one of the most common causes of death among children and adolescents. Children’s pain has been underestimated due to lack of knowledge and therefore inadequately treated. The aim of this study is to compile and illustrate research that describes whether fear can affect children’s experience of pain related to cancer treatment as well as describing measures taken to decrease fear and the pain experience. The method used is a literature review based on research within this area. The result is based on twenty scientific articles. The delimitation has been done between the years 1989-2007. The articles have been chosen by critical review. The result shows that the medical methods used for cancer treatment often produce higher levels of fear among children than the cancer disease itself. The pain can cause negative experience that might cause more fear and pain. The result also shows that if you diminish fear by the use of different methods a decrease of pain experience could be accomplished as well.

The purpose of this essay is to compile interventions for parents of children with cancer in a literature review based on 13 peer-reviewed articles. The objective is twofold: to describe the aim of the interventions, and to investigate their effectiveness. Results indicate that the aim is to reduce stress, prevent the development of posttraumatisk stress, improve problem-solving skills, improve coping behaviour or increase parents’ knowledge of childcancer. Some of the interventions have intended effect, others have effect but not intended effect, and finally some show no effect at all. The main conclusion is that the forthcoming studies need to focus more on developing interventions that are flexible and can satisfy multiple needs.

<p>Cancer är en sjukdom som drabbar människor i alla åldrar. Den är fortfarande en av de vanligaste dödsorsakerna bland barn och ungdomar. Smärtan hos barn har underskattats på grund av bristfällig kunskap och därför inte alltid behandlats på ett adekvat sätt. Syftet med studien är att sammanställa och belysa forskning som beskriver huruvida rädsla kan påverka barns upplevelse av smärta vid cancerbehandling samt beskriva vilka åtgärder som kan vidtas för att minska rädslan och därmed smärtupplevelsen. Metoden som används är en litteraturöversikt som grundar sig på forskning som finns inom området. Resultatet grundar sig på 20 vetenskapliga artiklar. Avgränsningen har gjorts från år 1989-2007. Artiklarna har valts ut genom kritisk granskning. Resultatet visar att de medicinska metoderna som används för att behandla cancer ofta skapar högre nivåer av rädsla hos barn än själva cancersjukdomen i sig. Smärtan kan leda till negativa upplevelser som kan orsaka mer rädsla och smärta. Resultatet visar också att med hjälp av olika åtgärder kan rädslan minskas och därmed även smärtupplevelsen.</p> / <p>Cancer is a disease that affects mankind, regardless of age. It is still one of the most common causes of death among children and adolescents. Children’s pain has been underestimated due to lack of knowledge and therefore inadequately treated. The aim of this study is to compile and illustrate research that describes whether fear can affect children’s experience of pain related to cancer treatment as well as describing measures taken to decrease fear and the pain experience. The method used is a literature review based on research within this area. The result is based on twenty scientific articles. The delimitation has been done between the years 1989-2007. The articles have been chosen by critical review. The result shows that the medical methods used for cancer treatment often produce higher levels of fear among children than the cancer disease itself. The pain can cause negative experience that might cause more fear and pain. The result also shows that if you diminish fear by the use of different methods a decrease of pain experience could be accomplished as well.</p>

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Agradecemos a compreensão. on 2016-11-25T19:41:14Z (GMT) / Submitted by GUILHERME COSTA LOPES null (guilhermelho@gmail.com) on 2016-12-01T15:19:25Z No. of bitstreams: 1 DISSERTAÇÃO FINAL - GUILHERME LOPES.2016.docx: 10485824 bytes, checksum: 4fc00b1c939cafe858de697dbe722d53 (MD5) / Rejected by Felipe Augusto Arakaki (arakaki@reitoria.unesp.br), reason: Solicitamos que realize uma nova submissão seguindo as orientações abaixo: A versão final da dissertação/tese deve ser submetida no formato PDF (Portable Document Format). O arquivo PDF não deve estar protegido e a dissertação/tese deve estar em um único arquivo, inclusive os apêndices e anexos, se houver. Por favor, corrija o formato do arquivo e realize uma nova submissão. Agradecemos a compreensão. on 2016-12-02T12:32:20Z (GMT) / Submitted by GUILHERME COSTA LOPES null (guilhermelho@gmail.com) on 2016-12-02T13:04:14Z No. of bitstreams: 1 DISSERTAÇÃO.FINAL-GUILHERME.LOPES.2016.pdf: 4570581 bytes, checksum: ba3e0a86c356250cc56a4e7061db89ac (MD5) / Approved for entry into archive by Felipe Augusto Arakaki (arakaki@reitoria.unesp.br) on 2016-12-05T15:14:08Z (GMT) No. of bitstreams: 1 lopes_gc_me_bot.pdf: 4570581 bytes, checksum: ba3e0a86c356250cc56a4e7061db89ac (MD5) / Made available in DSpace on 2016-12-05T15:14:08Z (GMT). No. of bitstreams: 1 lopes_gc_me_bot.pdf: 4570581 bytes, checksum: ba3e0a86c356250cc56a4e7061db89ac (MD5) Previous issue date: 2016-08-18 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / 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.

Bakgrund: Varje år drabbas cirka 300 familjer i Sverige av det otänkbara; ett barn får en cancerdiagnos. Diagnosen medför lidande hos hela familjen och skapar en osäkerhet i föräldrarollen. I en familjecentrerad omvårdnad är sjuksköterskans uppgift att stärka föräldrarna och aktivt arbeta med föräldrarnas delaktighet i vården för att indirekt höja barnets vårdkvalitet. En ansträngd vårdmiljö medför dock hinder för implementering av familjecentrerad omvårdnad. Syfte: Belysa föräldrars upplevelse av vården av ett cancersjukt barn. Metod: En kvalitativ metod valdes för att belysa föräldrars upplevelse av vården av ett cancersjukt barn. Datainsamlingen består av sju bloggar och analys av narratives användes för att bearbeta insamlad data. Resultat: I resultatet framkom fem kategorier; kommunikationsbrist, att vara förälder, vårdpersonalens oförmåga att ge stöd, vårdmiljö och trygghet i kontinuitet- konsekvenser av platsbrist. Utifrån kategorierna utformades underkategorier vilka beskriver mer detaljerat kring föräldrarnas upplevelser av barnets vård samt faktorer som påverkar upplevelsen. Slutsats: Sjuksköterskans arbetskomplexitet bestående av att främja familjecentrerad omvårdnad i en ansträngd vårdmiljö medför att ett aktivt arbete med föräldrarnas delaktighet hamnar i skymundan. Delaktigheten av föräldrarna blir enbart slentrianmässig när sjuksköterskan inte inger adekvat med stöd och information eller i tillräckligt hög utsträckning beaktar föräldrarnas åsikter. / Background: Every year, about 300 families in Sweden suffer from the unthinkable; a child receives a cancer diagnosis. The diagnosis causes suffering for the whole family and creates an uncertainty in the parenting role. In a family-centered nursing, the nurse's task is to strengthen the parents and actively work with the parents' involvement in the child’s care to indirectly raise the child's quality of care. A strained healthcare environment, however, impedes family- centered nursings implementation. Aim: Highlight parents' experience of the care of a cancer ill child. Method: A qualitative method was chosen to highlight the parents' experience of the care of a cancer ill child. The data collection consists of seven blogs and analysis of narratives was used to process collected data. Results: In the result, five categories emerged; lack of communication, being a parent, the inability of healthcare staff to provide support, healthcare environment and safety in continuity- consequences of lack of space. From the categories subcategories were designed which describe in more detail the parents' experiences of the child's care and factors that influence the experience. Conclusion: Nursing's work complexity consisting of promoting family-centered nursing in a stressed healthcare environment means that active work with parents involvement ends in the dark. Parents 'involvement will only be act of routine when the nurse does not give adequately provided support and information or takes sufficient account of the parents' opinions.

Abstrakt  Bakgrund: Globalt rapporteras 19 miljoner fall årligen av cancer varav 400 000 fall av dem är barn. Dessa fall påverkar inte bara barnen själva utan även familjerna. De ställs inför en svår och utmanande situation. De vanligaste cancerformerna hos barn är leukemi, lymfom och tumör.  Syfte: Syftet med studien var att beskriva föräldrars erfarenheter av att leva med ett cancersjukt barn. Metod: Kvalitativ litteraturstudie baserad på åtta empiriska studier. Sökning av artiklar gjordes i Pubmed, Cinahl och APA PsycINFO. Studierna kvalitetsgranskades och analyserades med hjälp av Fribergs modell. Resultat: I resultatet kom det fram två huvudkategorier och sex subkategorier, ”Ett annorlunda liv” och ”Utveckla hanteringsstrategier”. Konklusion: Att leva med barn som drabbats av cancer påverkade föräldrarna på flera olika sätt; psykiskt, depression, ångest och stress påvisades. Lyfta fram föräldrars erfarenheter skapar förståelse och ger kunskap till sjuksköterskan över hur de kan stötta familjer i svåra situationer. Författarna ville med studien ge uppmärksamhet till hur det är att vara förälder till en sjuk patient. / Abstract Background: Globally 19 million cases of cancer are reported annually, of which 400,000 cases are children. These cases affect not only the children themselves but also families. They are faced with difficult and challenging situation. The most common cancers among children is leukemia, lymphoma and tumor. Aim: The aim of this study was to describe parents' experiences of living with a child with cancer. Methods: Qualitative literature study based on eight empirical studies. Search for articles was done in Pubmed, Cinahl and APA PsycINFO. The studies were quality reviewed and analyzed using Friberg's model. Results: The result was two main categories and six subcategories ”A different life” och ”Develop management strategies to a higher power”. Conclusion: Living with children affected by cancer affected parents' in several different ways; mental, depression, anxiety and stress were demonstrated. Highlighting parents' experiences creates understanding and provides knowledge to the nurse about how they can support families in difficult situations. This study the authors wanted to draw attention to what it is like to be parent to a sick patient.

Made available in DSpace on 2016-08-19T18:16:08Z (GMT). No. of bitstreams: 1 FRANCISCO AMAZONAS ASSIS MELO.pdf: 267824 bytes, checksum: 4afd9a9968a7d18ef592b9bc3ca03f1e (MD5) Previous issue date: 2006-12-14 / Osteosarcoma is a malignance soft tumor, more frequently in children, teenagers and young adults and it represents 20% of all kind of sarcomas. It was aimed to describe epidemiological aspects such as age, gender, location and to classify kinds of osteosarcoma according to histopathological diagnose and histological grading and to relate it with clinical stage TNM data. It was done an observing and descriptive study in 26 (twenty-six) patients with age less than 20 years old with osteosarcoma treated in a High Complexity Oncology Assistance Centre called Instituto de Maranhense de Oncologia Aldenora Bello since April of 1996 to April of 2006. Variables were compared to Brazilian population database denominated PNAD from the year of 2005. Clinical, histopathological and histological grading aspects supported data to tumor classification. It was analyzed report books from these 26 patients in which was observed that age had a variety from 5 to 20, 14 were from female gender (53,8%) and 12 (46,2%) from male gender; twenty had brown skin (76,5%), white skin (15,4%) and 14 (53,8%) has come from country side of Maranhão. Most prevalent tumor locality was left femur (42,3%). Among the 22 pacients with conventional osteosarcoma, 13 were (50,0%) the mix type, followed by telangiectasic (11,5%; 3/26) and periosteal (3,8%; 1/26). There was a predominance of histology grade III (high grade) with 65,4%; grade II (low grade) with 30,8%. According to TNM stage, 15 (57,7%) were T1NxM0 and 7 were T1NxM1a, clinical stage was predominantly IIA (57,6%) followed by IVA (30,7%). From 10 patients initially diagnosed with mestastatic disease when admitted, 8 (34,6%) had lung implantation. The type of ostesarcomas, even with same clinical stage, may present outcome and time of survival different from each other and it depends on tumor grading. The research performed in the High Complexity Centre of Oncology in São Luís Maranhão had shown that conventional tumor and the ones with high grade was the most predominant. / O osteossarcoma é um tumor mesenquimal maligno, mais freqüente em crianças, adolescentes e adultos jovens, representando 20% de todos os sarcomas. Descreve-se aspectos epidemiológicos, enfatizando a faixa etária, sexo e procedência, além de classificar os tipos de osteossarcoma de acordo com o diagnóstico anatomopatológico e graus histológicos, e relacionar os achados com o estadiamento por TNM. Foi realizado um estudo observacional e descritivo em 26 (vinte e seis) pacientes com diagnóstico de osteossarcoma em menores de vinte anos de idade em um Centro de Assistência de Alta Complexidade em Oncologia (CACON), denominado Instituto Maranhense de Oncologia Aldenora Bello em São Luís-Maranhão, durante o período de abril de 1996 a abril de 2006. As variáveis foram comparadas com os percentuais levantados pela Pesquisa Nacional por Amostragem de Domicílios (PNAD) de 2005. Os aspectos clínicos, histopatológicos e graus histológicos constituíram os dados que deram suporte à classificação do tumor. Foram analisados os prontuários de 26 pacientes onde se observou que a idade variou de 5 a 20 anos, sendo 14 (53,8%) do sexo feminino e 12 (46,2%) do sexo masculino; vinte era da cor parda equivalendo 76,9%, seguindo-se a cor branca com 15,4 %, sendo que 14 (53,8%) eram oriundos do interior do estado. A localização mais comum do tumor foi no fêmur esquerdo (42,3%). Dentre os 22 pacientes com osteossarcoma convencional 13 (50,0%;13/26) eram do tipo misto seguido do tipo telangiectásico (11,5%;3/26) e periosteal (3,8%;1/26). Houve predomínio do grau histológico III (alto grau), compreendendo 65,4%; seguido do grau II (baixo grau) com 30,8%. Segundo o estadiamento, 15 (57,7%) eram T1NXM0 e 7 (26,9%) eram T1NXM1a, além de outros, cujo estadiamento clínico predominantemente foi IIA (57,6%) e IVA (30,7%). Dos dez pacientes com doença metastática ao estadiamento quando da admissão, 8 (34,6%) tinham predominantemente metástases pulmonares. Os tipos de osteossarcomas mesmo apresentando estadiamento clínico igual podem apresentar prognóstico e diferente sobrevida, e isto depende do grau de diferenciação tumoral determinado pelo estudo do grau histológico. A pesquisa realizada no CACON em São Luís-Ma demonstrou que o tipo convencional e os de alto grau detiveram a maioria dos casos.