Bakgrund: Bland barn i Sverige så insjuknar varje år drygt 300 barn och ungdomar mellan 0–18 år av cancer. Den palliativa vården bygger på ett förhållningssätt som syftar på att förbättra livskvalitén för både patienter och familjer som drabbas av problem vid livshotande sjukdomar. Allmänhet i vården ses familjen har stor betydelse i omvårdnaden. Syfte: Syftet med studien var att beskriva föräldrars upplevelse av stöd från sjuksköterskor vid palliativ vård av barn med cancer. Syftet med studien var även att granska de i studien ingående artiklarnas datainsamlingsmetod. Metod: Föreliggande litteraturstudie har en deskriptiv design. Sökstrategin utgick från två databaser PubMed och Cinahl. Sökorden använda var Childhood cancer, parents, experience, support och palliative care. Tio artiklar valdes ut för granskning och bearbetning. Huvudresultat: I resultatet framkom fyra hörnstenar: kommunikation, delaktighet, kontinuitet samt relation, som är en grund för föräldrars upplevelse av stöd. Föräldrars upplevelser av stöd i mötet med vården av deras barn med cancer, kretsar kring vårdpersonalens förhållningssätt. En ärlig och god kommunikation, delaktighet, kontinuitet i vården samt relationen mellan familjen och vårdpersonalen upplevdes som viktigast bland föräldrar. Den metodologiska aspekten som valdes för att granskas i den här studien var datainsamlingsmetoden. Utefter granskning av artiklarnas datainsamlingsmetod har det hittats tre olika datainsamlingsmetoder i de olika artiklarna, semistrukturerade intervjuer, fokusgrupper och enkäter. Slutsatser: Kännedom bland sjuksköterskor och vårdpersonal om föräldrars upplevelse av stöd i mötet med vård av ett cancersjukt barn är viktigt för att kunna bygga upp en öppen, ärlig och mellanmänsklig relation. Kommunikation, delaktighet, kontinuitet och vårdrelationen utgör underlag för att kunna uppnå denna mellanmänskliga relation. / Background: In Sweden, more than 300 children and adolescents aged 0-18 years are affected by cancer each year. Palliative care is based on an approach aimed at improving the quality of life for both patients and their families facing the problems of life threatening diseases. In healthcare in general, the family is considered to be of high value in nursing. Aim: The purpose of this study was to describe parents' experience of support from nurses in palliative care for children with cancer. The purpose of the study was also to examine the data collection method of the articles included in the study. Method: This literature review has a descriptive design. The search strategy was based on two databases, PubMed and Cinahl. The keywords used were Childhood Cancer, parents, experience, support and palliative care. Ten articles were selected for review and processing. Result: Four cornerstones were identified in the results: communication, participation, continuity and relationship, which is the foundation for the parents' perception of support. Parents' perceptions of support in the meeting with the care of their child with cancer, revolves around nursing staff approach. An honest and good communication, participation, continuity of care and the relationship between the family and the caregivers were perceived as most important among parents. The methodological aspect that was selected for examination in this study, was the data collection method In the review of the articles data collection methods, three different methods were found in the various articles, semi-structured interviews, focus groups and surveys. Conclusions: The knowledge among nurses and health professionals about parents' experience of support in the care of a cancer sick child is important, in order to build an open, honest and interpersonal relationship. Communication, participation, continuity and care-relationship is the basis for achieving this interpersonal relationship.

Background: Cancer is a disease that brings many emotions along just by naming it. The onset is increasing annually. When a child becomes ill in cancer, the parents go through a difficult time while supporting their child throughout the treatment. The healthcare professionals need more knowledge about how to support the parents through this time. Aim: The purpose of the study was to describe parents' experiences of living with a child who has cancer. Method: A method designed by Friberg (2012), aimed to contribute to evidence-based care based on the analysis of qualitative research, was used. Analysis of 11 scientific articles were performed. The analysis resulted in six main categories and seventeen sub categories. Results: The main categories that emerged was: information is everything in the disease process, life changed radically, to manage the disease they need support from others, the fight against the disease, the nurse´s role in the meeting and a sea of emotions. Conclusion: From these categories, the parents' struggles became highlighted and explained. The healthcare professionals had a role in providing the best care available for the parents and child.

Bakgrund: Nästan dagligen drabbas ett barn i Sverige av cancer. Barncancer kan vara en långvarig process som involverar hela familjen. Föräldrarna är barnets trygghet och är vanligtvis delaktiga i barnets vård. Cancerdiagnosen orsakar påfrestande känslor hos föräldrarna, då kan föräldrarna på olika sätt hantera och anpassa sig till den förändrade livssituationen.     Syfte: Syftet med föreliggande litteraturstudie var att beskriva hur föräldrar till ett cancersjukt barn hanterar/hanterade livssituationen under sjukdomstiden. Samt att beskriva undersökningsgruppen i de inkluderade artiklarna.   Metod: En deskriptiv litteraturstudie som grundar sig på tolv vetenskapliga artiklar med kvalitativ ansats som erhölls genom sökningar i databaserna Cinahl och PubMed.       Huvudresultat: Genomgående i resultatet sågs copingstrategier vara effektiva. I resultatet framkom copingstrategier som (1) stöd vilket föräldrarna inhämtade från religion, andra i liknande livssituation och omgivningen. (2) Upplevelse av kontroll, som föräldrarna åstadkom genom information, rutiner och planering. (3) Förändrat tankesätt och känslor, genom att bibehålla hoppet, tänka positivt, vara optimistisk, ha ett undvikande beteende och utföra distraherande aktiviteter. Majoriteten av deltagarna i inkluderade artiklar var kvinnor. Åldern varierade mellan 20-60 år. Två av artiklarna var genomförda i Sverige och resterande i andra länder.   Slutsats: Copingstrategier sågs vara ett effektivt sätt för föräldrarna att klara av den svåra tid som de infann sig i. Tre övergripande copingstrategier uppmärksammades vara behjälpliga för föräldrarna, stöd, förändrat tankesätt och känslor samt upplevelse av kontroll. Genom att hälso- och sjukvårdpersonal får förståelse för hanteringen hos föräldrarna och bidrar eller stärker copingstrategier kan de arbeta mot att främja hälsa och välbefinnande bland föräldrarna. / Background: Almost on a daily basis a child gets affected by cancer in Sweden. Childhood cancer can be a long process involving the whole family. The parents are the child’s safety and are usually involved in the care of the child. The cancer diagnosis causes demanding emotions among the parents, and that is when they can institute different ways to manage and adapt to change of living. Aim: The aim of the present study was to describe how parents to children diagnosed with cancer handle the life situation during the period of illness. Also to describe the included articles study sample. Method: A descriptive literature study based on twelve scientific articles with a qualitative approach, obtained through searches of the databases Cinahl and Pubmed. Main results: Throughout the result, coping strategies were seen to be effective. The result showed coping strategies as (1) support which parents obtain from religion, others in similar situation and people in the surrounding. (2) Experience of control, which parents achieved through information, routine and planning. (3) Changing the emotions and way of thinking, by maintaining hope, positive thinking, being optimistic, having an avoidance behavior and performing distracting activities. A majority of the participants in the included articles were women. Ranged in age from 20 to 60 years. Two of the articles were from Sweden and the remaining from other countries. Conclusion: Coping strategies were seen to be effective ways for the parents to cope with the difficult time they appeared in. Three general observed coping strategies were accommodating for the parents; support, changed emotions and way of thinking and experiences of control. By gaining an understanding of the management method of the parents and contribute and strengthen coping strategies, the health professionals can work to promote health and well-being among the parents.

OBJECTIVE: Pediatric cancer treatment is stressful for caregivers. Research has indicated that problem-solving coping reduces stress related to caregiving. The current study examines the effects of a problem-solving intervention (Parent Empowerment Program), based on Problem-Solving Therapy, for caregivers of children on active cancer treatment. It was hypothesized that participants who received the intervention would show decreases in caregiving stress and posttraumatic stress symptoms, and increases in problem-solving ability between baseline and post-test assessments compared to those who received an attention control. METHOD: Thirty-nine caregivers (all parents; 48% participation rate) participated. The majority were mothers (90%), married or partnered (59%) and Caucasian (56%). Participants were randomly assigned to condition (intervention vs. attention control) after completing baseline questionnaires. Participants who received the intervention received one session of problem solving intervention and a follow-up session. Those in the attention control condition received two general support sessions. Participants were assessed at baseline, one month after the second session, and three months after the second session. RESULTS: There were no effects of the intervention on any of the outcome variables when data for all participants was examined. However, there was a significant effect of the intervention on problem-solving ability among participants of children between 4-16 weeks post-diagnosis. CONCLUSIONS: There were many factors that contributed to the lack of effect, including small sample size, variations in time since diagnosis, low participation rates, and limited number of sessions. Future studies should target parents who are under the highest levels of stress and increase the intensity of sessions. However, the finding that the intervention has an effect on problem-solving ability early in the treatment trajectory replicates previous research and has potential clinical utility.

Abstrakt Bakgrund: När ett barn drabbas av livshotande sjukdom påverkar det hela familjen och deras livssituation. Sorgen hanteras på olika sätt beroende på individuella egenskaper och vilket stöd de fått. Sjuksköterskans stöd till föräldrar med döende barn är avgörande för hur sorgen hanteras. Syfte: Att beskriva föräldrars erfarenheter av att ens barn dött till följd av cancersjukdom. Metod: Litteraturstudiens datainsamling utfördes i databaserna PubMed, CINAHL och PsycINFO. Resultatet i åtta kvalitativa artiklar analyserades utifrån Fribergs analysmetod. Resultat: Litteraturstudiens resultat beskriver föräldrarnas erfarenheter av att förlora ett barn i cancer. Fyra kategorier skapades: “När det hemska sker”, “Att hantera sorgen”, “Stöd respektive brist på stöd” samt “Att gå vidare i livet”. Konklusion: Föräldrar som förlorat ett barn är utsatta för ett enormt lidande och hanterar sorgen olika. För att lindra det lidande som föräldrarna genomgår, och delvis kommer att leva med resten av sina liv, kan sjuksköterskan ge tröst och hopp. Sjuksköterskan bör sträva efter att visa förtroende och respekt för föräldrarna samt skapa en stödjande vårdkultur. För att lindra lidandet kan sjuksköterskan arbeta utifrån familjefokuserad omvårdnad, vilket kan innebära att föräldrarna är bättre förberedda när det hemska sker och på den sorg som drabbar dem. Nyckelord: Föräldrar, erfarenhet, barncancer, död. / Background: When a child die, parental grief is handled differently depending on individual characteristics and the type of support they receive. Nursing support is crucial for how parents handle the grief.Aim: To describe parents' experiences following the death of a child due to cancer disease.Method: The data collection of this literature study was performed in the databases PubMed, CINAHL and PsycINFO. Eight qualitative articles were analyzed based on Friberg’s method.Results: The results were compiled into four categories: "When the horrible happens", "Managing the grief", "Support and lack of support" and "Moving on with life".Conclusion: Parents who have lost a child are exposed to great suffering and are dealing with grief in different ways. In order to relieve the suffering that parents undergo and may live with the rest of their lives, the nurse can provide comfort and hope. The nurse should strive to show trust and respect for the parents' suffering as well as create a supportive care culture. In order to relieve suffering, the nurse can use family-focused nursing, which may mean that parents are better prepared when the terrible happens and on the grief that affects them.

ABSTRAKT Bakgrund: I världen diagnostiseras cirka 160 000 barn under 15 år varje år med cancer. När ett barn drabbas av cancer förändras livet för hela familjen, föräldrarnas fokus hamnar på det sjuka barnet och ensam kvar blir det friska syskonet. Alla familjemedlemmars behov bör uppmärksammas och tillgodoses. Syfte: Att beskriva friska syskons upplevelser av att leva med ett barn i familjen som drabbats av cancer. Metod: En litteraturstudie sammanställdes av åtta kvalitativa studier som samtliga kvalitetsgranskats och analyserats.   Resultat: Resultatet presenteras i tre kategorier och tio subkategorier. Kategorierna är: Att hantera den svåra situationen - omvälvande känslor, behov av information och delaktighet och tröst och stöd från omgivningen. Förändrade relationer i familjen - familjen splittras, syskonrelationen förändras, känsla av utanförskap och minskad uppmärksamhet. En annorlunda vardag - längtan efter ett normalt liv, ett ökat ansvar och gynnsamma konsekvenser av sjukdomen. Konklusion: Att känna delaktighet och vara nära sin familj är viktigt för de friska syskonen. Vården måste se syskonens behov, ge stöd och information för att de ska kunna hantera den svåra situationen. / ABSTRACT Background: Every year approximately 160 000 children under 15 years are diagnosed with cancer. When a child suffering with cancer life changes for the whole family, the parents have the focus on the sick child and the healthy sibling will be left alone. All family members’ needs must be recognized and accommodated. Aim: The aim of this literature study was to describe the healthy siblings’ experiences of living with a child in the family affected by cancer. Method: A literature study of eight qualitative studies have been reviewed and analyzed. Result: The results are presented in three categories and ten subcategories. The categories are: Dealing with the difficult situation - disruptive feelings, needs for information and involvement and comfort and support from the environment. Changing relationships in the family - to divide the family, sibling relationships change, a sense of alienation and decreased attention. A different everyday - the longing for a normal life, greater responsibility and favorable consequences of the disease. Conclusion: To feel involved and being close to the family is important for the healthy siblings. Healthcare must see the siblings' needs, provide support and information to enable them to cope with the difficult situation.

Bakgrund: Smärta är ett vanligt symtom hos cancersjuka barn och upplevs som påfrestande för både barnet och familjen. Sjuksköterskan har en central roll i barnets vård och har som uppgift att uppmärksamma och behandla barnets smärta, men även att minska föräldrarnas oro under behandlingstiden. Syfte: Syftet var att utvärdera föräldrarnas upplevelser av sitt cancersjuka barns smärta och smärtbehandling under cancerbehandling.  Metod: Kvantitativ data samlades in med hjälp av en enkät som mätte föräldrarnas upplevelse och oro kring barnets smärta under cancerbehandlingen. Urvalet bestod av 28 föräldrar till cancersjuka barn.   Resultat: Tjugosju (96,4%) av föräldrarna rapporterade att deras barn upplevt smärta under cancerbehandlingen. Majoriteten av föräldrarna hade upplevt oro och en otillräcklighet i samband med smärta hos barnet. Information om olika smärtlindringsmetoder värderades högt av föräldrarna för att minska deras oro. En signifikant skillnad fanns där föräldrar som upplevde att de fått för lite information om smärtlindringsmetoder skattade högre oro (p= 0.032). Det fanns inget samband mellan föräldrarnas oro kring barnets smärta och barnets eller föräldrarnas ålder. Det fanns inte heller någon skillnad i föräldrarnas oro beroende på barnets kön eller diagnos eller föräldrarnas kön.  Slutsats: Nästa alla föräldrar upplevde att deras barn haft smärta under sin cancerbehandling och majoriteten av föräldrarna var oroliga och kände sig otillräckliga i samband med barnets smärta. Då många föräldrar önskade mer information om olika smärtlindringsmetoder behöver vården bli bättre på att kommunicera med familjen vid smärta. / Background: Pain is a common symptom from children with cancer and is described as stressful for both the child and it´s family. The nurse has a central role in the child´s treatment and has the responsibility to observe and treat the child´s pain, but also to reduce the parent´s concernduring the cancer treatment.  Aim: The aim was to evaluate the parent´s experiences of their children´s pain and pain treatment during their cancer treatment.  Method: Quantitative data were collected through surveys that measured parent´s experiences and concern around the child´s pain during cancer treatment. The sample consisted 28 parents of cancer sick children.  Results: Twenty- seven (94,4%) parents reported that their children experienced pain during the cancer treatment. The majority of the parents had experienced concern and an inadequacy when their child was in pain. Information about different pain relief methods was highly valued by the parents helping them reduce their concern. A significant difference was that parents who experienced that they received to little information about pain reliefs methods measured higher concern (p= 0.032). There was no relation between the parents concern about the child´s pain and the child´s or the parents age. In addition, there was no difference between the parent’s concern depending on the child´s gender or diagnosis or the parent´s gender.  Conclusion: Almost every child experienced pain during their cancer treatment and the majorityof the parents were worried and felt inadequacy when their child had pain. Since many parents wanted more information on different pain relief methods the health care needs to be better at communicating with the family, when the child experiencing pain.

Bakgrund: Få studier har undersökt barns egna erfarenheter av att förberedas inför procedurer. Cancersjuka barn utsätts för mycket påfrestningar såsom smärta från medicinska procedurer. Syfte: Att undersöka cancersjuka barns erfarenheter av förberedelser inför smärtsamma procedurer. Metod: En kvantitativ tvärsnittsstudie. Barn (n=34) i åldrarna 7–17 år på ett barnonkologiskt centrum i Mellansverige besvarade en enkät med 16 frågor under våren 2019. Deskriptiv statistik, chitvåtest och Fishers exakta test användes för analys. Resultat: Majoriteten av barnen (62 %) förberedde sig på ett speciellt sätt och de flesta ansåg att de var tillräckligt förberedda inför procedurerna. Knappt en tredjedel (32 %) uppgav att de sällan eller aldrig blev tillfrågade om hur de ville förberedas. Drygt en tredjedel (35,5 %) av barnen uppgav att de alltid eller ofta kände sig rädda inför en procedur. Knappt en tredjedel (32 %) uppgav att vårdpersonalen sällan eller aldrig berättade om procedurens genomförande men inga barn uppgav att de fick för lite information. Inga skillnader sågs i om barnen kände sig tillräckligt förberedda utifrån ålder eller tid med cancerdiagnos. Slutsats: Det finns brister i vårdpersonalens kommunikation om förberedelser. Det är viktigt att alla barn får ge sin syn på hur de vill förberedas och att de förstår informationen som ges om proceduren. Flera barn kände sig rädda inför procedurerna, om denna rädsla inte hanteras kan den ge kort- och långsiktiga konsekvenser. Resultatet tyder på att individanpassade förberedelser är viktigt oavsett ålder eller tid med cancerdiagnos. / Background: Research about the children's own experience of preparation before procedures is limited. Children with cancer are exposed to a large amount of distress. Pain from medical procedures is one reason. Aim/objective: To examine the children´s experiences of preparations before painful procedures. Method: A quantitative cross-sectional study. Children (n=34) aged 7-17 at a children's oncology center in central Sweden completed a questionnaire with 16 questions during Spring, 2019. Descriptive statistics, chi-square test and Fisher’s exact test were used to analyze the data. Results: The majority of the children (62 %) prepared themselves in a particular way and most of them felt sufficiently prepared before the procedure/s. Approximately one third (32 %) stated that they seldom or never were asked how they wanted to be prepared. Just above one third (35,5 %) stated that they always or often were afraid before a procedure. Approximately one third (32 %) stated that the health care professionals never or seldom explained the procedure. However, none of the children stated that they had insufficient information. There were no differences in whether the children felt sufficiently prepared depending on age or time with cancer diagnosis. Conclusion:  The communication about preparations from the healthcare staff were insufficient. It is important that children get to express their own opinions about preparations and understand the given information. Several children felt afraid prior to the procedures which might cause short and long-term consequences. The result indicate that individual preparation is important regardless of age or time of cancer diagnosis.

Esta tese tem como objetivo geral investigar os significados que os adultos, sobreviventes de tumor de Sistema Nervoso Central (SNC) na infância, atribuem às suas experiências de vida durante o adoecimento e após o término do tratamento oncológico, a fim de oferecer subsídios para a formulação de novos dispositivos clínicos para o atendimento destes casos. Considera-se como adultos sobreviventes de câncer infanto-juvenil os pacientes, de 20 a 59 anos, que tenham concluído o tratamento oncológico há pelo menos cinco anos e estejam sem evidência da doença. A concepção de investigação que embasa esta tese é o modelo de pesquisa qualitativa em psicanálise que permite compreender os fenômenos em profundidade. Consta de uma pesquisa bibliográfica - uma revisão sobre a história da oncologia e da oncologia pediátrica no Brasil e sobre os textos psicanalíticos ligados ao tema aqui proposto - e de uma pesquisa de campo, através de entrevistas abertas que buscam o testemunho das experiências vivenciadas pelo sujeito a partir do diagnóstico. As entrevistas com onze adultos, pacientes do Hospital São Rafael / Unidade ONCO / Salvador, funcionam como material clínico para a discussão sobre alguns temas à luz da psicanálise Freud-lacaniana. Os temas estão divididos em cinco categorias: reações ao diagnóstico; sentidos e significados do adoecimento; lembranças do tratamento; vivências pós-tratamento; e percepção dos efeitos tardios. Os conceitos e as noções psicanalíticos norteadores para a discussão abarcam o trauma, o luto, o estádio do espelho, o narcisismo e o complexo de Édipo. Também são discutidos os desafios do psicanalista diante do inenarrável das vivências com o adoecimento e diante das condições que reproduzem, nas instituições de saúde, as situações socioculturais de preconceitos em relação a parcelas da população e que são decorrentes do contexto histórico brasileiro. Além disso, coloca-se em evidência a importância da presença do psicanalista nas equipes multidisciplinares que assistem os sobreviventes de câncer infanto-juvenil do SNC. E se discute as possibilidades de diferentes dispositivos clínicos, que preservem a ética e a escuta psicanalítica, poderem ser oferecidos pelo psicanalista, que deve levar em conta, também, as vicissitudes do trabalho nas instituições públicas de saúde / This thesis aims to investigate the meanings that adults, survivors of Central Nervous System (CNS) tumor in childhood, attribute to their life experiences during illness and after the end of the oncological treatment, to offer subsidies for the formulation of new clinical apparatus to treat these cases. The patients aged 20 to 59 years who have completed cancer treatment for at least five years and are without evidence of the disease are considered to be adult survivors of childhood cancer. The research conception that underlies this thesis is the qualitative model in psychoanalysis that allows understanding the phenomena in depth. It consists of a bibliographical research - a review on the history of pediatric oncology and oncology in Brazil and on the psychoanalytic texts related to the theme proposed in this thesis - and a field research, through open interviews that seek the testimony of experiences lived by the subjects since the diagnosis. Interviews with eleven adults, patients from São Rafael Hospital / ONCO / Salvador, serve as clinical material for the discussion of some themes in the light of Freud-Lacanian psychoanalysis. The themes are divided into five categories: reactions to diagnosis; meanings of illness; treatment recollection; post-treatment experiences; and perception of late effects. The psychoanalytic concepts and notions guiding the discussion include Trauma, Grief, the Mirror Stage, Narcissism, and the Oedipus Complex. Also discussed are the challenges of the psychoanalyst in view of the unspeakable experiences from the illness and the conditions that they reproduce, in healthcare institutions, the socio-cultural situations of prejudices in relation to portions of the population and that are derived from the Brazilian historical context. In the final considerations, it is highlighted the importance of the presence of the psychoanalyst in multidisciplinary teams that assist survivors of childhood CNS cancer. And it is discussed about the possibilities of different clinical apparatus, that preserve ethics and psychoanalytic listening, that could be offered by the psychoanalyst, who must also take into account the vicissitudes of work in public healthcare institutions

Introdução – As crianças e adolescentes com câncer recebem tratamentos que têm os mais diversos efeitos colaterais, entre eles, a ototoxicidade, que é a capacidade de provocar lesão em estruturas da orelha interna e que pode levar à perda auditiva. Objetivos – Estimar a prevalência de perda auditiva e os fatores associados à ocorrência desta nas crianças e adolescentes tratados no Instituto de Tratamento do Câncer Infantil – ITACI, utilizando três classificações propostas na literatura. Métodos – Foram analisados 94 pacientes atendidos no ITACI, no período de 2003 e 2004. Como a avaliação audiológica não é feita de rotina neste Instituto, os pacientes transferidos e os que foram a óbito não puderam ser incluídos no estudo. Os indivíduos foram submetidos a uma anamnese para verificar qualquer comprometimento auditivo. Em seguida, foi feita a inspeção visual do meato acústico externo, para verificar a presença de qualquer ocorrência que pudesse impedir a realização dos exames audiológicos. Foi realizada a avaliação dos limiares auditivos utilizando-se procedimentos de resposta condicionada (por meio da audiometria tonal liminar, audiometria lúdica condicionada ou audiometria com reforço visual), com a finalidade de determinar os limiares auditivos. Por fim, foram realizadas a timpanometria e a pesquisa dos reflexos acústicos, para avaliar as condições da orelha média. A caracterização da amostra foi realizada por meio da estatística descritiva e a análise da concordância no diagnóstico da perda auditiva para as três classificações, por meio da estatística Kappa. A análise dos fatores associados à presença de perda auditiva foi realizada por meio do teste associação pelo qui-quadrado e modelos de regressão logística univariados e múltiplos. Resultados – Os resultados mostraram prevalência de perda auditiva de 42,5% utilizando a classificação proposta pela American Speech-Language-Hearing Association (ASHA), 40,4% de acordo com a classificação proposta pelo Pediatric Oncology Group Toxicity (POGT) e 12,8% pela classificação de Perda Auditiva Bilateral (PAB). A concordância no diagnóstico de perda auditiva pelas classificações POGT e PAB, e para PAB e ASHA foi fraca (respectivamente, k=0,36 e k=0,33). Já a concordância entre as classificações ASHA e POGT foi quase perfeita (k=0,96). O único fator de risco para perda auditiva, pelas três classificações adotadas, foi o uso da cisplatina e este efeito foi potencializado com o uso concomitante da ifosfamida. Conclusões – A perda de audição é um efeito colateral importante nas crianças e adolescentes com câncer. A monitorização auditiva é fundamental, visto que possibilita a detecção precoce das perdas auditivas e a revisão do tratamento, além de identificar a progressão da seqüela. Recomenda-se que sejam feitas avaliações audiológicas periódicas, mesmo após o término do tratamento e que seja adotada uma classificação que contemple as perdas auditivas discretas, como a proposta pela ASHA. / Introduction – The treatment of childhood cancer has several side effects and the ototoxicity is one of them. It can affect the inner ear structures and may lead to a hearing loss. Aim – To estimate the prevalence of hearing loss and risk factors in children and adolescents attended at the Childhood Cancer Treatment Institute (ITACI), using three classifications proposed in the literature. Methods – 94 patients admitted at ITACI between 2003 and 2004 were analyzed. The evaluation of hearing loss is not usually done in this institution and, because of this, the patients who were transferred and those who died could not be evaluated. The parents answered a questionnaire about demographic and clinical conditions. Then, the visual inspection of the external auditory meatus was done in order to verify if there were clinical conditions to perform the audiologic evaluation. The audiologic evaluation was done using pure tone audiometry (conditioned audiometry, play audiometry or visual reinforcement audiometry), tympanometry and tests of acoustic reflexes. The statistical analysis was done using descriptive statistics, the Kappa statistics, chi-squared test and univariate and multiple logistic regression models. Results – The prevalence of hearing loss was 42,5% using the American Speech-Language-Hearing Association (ASHA) classification, 40,4% using the Pediatric Oncology Group Toxicity (POGT) classification and 12,8%, using the bilateral hearing loss (PAB) classification. The agreement on the diagnosis of hearing loss was weak for POGT and PAB (k= 0.36) and for PAB and ASHA (k=0.33). The agreement between ASHA and POGT was almost perfect (k=0.96). The only risk factor for hearing loss for all classifications was the use of cisplatin and its effect was higher if the patients use also the ifosfamide. Conclusions – Hearing loss is an important side effect in children and adolescents with cancer treated with cisplatin. It is recommended a periodic audiological monitoring, even after the patient has finished the treatment. It can early detect a hearing loss, the schedule of treatment can be reviewed and the speech-language pathologist may be indicated to address the consequences of the hearing loss. It is recommended to adopt a classification that can detect slight hearing loss (ASHA).