<p>Sexualiteten är en del av varje människas identitet och har varierande innebörd för den enskilda individen. Förmågan att älska och att känna sig älskad är en viktig förutsättning för god hälsa. Den som drabbas av cancer får ofta sexuella problem och det är flera orsaker till detta. Syftet med studien var att beskriva sjuksköterskors uppfattningar av att samtala med cancerpatienter om sexualitet och hur de uppfattar sexualitetens betydelse för patienterna. En kvalitativ metod med fenomenografisk ansats valdes. Sammanlagt 10 sjuksköterskor intervjuades från varierande arbetsplatser, som möter cancerpatienter i olika delar av vårdkedjan. Resultatet utföll i två delar med en varsin huvudkategorier med tillhörande beskrivningskategorier, kvalitativt skilda från varandra. Under huvudkategorin Hinder och möjligheter för samtal finns beskrivningskategorierna Sjuksköterskans professionalism och personliga mognad, Interaktion och relation mellan sjuksköterskan och patienten samt Omgivningens betydelse. Dessa beskriver förutsättningar för att samtalen ska komma till stånd. Den andra delens resultat består av huvudkategorin Cancerpatienternas behov av stöd och information i samtalen om sexualitet med beskrivningskategorierna Livssituationens betydelse, Positionen i vårdkedjan och dess betydelse samt Konsekvenser av sjukdom och behandling.</p> / <p>Sexuality is a part of every human beings identity and it has a varying meaning for the individual person. The ability to love and feel loved is an important part of good health. People suffering from cancer often experience sexual problems due to several reasons. The purpose of this study was to describe nurses’ perception of talking to cancer patients about sexuality and their experiences of what sexuality means for cancer patients. A qualitative method with a phenomenographic approach was used. Ten nurses from different clinics, who met patients in various places during the trajectory of care were interviewed. The nurses’ perceptions are captured in two main categories and six descriptive categories. The first of the two main categories Obstacles and possibilities for the conversation describe the necessary conditions for the dialog together with three descriptive categories: Nurse’s professionalism and individual maturity, Interaction and relationship between the nurse and the patient, and The meaning of the surrounding structure. The second of the two main categories was The cancer patients’ need for support and information. It describes the nurses’ perceptions of how the patients’ need for support and information about sexuality varies during the trajectory of care. Descriptive categories to this main category were: The situation of life, The position in the trajectory of care and its meaning, and Consequences of the illness and its treatment.</p>

Sexualiteten är en del av varje människas identitet och har varierande innebörd för den enskilda individen. Förmågan att älska och att känna sig älskad är en viktig förutsättning för god hälsa. Den som drabbas av cancer får ofta sexuella problem och det är flera orsaker till detta. Syftet med studien var att beskriva sjuksköterskors uppfattningar av att samtala med cancerpatienter om sexualitet och hur de uppfattar sexualitetens betydelse för patienterna. En kvalitativ metod med fenomenografisk ansats valdes. Sammanlagt 10 sjuksköterskor intervjuades från varierande arbetsplatser, som möter cancerpatienter i olika delar av vårdkedjan. Resultatet utföll i två delar med en varsin huvudkategorier med tillhörande beskrivningskategorier, kvalitativt skilda från varandra. Under huvudkategorin Hinder och möjligheter för samtal finns beskrivningskategorierna Sjuksköterskans professionalism och personliga mognad, Interaktion och relation mellan sjuksköterskan och patienten samt Omgivningens betydelse. Dessa beskriver förutsättningar för att samtalen ska komma till stånd. Den andra delens resultat består av huvudkategorin Cancerpatienternas behov av stöd och information i samtalen om sexualitet med beskrivningskategorierna Livssituationens betydelse, Positionen i vårdkedjan och dess betydelse samt Konsekvenser av sjukdom och behandling. / Sexuality is a part of every human beings identity and it has a varying meaning for the individual person. The ability to love and feel loved is an important part of good health. People suffering from cancer often experience sexual problems due to several reasons. The purpose of this study was to describe nurses’ perception of talking to cancer patients about sexuality and their experiences of what sexuality means for cancer patients. A qualitative method with a phenomenographic approach was used. Ten nurses from different clinics, who met patients in various places during the trajectory of care were interviewed. The nurses’ perceptions are captured in two main categories and six descriptive categories. The first of the two main categories Obstacles and possibilities for the conversation describe the necessary conditions for the dialog together with three descriptive categories: Nurse’s professionalism and individual maturity, Interaction and relationship between the nurse and the patient, and The meaning of the surrounding structure. The second of the two main categories was The cancer patients’ need for support and information. It describes the nurses’ perceptions of how the patients’ need for support and information about sexuality varies during the trajectory of care. Descriptive categories to this main category were: The situation of life, The position in the trajectory of care and its meaning, and Consequences of the illness and its treatment.

The landscape of cancer care is evolving and as a result nursing care continues to develop and respond to the changing needs of oncology patients and their families. There is a paucity of qualitative research examining the experience of being an oncology nurse on an inpatient unit. Therefore, a qualitative study using an interpretive phenomenological approach has been undertaken to discover the lived experience of being an oncology nurse. In-depth tape recorded interviews has been conducted with six oncology nurses who worked on two adult inpatient oncology units. Van Manen’s (1990) interpretive phenomenological approach has been used to analyze the data by subjecting the transcripts to an analysis both line by line and as a whole. The overarching theme of the interviews is: Investing to Make a Difference. The themes that reflect this overarching theme are: Caring for the Whole Person, Being an Advocate, Walking a Fine Line, and Feeling Like You are Part of Something Good. Oncology nurses provide care for their patients through a holistic lens that further enhances how they come to know their patients. Over time, relationships with patients and families develop and these nurses share that balancing the emotional aspects of their work is key in being able to continue to invest in their work and in these relationships. Their investment is further evident as oncology nurses continuously update their knowledge, for example, of treatment regimes, medication protocols, and as they champion their patients wishes and needs. As nurses develop their own identities as oncology nurses, they in turn enhance the team with their emerging skill and knowledge. These research findings serve to acknowledge the meaning of oncology nurses’ work and inform the profession’s understanding of what it means to be an oncology nurse.

Introduktion: Regionalt cancercenter (RCC) har i samarbete med Sveriges kommuner och landsting (SKL) beslutat att varje patient med en cancerdiagnos ska bli tilldelad en kontaktsjuksköterska. Syfte: Att undersöka hur väl implementeringen av kontaktsjuksköterskan har fungerat inom den onkologiska vården på Akademiska sjukhuset i Uppsala samt om de kontaktsjuksköterskor som finns arbetar i enlighet med SKL:s definition. Metod: Kvalitativ metod med semi-strukturerade intervjuer av åtta patienter med olika cancerdiagnos. Huvudresultat: Fem av de åtta deltagarna blev tilldelade en kontaktsjuksköterska eller motsvarande när de fick sin diagnos, antingen i direkt samband med diagnosen eller i ett senare skede. Resultaten tyder på att de patienter som ingår i någon slags forskningsstudie upplever sig ha en kontaktsjuksköterska som underlättar för dem och även deras behandling. Patienter som inte ingår i läkemedelsstudier upplever inte att kontaktsjuksköterskan har arbetat enligt SKL:s definition. Slutsats: Forskningssjuksköterskor är den personalkategori som arbetar närmast definitionen av kontaktsjuksköterska. Brister gällande sjukvårdens tillgänglighet, förmåga att ge fullgod information samt att erbjuda anhöriga stöd har uppmärksammats. Ytterligare forskning måste utföras för att resultaten ska kunna bekräftas. / Introduction:  The Regional Cancer Centre in Sweden (RCC), in collaboration with Local Authorities and Regions (SKL) has decided that every patient with a diagnosis of cancer should be assigned a contact nurse/patient navigator. Objective: To examine how well the implementation of this has been within the oncology care at the University Hospital in Uppsala and whether the patient navigators are working according to the definition decided by SKL. Methods: Qualitative methodology with semi-structured interviews of eight patients with different types of cancer. Main results: Five of the eight participants were assigned a patient navigator or equivalent at the time of their diagnoses or at a later stage. The result suggests that patients included in this study perceive that they have been provided with a patient navigator who facilitates their treatment. Patients assigned with a patient navigator but not included in drug trials do not feel that the patient navigators met the requirements asked by SKL. Conclusion: Research Nurses are the personnel who work most closely with SKLs definition of the patient navigator. Shortcomings regarding health care availability, the ability to provide adequate information and to offer family support have been noted. Further research must be carried out for the results to be confirmed.

SAMMANFATTNING                                                                                             Syftet med interventionsstudien var att undersöka om ROAG (revised oral assessment guide) munbedömningsinstrument förbättrade sjuksköterskor bedömning av cancerpatienters munhälsa på en palliativ vårdenhet. Metoden hade en kvasiexperimentell design med en journalgranskning före och efter en intervention. Interventionen bestod av en kortare utbildning av munhälsa samt införandet av ROAG munbedömningsinstrumentet. Resultatet visade att både bedömningar och åtgärder av munhälsan har ökat statistiskt signifikant jämfört med före interventionen på den palliativa vårdenheten, resultatet visar också att det inte alltid finns rätt koppling mellan symtom och åtgärd. Slutsats ROAG munbedömningsinstrument är ett bra verktyg för sjuksköterskor att använda för att bedöma munhälsan på en palliativ vårdenhet, men det räcker inte bara med ROAG munbedömningsinstrument utan det behövs kontinuerlig utbildning för att förbättra bedömningar och åtgärder . / ABSTRACT The purpose of the intervention study was to investigate whether ROAG (Revised oral assessment guide) improved nurses’ estimation of cancer patients’ oral health at a palliative care unit. The method was of a quantitative design with a quasi-experimental survey. Medical records were studied before and after an intervention, which consisted of a brief lecture on oral health and an introduction of ROAG. The results show significant increase in both assessment and measure of oral health after the intervention at the palliative care unit compared to before the intervention. The result also shows that the link between symptom and action does not always correspond to each other.   In conclusion, ROAG oral assessment is a great instrument for nurses to evaluate oral health at a palliative care unit, although it is not enough. Continuous education is required to improve evaluation and intervention.

Durante minha trajetória profissional experenciando o cuidar de clientes portadores de doença onco-hematológica percebi a luta destes seres humanos pela vida e como a relação enfermeiro-cliente era vital para a realização do cuidado. O enfermeiro interage grande parte do tempo com esta clientela a qual percorre uma trajetória de re-internações e longos períodos de tratamento. Nesse sentido, entendendo que a relação interpessoal como uma condição importante para que o enfermeiro compreenda o outro em sua totalidade e preste um cuidado singular, delimitei como objeto de estudo as relações interpessoais do enfermeiro na ação de cuidar do cliente internado para tratamento onco-hematológico. Para tanto, o objetivo foi compreender o significado das relações interpessoais na ação de cuidar do enfermeiro junto ao cliente internado para tratamento onco-hematlógico. Trata-se de estudo de natureza qualitativa, cujo referencial teórico pautou-se nas concepções da fenomenologia sociológica de Alfred Schutz. O cenário de realização do estudo foi a enfermaria de Hematologia de um Hospital Universitário Federal do estado do Rio de Janeiro e os sujeitos foram todos os seis enfermeiros lotados nessa unidade. Antes da etapa de campo e em cumprimento aos princípios éticos da Resolução 196/96 do CNS que trata da pesquisa com seres humanos, o projeto foi submetido ao Comitê de Ética dessa instituição cenário do estudo, sendo aprovado com o Parecer n 092/11. A captação das falas deu-se por meio de entrevista com a utilização das seguintes questões orientadoras: fale para mim sobre as ações que você desenvolve junto ao cliente internado para tratamento onco-hematológico; o que significam as relações interpessoais na ação de cuidar do cliente internado para tratamento onco-hematológico?; e o que você faz para que esta relação aconteça? A análise compreensiva das falas possibilitou a apreensão das categorias: cuidar através de procedimentos técnicos e científicos, orientando para o enfrentamento da doença e atender o paciente na perspectiva de suas necessidades estabelecendo a relação interpessoal entre enfermeiro e o cliente. O enfermeiro descreve as ações desenvolvidas junto ao cliente em tratamento onco-hematológico como um fazer técnico, rico em procedimentos, que tem em vista apoiar o cliente para enfrentar o tratamento difícil de uma doença grave, a partir de suas necessidades, estabelecendo uma relação íntima, transparente e forte, ocorrendo de forma espontânea e natural. Para estabelecer esta relação os enfermeiros utilizam estratégias como: a empatia, a brincadeira, o carinho, a confiança e a disponibilidade para promover o cuidado de enfermagem. As relações interpessoais se mostraram inerentes à ação de cuidar desse enfermeiro, ator social da equipe de saúde, o qual possui a disponibilidade para interagir com o cliente, transcendendo o aspecto tecnicista, fazendo parte de sua identidade profissional o constituinte relacional. / During my professional trajectory experiencing the take care of the clients with onco-hematological disease, I perceived the fight of these human beings for the life and how the nurse-client relationship was vital for the care realization. The nurse interacts much of the time with this clientele which comes a way of re-hospitalizations and long ways of treatment. In this sense, understanding that the interpersonal relation be an important condition so that the nurse understand the other in its totality and take a singular care I delineated as study object the nurse s interpersonal relations in the action of take care of the client hospitalized for onco-hematological treatment. For such, the objective was to understand the meaning of the interpersonal relationship in the action of take care of the nurse with the hospitalized client for onco-hematological treatment. It treats of study of qualitative nature, which theoretical reference based on the conceptions of the sociological phenomenology of Alfred Schütz. The Scenario of the study realization was the nursery of Hematology of a Federal University Hospital of the Rio de Janeiro state and the subjects were all the six (06), nurses placed in this unit. Before the field step and in compliance with the ethical principles of the 196/96 Resolution of the CNS that treats of the research with human beings, the project was submitted to the Ethical Committee of this institution scenario of this study, being approved with the Opinion n. 092/11. The speeches capture occurred by means of interview with the utilization of the following guiding questions: Talk to me about the actions that you develop with the hospitalized client for onco-hematological treatment. What means the interpersonal relationships in the action of take care of the hospitalized client for onco-hematological treatment? What do you do so that this relationship occurs? The comprehensive analysis of the speeches made possible the categories apprehension: To take care through technical and scientific procedures guiding to the confronting of the disease and Attend the patient in the perspective of its needs establishing the interpersonal relationship between nurse and the client. The nurse describes the actions developed with the client in onco-hematological treatment as a technical making, rich in procedures that have in view to support the client to confront the hard treatment of a serious disease, from its needs, establishing a close, transparent and strong relationship occurring in a spontaneous and natural way. To establish this relationship the nurses use strategies like: the empathy, the joke, the confidence, the availability to promote the care of nursing. The interpersonal relationships showed inherent to the action of take care of this nurse, social actor of the health team, which has the possibility to interact with the client, transcending the technicality aspect, being part of its professional identity the relational constituent.

Made available in DSpace on 2014-12-17T14:46:58Z (GMT). No. of bitstreams: 1 JoaoEC_DISSERT.pdf: 2165239 bytes, checksum: 7108f100f84dfe4688e985e847267ed2 (MD5) Previous issue date: 2013-02-18 / The studies paths in the maze: life story of individuals with oncological diseases into use of blood transfusion in Natal has the hemotherapy as a primordial procedure to review the relationship between users of oncological health and the due ramifications. The hemotherapy looks for supply the organic needs through blood transfusion, which acquires vital function to the ones that have cancer, because it might reestablish the functionality of the organism throughout the raising of blood components. The impact over the transfusion affects emotionally and physically the users life. Aiming to reflect on these impacts, this study tried, through narratives of lives, rescue their experience since their knowledge of the disease until the time of blood transfusion using. It s about an exploratory-descriptive study, where the qualitative approach uses the theoretical-methodological reference of the oral life history to analyze a colony consisting of five users of health diagnosed with cancer, with achievement of at least three blood transfusions, the clinic N?cleo de Hematologia e Hemoterapia - UFRN, in Natal-RN. The network, in turn, was composed by employees of both sexes, regardless of age, who voluntarily agreed to participate in the study. The data collection, with approval of the Ethics Committee in Research, Liga Norte Riograndense Contra o Cancer, on the number 001/001/2012, occurred through semi-structured interviews, recorded individually in the home context that was previously chosen by employees. The methodological procedure occurred with the transcription of the interviews and their transcreations, and analysis of reports by thematic content analysis. At the reading orientation and interpretation of the employees stories, were discussed three categories of analysis: the impact on psychological REVIEW; impact on socialization and group membership, the environment and the impact of blood transfusion on treatment. Based on the narrative of the life histories of employees, we conclude that the experiences and feelings, hope and sorrow, pain and faith, even when facing a disease like cancer, bring lots of teaching and learning to health professional that deposits humanization health and reinstate hemotherapy forms of clinical critical / O estudo Trajetos no Labirinto: hist?ria de vida de portadores de doen?as oncol?gicas em uso de transfus?o sangu?nea na cidade de Natal tem a hemoterapia como procedimento primordial para se repensar a rela??o entre usu?rios de sa?de oncol?gicos e os desdobramentos decorrentes. A hemoterapia busca suprir car?ncias org?nicas atrav?s da hemotransfus?o, que adquire fun??o vital aos portadores de c?ncer por poder restabelecer o funcionamento do organismo atrav?s do aumento de componentes sangu?neos. O impacto sobre a transfus?o afeta emocional e fisicamente a vida desses usu?rios. Objetivando refletir acerca desse impacto, o presente estudo procurou, atrav?s das narrativas de vida, resgatar suas viv?ncias desde o diagn?stico da doen?a at? os instantes de uso da transfus?o sangu?nea. Trata-se de um estudo explorat?rio-descritivo, em que a abordagem qualitativa utiliza o referencial te?rico-metodol?gico da hist?ria oral de vida para analisar uma col?nia formada por cinco usu?rios de sa?de com diagn?stico de c?ncer, com realiza??o m?nima de tr?s transfus?es sangu?neas, no ambulat?rio do N?cleo de Hematologia e Hemoterapia - UFRN, na cidade de Natal-RN. A rede, por sua vez, foi composta por colaboradores de ambos os sexos, sem limite de idade, que concordaram voluntariamente em participar do estudo. A coleta de dados, com aprova??o do Comit? de ?tica em Pesquisa, da Liga Norte Riograndense Contra o C?ncer, sob parecer 001/001/2012, ocorreu por meio de entrevistas semi-estruturadas, gravadas individualmente, em contexto domiciliar, local previamente escolhido pelos colaboradores. O procedimento metodol?gico se deu com a transcri??o das entrevistas e suas transcria??es, e a an?lise dos relatos por meio da an?lise de conte?do tem?tico. Na orienta??o de leitura e interpreta??o dos relatos dos colaboradores, discutiu-se tr?s categorias de an?lise: o impacto no psicol?gico REVER ; o impacto na socializa??o e no grupo de perten?a; o impacto do ambiente e da transfus?o sangu?nea no tratamento. Com base nas narrativas das hist?rias de vida dos colaboradores, conclui-se que as viv?ncias e os sentimentos, a esperan?a e a tristeza, a dor e a f?, mesmo em face de uma doen?a como o c?ncer, trazem muito de ensinamento e aprendizagem ao profissional da sa?de que deposita na humaniza??o e na hemoterapia formas de restabelecer quadros cl?nicos cr?ticos

Durante minha trajetória profissional experenciando o cuidar de clientes portadores de doença onco-hematológica percebi a luta destes seres humanos pela vida e como a relação enfermeiro-cliente era vital para a realização do cuidado. O enfermeiro interage grande parte do tempo com esta clientela a qual percorre uma trajetória de re-internações e longos períodos de tratamento. Nesse sentido, entendendo que a relação interpessoal como uma condição importante para que o enfermeiro compreenda o outro em sua totalidade e preste um cuidado singular, delimitei como objeto de estudo as relações interpessoais do enfermeiro na ação de cuidar do cliente internado para tratamento onco-hematológico. Para tanto, o objetivo foi compreender o significado das relações interpessoais na ação de cuidar do enfermeiro junto ao cliente internado para tratamento onco-hematlógico. Trata-se de estudo de natureza qualitativa, cujo referencial teórico pautou-se nas concepções da fenomenologia sociológica de Alfred Schutz. O cenário de realização do estudo foi a enfermaria de Hematologia de um Hospital Universitário Federal do estado do Rio de Janeiro e os sujeitos foram todos os seis enfermeiros lotados nessa unidade. Antes da etapa de campo e em cumprimento aos princípios éticos da Resolução 196/96 do CNS que trata da pesquisa com seres humanos, o projeto foi submetido ao Comitê de Ética dessa instituição cenário do estudo, sendo aprovado com o Parecer n 092/11. A captação das falas deu-se por meio de entrevista com a utilização das seguintes questões orientadoras: fale para mim sobre as ações que você desenvolve junto ao cliente internado para tratamento onco-hematológico; o que significam as relações interpessoais na ação de cuidar do cliente internado para tratamento onco-hematológico?; e o que você faz para que esta relação aconteça? A análise compreensiva das falas possibilitou a apreensão das categorias: cuidar através de procedimentos técnicos e científicos, orientando para o enfrentamento da doença e atender o paciente na perspectiva de suas necessidades estabelecendo a relação interpessoal entre enfermeiro e o cliente. O enfermeiro descreve as ações desenvolvidas junto ao cliente em tratamento onco-hematológico como um fazer técnico, rico em procedimentos, que tem em vista apoiar o cliente para enfrentar o tratamento difícil de uma doença grave, a partir de suas necessidades, estabelecendo uma relação íntima, transparente e forte, ocorrendo de forma espontânea e natural. Para estabelecer esta relação os enfermeiros utilizam estratégias como: a empatia, a brincadeira, o carinho, a confiança e a disponibilidade para promover o cuidado de enfermagem. As relações interpessoais se mostraram inerentes à ação de cuidar desse enfermeiro, ator social da equipe de saúde, o qual possui a disponibilidade para interagir com o cliente, transcendendo o aspecto tecnicista, fazendo parte de sua identidade profissional o constituinte relacional. / During my professional trajectory experiencing the take care of the clients with onco-hematological disease, I perceived the fight of these human beings for the life and how the nurse-client relationship was vital for the care realization. The nurse interacts much of the time with this clientele which comes a way of re-hospitalizations and long ways of treatment. In this sense, understanding that the interpersonal relation be an important condition so that the nurse understand the other in its totality and take a singular care I delineated as study object the nurse s interpersonal relations in the action of take care of the client hospitalized for onco-hematological treatment. For such, the objective was to understand the meaning of the interpersonal relationship in the action of take care of the nurse with the hospitalized client for onco-hematological treatment. It treats of study of qualitative nature, which theoretical reference based on the conceptions of the sociological phenomenology of Alfred Schütz. The Scenario of the study realization was the nursery of Hematology of a Federal University Hospital of the Rio de Janeiro state and the subjects were all the six (06), nurses placed in this unit. Before the field step and in compliance with the ethical principles of the 196/96 Resolution of the CNS that treats of the research with human beings, the project was submitted to the Ethical Committee of this institution scenario of this study, being approved with the Opinion n. 092/11. The speeches capture occurred by means of interview with the utilization of the following guiding questions: Talk to me about the actions that you develop with the hospitalized client for onco-hematological treatment. What means the interpersonal relationships in the action of take care of the hospitalized client for onco-hematological treatment? What do you do so that this relationship occurs? The comprehensive analysis of the speeches made possible the categories apprehension: To take care through technical and scientific procedures guiding to the confronting of the disease and Attend the patient in the perspective of its needs establishing the interpersonal relationship between nurse and the client. The nurse describes the actions developed with the client in onco-hematological treatment as a technical making, rich in procedures that have in view to support the client to confront the hard treatment of a serious disease, from its needs, establishing a close, transparent and strong relationship occurring in a spontaneous and natural way. To establish this relationship the nurses use strategies like: the empathy, the joke, the confidence, the availability to promote the care of nursing. The interpersonal relationships showed inherent to the action of take care of this nurse, social actor of the health team, which has the possibility to interact with the client, transcending the technicality aspect, being part of its professional identity the relational constituent.

O presente estudo caracterizou o perfil farmacológico utilizado por pacientes submetidos a transplante de medula óssea (TMO), identificou as combinações existentes entre antimicrobianos potencialmente interativos e outros medicamentos decorrentes da co-administração e analisou, a partir das combinações identificadas, as interações medicamentosas (IM) potenciais quanto aos seguintes aspectos: tipo de IM, nível de severidade, evidência cientifica e implicações clínicas potenciais. Analisaram-se 70 prescrições de medicamentos de pacientes submetidos a TMO, que se encontraram na fase de condicionamento (dia –1), e que estiveram internados, no período de janeiro a junho de 2005, no Instituto do Coração do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo. Os dados relativos ao perfil terapêutico dos medicamentos foram coletados do prontuário do paciente, e aqueles acerca das IM foram obtidos por meio de consulta ao Drug Interactions Facts e Drug Interactions Handbook. Para análise dos dados utilizou-se estatística descritiva e analiinferencial sendo aplicada a regressão logística multivariada. Os resultados apontaram que a amostra foi composta em sua maioria por pacientes do sexo masculino (52,9%), com média de idade de 37 anos, com diagnósticos de linfomas (38,6%) e submetidos a transplantes do tipo autólogo (65,7%). Quanto ao perfil terapêutico observou-se 33 medicamentos distintos pertencentes a 8 classes terapêuticas com predomínio dos quimioterápicos (34%). Observou-se que 72,7% dos medicamentos apresentaram potencial para interação medicamentosa, sendo que 79,2% eram precipitadores. Quanto à análise das características farmacológicas que predispunham as IM verificou-se que 66,6% dos medicamentos afetavam o metabolismo hepático, inibindo-o (45,8%) ou estimulando-o (20,8%). Entre os quimioterápicos antimicrobianos 66,7% apresentaram características potencialmente interativas. Metade da amostra foi exposta a combinações de antimicrobianos potencialmente interativos (fluconazol, ciprofloxacina e sulfametoxazol+trimetoprima) e outros medicamentos; sendo identificadas 13 IM distintas, todas do tipo farmacocinética. A maioria das IM (92,3%) apresentou severidade moderada, com bom nível de evidência cientifica (61,6%), que poderiam resultar em elevação dos níveis séricos do agente combinado com o antimicrobiano (77,0%), com tempo de inicio dos efeitos demorado (61,5%). Houve associação estatisticamente significante entre ocorrência de IM e sexo (p<0,001); entre IM e faixa etária (p<0,001); entre IM e número de medicamentos (p<0,001) / The present study have characterized the pharmacologic profile used by patients who undergo bone marrow transplant (BMT); identified the existing combinations between the potentially interactive anti-microbial drugs and those deriving from co-administration; and analyzed, using identified combinations, the possible drug interactions (DI) in regard to the following aspects: type of DI, severity level, scientific evidence, and potential medical implications. There were analyzed 70 prescriptions medication for patients who underwent a BMT in the phase of conditioning (day – 1), and who were in the hospital within the period of January to June 2005, in the Heart Institute of the School of Medicine Hospital of the University of São Paulo (Instituto do Coração do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo). The data related to the medication therapy profile were collected from the patient handbook and the DI data were obtained by looking up in the Drug Interactions Facts and Drug Interactions Handbook. For data analysis, the description and inferential statistics were used and the multi-diverse logistic regression was applied. The results pointed out that the sample was primarily of patients of masculine gender (52,9%), with an average age of 37 years old, with lymphoma diagnosis (38,6%) and who were undergoing auto-transplants (65,7%). In regard to therapeutic profile, there were observed 33 different drugs from 8 therapy classes mainly of chemotherapy (34%). 72,7% of the medications showed to be potentially drug interactive, whereas 79,2% of them were precipitators. As for the pharmacology characteristic analysis that predisposes DI, it was verified that 66,6% of the medications affected the hepatic metabolism by inhibiting it (45,8%) or stimulating it (20,8%). Among the anti-microbial chemotherapy drugs, 66,7% presented potentially interactive characteristics. Half of the sample were exposed to anti-microbial combinations potentially interactive (fluconazole, ciprofloxacin e sulphamethoxazole+trimethoprim) and other medicaments; where 13 different DI were identified, all of them of the pharmacokinetic type. Most of the DI (92,3%) presented moderate severity, with good level of scientific evidence (61,6%), which could result in a higher level of serum of the agent when combined with the anti-microbial drugs (77,0%), with prolonged time for starting the effects (61,5%). There was a statistically significant association between the DI occurrence and sex (p<0,001); between DI and 40-49 year-old age-group (p<0,001); between DI and more than 4 number of medicaments (p<0,001)

Introdução: As repercussões causadas pelo diagnóstico de câncer na vida de uma criança ou adolescente vão além dos danos físicos diretamente relacionados ao tratamento. O medo, a dor e a incerteza relacionada à cura passam a fazer parte de sua vida e de sua família e as desestruturações na rotina familiar pelas constantes idas ao hospital, pelo afastamento da escola, assim como pelos diversos efeitos que o tratamento traz, alteram a qualidade de vida desses indivíduos. Os profissionais de saúde, destacando-se aqui a enfermagem, devem estar atentos para essas alterações, a fim de planejar e executar uma assistência eficiente e promotora de bem estar. Objetivo: Avaliar a qualidade de vida (QV) e o impacto do tratamento em crianças e adolescentes com câncer, mediante aplicação dos inventários PedsQL 4.0 Generic Core Scale e PedsQL 3.0 Cancer Module. Material e métodos: Estudo descritivo, transversal, realizado com 215 crianças e adolescentes brasileiros e seus cuidadores, com idade entre dois e 18 anos e tempo de tratamento entre um e 12 meses. Para avaliação da QV geral, utilizou-se o inventário PedsQL 4.0 Generic Core; já para análise do impacto do tratamento, o inventário utilizado foi PedsQL 3.0 Cancer Module, ambos traduzidos para o Brasil. Para análise estatística, utilizou-se a média para o cálculo dos escores dos domínios, conforme orientação dos autores do instrumento e coeficiente de correlação intraclasse, teste t-Student e teste de correlação de Pearson para as demais análises. Resultados: Na avaliação do escore total (escala de 0 a 100), as crianças e adolescentes atingiram escore de 72,91 e seus cuidadores, 66,86. Analisando-se os domínios para os pacientes, notou-se que o de maior impacto foi o de preocupações (56,79) e o de menor, a ansiedade frente ao tratamento (83,23). Já na visão dos cuidadores, esse domínio foi o de maior impacto (57,14) e o de menor, o de dor e ferimentos (74,57). As crianças e adolescentes, de forma geral, avaliaram, em relação aos cuidadores, maiores escores em 7 dos 9 domínios analisados. Também se observou diferenças nas avaliações de acordo com a faixa etária. Notou-se nos resultados que o nível de concordância entre as avaliações variou de acordo com a faixa etária estudada e o domínio analisado. Conclusão: A avaliação de qualidade de vida relacionada à saúde das crianças e adolescentes deve ser usada como desfecho primário, sempre que possível, mas sugere-se que se aprecie, também, o ponto de vista dos cuidadores, pois se torna meio para observações mais acuradas e para planejamento de intervenções mais eficazes e efetivas. / Introduction: The impact caused by the cancer diagnosis in the life of a child or teenager goes beyond the physical damage directly related to treatment. The fear, pain and uncertainty about the cure become part of his life and his family and deconstructed the familiar routine by constant trips to the hospital, the remoteness of the school, as well as the various effects that the treatment brings, change the quality of life of individuals. Health professionals, especially nurses, should be alert to these changes in order to plan and execute an efficient assistance and promoting wellness. Aim: To assess the quality of life (QOL) and the impact of treatment in children and adolescents with cancer through the application of inventories PedsQL 4.0 Generic Core Scale and PedsQL 3.0 Cancer Module. Material and methods: Cross-sectional study was conducted with 215 children and adolescents and their caregivers, aged between two and 18 years and duration of treatment between one and 12 months. To assess the overall QoL, we used the PedsQL 4.0 Generic Core inventory, while for analysis of the impact of treatment, the inventory was used PedsQL 3.0 Cancer Module, both translated into Brazil. Statistical analysis was used to calculate the average of domain scores, as recommended by the authors of the instrument and the intraclass correlation coefficient, t-Student test and Pearson correlation test for the remaining analyzes. Results: In the evaluation of the total score (scale of 0 to 100), children and adolescents reached a score of 72.91 and their caregivers, 66.86. Analyzing areas for patients, it was noted that the greatest impact was of concern (56.79) and lower the anxiety during treatment (83.23). In the view of caregivers, this area was the highest impact (57.14) and the least, the pain and injuries (74.57). Children and adolescents, in general, assessed in relation to carers, higher scores in seven of the nine areas analyzed. It also observed differences in ratings according to age. It was noted in the results that the level of agreement between evaluations varied according to age group studied and analyzed field. Conclusion: The assessment of quality of life related to health of children and adolescents should be used as the primary outcome, whenever possible, but it is suggested that to appreciate also the view of caregivers, because it becomes a means of observations more accurate and to plan interventions more efficient and effective.