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Previous issue date: 2015-02-27 / Cancer is a disease that causes great emotional imbalance, physical, social and spiritual in the patient and family, especially when it involves a child or adolescent. The family caregiver is the fundamental core of support throughout the disease process, being the key piece of the triad patient-family-health professionals. It features increased physical, emotional and social disorders as consequences of practical and emotional demands of treatment. This study describes and analyzes the coping process of family caregivers of children and adolescents with cancer, according to the Theory of Coping Motivational also assessing the impact of the disease in the family. The sample consisted of 4 mothers of children between 7 and 13 years, with cancer at different stages of the disease - [M1] diagnosis, [M2] treatment, maintenance [M3] and terminally [M4] - which were attended by a charity institution in a city named Uberaba, Minas Gerais state. Data were collected by the instruments: a) Economic Classification Criteria Brazil; b) PedsQLTM Family Impact Module [PedsQL-FIM], with 36 items, 8 dimensions; c) Interview Protocol on Coping Mothers of Children and adolescents with cancer, based on the Motivational Theory of Coping Scale-12 [MTC-12], with 34 issues; d) Responses to Stress Questionnaire - Cancer [RSQ-CA-PTC], with 57 items and e) Interview Protocol semi structured [PES], with 30 questions. Data were analyzed in qualitative and quantitative terms, making the description of cases, identifying the maternal beliefs, stressors and mother?s coping strategies [EE]. All families are impacted by the disease, differentially in relation to the stage of the disease, in descending order: M4 - M2 - M1 - M3, as shown by PedsQL-END. The dimensions with worse functioning were: Physical Functioning (M1); Daily Activities (M2); Relationships (M3) and Communication (M4). The biggest stressors are related to the difficulty of the case prognosis, lack of time and energy to devote to the family, financial difficulties, less often for M1 and more often for M4. The beliefs and values of mothers include feelings of self guilty or fatality of the disease, self-denial and self-neglect, with exclusive dedication to the child, miracle expectation, impotence and denial of death, for example. Stress responses were different according to the stages of the disease: M1- Voluntary Engagement for Secondary Control (Positive Thinking, Cognitive Restructuring and Acceptance); M2 and M3 - Voluntary Engagement for Primary Control (Problem Solution, Emotional Regulation and Emotional Expression); and M4 - Involuntary Engagement (Rumination, Intrusive Thoughts, Excitement Physiological, Emotional Excitement and Involuntary Action), according to RSQ-CA-PTC. Mothers use more adaptive coping strategies [EE] to deal with the situation, such as: Self-Confidence, Problem Solution, Search for Information and Accommodation, indicative of perceived challenge to Relationship needs, Competence and Autonomy. Other coping strategies [EE] used for the majority (N = 3) were: Search for Support, Negotiation (adaptive), Isolation and Submission (nonadaptive, with perceived threat). The data emphasize the need to assess and take care of the demands of this population, considering the stage of the disease and the psychological variables of the mother, assisting the process of coping with a major life stressors - the risk of death of the son. / C?ncer ? uma doen?a que gera grande desequil?brio emocional, f?sico, social e espiritual no paciente e na fam?lia, principalmente quando atinge uma crian?a ou adolescente. O cuidador familiar ? o n?cleo fundamental de apoio durante todo o processo da doen?a, sendo a pe?a-chave da tr?ade paciente-fam?lia-profissionais de sa?de. A ele cabe a maior sobrecarga f?sica, emocional e social, por centralizar as exig?ncias pr?ticas e emocionais do tratamento. Esta pesquisa descreveu e analisou o processo de enfrentamento de cuidadores familiares de crian?as e adolescentes com c?ncer, segundo a Teoria Motivacional do Coping, tamb?m identificando o impacto da doen?a na fam?lia. A amostra foi composta por 4 m?es de meninos de 7-13 anos, com c?ncer em fases distintas da doen?a diagn?stico [M1], tratamento [M2], manuten??o [M3] e terminalidade [M4] - os quais eram atendidos por uma institui??o beneficente de Uberaba, MG. Os dados foram coletados pelos instrumentos: a) Crit?rio de Classifica??o Econ?mica Brasil; b) PedsQLTM Family Impact Module [PedsQL-FIM], com 36 itens, em 8 dimens?es; c) Protocolo de Entrevista sobre Enfrentamento de M?es de Crian?as e Adolescentes com c?ncer, baseado na Motivational Theory of Coping Scale-12 [MTC 12], com 34 quest?es; d) Responses to Stress Questionnaire Cancer [RSQ-CA-PTC], com 57 itens; e e) Protocolo de Entrevista Semiestruturada [PES], com 30 quest?es. Os dados foram analisados qualitativos e quantitativamente, compondo a descri??o dos casos, com a identifica??o das cren?as maternas, estressores e estrat?gias de enfrentamento [EE] das m?es. Todas as fam?lias sofrem o impacto da doen?a, diferencialmente em rela??o ? fase da doen?a, em ordem decrescente: M4 M2 M1 M3, pelo PedsQL-FIM. As dimens?es com pior funcionamento foram: Funcionamento F?sico (M1); Atividades Di?rias (M2); Relacionamentos (M3) e Comunica??o (M4). Os maiores estressores relacionam-se ? dificuldade do progn?stico do caso, ? falta de tempo e energia para dedicar-se ? fam?lia e ?s dificuldades financeiras, com menor frequ?ncia para M1 e maior para M4. As cren?as e valores das m?es incluem a autoculpabiliza??o ou fatalidade da doen?a, abnega??o e autoneglig?ncia, com dedica??o exclusiva ao filho, expectativa de milagre, impot?ncia e nega??o da morte. As respostas ao estresse se diferenciaram segundo as fases da doen?a: M1- Engajamento Volunt?rio por Controle Secund?rio (Pensamento Positivo, Reestrutura??o Cognitiva e Aceita??o); M2 e M3 - Engajamento Volunt?rio por Controle Prim?rio (Resolu??o de Problemas, Regula??o Emocional e Express?o Emocional); e M4 - Engajamento Involunt?rio (Rumina??o, Pensamentos Intrusivos, Excita??o Fisiol?gica, Excita??o Emocional e A??o Involunt?ria), pelo RSQ-CA-PTC. As m?es recorrem mais EE adaptativas para lidar com a situa??o, como: Autoconfian?a, Resolu??o de problemas, Busca de informa??o e Acomoda??o, indicativas de percep??o de desafio ?s necessidades de Relacionamento, de Compet?ncia e de Autonomia. Outras EE utilizadas pela maioria (N = 3) foram: Busca de suporte, Negocia??o (adaptativas), Isolamento e Submiss?o (mal adaptativas, com percep??o de amea?a). Os dados evidenciam a necessidade de avaliar e atender ?s demandas dessa popula??o, considerando a fase da doen?a e as vari?veis psicol?gicas da m?e, auxiliando seu processo de enfrentamento de um dos maiores estressores de vida o risco de morte do pr?prio filho.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede.bibliotecadigital.puc-campinas.edu.br:tede/466 |
| Date | 27 February 2015 |
| Creators | Guimar?es, Claudiane Aparecida |
| Contributors | Enumo, S?nia Regina Fiorim, Nucci, Nely Aparecida Guernelli, Prebianchi, Helena Bazanelli, Barros, Maria Lu?sa Torres Queiroz de, Batista, Cecilia Guarnieri |
| Publisher | Pontif?cia Universidade Cat?lica de Campinas, Programa de P?s-Gradua??o em Psicologia, PUC-Campinas, BR, CCV ? Centro de Ci?ncias da Vida |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_CAMPINAS, instname:Pontifícia Universidade Católica de Campinas, instacron:PUC_CAMP |
| Rights | info:eu-repo/semantics/openAccess |
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