Assessment and management of adverse effects of pediatric chemotherapy treatment: an integrative review
DOI:
https://doi.org/10.33448/rsd-v11i10.32131Keywords:
Child; Adolescents; Symptoms; Neoplasms; Nursing.Abstract
The main therapy for the treatment of childhood and adolescent cancer is chemotherapy and its most frequent adverse effects are: pain, fatigue, apathy, loss of appetite, weight loss, alopecia, hematomas, bleeding, mucositis, nausea, among others. And the objective of this study was to identify in the literature the role of nurses facing the most common adverse effects of pediatric chemotherapy treatment, and for this, an integrative review of the literature was conducted in the period from January 2010 to February 2022, being included 21 productions in full. Chemotherapy promotes a series of physical, emotional and transformations in routine for children and adolescents. The studies show that approximately 80% of these patients had symptoms that classify as severe and very severe. Pain is common and persistent, and was the most frequently mentioned symptom among the studies, followed by fatigue. The long treatment journey makes it the nurse's mission to encourage and help patients and their families to overcome adversities, and to promote compliance and continuity of treatment, guiding good practices to deal with adverse events, awakening a sense of comfort and safety. All adverse effects of chemotherapy treatment can be properly managed by nursing professionals aiming to provide a less traumatic treatment, with control and relief of symptoms pharmacologically or through alternative therapies, and promoting an emotional support to families.
References
Arslan, F. T. & Basbakkal, K. M. (2013). Quality of Life and Chemotherapy-related Symptoms of Turkish Cancer Children Undergoing Chemotherapy. Asian Pacific Journal of Cancer Prevention. 14(3): 1761-1768. doi: 10.7314/APJCP.2013.14.3.1761
Azevedo, D. M., Nascimento, V. M., Azevedo, I. C., Cavalcanti, R. D. & Sales, L. K. O. (2014). Assistência de enfermagem à criança com dor: avaliação e intervenções da equipe de enfermagem. Revista Brasileira de Pesquisa em Saúde. 16(4): 23-31. https://periodicos.ufes.br/rbps/article/view/11170
Baggott, C. R.; Dodd, M.; Kennedy, C.; Marina, N.; Matthay, K. K. & Miaskowski, B. C. C. (2011). An evaluation of the factors that affect the health-related quality of life of children following myelosuppressive chemotherapy. Support Care Cancer. 19(3): 353-61. DOI: 10.1007/s00520-010-0824-y
Baggott, C.; Dodd, M.; Kennedy, C.; Marina, N.; Matthay, K. K.; Cooper, B. A. & Miaskowski, C. (2010). Changes in Children’s Reports of Symptom Occurrence and Severity During a Course of Myelosuppressive Chemotherapy. Journal of Pediatric Oncology Nursing. 27(6): 307–315. doi: 10.1177/1043454210377619
Brasil a. (2021). Câncer infantojuvenil. Instituto Nacional de Câncer - Ministério da Saúde. https://www.inca.gov.br/tipos-de-cancer/cancer-infantojuvenil
Brasil b. (2021). 15/02 – Dia Internacional do Câncer na Infância. Ministério da Saúde. https://bvsms.saude.gov.br/15-02-dia-internacional-do-cancer-na-infancia/
Brasil c. (2021). OPAS pede maior acesso ao diagnóstico e tratamento para crianças e adolescentes com câncer na América Latina e no Caribe. Representação da Organização Pan-Americana da Saúde (OPAS) e da Organização Mundial da Saúde (OMS) no Brasil. https://www.paho.org/pt/noticias/16-9-2021-opas-pede-maior-acesso-ao-diagnostico-e-tratamento-para-criancas-e-adolescentes
Cheng, K. K. F.; Lee, V.; Li, C. H.; Goggins, W.; Thompson, D. R.; Yuen, H. L. & Epstein, J. B. (2011). Incidence and risk factors of oral mucositis in paediatric and adolescente patients undergoing chemotherapy. Oral Oncology. 47(3): 153–162. DOI: 10.1016/j.oraloncology.2010.11.019
Cheng, K. K. F.; Lee, V.; Li, C. H.; Yuen, H. L.; Ip, W. Y.; Ele, H. G. & Epstein, J. B. (2013). Impact of oral mucositis on short-term clinical outcomes in paediatric and adolescent patients undergoing chemotherapy. Support Care Cancer. 21(8): 2145–2152. DOI: 10.1007/s00520-013-1772-0
Cheng, K. K. F. & Tan, L. M. L. (2021). Pilot Study of the Effect of a Home-Based Multimodal Symptom-Management Program in Children and Adolescents Undergoing Chemotherapy. Cancer Rep (Hoboken). 4(3): e1336. DOI: 10.1002/cnr2.1336
CicognaI, E. C.; Nascimento, L. C. & Lima, R. A. G. (2010). Crianças e adolescentes com câncer: experiências com a quimioterapia. Revista Latino-Americana de Enfermagem. 18(5): 1-9. DOI: 10.1590/S0104-11692010000500005
Duran, J.; Bravo, L.; Torres, V.; Craig, A.; Heidari, J.; Adlard, K.; Secola, R.; Granados, R. & Jacob, E. (2020). Quality of Life and Pain Experienced by Children and Adolescents With Cancer at Home Following Discharge From the Hospital. Journal Pediatric Hematology Oncology. 42(1): 46–52. DOI: 10.1097/MPH.0000000000001605
Fraga, M. M.; Terreria, M. T.; Azevedoa, R. T.; Hilárioa, M. O. E. & Len, C. A. (2019). Percepção e enfrentamento da dor musculoesquelética. Revista Paulista de Pediatria. 37(1): 11-19. DOI: 10.1590/1984‑0462/;2019;37;1;00006
Gonzalez, V. G.; Williams, P. D.; Williams, A. D.; Pharm, E. P. & Colon, G. (2016). The symptom experiences of Puerto Rican children undergoing cancer treatments and alleviation practices as reported by their mothers. International Journal of Nursing Practice. 23(1): 1-8. DOI: 10.1111/ijn.12500
Guimarães, C. A.; Dellazzana-Zanon, L. L. & Enumo, S. R. F. (2021). Enfrentamento materno do câncer pediátrico em quatro fases da doença. Pensando Famílias. 25(2): 81-97. http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1679-494X2021000200007
Heumann, S. & Cavalcante, L. I. C. (2018). Rotinas de crianças e adolescentes em acolhimento institucional: estudo descritivo. Arquivos Brasileiros de Psicologia. 70(2): 22-37. http://pepsic.bvsalud.org/pdf/arbp/v70n2/03.pdf
Hooke, M. C.; Garwick, A. W. & Gross, C. R. (2011). Fatigue and physical performance in children and adolescents receiving chemotherapy. Oncology Nursing Forum. 38(6): 649-657. DOI: 10.1188/11.ONF.649-657
Hooke, M. C.; McCarthyc, K.; Taylor, O. & Hockenberry, M. J. R. (2015). Fatigue and carnitine levels over multiple cycles of chemotherapy in children and adolescents. European Journal of Oncology Nursing. 19(1): 7-12. DOI: 10.1016/j.ejon.2014.07.015
Hundert, A. S.; Birnie, K. A.; Abla, O.; Positano, K.; Cassiani, C.; Lloyd, S.; Tiessen, P. H.; Lalloo, C.; Jibb, L. A. & Stinson, J. (2022). A Pilot Randomized Controlled Trial of Virtual Reality Distraction to Reduce Procedural Pain During Subcutaneous Port Access in Children and Adolescents With Cancer. The Clinical Journal of Pain. 38(3): 189-196. DOI: 10.1097/AJP.0000000000001017
Instituto Desiderata. (2021) Panorama da Oncologia Pediátrica. http://desiderata.org.br/production/content/uploads/2021/08/3d12c3585d19f20ae72eddbec38978be.pdf
Iuchno, C. W. & Carvalho, G. P. (2019). Toxicidade e efeitos adversos decorrente do tratamento quimioterápico antineoplásico em pacientes pediátricos: revisão integrativa. Ciência & Saúde. 12(1): e30329. https://revistaseletronicas.pucrs.br/index.php/iberoamericana/N%C3%83%C6%92O%20https:/www.scimagojr.com/index.php/faenfi/article/view/30329
Linder, L. A. & Hooke, M. C. (2019). Symptoms in Children Receiving Treatment for Cancer-Part II: Pain, Sadness, and Symptom Clusters. Journal of Pediatric Oncology Nursing. 36(4): 262-279. DOI: 10.1177/1043454219849578
Maraba, R. R. B.; Lima, S. F. S.; Bezerra, D. G.; Lima, A. S. & Reis, R. P. (2019). O papel do enfermeiro frente à criança hospitalizada com câncer. Brazilian Journal of Surgery and Clinical Research. 28(1): 80-86. https://www.mastereditora.com.br/periodico/20190905_224334.pdf
Momani, T. G.; Mandrell, B. N.; Gattuso, J. S.; Oeste, N. K.; Taylor, S. L. & Hinds, P. S. (2016). Children with minimal chance for cure: parent proxy of the child's health-related quality of life and the effect on parental physical and mental health during treatment. International Journal of Neuro-Oncology. 129(2): 373-381. DOI: 10.1007/s11060-016-2187-9.
Monteiro, A. C. M.; Rodrigues, B. M. R. D. & Pacheco, S. T. A. (2012). O enfermeiro e o cuidar da criança com câncer sem possibilidade de cura atual. Escola Anna Nery. 16(4): 741-746 DOI: 10.1590/S1414-81452012000400014
Reeve, B. B.; Edwards, L. J.; Jaeger, B. C.; Hinds, P. S.; Dampier, C.; Gipson, D. S.; Selewski, D. T.; Troost, J. P.; Thissen, D.; Barry, V.; Gross, H. E. & DeWalt, D. A. (2017). Assessing responsiveness over time of the PROMIS pediatric symptom and function measures in cancer, nephrotic syndrome, and sickle cell disease. Quality of Life Research. 27(1): 249–257 DOI: 10.1007/s11136-017-1697-z.
Reeve, B. B.; McFatrich, M.; Lin, L.; Lucas, N. R.; Mack, J. W.; Jacobs, S. S.; Withycombe, J. S.; Baker, J. N.; Freyer, D. R. & Hinds, P. S. (2021). Validation of the Caregiver Pediatric Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events Measure. American Chemical Society Online Journals. 127(9): 1483–1494. DOI: 10.1002/cncr.33389.
Rodriguez, M. M. L.; Millan, A. F.; Fernández, M. D. R.; Sanz, I. D. & Medina, I. M. F. (2020). New Technologies to Improve Pain, Anxiety and Depression in Children and Adolescents with Cancer: A Systematic Review. International Journal of Environmental Research and Public Health. 17(10): 3563-3577. DOI: 10.3390/ijerph17103563
Santos, S. C. (2018). Revelando os sintomas vivenciados a cada sessão de quimioterapia: a experiência da criança e do adolescente com câncer. Anais dos Seminários de Iniciação Científica. 20(1): 1-4. DOI: 10.13102/semic.v0i20.3499
Silva, E. M. V. B.; Silva, D.; Aparício, G.; Bica, I.; Albuquerque, C. & Cunha, M. (2020). Promoção da saúde mental das crianças: contributos dos enfermeiros. Acta Paulista de Enfermagem. 33(1): 1-7. DOI: 10.37689/acta-ape/2020AO0254
Silva, K. A. S.; Dassi, N.; Michalowski, M. B. & Daudt, E. L. (2016). Efeitos tardios do tratamento do câncer infantil. Boletim Científico de Pediatria. 5(3): 87-91. Recuperado de https://www.sprs.com.br/sprs2013/bancoimg/170118174017bcped_05_03_a04.pdf
Walker, A. J.; Johnson, K. P.; Miaskowski, C.; Lee, K. A. & Gedaly-Duff, V. (2010). Sleep quality and sleep hygiene behaviors of adolescents during chemotherapy. Journal of Clinical Sleep Medicine. 6(5): 439-444. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2952746/
Walker, A. J.; Pongsing, Y.; Nail, L.; Pedhiwala, N.; Leo, M.; Price, J.; Lee, K. & Gedaly-Duff, V. (2011). Sleep-wake patterns of school-age children and adolescents before diagnosis and during induction chemotherapy for acute lymphocytic leukemia. Journal of Pediatric Nursing. 26(6): 37-44. DOI: 10.1016/j.pedn.2011.02.006.
Whittemore, R. & Knafl, K. (2005). The integrative review: updated methodology. Journal of Advanced Nursing. 52(5) :546-553. DOI: 10.1111/j.1365-2648.2005.03621.x
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