Análisis de la implementación de cuidados paliativos en pacientes pediátricos oncológicos en etapas terminales
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Publicado:
Aug 30, 2023
Palabras clave:
Cuidados paliativos pediátricos; oncología pediátrica; etapa terminal; intervención psicología; social; espiritual
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Resumen
Introducción. El cáncer infantil es una de las principales causas de muerte en el mundo, este padecimiento genera cambios en el estilo de vida del niño y la familia, varias esferas se ven afectadas luego de un diagnóstico, por esta razón surgen los Cuidados Paliativos Pediátricos (CPP) que tienen como finalidad atender las necesidades físicas, psicológicas, sociales y espirituales que presenta el niño oncológico y su familia. Objetivo. El objetivo de este estudio es describir la implementación de cuidados paliativos en pacientes pediátricos oncológicos que se encuentran en etapa terminal. Metodología. Se realizó una revisión bibliográfica sistemática descriptiva en las bases de datos Scopus, Taylor & Francis, Web Of Science, ProQuest y PubMed, los artículos seleccionados se sometieron a criterios de inclusión y exclusión y se reflejaron mediante el método Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA), obteniendo como resultado de la depuración 19 artículos. Resultados. Los estudios reflejan las alteraciones clínicas, emocionales, espirituales y sociales que presentan los pacientes pediátricos oncológicos luego de su diagnóstico, y las diferentes intervenciones médicas, psicológicas, sociales y espirituales efectuados por los profesionales así como los beneficios a nivel emocional, conductual, espiritual, social, biológico y familiar. Conclusión. Las investigaciones analizadas centran su atención a nivel fisiológico y en un menor porcentaje en la intervención psicológica, social o espiritual. En la atención multidisciplinaria hay la escasez de personal especializado, observándose que la atención psicológica muchas veces es abordada por profesionales de otras áreas de la salud como médicos, enfermeras, etc., situación semejante se observa en al área social y espiritual. Área de estudio general: psicología. Área de estudio especifica: pacientes oncológicos. Tipo de estudio: original.
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Cómo citar
Ojeda Carche, G. F., Malavé Pérez, Y. M., & Polo Martínez, E. M. (2023). Análisis de la implementación de cuidados paliativos en pacientes pediátricos oncológicos en etapas terminales. ConcienciaDigital, 6(3.1), 90-116. https://doi.org/10.33262/concienciadigital.v6i3.1.2661
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Artículos
Citas
Beller, R., Gauß, G., Reinhardt, D., & Götte, M. (2023). Is an Exercise Program for Pediatric Cancer Patients in Palliative Care Feasible and Supportive? A Case Series. Children, 10 (2), 318. https://doi.org/10.3390/children10020318
Benini, F., Avagnina, I., Giacomelli, L., Papa, S., Mercante, A., & Perilongo, G. (2022). Pediatric Palliative Care in Oncology: Basic Principles. Revista Cancers, 14(8), 1972. https://doi.org/10.3390/cancers14081972
Beretta, S., Polastri, D., Clerici, A., Casanova, M., Cefalo, G., Ferrari, A., Luksch, R., Massimino, M., Meazza, C., Podda, G., Spreafico, F., Terenziani, M., & Bellani, F. (2010). End of life in children with cancer: experience at the pediatric oncology department of the istituto nazionale tumori in Milan. Pediatric blood & cancer, 54(1), 88–91. https://doi.org/10.1002/pbc.22284
Cheng, B., Rost, M., De Clercq, E., Arnold, L., Elger, B., & Wangmo, T. (2019). Palliative care initiation in pediatric oncology patients: A systematic review. Cancer Medicine, 8(1), 3-12. https://doi.org/10.1002/cam4.1907
Chong, L., & Khalid, F. (2014). Pediatric palliative care in Malaysia: Survey of knowledge base and barriers to referral. Progress in Palliative Care, 22(4), 195-200. https://doi.org/10.1179/1743291X13Y.0000000074
Comas, E., Ortega, D., & Busquets, E. (2021). The psychological experience of pediatric oncology patients facing life-threatening situations: A systematic review with narrative synthesis. Palliative and Supportive Care, 19(6), 733-743. https://doi.org/10.1017/S1478951521000031
Cuartas, P., Charry, L., Ospina, P., & Carreño, S. (2019). Spiritual care: A look from the perspective of the model of symptom management and palliative care. Revista Colombiana de Enfermería, 18(1), e005. https://doi.org/10.18270/rce.v18i1.2341
Eche, I., Eche, I., & Aronowitz, T. (2020). An Integrative Review of Factors Associated with Symptom Burden at the End of Life in Children with Cancer. Journal of Pediatric Oncology/Nursing, 37(4), 284-295. https://doi.org/10.1177/1043454220909805
Friebert, S., Grossoehme, D., Baker, J., Needle, J., Thompkins, J., Cheng, Y., Wang, J., & Lyon, M. (2020). Congruence Gaps Between Adolescents with Cancer and Their Families Regarding Values, Goals, and Beliefs About End-of-Life Care. JAMA Network Open, 3(5), e205424. https://doi.org/10.1001/jamanetworkopen.2020.5424
Gómez, A., Becerra, A., Tron, R., & Hernández, P. (2018). Intervención cognitivo-conductual en cuidados paliativos pediátricos: un caso clínico. Revista Psicooncología, 15(2), 385-398. http://dx.doi.org/10.5209/PSIC.61444
Hernández, M., Lorenzo, R., Cata del Palacio, E., López, A., Martino, R., Madero, L., & Pérez, A. (2009). Hablar de la muerte al final de la vida: el niño con cáncer en fase terminal. Revista Anales de Pediatría, 71(5), 419-426. https://doi.org/10.1016/j.anpedi.2009.08.003
Jones, B., Currin, J., Pelletier, W., Sardi, V., Brown, P., & Wiener, L. (2018). Psychosocial standards of care for children with cancer and their families: A national survey of pediatric oncology social workers. Social work in health care, 57(4), 221–249. https://doi.org/10.1080/00981389.2018.1441212
Kazak, A., & Noll, R. (2015). The integration of psychology in pediatric oncology research and practice: collaboration to improve care and outcomes for children and families. American Psychologist, 70 (2), 146-158. https://psycnet.apa.org/doi/10.1037/a0035695
Liu, Q., Ho, K., Lam, K., Ho, J., Lam, W., Ma, P., Abu-Odah, H., Belay, G., Ling, D., Ching, S., & Wong, F. (2023). Effectiveness of spiritual interventions on psychological outcomes and quality of life among pediatric patients with cancer: a study protocol for a systematic review. BMJ Open, 13(3), e070810. https://doi.org/10.1136/bmjopen-2022-070810
Organización Mundial de la Salud [OMS]. (2021, 13 de diciembre). El Cáncer Infantil. https://www.who.int/es/news-room/fact-sheets/detail/cancer-in-children
Organización Panamericana de la Salud [OPS]. (2020, 20 de agosto). Cuidados Paliativos. https://www.who.int/es/news-room/fact-sheets/detail/palliative-care
Podda, M., Schiavello, E., Visconti, G., Clerici, C., Armiraglio, M., Casiraghi, G., Ambroset, S., Grossi, A., Rizzi, B., Lonati, G., & Massimino, M. (2021). Customised pediatric palliative care: Integrating oncological and palliative care priorities. Acta Paediatrica, 110(2), 682-688. https://doi.org/10.1111/apa.15415
Pravin, R., Enrica, T., & Moy, T. (2019). The portrait of a dying child. Indian Journal of Palliative Care, 25(1), 156-160.
Robert, R., Stavinoha, P., Jones, B., Robinson, J., Larson, K., Hicklen, R., Smith, B., Perko, K., Koch, K., Findley, S., &Weaver, M. (2019). Spiritual assessment and spiritual care offerings as a standard of care in pediatric oncology: A recommendation informed by a systematic review of the literature. Pediatric Blood Cancer, 66(9), e27764. https://doi.org/10.1002/pbc.27764
Rodríguez, C., Noreña, A., Chafer, T., Lorenzo, A., González de Dios, J., & Solano, C. (2022). The relevance of music therapy in pediatric and adolescent cancer patients: a scoping review. Global Health Action, 15(1), 2116774. https://doi.org/10.1080/16549716.2022.2116774
Rosenberg, A. & Wolfe, J. (2017). Approaching the third decade of pediatric palliative oncology investigation: historical progress and future directions. The Lancet Child & Adolescent Health, 1(1), 56–67. https://doi.org/10.1016/S2352-4642(17)30014-7
Salins, N., Hughes, S., & Preston, N. (2022). Palliative Care in Pediatric Oncology: An Update. Current oncology reports, 24(2), 175–186. https://doi.org/10.1007/s11912-021-01170-3
Snaman, J., McCarthy, S., Wiener, L., & Wolfe, J. (2020). Pediatric Palliative Care in Oncology. Journal of clinical oncology, 38(9), 954–962. https://doi.org/10.1200/JCO.18.02331
Umarani, J. (2016). Case reflections on care of a child with palliative care needs. Manipal Journal of Nursing and Health Sciences, 2(2), 75-77. https://impressions.manipal.edu/mjnhs/vol2/iss2/20?utm_source=impressions.manipal.edu%2Fmjnhs%2Fvol2%2Fiss2%2F20&utm_medium=PDF&utm_campaign=PDFCoverPages
Upshaw, N., Roche, A., Gleditsch, K., Connelly, E., Wasilewski, k., & Brock, K. (2021). Palliative care considerations and practices for adolescents and young adults with cancer. Pediatric Blood and Cancer, 68(1), e28781. https://doi.org/10.1002/pbc.28781
Van der Geest, I., Bindels, P., Pluijm, S., Michiels, E., van der Heide, A., Pieters, R., Darlington, A., & van de Heuvel, M. (2017). Home-Based Palliative Care for Children with Incurable Cancer: Long- term Perspectives of and Impact on General Practitioners. Journal of Pain and Symptom Management, 53 (3), 578-587. https://doi.org/10.1016/j.jpainsymman.2016.09.012
Veldhuijzen, S., van Meerwijk, C., Jansen, M., Twisk, J., Anderson, A., Coombes, L., Breen, M., Hargrave, O., Hemsley, J., Craig, F., Cruz, O., Kaspers, J., van Vuurden, D., & Hargrave, D. (2015). Palliative and end-of-life care for children with diffuse intrinsic pontine glioma: results from a London cohort study and international survey. Neuro Oncology, 18(4), 582-588. https://doi.org/10.1093/neuonc/nov250
Weaver, M., Heinze, K., Kelly, P., Wiener, L., Casey, R., Bell, C., Wolfe, J., Garee, A., Watson, A., & Hinds, P. (2015). Palliative Care as a Standard of Care in Pediatric Oncology. Pediatric Blood & Cancer, 62(5), S829–S833. https://doi.org/10.1002/pbc.25695
Benini, F., Avagnina, I., Giacomelli, L., Papa, S., Mercante, A., & Perilongo, G. (2022). Pediatric Palliative Care in Oncology: Basic Principles. Revista Cancers, 14(8), 1972. https://doi.org/10.3390/cancers14081972
Beretta, S., Polastri, D., Clerici, A., Casanova, M., Cefalo, G., Ferrari, A., Luksch, R., Massimino, M., Meazza, C., Podda, G., Spreafico, F., Terenziani, M., & Bellani, F. (2010). End of life in children with cancer: experience at the pediatric oncology department of the istituto nazionale tumori in Milan. Pediatric blood & cancer, 54(1), 88–91. https://doi.org/10.1002/pbc.22284
Cheng, B., Rost, M., De Clercq, E., Arnold, L., Elger, B., & Wangmo, T. (2019). Palliative care initiation in pediatric oncology patients: A systematic review. Cancer Medicine, 8(1), 3-12. https://doi.org/10.1002/cam4.1907
Chong, L., & Khalid, F. (2014). Pediatric palliative care in Malaysia: Survey of knowledge base and barriers to referral. Progress in Palliative Care, 22(4), 195-200. https://doi.org/10.1179/1743291X13Y.0000000074
Comas, E., Ortega, D., & Busquets, E. (2021). The psychological experience of pediatric oncology patients facing life-threatening situations: A systematic review with narrative synthesis. Palliative and Supportive Care, 19(6), 733-743. https://doi.org/10.1017/S1478951521000031
Cuartas, P., Charry, L., Ospina, P., & Carreño, S. (2019). Spiritual care: A look from the perspective of the model of symptom management and palliative care. Revista Colombiana de Enfermería, 18(1), e005. https://doi.org/10.18270/rce.v18i1.2341
Eche, I., Eche, I., & Aronowitz, T. (2020). An Integrative Review of Factors Associated with Symptom Burden at the End of Life in Children with Cancer. Journal of Pediatric Oncology/Nursing, 37(4), 284-295. https://doi.org/10.1177/1043454220909805
Friebert, S., Grossoehme, D., Baker, J., Needle, J., Thompkins, J., Cheng, Y., Wang, J., & Lyon, M. (2020). Congruence Gaps Between Adolescents with Cancer and Their Families Regarding Values, Goals, and Beliefs About End-of-Life Care. JAMA Network Open, 3(5), e205424. https://doi.org/10.1001/jamanetworkopen.2020.5424
Gómez, A., Becerra, A., Tron, R., & Hernández, P. (2018). Intervención cognitivo-conductual en cuidados paliativos pediátricos: un caso clínico. Revista Psicooncología, 15(2), 385-398. http://dx.doi.org/10.5209/PSIC.61444
Hernández, M., Lorenzo, R., Cata del Palacio, E., López, A., Martino, R., Madero, L., & Pérez, A. (2009). Hablar de la muerte al final de la vida: el niño con cáncer en fase terminal. Revista Anales de Pediatría, 71(5), 419-426. https://doi.org/10.1016/j.anpedi.2009.08.003
Jones, B., Currin, J., Pelletier, W., Sardi, V., Brown, P., & Wiener, L. (2018). Psychosocial standards of care for children with cancer and their families: A national survey of pediatric oncology social workers. Social work in health care, 57(4), 221–249. https://doi.org/10.1080/00981389.2018.1441212
Kazak, A., & Noll, R. (2015). The integration of psychology in pediatric oncology research and practice: collaboration to improve care and outcomes for children and families. American Psychologist, 70 (2), 146-158. https://psycnet.apa.org/doi/10.1037/a0035695
Liu, Q., Ho, K., Lam, K., Ho, J., Lam, W., Ma, P., Abu-Odah, H., Belay, G., Ling, D., Ching, S., & Wong, F. (2023). Effectiveness of spiritual interventions on psychological outcomes and quality of life among pediatric patients with cancer: a study protocol for a systematic review. BMJ Open, 13(3), e070810. https://doi.org/10.1136/bmjopen-2022-070810
Organización Mundial de la Salud [OMS]. (2021, 13 de diciembre). El Cáncer Infantil. https://www.who.int/es/news-room/fact-sheets/detail/cancer-in-children
Organización Panamericana de la Salud [OPS]. (2020, 20 de agosto). Cuidados Paliativos. https://www.who.int/es/news-room/fact-sheets/detail/palliative-care
Podda, M., Schiavello, E., Visconti, G., Clerici, C., Armiraglio, M., Casiraghi, G., Ambroset, S., Grossi, A., Rizzi, B., Lonati, G., & Massimino, M. (2021). Customised pediatric palliative care: Integrating oncological and palliative care priorities. Acta Paediatrica, 110(2), 682-688. https://doi.org/10.1111/apa.15415
Pravin, R., Enrica, T., & Moy, T. (2019). The portrait of a dying child. Indian Journal of Palliative Care, 25(1), 156-160.
Robert, R., Stavinoha, P., Jones, B., Robinson, J., Larson, K., Hicklen, R., Smith, B., Perko, K., Koch, K., Findley, S., &Weaver, M. (2019). Spiritual assessment and spiritual care offerings as a standard of care in pediatric oncology: A recommendation informed by a systematic review of the literature. Pediatric Blood Cancer, 66(9), e27764. https://doi.org/10.1002/pbc.27764
Rodríguez, C., Noreña, A., Chafer, T., Lorenzo, A., González de Dios, J., & Solano, C. (2022). The relevance of music therapy in pediatric and adolescent cancer patients: a scoping review. Global Health Action, 15(1), 2116774. https://doi.org/10.1080/16549716.2022.2116774
Rosenberg, A. & Wolfe, J. (2017). Approaching the third decade of pediatric palliative oncology investigation: historical progress and future directions. The Lancet Child & Adolescent Health, 1(1), 56–67. https://doi.org/10.1016/S2352-4642(17)30014-7
Salins, N., Hughes, S., & Preston, N. (2022). Palliative Care in Pediatric Oncology: An Update. Current oncology reports, 24(2), 175–186. https://doi.org/10.1007/s11912-021-01170-3
Snaman, J., McCarthy, S., Wiener, L., & Wolfe, J. (2020). Pediatric Palliative Care in Oncology. Journal of clinical oncology, 38(9), 954–962. https://doi.org/10.1200/JCO.18.02331
Umarani, J. (2016). Case reflections on care of a child with palliative care needs. Manipal Journal of Nursing and Health Sciences, 2(2), 75-77. https://impressions.manipal.edu/mjnhs/vol2/iss2/20?utm_source=impressions.manipal.edu%2Fmjnhs%2Fvol2%2Fiss2%2F20&utm_medium=PDF&utm_campaign=PDFCoverPages
Upshaw, N., Roche, A., Gleditsch, K., Connelly, E., Wasilewski, k., & Brock, K. (2021). Palliative care considerations and practices for adolescents and young adults with cancer. Pediatric Blood and Cancer, 68(1), e28781. https://doi.org/10.1002/pbc.28781
Van der Geest, I., Bindels, P., Pluijm, S., Michiels, E., van der Heide, A., Pieters, R., Darlington, A., & van de Heuvel, M. (2017). Home-Based Palliative Care for Children with Incurable Cancer: Long- term Perspectives of and Impact on General Practitioners. Journal of Pain and Symptom Management, 53 (3), 578-587. https://doi.org/10.1016/j.jpainsymman.2016.09.012
Veldhuijzen, S., van Meerwijk, C., Jansen, M., Twisk, J., Anderson, A., Coombes, L., Breen, M., Hargrave, O., Hemsley, J., Craig, F., Cruz, O., Kaspers, J., van Vuurden, D., & Hargrave, D. (2015). Palliative and end-of-life care for children with diffuse intrinsic pontine glioma: results from a London cohort study and international survey. Neuro Oncology, 18(4), 582-588. https://doi.org/10.1093/neuonc/nov250
Weaver, M., Heinze, K., Kelly, P., Wiener, L., Casey, R., Bell, C., Wolfe, J., Garee, A., Watson, A., & Hinds, P. (2015). Palliative Care as a Standard of Care in Pediatric Oncology. Pediatric Blood & Cancer, 62(5), S829–S833. https://doi.org/10.1002/pbc.25695