Care management for the hospitalized child with chronic cancer pain: intervening conditions.

Thiago Privado Da Silva,Marialda Moreira Chistoffel,Benedita Maria Rêgo Deusdará Rodrigues,Joséte Luzia Leite,Laura Johanson Da Silva,Ítalo Rodolfo Silva

doi:10.1590/0034-7167-2017-0514

Abstract

To understand the intervening conditions of care management for the hospitalized child with chronic cancer pain. Qualitative research, anchored in the methodological and theoretical frameworks, respectively, Grounded Theory and Complex Thinking. The semi-structured interview and non-participant observation were used to collect the data. Twenty-one health professionals, organized in three sample groups: nurses; nursing technicians; and professionals of the multiprofessional health staff. They emerged as intervening conditions of care management: human resources and materials, teamwork, absenteeism, professional relocation, professional qualification, family, playful, dialogue, empathy and caring relationship. It was understood as limiting conditions for care management: deficits of human resources and materials, absenteeism, ineffective teamwork, professional relocation, and insufficient professional qualification. On the other hand, they were presented as facilitating conditions: adequate professional knowledge, effective teamwork, dialogue, empathy, playful and affective relationship with the child.

Highlights

Pain, among other symptoms, is more common in the child with cancer, being the main cause of suffering[1,2,3]
The Complex Thinking was used as theoretical support, aiming at a contextualized, dynamic, objective and subjective understanding about the conditions that permeate the care management
It should be noted that the pharmaceutical company that participated in the study did not act directly in the care of the child with cancer, given their responsibility to manage the institution’s pharmacy. She pointed out that for two years she has teamed with the health professionals of the Pediatric Inpatient Unit, subsidizing drugs capable of promoting the relief of chronic cancer pain

Summary

Introduction

Among other symptoms, is more common in the child with cancer, being the main cause of suffering[1,2,3]. In developing countries, where many children have advanced cancer and few have access to effective treatment, cancer pain is related to the progression of the disease. Cancer pain is related to the treatment and to the diagnostic and therapeutic procedures performed in the child[4]. Cancer pain can be either acute or chronic. Acute pain is usually self-limiting and arises as a result of a tissue injury that tends to disappear when the wound heals. On the other hand, is continuous (persistent) or recurrent (episodic) and goes beyond the expected cure time (>3 to 6 months)(4-5)

Methods

Results

Conclusion