As repercussões dos cuidados paliativos para crianças com doença ameaçadora da vida: uma revisão integrativa

Abstract

The study aimed to analyze the scientific evidence about the repercussions of palliative care in children with life-threatening illness through the integrative review methodology. Therefore, an integrative literature review was developed, following the steps recommended by Souza, Silva, and Carvalho (2010). The search and selection of studies were carried out in the COCHRANE, PUBMED/MEDLINE, EMBASE, LILACS and PsycINFO databases. The sample consisted of 09 non-experimental studies, including primary articles published electronically in full, in national and international journals. Regarding the results, the studies were published between 2013 and 2022 in English and Portuguese, respectively. In the article identification phase, 2,627 studies were initially selected from the databases, of which 204 were excluded because they were duplicates, 2,322 were eliminated after reading titles and abstracts, remaining eligible 12 and included in a qualitative synthesis 9 studies in full. The study selection and eligibility process followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta Analyzes (PRISMA). Regarding the classification of the levels of evidence of the selected studies, 8 were classified, according to the research design, in level IV - evidence from descriptive studies (non-experimental) or with a qualitative approach and 1 article in level V - evidence from reports of case or experience. In addition, it allowed for theoretical deepening on evidence-based practice in the context of pediatric palliative care whose integrative review methods brought directions and showed the repercussions on the quality of life of the patient and the family. Therefore, it can be inferred that most studies corroborate the guiding question of that research, since they answered the guiding question and raised possibilities for new studies that directly address the developmental milestones. It was observed that there are few publications on the proposed theme, mainly due to the scarcity of evidence that used evaluative tools. Thus, in this review, instruments to assess the methodological quality and risk of bias were not adopted for the selected articles. However, the studies met the objectives and emphasized the importance of early indication of palliative care for symptom management and decision making, which make it possible to benefit pediatric patients and their families by changing the course of quality of life.