Fatores relacionados de conforto prejudicado em crianças e adolescentes com câncer

Abstract

There are clinical situations in which the relationship between exposure to an etiological factor and the development of a nursing diagnosis is not easily recognizable, especially when this human response is complex and subjective, such as the nursing diagnosis Impaired Comfort in the oncology and pediatric population. This is a cross-sectional study carried out in a tertiary hospital, reference in the treatment of childhood cancer in the city of FortalezaCeará. The study population consisted of 200 children and adolescents with cancer and undergoing treatment at the pediatric oncology unit. To assist in obtaining the information, we built data collection instruments and protocols with operational and conceptual definitions of the defining characteristics and related factors. Data collection was performed by the researcher and undergraduate students, previously trained. The data were compiled in an Excel® spreadsheet (2010). Statistical analysis was performed with the support of the IBM® SPSS® version 21.0 for Windows® statistical program and the R software version 3.2. The descriptive analysis of the data included the calculation of absolute frequencies, percentages, measures of central tendency and dispersion. The latent class model with adjusted random effects was used to determine impaired comfort and measures of sensitivity and specificity of defining characteristics. Finally, a univariate logistic regression analysis for the causal factors of Impaired Comfort was performed. The research was developed after the consent of the proposing and coparticipant institution, and the data collection was carried out after signing the consent form. The most prevalent types of cancers in the juvenile population were leukemias. The participants were mostly male and had a median age of 11 years. The main therapeutic modality was chemotherapy. The manifestation of the indicators Irritability, Regret, Anxiety and Pruritus was associated with the high probability of the child or adolescent presenting the diagnosis Impaired comfort. The related factors of this diagnosis in children and adolescents with cancer that had a high prevalence were six: Harmful environmental stimuli, Insufficient situational control, Insufficient resources, Treatment regimen, Disease-related symptoms and Insufficient environmental control. In this research, the variables female gender and fewer days of hospitalization showed a statistically significant relationship with the diagnosis Impaired comfort. The results obtained in this investigation can help the more accurate diagnostic inference of Impaired Comfort in children and adolescents with cancer as well as direct interventions to the related modifiable factors 8 that trigger this phenomenon in order to avoid or minimize the signs and symptoms of the diagnosis.