Adaptação da teoria do final de vida pacífico para crianças com doenças ameaçadoras da vida

Abstract

The present study aimed to adapt the theory of peaceful end-of-life care for children with life threatening conditions. It was a theoretical study employing a qualitative approach, utilizing Walker and Avant's theory adaptation process. A scoping review was conducted, adhering to the methodological recommendations of the Joanna Briggs Institute and the PRISMA-ScR guideline. The theoretical framework was grounded in the Theory of Peaceful End-of-Life and Poulis and Bousso's concept of a child's dignified death. Data analysis was performed using IRAMUTEQ for data grouping and classification, incorporating techniques such as word clouds, similarity analysis, hierarchical descending classification, and factor analysis. The results were subsequently analyzed based on the cited references. The scoping review encompassed 17 studies that focused on nursing interventions for children facing life-threatening illnesses. While the original theory's "Experience of comfort" indicator remained unchanged, others were adapted to include: pain and suffering relief, accurate medication administration, support during the dying process, humanized care for both the child and family, and the establishment of a dialogic relationship. This adaptation underscored the need to tailor end-of-life care for children, differentiating it from adult care. The most frequent interventions directed solely at children involved stimulating play (art, drawing, storytelling, singing), pain management, and open communication. For the child-family dyad, key interventions included active listening, physical presence, extended visitation during the active dying phase, empathetic care, and building strong relationships. Family-centered interventions focused on providing support during difficult times, helping families understand the stages of death, involving them in care, and fostering trust. In conclusion, the study successfully adapted the Theory of Peaceful End-of-Life to suit the needs of children with life-threatening illnesses. It is anticipated that this research will enhance the quality of care provided to these children, ensuring a peaceful end-of-life and empowering healthcare professionals. Furthermore, it provides a robust theoretical foundation for future practice.