ABSTRACT
El cáncer es una de las principales causas de mortalidad en la niñez y la adolescencia. Tanto el impacto biopsicosocial y espiritual que produce, puede llevar al niño a experimentar dolor y sufrimiento. OBJETIVO: Comprender aspectos comunes percibidos por la enfermera oncológica y como se relacionan en la valoración de un niño con dolor. MÉTODO: se trató de un estudio cualitativo con diseño de teoría fundamentada de datos según referencial metodológico de Strauss y Corbin. Por medio de muestreo teórico fueron seleccionados 13 participantes profesionales de enfermería pertenecientes a diferentes hospitales de Santiago de Chile. Los datos fueron recolectados a través de entrevistas semiestructuradas y en profundidad. El estudio se rigió por medio de los criterios de credibilidad, confirmabilidad y fidelidad de Guba y Lincoln. Los datos recolectados fueron transcritos posterior a cada entrevista y analizados en tres etapas: codificación abierta, axial y selectiva. RESULTADOS: para las enfermeras que trabajan en el área de oncología infantil, es central el cuidado entregado en el proceso de enfermedad del niño hospitalizado por cáncer, considerando aspectos como el perfil de las profesionales, las emociones, la capacitación, las reacciones frente a un niño con dolor y las relaciones que existe entre ellos. CONCLUSIONES: Existen aspectos que resultan común en las enfermeras que se desempeñan en oncología infantil y que producto de las relaciones existentes entre ellos, pueden inclinar a las profesionales a reconocer el dolor en los niños con cáncer desde diversas perspectivas.
Cancer is one of the main causes of mortality in childhood and adolescence. Both the biopsychosocial and spiritual impact it produces can lead the patient child to experience pain and suffering. OBJETIVE: To understand common aspects perceived by the oncology nurse and how they are related to the assessment of a child in pain. METHOD: We conducted a qualitative study with a grounded theory approach based on Strauss and Corbin's methodological framework. Through theoretical sampling, 13 nursing professionals who worked in different hospitals in Santiago, Chile were selected. Data collection took place through semi-structured, in-depth interviews. The study followed Guba and Lincoln's criteria for credibility, confirmability, and fidelity. The data collected was transcribed after each interview and analyzed in three stages: open, axial and selective coding. RESULTS: For nurses who work in pediatric oncology, the care provided throughout the illness process for the child is central, considering aspects such as the profile of the professionals, the emotions, training, reactions to a child in pain, and the relationship that exist amongst them. CONCLUSIONS: There are common aspects amongst nurses who work in pediatric oncology. Because of the relationships between them, these aspects can help professionals to recognize pain in children with cancer following diverse perspectives.
ABSTRACT
In February 2022, the German Society of Pediatric and Adolescent Medicine published the first Evidence-based Recommendations for the Treatment and Prevention of Non-specific Back Pain in Children and Adolescents, which provides clinical evidence and recommendations for the etiology, risk factors and diagnosis of back pain in children and adolescents, and the treatment and prevention suggestions on the non-specific back pain.Although the guideline for the diagnosis and treatment of non-specific low back pain have been launched in China, a specific description of back pain in children and adolescents is lacking.With regard to increasing incidence of low back pain in children and adolescents, and differences in term of the etiology, risk factors, diagnosis and treatment of back pain between children-adolescents and adults, this article aims to interpret the guidelines to provide references and guidance for the clinical diagnosis and treatment of back pain in children and adolescents.
ABSTRACT
Objective To observe the clinical effect of Futongning Granules for the treatment of functional abdominal pain in children. Methods A total of 187 children with functional abdominal pain were randomized into treatment group(N = 122)and control group(N = 65). The treatment group was treated with Futongning Granules and the control group was treated with Compound Pepsin Powder. The gastrointestinal syndrome scores of the two groups were observed, and the short-term and long-term clinical efficacy of the two groups was evaluated after treatment. Results (1)The total effective rate and the effective rate for syndromes of abdominal internal cold, spleen-stomach deficiency cold, indigestion induced by milk and food stagnation, liver-Qi stagnation, blood collateral obstruction, gastrointestinal heat stagnation in the treatment group were 92.3％, 92.9％, 95.0％, 95.2％, 90.3％, 85.7％, 90.0％, and those in the control group were 71.0％, 69.2％, 69.2％, 86.7％, 66.7％, 50.0％, 60.0％, respectively. The total effective rate and the effective rate for various syndromes in the treatment group were superior to those of the control group (P < 0.05). (2) After treatment, gastrointestinal syndrome scores of various syndromes and overall scores in the two groups were obviously decreased(P<0.05 or P<0.01 compared with those before treatment), and the decrease in the treatment group was superior to that in the control group (P < 0.05). (3) The results of 6-month follow-up showed that the clinical efficacy during the follow-up in the treatment group was better than that in the control group(P < 0.05), and the difference was statistically significant(P<0.05). Conclusion Futongning Granules exert certain effect for the treatment of functional abdominal pain in children, and are effective for significantly relieving clinical symptoms and reducing the recurrence of disease.
ABSTRACT
Objective: Medically unexplained pain is a common manifestation of psychological distress in children, though establishing this diagnosis is seldom an easy task. This study aimed to enhance and share clinical insights in the complex interplay of medical and/ or psychological factors in these children as revealed by multidimensional assessment, to help in their effective management. Methods: Researchers assessed 65 consecutive children with unexplained pain for more than a month, referred by pediatrician. Of these, 59 consented and completed the interview. Clinical interview by psychiatrist generated psychiatric diagnosis as per ICD – 10 research criteria. Global functioning of the child (CGAS) and relational functioning of the family (GARF) were assessed before and after treatment. Psychosocial stresses were assessed clinically and treatments given to child and/or parent were recorded. Psychologist assessed intelligence of the child using Raven’s Coloured Progressive Matrices and administered Children’s Apperception Test (CAT). Results: A total of 38 (64.4%) children fulfilled criteria for Persistent Somatoform Pain Disorder. Most of them (89.8 %) were undergoing personal, familial and social stresses, many of which were revealed only after detailed clinical assessment. Major depression (28.8%), intellectual subnormality (11.9%), non-organic enuresis (8.5%) and ADHD (8.5%) were common co-morbid psychiatric diagnoses. Children with varying intellectual levels were proportionately represented, and colored the clinical complexity. Repression and reaction formation were common defenses and fear of loss of love of parent, injury, being overpowered were common fears as revealed on CAT. Conclusion: Unexplained pain was often a somatic expression of emotional needs in these children. Psychosocial adversities were common and often causative. However being subtle, these were routinely unidentified. Precise assessment is the key to effective management of these cases.
ABSTRACT
A la luz de estudios recientes se explican e interpretan la forma como el nino expresa el dolor ( conducta dolorosa) y la manera como emergen los aspectos biologicos, de comportamiento y cognitivos de esa expresion, a medida que avanza en el proceso de maduracion. Se hace enfasis en que a menudo, con base en conceptos ya revaluados, se permite que los ninos sufran dolor innecesariamente; tambien en la necesidad de que el medico y la enfermera sepan descifrar el lenguaje no verbal por medio del cual el nino expresa el dolor para poderlo prevenir yaliviar
The expression of pain by Infants and small children (painful conduct) Is reviewed based on recent studies; the emergence of biologic, behavioral and cognitive aspects of that expression, as maturation takes place, is briefly described; emphasis is made on the fact that Infants and small children are often allowed to suffer unnecessary pain, on the basis of previous misconceptions; also, the need for physicians and nurses to be able to interpret the non-verbal language of Infant's pain is underlined, so that prevention and early treatment can become possible.