ABSTRACT
BACKGROUND: Palliative care aims to improve the quality of life of people with life-limiting illness and their families by addressing physical, psychological, social and spiritual suffering. Allied Health and Social Care Professionals (AHSCP) are key to delivering comprehensive, high quality palliative care. In recent years, Colombia has developed changes in the legal, and regulatory framework for access to palliative care but barriers and facilitators to palliative care for patients with non-curable cancer have not been explored from the perspective of AHSCP. METHOD: This study aims to address this knowledge gap in two cities in Colombia: one in a medium-sized city in a rural area (Popayan) and one in a highly urbanized area (Bogota). Two focus groups with AHSCP were conducted using the World Cafe method, and a subsequent thematic analysis was performed to establish the main barriers and facilitators. RESULTS: A wide range of 18 AHSCPs attended the two World Cafe groups in Popayan and Bogota. As a result of this iterative process, we established five thematic areas: (i) Humanizing care, (ii) Normalizing palliative care: referral at the time of diagnosis, (iii) Misunderstandings related to palliative care, (iv) Barriers within the health system, and (v) Geographic barriers. CONCLUSION: This study provided the perspectives of AHSCPs in Colombia in relation to barriers and facilitators in the framework of comprehensive palliative care attention. Participants identified misconceptions about palliative care, which are explained by the lack of inclusion of this area in the educational programs of health professionals and AHSCPs, along with the limited supply and access to palliative care, especially in rural areas.
Subject(s)
Neoplasms , Palliative Care , Humans , Palliative Care/methods , Colombia , Quality of Life , Qualitative Research , Social Support , Neoplasms/therapyABSTRACT
Cancer survivorship care in Colombia is of increasing importance. International survivorship initiatives and studies show that continuing symptoms, psychological distress, and late effects impact the quality of life for survivors. Priorities for quality survivorship according to Colombian patients and clinicians are unknown. We undertook a nominal consensus approach with 24 participants using virtual meeting technology to identify the priorities for cancer survivorship. We applied an iterative approach conducted over eight weeks with five workshops and one patient focus group followed by a priority setting survey. The consensus group established six main themes, which were subsequently evaluated by experts: (i) symptoms and secondary effects of cancer; (ii) care coordination to increase patient access and integration of cancer care; (iii) psychosocial support after cancer treatment; (iv) mapping information resources and available support services for long-term cancer care; (v) identifying socioeconomic and regional inequalities in cancer survival to improve care and outcomes; and (vi) health promotion and encouraging lifestyle change. The order of priorities differed between clinicians and patients: patients mentioned psychosocial support as the number one priority, and clinicians prioritized symptoms and surveillance for cancer recurrence. Developing survivorship care needs consideration of both views, including barriers such as access to services and socioeconomic disparities.
ABSTRACT
Las náuseas y el vómito son sensaciones desagradables que generan desánimo e impotencia en el niño y cuidadores. El enfermero que brinda cuidado debe estar en capacidad de integrar el conocimiento a la práctica, con el propósito de disminuir estos síntomas desagradables en la esfera biológica, psicológica y social. Objetivo: Presentar la relación a la teoría de los síntomas desagradables en la planeación del cuidado en las náuseas y el vómito en el paciente pediátrico con diagnóstico oncoló-gico en tratamiento con quimioterapia. Metodología:Búsqueda de la literatura sobre náuseas y vómito como síntoma desagradable en pacientes pediátricos con diagnóstico oncológico. las bases de datos fueron: Scielo, Lilacs, ProQuest, PubMed, sin límite de tiempo, en idioma inglés, español y portugués, y los términos: síntomas desagradables, náuseas y vómito, oncología, oncología pediátrica.Resultados: Las náuseas y el vómito son síntomas desagradables frecuentes en el paciente pediátrico con quimioterapia, a menudo tratados con medicamentos antieméticos, para prevenir o disminuir este efecto incapacitante, sin embargo, estos síntomas pueden ser abordados con la Teoría de los Síntomas Desagradables, valorando factores físicos, psi-cológicos, situacionales que facilite la planeación e intervención efectiva del cuidado de enfermería en el manejo del paciente oncológico. Conclusión: La interrelación teoría-práctica, permite usar la valoración de enfermería en los pacientes pediátricos con diagnóstico oncológico disponiendo de la propuesta teórica de los síntomas desagradables para justificar el cuidado en postulados de teóricas de en-fermería con las necesidades reales de los niños.
Nausea and vomiting are unpleasant sensations that generate discouragement and helplessness in the child and caregivers. The nurse who provides care must be able to integrate knowledge into practice, in order to reduce these unpleasant symptoms in the biological, psychological and social sphere. Objective: to present the relationship with the theory of unpleasant symptoms in the planning of care in nausea and vomiting in pedia-tric patients with an oncological diagnosis undergoing chemotherapy treatment. Metho-dology: literature search on nausea and vomiting as an unpleasant symptom in pediatric patients with cancer diagnosis. the databases were: Scielo, Lilacs, ProQuest, PubMed, wi-thout a time limit, in English, Spanish and Portuguese, and the terms: unpleasant symp-toms, nausea and vomiting, oncology, pediatric oncology. Results: Nausea and vomiting are frequent unpleasant symptoms in pediatric patients with chemotherapy, often treated with antiemetic drugs, to prevent or reduce this disabling effect, however, these symp-toms can be addressed with the Theory of Unpleasant Symptoms, evaluating physical, psychological and situational factors that facilitate the planning and effective intervention of nursing care in the management of cancer patients. Conclusion: The theory-practice interrelation allows the use of the nursing evaluation in pediatric patients with available oncological diagnosis of the theoretical proposal of unpleasant symptoms to justify the care in theoretical nursing postulates with the real needs of children
Subject(s)
Patients , Signs and Symptoms , Nursing CareABSTRACT
Las náuseas y el vómito son sensaciones desagradables que generan desánimo e impotencia en el niño y cuidadores. El enfermero que brinda cuidado debe estar en capacidad de integrar el conocimiento a la práctica, con el propósito de disminuir estos síntomas desagradables en la esfera biológica, psicológica y social. Objetivo presentar la relación a la teoría de los síntomas desagradables en la planeación del cuidado en las náuseas y el vómito en el paciente pediátrico con diagnóstico oncológico en tratamiento con quimioterapia. Metodología Búsqueda de la literatura sobre náuseas y vómito como síntoma desagradable en pacientes pediátricos con diagnóstico oncológico. las bases de datos fueron: Scielo, Lilacs, ProQuest, PubMed, sin límite de tiempo, en idioma inglés, español y portugués, y los términos: síntomas desagradables, náuseas y vómito, oncología, oncología pediátrica. Resultados Las náuseas y el vómito son síntomas desagradables frecuentes en el paciente pediátrico con quimioterapia, a menudo tratados con medicamentos antieméticos, para prevenir o disminuir este efecto incapacitante, sin embargo, estos síntomas pueden ser abordados con la Teoría de los Síntomas Desagradables, valorando factores físicos, psicológicos, situacionales que facilite la planeación e intervención efectiva del cuidado de enfermería en el manejo del paciente oncológico. Conclusión La interrelación teoría-práctica, permite usar la valoración de enfermería en los pacientes pediátricos con diagnóstico oncológico disponiendo de la propuesta teórica de los síntomas desagradables para justificar el cuidado en postulados de teóricas de enfermería con las necesidades reales de los niños.
Nausea and vomiting are unpleasant sensations that generate discouragement and helplessness in the child and caregivers. The nurse who provides care must be able to integrate knowledge into practice, in order to reduce these unpleasant symptoms in the biological, psychological and social sphere Objective To present the relationship to the theory of unpleasant symptoms in the planning of care in nausea and vomiting in pediatric patients with an oncological diagnosis undergoing chemotherapy treatment. Methodology Search of the literature on nausea and vomiting as an unpleasant symptom in pediatric patients with an oncological diagnosis. the databases were: Scielo, Lilacs, ProQuest, PubMed, without time limit, in English, Spanish and Portuguese, and the terms: unpleasant symptoms, nausea and vomiting, oncology, pediatric oncology. Results Nausea and vomiting are frequent unpleasant symptoms in pediatric patients with chemotherapy, often treated with antiemetic drugs, to prevent or reduce this disabling effect, however, these symptoms can be addressed with the Theory of Unpleasant Symptoms, assessing physical factors , psychological, situational that facilitates planning and effective intervention of nursing care in the management of cancer patients. Conclusion The theory-practice interrelation allows the use of the nursing assessment in pediatric patients with an oncological diagnosis, having the theoretical proposal of unpleasant symptoms to justify the care in theoretical nursing postulates with the real needs of children.
