Emiliana de Omena Bomfim

High Validity and Reliability of the PedsQL™ Multidimensional Fatigue Scale for Brazilian Children With Cancer

Among the main factors that affect patients’ quality of life, fatigue is a significant symptom experienced by children during treatment. Despite the high incidence, there has been no validated scale to evaluate fatigue in children with cancer in Brazil. The purpose of this study was to examine the psychometric properties of the PedsQL™ Multidimensional Fatigue Scale, using self-reports of Brazilian children, 8 to 18 years of age, and proxy reports. A cross-sectional method was used to collect data from 216 subjects over an 18-month period. Reliability ranged from .70 to .90 except for sleep/rest fatigue, self-report (α = .55). No floor or ceiling effects were found in any dimension. Convergent validity was higher than .40 and divergent validity had 100% adjustment. The root mean square error of approximation was acceptable. The comparative fit index was lower than expected. The agreement between self and proxy responses was weak and moderate. The results demonstrate the reliability and validity of the Brazilian version in children with cancer. This is the first validated scale that assesses fatigue in Brazilian children and adolescents with cancer.

Theory of unpleasant symptoms: support for the management of symptoms in children and adolescents with cancer

OBJECTIVE To present an overview of the clusters of neuropsychological symptoms in children and adolescents with cancer from the perspective of the Theory of Unpleasant Symptoms. METHODS A theoretical and reflective study based on international literature and the critical analysis of the authors. RESULTS In scientific literature, there is scarcity of international studies and an absence of studies in Brazil regarding the neuropsychological symptom clusters in children and adolescents with cancer. The theory of unpleasant symptoms is consistent because it emphasizes the complexity and interaction of the symptoms, the interrelationship between symptoms, the factors that influence symptoms, and the results and consequences of symptoms, thus supporting the planning of nursing interventions in paediatric oncology. CONCLUSION It is essential to update knowledge on this subject and discuss the theories that support research and the clinical practice of symptom management in order to better qualify nursing care.Objetivo: Presentar el panorama actual de grupos de sintomas neuropsicologicos en ninos y adolescentes con cancer, en perspectiva de Teoria de Sintomas Desagradables.Metodos: Estudio teorico y reflexivo basado en la literatura internacional y el analisis critico de los autores.Resultados: La literatura cientifica presenta internacionalmente escasos resultados y que faltan en Brasil con respecto a los grupos de sintomas neuropsicologicos en ninos y adolescentes con cancer. Esta es una teoria consistente, ya que hace hincapie en complejidad e interaccion de los sintomas, las interrelaciones entre ellos, los factores que influyen y los resultados y las consecuencias de estos, el apoyo a la planificacion de las intervenciones de enfermeria en oncologia pediatrica.Conclusion: Actualizar el conocimiento sobre este tema, asi como para discutir las teorias que apoyan la investigacion y la practica clinica en el manejo de los sintomas es fundamental para calificar el cuidado de enfermeria.

Translational research and symptom management in oncology nursing

In recent years, translational research (TR) has become a new approach for bridging basic research and clinical practice. This article examines studies in which the authors used TR to learn more about the underlying causes of selected symptoms, and to discuss these results in the context of cancer nursing and symptom management. A literature review was undertaken, plus critical analysis of the authors. TR conducted by cancer nursing scholars has been relatively limited in the past, but is becoming more common as nurses complete additional academic work in the basic sciences and develop research teams with colleagues of those areas of knowledge. The goal in these studies is to show how a set of variables explains differential interventional effects. The availability of TR provides new evidence for the management of symptoms experienced by individuals with cancer, which could lead to improvements in the care of cancer patients across the world.

Correlations between functional Interleukin-1 and changes in fatigue and quality of life in children and adolescents with cancer.

95 Background: Several studies have explored the hypothesis of involvement of the immune system in the cancer-related fatigue (CRF) and quality of life in adults with cancer via release of cytokines. However, how the immune system may produce these outcomes remains a largely unanswered question. Furthermore, research on fatigue in children and adolescents with cancer has included primarily self-reports of this symptom, with scarce although increasing data exploring biologic variables related to this symptom. METHODS To comprehensively examine the influence of cytokines in the fatigue and health related quality of life (HRQOL) in children and adolescents with cancer, we investigated the plasma levels of pro and anti-inflamatory cytokines and its correlation with fatigue and HRQOL in children and adolescents with cancer. Plasma levels of 6 cytokines were measured via flow cytometry. RESULTS The final sample consisted of 33 hospitalized children and adolescents aged between 8 and 18 years. We found a correlation between general fatigue and IL-1β (r = -0.361, p = 0.039) and correlation with quality of life was noted with IL-1β (r = -0.382, p = 0.028). The results of this research indicate that there may be a relationship between cytokines and fatigue, and HRQOL in children and adolescents with cancer. When analyzed the correlation between fatigue and some confounding variables found the link between general fatigue and neutrophils (r = -0.360, p = 0.040). This correlation is a novel found in this population under cancer condition, implicating a possible interleukin-hematological pathway for CRF in oncology. CONCLUSIONS Our study confirms the potential role of cytokines in developing cancer-related symptoms, thus supporting the utility of the neuroimmunological approach to the discovery of biomarkers linked to the clusters of cancer-related symptoms.

Practicability of comprehensive care in clinical genetics in the brazilian unified health system: expanding the debate

Este estudio objetivo tornar prominentes discusiones acerca de la Politica Nacional de Cuidado Integral en Genetica Clinica y reflexionar sobre su regulacion pendiente cuando descubrimientos genomicos transforman el modelo de atencion a salud. Nueve entre diez causas de morbilidad y mortalidad en todo mundo presentan predisposicion genetica/genomica. La Politica, fundamentada en la planificacion estrategica, propone ofrecimiento de asesoramiento genetico, mediante estructuracion de una red de servicios de referencia y centros especializados, para satisfacer las necesidades de la poblacion. Su regulacion requiere capacitacion y cualificacion de profesionales de salud para ofrecer el cuidado integral, optimizar el acceso, identificar y diagnosticar precozmente individuos con mayor riesgo de enfermedades con predisposicion genetica. En la atencion primaria de salud, el cuidado en cuestion no debe ser interpretado como una especialidad, pero si como especializado. Este modelo presenta perspectivas innovadoras en consonancia con principios y directrices de los modeladores del Sistema Unico de Salud.This article aims to highlight the discussions on the National Policy for Comprehensive Care in Clinical Genetics and reflect on its pending regulation when genomic discoveries change the model of health care. Nine of the ten causes of morbidity and mortality worldwide presents genetic/genomic predisposition. Based on strategic planning, this Policy proposes the organization of a network of referral services and specialized centers in genetics, with capacity to meet the needs of the population. Its regulation requires training and qualification of the health care professionals to provide comprehensive care, to optimize access, to identify and diagnose individuals with increased risk for injuries with genetic predisposition early. In primary health care, the care in question should not be interpreted as a specialty, but as specialized. This model presents innovative perspectives, in line with the principles and guidelines of the Unified Health System. DESCRIPTORS: Genetics. Genomics. Public health. Health policy.

Teoría de los síntomas desagradables: subvenciones para manejar síntomas en niños y adolescentes con câncer

OBJECTIVE To present an overview of the clusters of neuropsychological symptoms in children and adolescents with cancer from the perspective of the Theory of Unpleasant Symptoms. METHODS A theoretical and reflective study based on international literature and the critical analysis of the authors. RESULTS In scientific literature, there is scarcity of international studies and an absence of studies in Brazil regarding the neuropsychological symptom clusters in children and adolescents with cancer. The theory of unpleasant symptoms is consistent because it emphasizes the complexity and interaction of the symptoms, the interrelationship between symptoms, the factors that influence symptoms, and the results and consequences of symptoms, thus supporting the planning of nursing interventions in paediatric oncology. CONCLUSION It is essential to update knowledge on this subject and discuss the theories that support research and the clinical practice of symptom management in order to better qualify nursing care.Objetivo: Presentar el panorama actual de grupos de sintomas neuropsicologicos en ninos y adolescentes con cancer, en perspectiva de Teoria de Sintomas Desagradables.Metodos: Estudio teorico y reflexivo basado en la literatura internacional y el analisis critico de los autores.Resultados: La literatura cientifica presenta internacionalmente escasos resultados y que faltan en Brasil con respecto a los grupos de sintomas neuropsicologicos en ninos y adolescentes con cancer. Esta es una teoria consistente, ya que hace hincapie en complejidad e interaccion de los sintomas, las interrelaciones entre ellos, los factores que influyen y los resultados y las consecuencias de estos, el apoyo a la planificacion de las intervenciones de enfermeria en oncologia pediatrica.Conclusion: Actualizar el conocimiento sobre este tema, asi como para discutir las teorias que apoyan la investigacion y la practica clinica en el manejo de los sintomas es fundamental para calificar el cuidado de enfermeria.

Teoria dos sintomas desagradáveis: subsídios para o manejo de sintomas em crianças e adolescentes oncológicos.

OBJECTIVE To present an overview of the clusters of neuropsychological symptoms in children and adolescents with cancer from the perspective of the Theory of Unpleasant Symptoms. METHODS A theoretical and reflective study based on international literature and the critical analysis of the authors. RESULTS In scientific literature, there is scarcity of international studies and an absence of studies in Brazil regarding the neuropsychological symptom clusters in children and adolescents with cancer. The theory of unpleasant symptoms is consistent because it emphasizes the complexity and interaction of the symptoms, the interrelationship between symptoms, the factors that influence symptoms, and the results and consequences of symptoms, thus supporting the planning of nursing interventions in paediatric oncology. CONCLUSION It is essential to update knowledge on this subject and discuss the theories that support research and the clinical practice of symptom management in order to better qualify nursing care.Objetivo: Presentar el panorama actual de grupos de sintomas neuropsicologicos en ninos y adolescentes con cancer, en perspectiva de Teoria de Sintomas Desagradables.Metodos: Estudio teorico y reflexivo basado en la literatura internacional y el analisis critico de los autores.Resultados: La literatura cientifica presenta internacionalmente escasos resultados y que faltan en Brasil con respecto a los grupos de sintomas neuropsicologicos en ninos y adolescentes con cancer. Esta es una teoria consistente, ya que hace hincapie en complejidad e interaccion de los sintomas, las interrelaciones entre ellos, los factores que influyen y los resultados y las consecuencias de estos, el apoyo a la planificacion de las intervenciones de enfermeria en oncologia pediatrica.Conclusion: Actualizar el conocimiento sobre este tema, asi como para discutir las teorias que apoyan la investigacion y la practica clinica en el manejo de los sintomas es fundamental para calificar el cuidado de enfermeria.

Exequibilidade da atenção integral em genética clínica no sistema único de saúde: ampliando o debate

Este estudio objetivo tornar prominentes discusiones acerca de la Politica Nacional de Cuidado Integral en Genetica Clinica y reflexionar sobre su regulacion pendiente cuando descubrimientos genomicos transforman el modelo de atencion a salud. Nueve entre diez causas de morbilidad y mortalidad en todo mundo presentan predisposicion genetica/genomica. La Politica, fundamentada en la planificacion estrategica, propone ofrecimiento de asesoramiento genetico, mediante estructuracion de una red de servicios de referencia y centros especializados, para satisfacer las necesidades de la poblacion. Su regulacion requiere capacitacion y cualificacion de profesionales de salud para ofrecer el cuidado integral, optimizar el acceso, identificar y diagnosticar precozmente individuos con mayor riesgo de enfermedades con predisposicion genetica. En la atencion primaria de salud, el cuidado en cuestion no debe ser interpretado como una especialidad, pero si como especializado. Este modelo presenta perspectivas innovadoras en consonancia con principios y directrices de los modeladores del Sistema Unico de Salud.This article aims to highlight the discussions on the National Policy for Comprehensive Care in Clinical Genetics and reflect on its pending regulation when genomic discoveries change the model of health care. Nine of the ten causes of morbidity and mortality worldwide presents genetic/genomic predisposition. Based on strategic planning, this Policy proposes the organization of a network of referral services and specialized centers in genetics, with capacity to meet the needs of the population. Its regulation requires training and qualification of the health care professionals to provide comprehensive care, to optimize access, to identify and diagnose individuals with increased risk for injuries with genetic predisposition early. In primary health care, the care in question should not be interpreted as a specialty, but as specialized. This model presents innovative perspectives, in line with the principles and guidelines of the Unified Health System. DESCRIPTORS: Genetics. Genomics. Public health. Health policy.

Ejecutabilidad del cuidado integral en genética clínica en sistema único de salud: la ampliación del debate

Este estudio objetivo tornar prominentes discusiones acerca de la Politica Nacional de Cuidado Integral en Genetica Clinica y reflexionar sobre su regulacion pendiente cuando descubrimientos genomicos transforman el modelo de atencion a salud. Nueve entre diez causas de morbilidad y mortalidad en todo mundo presentan predisposicion genetica/genomica. La Politica, fundamentada en la planificacion estrategica, propone ofrecimiento de asesoramiento genetico, mediante estructuracion de una red de servicios de referencia y centros especializados, para satisfacer las necesidades de la poblacion. Su regulacion requiere capacitacion y cualificacion de profesionales de salud para ofrecer el cuidado integral, optimizar el acceso, identificar y diagnosticar precozmente individuos con mayor riesgo de enfermedades con predisposicion genetica. En la atencion primaria de salud, el cuidado en cuestion no debe ser interpretado como una especialidad, pero si como especializado. Este modelo presenta perspectivas innovadoras en consonancia con principios y directrices de los modeladores del Sistema Unico de Salud.This article aims to highlight the discussions on the National Policy for Comprehensive Care in Clinical Genetics and reflect on its pending regulation when genomic discoveries change the model of health care. Nine of the ten causes of morbidity and mortality worldwide presents genetic/genomic predisposition. Based on strategic planning, this Policy proposes the organization of a network of referral services and specialized centers in genetics, with capacity to meet the needs of the population. Its regulation requires training and qualification of the health care professionals to provide comprehensive care, to optimize access, to identify and diagnose individuals with increased risk for injuries with genetic predisposition early. In primary health care, the care in question should not be interpreted as a specialty, but as specialized. This model presents innovative perspectives, in line with the principles and guidelines of the Unified Health System. DESCRIPTORS: Genetics. Genomics. Public health. Health policy.