Sobrevivência de câncer na infância: uma investigação sobre o estresse pós-traumatico da criança e sua percepção acerca da experiência parental

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

In the last decades, parallelly to the progressive increase of the healing rates on Pediatric Oncology, a growing interest for the investigation of the survival to childhood cancer is evident. Several essays show that the experiences associated to the occurrence and coping of a cancer in this period of a persons development present adverse meanings to the child and its relatives. However, more studies are necessary to amplify the theoretical and practical knowledge about the effects of this experience after treatment. More specifically, the post-traumatic stress has been pointed out as one of the possible consequences both to the survivors as to its relatives. Some authors also consider that the post-traumatic stress is a pattern of adjustment that captures the traumatic nature of childhood cancer. Considering, therefore, the evidences gathered by previous researches, an investigation was done aiming to describe, analyze and comprehend such experience through the eyes of the cancer survivor, emphasizing aspects related to the childs perception of the parents experience and the evaluation of the infantile Post-Traumatic Stress Disorder. So, a semistructured interview script was designed and the Posttraumatic Stress Disorder Reaction Index was chosen, designated to identify the Post-Traumatic Stress Disorder and symptoms in children submitted to severe traumas. As a criterion of inclusion, the period of at least one year out of treatment was stipulated, considered by literature as the minimum interval to characterize a survivor. As to age, the criterion used was of at least five years during most of half the disease lasting, because studies have shown that this age group on is the most susceptibility to post-traumatic stress. To select the participants a first contact took place with the survivors and its auxiliaries at the ambulatory of the hospital. Then, each participant received one home visit. The next step was the data analysis of the thematic reports and then the recommendations of the PTSD Reaction Index were followed. The data referent to the category survival of childhood cancer and the total score of seriousness of PTSD were compared one to the other. The total and partial diagnosis rates of Post-Traumatic Stress Disorder were modest, according to what literature predict in similar cases. Besides, the symptom rates of post-traumatic stress were also low. On the other hand, the partial diagnosis of PTSD was positively related to the age of the oncologic patient because of the diagnosis and negatively when to the duration of the disease, since the correlation of the childs age and the PTSD diagnosis seems to demonstrate the older childs greater susceptibility to post-traumatic stress. It was also possible to characterize this experience from the data of the interviews: a) the mother as the main escort; b) the positive emotional reaction brought up by the discharge; c) the negative reactions unleashed by the diagnosis; and d) the difficulties with the environment and hospital routine. The childs perception of the parental experience confirmed evidences pointed out by specialized literature, including those related to the parents. Finally, it was possible to suggest a likely connection between the way the parental experience is perceived and the total severity score of the Post-Traumatic Stress Disorder on children, especially as to the paradox recurrence versus cure and the hospital and disease context as generator of negative reactions to the ones responsible for the infant care.

ASSUNTO(S)

ptsd infantile post-traumatic stress disorder psicologia survival sobrevivência cancer câncer parental experience ptsd experiência parental desordem de estresse póstraumático infantil

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