O enfermeiro na oncologia pediátrica: perfil das crianças, diagnóstico situacional e gestão de caso

Abstract

The aim of the following paper is to characterize, in a sociodemographic and in a clinic way, kids undergoing oncological treatment and make a situational diagnosis of a service specialized in oncology in the west of Paraná. In order to achieve that, a three-step descriptive, exploratory and cross-sectional study was done. The research encompassed a medical institution in the west of Paraná and another facility in the metropolitan region of Asunción, Paraguay. During the first and second steps, data was collected from 199 online medical records related to kids undergoing oncological treatment, whose age range was up to 5, from December 2022 to June 2023. Besides that, other institutional documents have been verified, such as the development plan, operational procedures, risk maps and personal systematization for situational diagnosis. During the third step, a technical visit was made to the Cancer institute of Asunción, Paraguay, where the case management led by the nurse was explored. The obtained data were transferred to a spreadsheet and, in sequence, organized to analysis through descriptive statistics. The study was approved by the research ethics committee, under the technical report number 5.729.970 and CAAE number 64312622.4.0000.0107. Through the analysis, it was possible to grasp that children undergoing oncological treatment are mostly males (64,3%), white (72,9%), ranging from 1 to 4 years old (49,2%), living far from the hospital facilities (78,4%), Leukemic (50,7%) and diagnosed and treated with isolated chemotherapy (52,8%). It has also been observed that, most of the time, the time gap between the diagnosis and the start of the treatment respected the legal parameters, which revolves around less than 60 days. However, the process of referring these patients to specialized treatment took too long. Yet, due to the institutional vulnerability, it can be highlighted that the provided assistance is fragmented, which exposes the lack of enough working staff, as well as the absence of hospital beds in comparison to the number of patients under treatment, on top of the inexistence of a flowchart to point out the necessary steps to be taken. Considering the ideas presented, it was possible to point out the urge for another type of medical approach, especially one that aims to be full time, to reduce diagnosis and treatment time and also to lower the mortality rate. Furthermore, a new way of tackling these issues has to improve the work processes for all workers who are involved in taking care of these kids and their families. Therefore, considering the verified and obtained data, the management led by the nurse can be considered effective within the oncological area.