Intervenções de enfermagem especializadas às pessoas submetidas a transplante de progenitores hematopoiéticos para prevenção e tratamento de alterações cutâneas / Specialized nursing interventions for people undergoing transplantation of hematopoietic progenitors for the prevention and treatment of skin changes

Um dos desafios para os enfermeiros na abordagem ao doente submetido a transplante de células progenitoras hematopoiéticas é a prevenção, apreciação, diagnóstico diferencial e tratamento das alterações cutâneas, vistas aqui como sinais alarmantes, durante o período pós-transplante. A complexidade, especificidade e carácter multifatorial da situação clínica, plano de tratamento submetido e contexto em que se encontra, sujeitam a pessoa a risco de surgimento de alterações cutâneas. Os enfermeiros devem ter um papel ativo nas estratégias de transição dos cuidados a fim de prevenir e tratar alterações cutâneas, bem como garantir que o doente compreende os sinais de alerta e está capacitado para adequar medidas. Como tal, deliberou-se mapear a evidência disponível sobre a prevenção e tratamento de alterações cutâneas dos doentes submetidos a transplante de células progenitoras hematopoiéticas, com a finalidade de acautelar complicações e controlar sintomas. Como consequência, surge o título "Intervenções de enfermagem especializadas às pessoas submetidas a transplante de células progenitoras hematopoiéticas para prevenção e tratamento de alterações cutâneas". O Neuman Systems Model, desenvolvido por Betty Neuman em 1995, foi a teórica de enfermagem utilizada, enquanto a metodologia consistiu na execução de uma Scoping Review, na elaboração de uma reflexão crítica perseverante e na realização de estágios em três contextos clínicos diferenciados. A implementação deste projeto, para além de contribuir para o desenvolvimento de competências de Enfermeiro Especialista em Enfermagem Médico-Cirúrgica, na vertente oncológica e Mestre em Enfermagem, também contribui para a melhoria da qualidade dos cuidados de enfermagem na prevenção e controlo sintomático das alterações cutâneas do doente submetido a transplante de células progenitoras hematopoiéticas durante o período póstransplante e para a melhoria da qualidade de vida dos doentes submetidos a transplante de células progenitoras hematopoiéticas.

One of the challenges for nurses in their approach to patients undergoing hematopoietic progenitor cell transplantation is the prevention, assessment, differential diagnosis and treatment of skin changes, seen here as alarming signs, during the posttransplantation period. The complexity, specificity and multifactorial nature of the clinical situation, the treatment plan submitted and the context in which it takes place, subject the person to the risk of skin changes. Nurses should play an active role in care transition strategies in order to prevent and treat skin changes, as well as ensure that the patient understands the warning signs and is empowered to adapt measures. Therefore, it was decided to map the available evidence on the prevention and treatment of skin disorders in patients undergoing hematopoietic progenitor cell transplantation, with the aim of avoiding complications and controlling symptoms. As a result, the title "Intervenções de enfermagem especializadas às pessoas submetidas a transplante de células progenitoras hematopoiéticas para prevenção e tratamento de alterações cutâneas" was created. The Neuman Systems Model, developed by Betty Neuman in 1995, was the nursing theory used, while the methodology consisted of the implementation of a Scoping Review, the elaboration of a persevering critical reflection and the internship in three different clinical settings. The implementation of this project, in addition to contributing to the development of competencies as a Nurse Specialist in Medical-Surgical Nursing, in the oncology area and Master in Nursing, also contributes to improving the quality of nursing care in the prevention and symptomatic control of skin changes in patients undergoing hematopoietic progenitor cell transplantation during the post-transplantation period and to improving the quality of life of patients undergoing hematopoietic progenitor cell transplantation.

Homecare Encounters: An Organizational Response to Innovative Care for Patients Undergoing Hematopoietic Stem Cell Transplantation During COVID-19.

BACKGROUND: Healthcare delivery has been significantly changed because of the COVID-19 pandemic. Patients undergoing hematopoietic stem cell transplantation (HSCT) are vulnerable to infections because of their immunocompromised status. The risk of nosocomial infection may be reduced by providing care to patients at home. OBJECTIVES: This article describes one cancer center's approach for delivering safe patient care through homecare encounters, the benefits of home care for HSCT, and future directions. METHODS: Patients received detailed information on home encounters. Advanced practice providers visited patients daily and then returned to the clinic to formulate a plan of care with the interprofessional care team. Transplantation RNs visited patients on the same day to provide the prescribed care. FINDINGS: Based on evaluations from 32 patients and 12 providers, the results indicated that home care was safe, feasible, and beneficial for patient care post-HSCT during the COVID-19 pandemic.

Sobrecarga de los cuidadores familiares de niños y adolescentes en post-trasplante inmediato de células madre hematopoyéticas / Sobrecarga de cuidadores familiares de crianças e adolescentes em pós-transplante de células-tronco hematopoéticas imediato / Burden on family caregivers of children and adolescent in immediate post hematopoietic stem cell transplantation

OBJETIVO: Evaluar la sobrecarga de los cuidadores familiares de niños y adolescentes en el post-trasplante inmediato de células madre hematopoyéticas. MÉTODO: Estudio de tipo cuantitativo, analítico y transversal, realizado en dos instituciones de salud, con 31 cuidadores de niños y adolescentes en post-trasplante inmediato. La recolección de datos se llevó a cabo entre octubre de 2018 y junio de 2019. Se trazó el perfil socio demográfico de los cuidadores y se evaluó la sobrecarga de los mismos utilizando la Escala Caregiver Burden. Se utilizó estadística descriptiva y la correlación de Spearman. RESULTADOS: Se obtuvo un puntaje de sobrecarga global de 2.4/4, los dominios que presentaron los puntajes más altos fueron: tensión general y decepción, ambos con 2.8/4. CONCLUSIÓN: La comprensión sobre la forma como la familia enfrenta los desafíos impuestos por el TCMH en la etapa inmediatamente posterior le sirve de orientación al equipo interprofesional para realizar cuidados centrados en la familia y para ofrecer el máximo apoyo y orientación al cuidador

OBJETIVO: Avaliar a sobrecarga de cuidadores familiares de crianças e adolescentes em pós-transplante de células-tronco hematopoéticas imediato. MÉTODO: Estudo de natureza quantitativa, do tipo analítico e transversal, realizado em duas instituições de saúde, com 31 cuidadores de crianças e adolescentes no pós-transplante imediato. A coleta de dados foi realizada entre outubro de 2018 e junho de 2019. Caracterizou-se o perfil sociodemográfico dos cuidadores e avaliou-se a sobrecarga pela Caregiver Burden Scale. Utilizaram-se a estatística descritiva e a correlação de Spearman. RESULTADOS: Obteve-se um escore global de sobrecarga no valor de 2,4/4, tendo sido os domínios com maiores escores: tensão geral e decepção, ambos com 2,8/4. CONCLUSÃO: A compreensão da sobrecarga vivenciada pela família e o modo como enfrenta os desafios impostos pelo pós-transplante de células-tronco hematopoéticas imediato orienta a equipe multiprofissional a um cuidado centrado na família e a ofertar o máximo de apoio e orientação ao cuidador

OBJECTIVE: To evaluate the burden on family caregivers of children and adolescents in immediate post hematopoietic stem cell transplantation. METHOD: Study of quantitative nature, of analytical and traverse type, accomplished in two institutions of health with 31 caregivers of children and adolescents in immediate post transplantation. The data collection was accomplished between October of 2018 and June of 2019. The caregivers' social-demographic profile was characterized, and the burden was evaluated by Caregiver Burden Scale. The descriptive statistics and the Spearman correlation were used. RESULTS: It was obtained a burden global score of 2.4/4; the domains with larger scores were: general stress and frustration, both with 2.8/4. CONCLUSION: The understanding of how the family faces the challenges imposed by the immediate post hematopoietic stem cell transplantation guides the multiprofessional team a care centered in the family and to offer maximum support and guidance to the caregiver

Cuidados de enfermagem com pacientes submetidos a transplante de células-tronco hematopoiética / Cuidados de enfermería de pacientes sometidos a trasplante de células madre hematopoyética / Nursing care for patients undergoing hematopoietic stem cell transplantation

Resumo Objetivo: Mapear estudos de enfermagem que contemplem os cuidados de enfermagem com pacientes submetidos ao transplante de células-tronco hematopoiética. Métodos: Revisão de escopo, cuja busca foi realizada nas bases MEDLINE, CINAHL e LILACS, no período de junho a agosto de 2019, em português, inglês e espanhol. Foram selecionadas 18 publicações que contemplavam a temática. Resultados: Os cuidados de enfermagem estiveram relacionados às fases do transplante, a saber: condicionamento, infusão, pega e pós-transplante. Conclusão: O conhecimento específico do cuidado de enfermagem com o paciente submetido ao transplante de células-tronco hematopoiética permite ao enfermeiro o reconhecimento de complicações dessa clientela, favorecendo intervenções precoces e visando ao restabelecimento do indivíduo, contribuindo, assim, para uma assistência de enfermagem baseada em evidências.

Resumen Objetivo: Mapear estudios de enfermería que contemplen los cuidados de enfermería de pacientes sometidos al trasplante de células madre hematopoyética. Métodos: Revisión de alcance, cuya búsqueda fue realizada en las bases MEDLINE, CINAHL y LILACS, en el período de junio a agosto de 2019, en portugués, inglés y español. Fueron seleccionadas 18 publicaciones que contemplaban la temática. Resultados: Los cuidados de enfermería estuvieron relacionados con las fases del trasplante, a saber: acondicionamiento, infusión, injerto y postrasplante. Conclusión: El conocimiento específico sobre los cuidados de enfermería de pacientes sometidos al trasplante de células madre hematopoyética permite al enfermero reconocer las complicaciones de esta clientela, favorece intervenciones precoces en busca de la recuperación del individuo y, de esta forma, contribuye para una atención de enfermería basada en evidencias.

Abstract Objective: To map nursing studies that address nursing care for patients submitted to hematopoietic stem cell transplantation. Methods: Scoping review, whose search was carried out in the MEDLINE, CINAHL and LILACS bases, from June to August 2019, in Portuguese, English and Spanish. We selected 18 publications on the theme. Results: The nursing care was related to the phases of the transplantation, namely: conditioning, infusion, harvest, and post-transplantation. Conclusion: The specific knowledge of nursing care for patients submitted to hematopoietic stem cell transplantation allows the nurse to recognize complications of this clientele, favoring early interventions and aiming to restore the patient, thus contributing to evidence-based nursing care.

Daily received support and relational functioning in HCT survivors and their caregivers.

OBJECTIVES: Numerous authors have expressed their interest in adjustment and social support in the context of cancer. However, none of the previous studies has directly examined the models describing the links between daily social support and adjustment fluctuation, particularly at the relational level. This study aimed to verify the additive and buffering models of daily received support regarding the relational level of patient-caregiver relationship, that is, the relationship-related stress and relationship satisfaction following hematopoietic cell transplantation (HCT). METHODS: Two hundred patient-caregiver dyads participated in a 28-day diary study that was started on the first day after post-HCT discharge. The participants rated the extent of daily relationship-related stress, relationship satisfaction, and received support every evening during the study. The analyses were based on the actor-partner interdependence moderation model. RESULTS: Daily deviations in received support were directly associated with concurrent and lagged daily deviations in relationship satisfaction, regardless of relationship-related stress level in both patients and caregivers. In addition, in caregivers, the effect of daily deviations in received support on relationship satisfaction depended on deviations in relationship-related stress and was significant on the days with higher relationship-related stress. CONCLUSIONS: The findings supported both the additive (in patients and caregivers) and the buffering hypotheses (in caregivers) of daily received support in patient-caregiver dyads during the first month following HCT. The theoretical and practical implications of the findings are further highlighted.

COVID-19 rapid guideline: haematopoietic stem cell transplantation

The purpose of this guideline is to maximise the safety of patients who need haemopoietic stem cell transplantation and make the best use of NHS resources, while protecting staff from infection. It will also enable services to match the capacity for transplantation to patient needs if services become limited because of the COVID­19 pandemic.

A mindfulness-based intervention for caregivers of allogeneic hematopoietic stem cell transplant patients: Pilot results.

Despite high levels of stress, there are few empirically supported stress management interventions for caregivers of allogeneic hematopoietic stem cell transplant (HCT) cancer patients. This study examined the feasibility, acceptability, and various stress-related outcomes from pre- to post-treatment of a pilot, single-arm trial of a 6-week mindfulness-based intervention (FOCUS) for stress management. Caregivers (N = 21; 76% female; mean age = 57.43) were enrolled prior to patient transplant and received FOCUS during the first 90 days post-transplant. Findings indicated that FOCUS was highly feasible and acceptable (e.g., 71% attended at least four of six sessions; 100% reported using the skills learned at follow-up; high treatment engagement). Significant increases in mindfulness, post-traumatic growth, and general mental health were observed, along with significant decreases in negative affect (all ps < .05).

Programa de intervenção de enfermagem na vacinação dos doentes submetidos a transplante de células progenitoras da hematopoiese / Nursing intervention program on the vaccination of patients undergoing hematopoietic stem cell transplant

The vaccination project for patients undergoing Hematopoietic Stem Cell Trans-plant (HSCT) arose because they lose the immunization provided by vaccines administered prior to transplantation and are extremely vulnerable to infection. This program began in 2012, was based on the organization of the post-HSCT vaccination schedule in nursing consultations aimed at providing the patient with vaccination and verifying compliance with the National Vaccination Plan. The aim of this article is to evaluate the results of the implementation of the vaccination project of patients undergoing hematopoietic stem cell transplant. The method used was a retrospective quantitative analysis of the application of the project methodology, through the defined outcome quality indicator - vaccination rate of patients undergoing HSCT with the National Vaccination Plan. From 2017 to 2018, the number of telephone contacts made in the scope of vaccination was defined as a process quality indicator and the content analyzed. We covered a population of 348 people, 229 patients undergoing allogeneic HSCT and 119 autologous. We achieved vaccination rates of 100. By implementing improvement strategies over the years we have been able to improve project effectiveness and vaccination for a larger number of patients.The project plays an important role in the area of public health and rehabilitation of patients undergoing HSCT as it allows the patient to be linked to the caregiver community, which contributes to a greater connection and proximity of the person to the health unit. enabling them to better integrate into everyday life in the various dimensions of the person

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[A specialist nurse consultation for post-transplant follow-up of patients undergoing allogeneic hematopoietic cell transplantation: Recommendations of the Francophone Society of Marrow Transplantation and Cellular Therapy (SFGM-TC)]. / Mise en place d'une consultation infirmière de suivi post-allogreffe de cellules souches hématopoïétiques : recommandations de la Société francophone de greffe de moelle et de thérapie cellulaire (SFGM-TC).

The number of hematopoietic stem cell transplantation is in constant rise. This increase has put in spotlight the lack of physician availability. Some healthcare centers have already organised a nurse's consultation under the supervision of an expert physician. We conducted a survey among nurses and physicians from the French Society of Bone Marrow Transplantation and Cell Therapy (SFGM-TC) centers who confirmed the need to create a special transplantation-skilled population of nurses. During this ninth annual workshop of the SFGM-TC, we have defined the required conditions for a transplant nurse consultation until day 100 post-transplant with the responsibility of the transplant expert physician. To help the centers in this dynamic, we provided practical tools to support this consultation. The current heath policy is in favor of an increased autonomy of the expert nurse. The implementation of the status of nurse in advanced practice is the first step in this professional development.

The Meaning of Self-efficacy for Symptom Management in the Acute Phase of Hematopoietic Stem Cell Transplantation.

BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is an intensive treatment that offers the potential for longer life or cure for some types of cancer. Hematopoietic stem cell transplant is associated with decreased quality of life and functional status and distressing symptoms. Self-efficacy for symptom management (SESM) is a person's belief in his/her ability to implement behaviors to manage these symptoms. Presence of SESM can affect symptom distress, healthcare utilization, and posttransplantation outcomes. OBJECTIVE: The aim of this study was to explore the meaning of SESM in adults during the acute phase of HSCT. METHODS: Interviews were conducted before and at 30 days after transplantation. Descriptive thematic analysis was performed on verbatim interview transcripts. RESULTS: Themes of confidence, being responsible, and caring for mind, body, and spirit were identified, with subthemes of self-confidence, confidence in others, confidence and symptom level, vigilance, self-advocacy, and normalcy. Participants reported having high SESM before transplantation and having much less or no SESM when symptom distress was the most severe. CONCLUSIONS: This is the first study to examine the patient's perspective of self-efficacy in the acute phase of HSCT. This contributes to existing literature on the concept of symptom management and expands nursing knowledge of SESM in patients undergoing HSCT. IMPLICATIONS FOR PRACTICE: Nurses can assess SESM before transplantation and implement interventions to enhance SESM when symptoms are at their most distressing after HSCT. The findings from this study can provide the basis for creating behavioral interventions to enhance self-efficacy for symptom management in HSCT patients.

Short report: relationships among resilience, social support, coping style and posttraumatic growth in hematopoietic stem cell transplantation caregivers.

Posttraumatic growth has become a focus of concern in cancer caregivers, but a few studies have explored relationships among resilience, social support, coping style, and posttraumatic growth, especially in hematopoietic stem cell transplantation caregivers. A descriptive cross-sectional survey was conducted. Three hundred and fourteen participants completed questionnaires consisting of demographics, Posttraumatic Growth Inventory, Perceived Social Support Scale, Connor-Davidson Resilience Scale 10 and Coping Style Questionnaire. Pearson correlation analyses revealed that posttraumatic growth was positively associated with resilience, social support, and positive coping style, while, passive coping style was negatively associated with posttraumatic growth. At the same time, structural equation modeling analyses showed that resilience mediated the relationship between positive coping style and posttraumatic growth. Positive coping style and resilience played completely intermediary role between social support and posttraumatic growth.

Hand hygiene: knowledge and skill of caregivers in the hematopoietic stem cell transplantation / Higiene de las manos: conocimiento y habilidad de cuidadores en el trasplante de células madre hematopoyéticas / Higiene das mãos: conhecimento e habilidade de cuidadores no transplante de células-tronco hematopoéticas

ABSTRACT Objective: to identify the knowledge and ability of caregivers on hand hygiene in hematopoietic stem cell transplantation. Method: a prospective cross-sectional study. A questionnaire was used to identify the knowledge and it was observed the hygiene technique performance. Data were collected in two units (autologous and allogeneic transplant). Results: the 37 participants recognized the importance of hand hygiene and 95.5% related to removal of dirt or infection prevention. 91.9% stated that it was important to clean their hands with soap and water when entering and leaving the room, and 64.9% understood that it was necessary to apply alcoholic solution after washing. On average, the caregivers scored 6.16 steps, when demonstrating the washing technique and 3.91 steps in the friction with alcoholic solution. Conclusion: although they recognize the importance of the procedure, there are deficits related to the moment and the correct way of doing it, evidencing the need for strategies aimed at improving this process.

RESUMEN Objetivo: identificar el conocimiento y la habilidad de los cuidadores sobre la higiene de las manos en el trasplante de células madre hematopoyéticas. Método: estudio transversal prospectivo. Se utilizó un cuestionario para identificar el conocimiento y se observó la ejecución de la técnica de higienización. Los datos fueron recolectados en 2 unidades (transplante autólogo y alogénico). Resultados: los 37 participantes reconocieron la importancia de la higienización de las manos y el 95,5% la relacionaron con remoción de suciedad o prevención de infecciones. 91,9% citaron ser importantes higienizar las manos con agua y jabón al entrar y salir de la habitación, y el 64,9% entendieron que era necesaria la aplicación de una solución alcohólica después del lavado. En promedio, los cuidadores acertaron 6,16 pasos, al demostrar la técnica de lavado, y 3,91 pasos en la fricción con solución alcohólica. Conclusión: aunque reconocen la importancia del procedimiento, hay déficit relacionados con el momento y la forma correcta de realizarlo, evidenciando la necesidad de estrategias para la mejora de ese proceso.

RESUMO Objetivo: identificar o conhecimento e habilidade de cuidadores sobre higiene das mãos no transplante de células-tronco hematopoéticas. Método: estudo transversal prospectivo. Utilizou-se questionário para identificar o conhecimento e foi observada a execução da técnica de higienização. Os dados foram coletados em duas unidades (transplante autólogo e alogênico). Resultados: os 37 participantes reconheceram a importância da higienização das mãos e 95,5% a relacionaram com remoção de sujidade ou prevenção de infecções. 91,9% citaram ser importante higienizar as mãos com água e sabonete ao entrar e sair do quarto, e 64,9% entenderam ser necessária a aplicação de solução alcoólica após a lavagem. Em média, os cuidadores acertaram 6,16 passos, ao demonstrarem a técnica de lavagem, e 3,91 passos na fricção com solução alcoólica. Conclusão: embora reconheçam a importância do procedimento, há déficits relacionados aos momentos e à forma correta de realizá-lo, evidenciando a necessidade de estratégias visando à melhoria desse processo.

The Roles of Nurses in Hematopoietic Cell Transplantation for the Treatment of Leukemia in Older Adults.

OBJECTIVE: To review and summarize nurses' roles in the care of the older adult undergoing an allogeneic hematopoietic cell transplant (HCT) for the treatment of leukemia. DATA SOURCES: Published literature indexed in PubMed, CINAHL, textbooks, and clinical expertise. CONCLUSION: Nurses are a vital component of the highly specialized care delivered before, during, and after an allogeneic HCT. IMPLICATIONS FOR NURSING PRACTICE: Nurses who are prepared for the complex HCT care trajectory will be able to optimally meet the complex needs of the older adult patient and their caregiver(s).

Hand hygiene: knowledge and skill of caregivers in the hematopoietic stem cell transplantation.

OBJECTIVE: to identify the knowledge and ability of caregivers on hand hygiene in hematopoietic stem cell transplantation. METHOD: a prospective cross-sectional study. A questionnaire was used to identify the knowledge and it was observed the hygiene technique performance. Data were collected in two units (autologous and allogeneic transplant). RESULTS: the 37 participants recognized the importance of hand hygiene and 95.5% related to removal of dirt or infection prevention. 91.9% stated that it was important to clean their hands with soap and water when entering and leaving the room, and 64.9% understood that it was necessary to apply alcoholic solution after washing. On average, the caregivers scored 6.16 steps, when demonstrating the washing technique and 3.91 steps in the friction with alcoholic solution. CONCLUSION: although they recognize the importance of the procedure, there are deficits related to the moment and the correct way of doing it, evidencing the need for strategies aimed at improving this process.

Bronchoalveolar lavage with pediatric flexible fibreoptic bronchoscope in pediatric haematopoietic stem cell transplant patients: Nursing considerations for operative complications.

PURPOSE: Bronchoalveolar lavage (BAL) with pediatric flexible fibreoptic bronchoscopy (FB) is used for diagnostic and therapeutic purposes in pediatric haematopoietic stem cell transplant (HSCT) patients with pulmonary complications. The aim of our study was to evaluate complications in pediatric HSCT patients undergoing BAL/FB and to explore the nursing emphases on complications. DESIGN AND METHODS: We performed a retrospective, case-controlled study to evaluate perioperative complications of HSCT children. BAL/FB was conducted for 42 children with HSCT who experienced pulmonary complications between January 2017 and January 2018 within a tertiary hospital. Forty patients diagnosed with general pneumonia were randomly selected during the same period and served as the control group. We analyzed the signs and symptoms of all patients and compared the operative complications between the two groups. Furthermore, we presented the methods used to manage complications. RESULTS: The presence of cough, lung rales, and imaging findings in the HSCT patients was significantly different from that of the control group (p < 0.0001). The complication rate was 66.67% (28/42) in the HSCT group and 22.5% (9/40) in the control group, and the difference was significant (p < 0.0001). Twelve out of 42 HSCT patients experienced airway mucosal bleeding (28.57%), and six had transient fever (14.29%). The topical use of epinephrine diluted saline (1:10,000) was highly effective for controlling airway mucosal bleeding without causing fluctuations in blood pressure. PRACTICE IMPLICATIONS: There were more perioperative complications in the HSCT patients than in the general pneumonia patients who underwent BAL/FB. Airway mucosal bleeding was a key focus of perioperative nursing in HSCT patients undergoing bronchoscopy as main complication. BAL with the use of epinephrine diluted saline (1:10,000) effectively decreased airway mucosal bleeding.

Care performed by family caregivers of children submitted to hematopoietic stem cell transplantation.

OBJECTIVE: to know the care provided by family caregivers of children submitted to hematopoietic stem cell transplantation. METHOD: the Grounded Theory was used as methodology. The study comprised four sample groups, comprising 36 caregivers. Data were collected by semi-structured interviews and analyzed according to the coding proposed by Strauss and Corbin in three phases: open, axial and selective. RESULTS: eight propositions were identified for the care provided to the child in the researched context, namely administering medications; attention to cleaning issues; care with water and food intake; care with the body; experiencing protective isolation; addressing the child's need for emotional support; addressing the child's self-care; and facing complications. CONCLUSION: the different aspects in which the caregiver acts in the care of the child were understood. Such care equips the health team to elaborate measures for guidance and preparation of home care that are effective and directed to the needs of the patient and their family. The understanding of the care that they accomplish enables the caregiver a greater understanding of their role, as well as of the decisions they will make by their being under treatment.

Long-term implications of autologous HCT for caregiver quality of life: how does the survivor's health matter?

INTRODUCTION: This study examines caregiver quality of life (CQOL) 3-26 years after autologous hematopoietic cell transplantation (HCT) for patients with lymphoma. Using a framework that views the patient-caregiver dyad as a system of mutual influence, we argue that CQOL is associated with survivor functional health status and sense of personal control. METHODS: Ninety-nine autologous HCT survivor-caregiver dyads participated. CQOL was measured using the Caregiver Quality of Life Scale-Cancer. Survivor functional health status was assessed using the Functional Assessment of Cancer Therapy-General. Sense of control was examined using an instrument from the MIDUS II study. Clinical measures were collected from medical records. RESULTS: After controlling for sociodemographic and clinical covariates, caregivers with higher sense of control had higher CQOL. Poorer survivor functional health was associated with lower CQOL but only when the survivor reported low personal control. When the survivor reported high personal control, functional health was not a factor. Lower CQOL was observed for younger and more educated caregivers. In contrast, more education among survivors was linked to higher CQOL. CONCLUSION: These results (1) support using a mutuality framework for the study of long-term outcomes of caregivers, (2) suggest the importance of ongoing support for caregivers, and (3) help identify caregivers at risk for poorer adaptation. Poorer survivor functional health is a risk factor, but its adverse implications can be offset by higher caregiver and survivor sense of control, a psychological resource aiding caregiver adaptation. These findings can inform the development of support programs for long-term caregivers.

Contribuições da pesquisa para os cuidados de enfermagem em transplante pediátrico de células-tronco hematopoiéticas / Research contributions for the nursing care in pediatric transplantation of hematopoietic stem cells / Contribuciones del estudio para los cuidados de enfermería en el trasplante de células madre hematopoyéticas pediátrico

Objetivo: Propor cuidados de Enfermagem ambulatoriais que subsidiem o tratamento de crianças em pós-transplante de células-tronco hematopoiéticas a partir dos dados advindos de pesquisa sobre perfil sociodemográfico e clínico. Método: Ensaio repercussivo sobre proposição de cuidados de Enfermagem baseados em resultados de pesquisa e por diagnósticos de Enfermagem segundo a taxonomia da North American Nursing Diagnosis Association. Resultados: Os principais diagnósticos foram risco de infecção, risco de função hepática prejudicada e risco de função cardiovascular prejudicada. Os cuidados de Enfermagem incluíram controle de sinais vitais, avaliação da ingesta alimentar, cuidados com cateteres, controle de exames laboratoriais, avaliação do funcionamento dos sistemas corporais, administração de medicamentos e transfusões, medidas de controle de transmissão de micro-organismos, educação em saúde/serviço e comunicação integrada com a equipe interdisciplinar. Conclusão: Os cuidados de Enfermagem foram sustentados por evidências e buscou-se o atendimento da criança em todas as suas necessidades

Objective: This paper aims to propose outpatient Nursing care that helps the children's treatment after hematopoietic stem cell transplantation, using data from research on sociodemographic and clinical profile. Method: Essay on Nursing care proposition was used, on the basis of the research results and Nursing diagnoses, in accordance with the taxonomy of the North American Nursing Diagnosis Association. Results: The main diagnoses were infection risk, impaired liver function risk, and impaired cardiovascular function. Nursing care included vital signs control, food intake evaluation, catheter care, control of laboratory tests, evaluation of the body systems functioning, administration of medications and transfusions, control measures of microorganisms' transmission, health/service education, and integrated communication with the interdisciplinary team. Conclusion: Nursing care was supported by evidence and the child's care was sought in all his/her needs

Objetivo: Proponer cuidados de Enfermería ambulatoria que subsidien el tratamiento de niños en el post trasplante de células madre hematopoyéticas a partir de los datos provenientes de estudios sobre el perfil sociodemográfico y clínico. Método: Ensayo repercusivo sobre proposición de cuidados de Enfermería basados en resultados de estudios y diagnósticos de Enfermería según la taxonomía de la North American Nursing Diagnosis Association. Resultados: los principales diagnósticos fueron el riesgo de infección, el riesgo de función hepática perjudicada y el riesgo de función cardiovascular perjudicada. Los cuidados de Enfermería incluyeron el control de señales vitales, evaluación de la ingesta alimentaria, cuidados con catéteres, control de exámenes de laboratorios, evaluación del funcionamiento de los sistemas corporales, administración de medicamentos y trasfusiones, medidas de control de trasmisión de microorganismos, educación en salud/servicio y comunicación integrada con el equipo interdisciplinar. Conclusiones: Los cuidados de Enfermería se sostuvieron por las evidencias y se buscó el atendimiento del niño en todas sus necesidades

Produção científica da enfermagem sobre transplante de células-tronco hematopoéticas de sangue do cordão umbilical / No disponible

Introdução: O Transplante de Células-Tronco Hematopoéticas (TCTH) é um procedimento que substitui células doentes por células sadias, por meio da infusão de células-tronco hematopoéticas. Objetivo: Identificar na literatura as publicações da enfermagem que abordem o TCTH de Sangue de Cordão Umbilical (SCU). Método: Trata-se de uma revisão integrativa, para qual se realizou buscas por meio das bases de dados eletrônicas: Biblioteca Virtual em Saúde, National Library of Medicine (PUBMED/MEDLINE), Science Direct e SCOPUS. Foram estabelecidos os seguintes critérios de inclusão: estudos disponíveis em qualquer idioma, estudos que abordassem o TCTH de sangue de cordão umbilical e estudo publicado na íntegra. Resultados: O processo de busca eletrônica dos estudos resultou em um total de 978 estudos, dos quais cinco compuseram a amostra da revisão. Os estudos selecionados abordaram o conhecimento dos enfermeiros sobre o transplante de SCU, a coleta e armazenamento do SCU e o banco de SCU. Conclusão: O presente estudo proporcionou a percepção da importância do papel do enfermeiro no TCTH de SCU, visto que seu empenho junto à equipe dos bancos públicos de SCU é importante para alcançar melhores resultados, com a ampliação do número de doadores e maior satisfação dos clientes e seus familiares

Introducción: El trasplante de células madre hematopoyéticas (TCMH) es un procedimiento que reemplaza las células enfermas a las células sanas, a través de la infusión de células madre hematopoyéticas. Objetivo: Identificar en la literatura las publicaciones de enfermería que se ocupan de la sangre de cordón umbilical La sangre (UCB) TCMH. Método: Se trata de una revisión integradora, para lo cual allanó a través de bases de datos electrónicas: Biblioteca Virtual en Salud, Biblioteca Nacional de Medicina (PubMed/MEDLINE), Science Direct y Scopus. Se establecieron los siguientes criterios de inclusión: los estudios disponibles en cualquier idioma, los estudios que abordaron la sangre del cordón umbilical TPH y el estudio en su totalidad. Resultados: El proceso de búsqueda electrónica de los estudios dieron como resultado un total de 978 estudios, de los cuales cinco fueron incluidas en la muestra de revisión. Los estudios seleccionados abordan el conocimiento del personal de enfermería en el trasplante de SCU, la recogida y almacenamiento de sangre del cordón umbilical y el Banco de SCU. Conclusión: Este estudio proporciona la percepción de la importancia del papel de la enfermera en TPH de SCU, como su compromiso con el equipo de los bancos públicos UCB es importante para lograr mejores resultados al aumentar el número de donantes y el aumento de la satisfacción del cliente y sus familias

Introduction: Hematopoietic stem cell transplantation (HSCT) is a procedure that replaces diseased cells with healthy cells by infusing hematopoietic stem cells. Objective: To identify in the literature the nursing publications that addresses HSCT of Umbilical Cord Blood (UCB). Method: This is an integrative review which has been searched through electronic databases: Virtual Health Library, National Library of Medicine (PUBMED/MEDLINE), Science Direct and SCOPUS. The following inclusion criteria were established: studies available in any language, studies addressing HSCT of umbilical cord blood and a study published in its entirety. Results: The electronic search process of the studies resulted in a total of 978 studies, of which five comprised the review sample. The selected studies addressed the nurses' knowledge about SCU transplantation, the collection and storage of SCU and the SCU database. Conclusion: The present study provided an insight into the importance of the role of nurses in HSCTWC, since their commitment to the team of SCU public banks is important to achieve better results, with a larger number of donors and greater customer satisfaction And their families