Assessment of symptom intensity and psychological well-being of patients with advanced cancer undergoing palliative care in a Brazilian public hospital: A cross-sectional study.

OBJECTIVES: The characterization of clinical-emotional aspects of advanced cancer patients is essential for palliative care. To date, there is scarce information regarding the socio-demographic and clinical profiles, as well as the quality of care given to hospitalized patients under this condition, particularly in South American countries. The objectives of this study were to analyze the socio-demographic profile, symptoms (including psychological well-being), and the quality of life of advanced cancer patients admitted to the oncology ward of the General Hospital of the University of Campinas, Brazil. METHODS: In this cross-sectional study, patients were invited to fill the selected questionnaires such as Edmonton Symptom Assessment Scale (ESAS) and Palliative Care Outcome Scale (POS). Descriptive analyses were performed, regarding socio-demographic profile, symptoms, level of information over treatment aims, and quality-of-life scores. RESULTS: Fifty-nine patients were included, of whom 29 were male and 30 female, with a mean age of 58 years. Overall, 31.9% presented pain at the time of the interview, 52.5% depression, and 76.3% anxiety. The median individual scores for ESAS and POS (and interquartile range) were, respectively, 27 (17-41) and 14 (9-19). Patients with previous knowledge of treatment objectives reported worse depression scores in the ESAS (median 2 vs. 0, p 0.02), even when correcting for possible confounders. SIGNIFICANCE OF RESULTS: In contrast to current literature, in which pain is a prevalent report, depression and anxiety were more evident in this specific population of hospitalized patients. This framework reflects the need for valuing not only physical but also emotional symptoms to achieve the integrality of care.

Reconhecimento tardio de paternidade e suas repercussões no desenvolvimento dos filhos / Late recognition of fatherhood and its effects on the development of children / Reconocimiento tardío de la paternidad y de sus efectos sobre el desarrollo de los niños

Este estudo de caso coletivo teve por objetivo compreender as possíveis repercussões do reconhecimento tardio da paternidade no desenvolvimento dos filhos. Foram entrevistados 11 filhos que tiveram o reconhecimento tardio de paternidade fora dos prazos legais, ou seja, até 60 dias após o nascimento. Utilizou-se a técnica da história oral de vida e a entrevista semiestruturada, com emprego da análise de conteúdo. O reconhecimento tardio de paternidade promoveu mudanças significativas no desenvolvimento dos filhos, em movimentos como a maior valorização da figura materna e de tentativa de reescrever o conceito de paternidade a partir da própria experiência de parentalidade, sobretudo nos homens. Embora o reconhecimento legal tenha sido alcançado, este não equivale ao estabelecimento de um vínculo afetivo ou de maior proximidade com as figuras paternas, demonstrando que os operadores legais cumprem a sua função em nível dos direitos, mas não contribuem necessariamente para um desenvolvimento psicológico considerado mais positivo.

This collective case study aimed to understand the possible repercussions of the late recognition of fatherhood in children's development. Eleven sons and daughters, who have had the late recognition of fatherhood outside the legal time limits (that is, 60 days after birth) were interviewed. We used the history of life technique and the semi-structured interview; and we also used the content analysis. The late recognition of fatherhood promoted significant changes in children's development, in movements such as the greater appreciation of the mother and attempt to rewrite the concept of fatherhood from the experience of parenting, especially with men. Even though the legal recognition has been achieved, this does not mean the same as to the establishment of a link or greater proximity to the father figures, showing that legal operators fulfil their function in the level of the duties but not necessarily contribute to a psychological development considered more positive.

Este estudio de caso colectivo, tiene por objetivo comprender las posibles repercusiones del reconocimiento tardío de la paternidad en el desarrollo de los hijos. Fueron entrevistados once hijos e hijas, que tuvieron reconocimiento tardío fuera de los plazos legales, o sea, sesenta días después del nacimiento. Se utilizó la técnica historia de vida y la entrevista semiestructurada, con el uso de análisis de contenido. El reconocimiento tardío de la paternidad genero cambios significativos en el desarrollo de los hijos, al permitir movimientos de mayor valorización de la figura maternal y de tentativas de reescribir el concepto de paternidad a partir de la propia experiencia de relación parental, sobre todo los hombres. Mismo que el reconocimiento legal haya sido alcanzado, este no equivale a la construcción de un relación o de mayor proximidad con la imagen paterna, demostrando que los medio legales realizan sus funciones a nivel jurídico, pero no contribuyen necesariamente para un desarrollo psicológico considerado más positivo.

Cuidados paliativos no Brasil: revisão integrativa da literatura científica / Palliative care in Brazil: an integrative review of scientific literature

O objetivo deste estudo foi apresentar uma revisão integrativa da literatura científica nacional sobre cuidados paliativos na assistência a portadores de doenças graves, evidenciando, principalmente, o papel das equipes multidisciplinares. Foram recuperadas, a partir de critérios de localização e seleção, 12 artigos veiculados nas bases de dados PePSIC, SciELO e LILACS, todos publicados entre 2000 e 2011. De modo geral, tais artigos são exploratórios, descritivos e qualitativos, e foram desenvolvidos junto a amostras de tamanho reduzido constituídas essencialmente por pacientes oncológicos ou profissionais de saúde inseridos em serviços de cuidados paliativos. Sugere-se, portanto, o desenvolvimento de novos estudos, sobretudo meta-análises e estudos experimentais ou quase-experimentais, junto a pacientes acometidos por outras doenças graves - tais como doenças cardiovasculares, pulmonares ou neurológicas - às quais ações de cuidados paliativos também são aplicáveis

The aim of this study was to present an integrative review of the national scientific literature about palliative care in the assistance of patients with serious diseases, showing mainly the role of multidisciplinary teams. 12 articles published in the databases PePSIC, SciELO and LILACS between 2000 and 2011 were recovered with location and selection criteria. Generally, such articles are exploratory, descriptive and qualitative, and they were developed with the small samples constituted essentially of cancer patients or health professionals placed in hospice services. It is suggested, therefore, the development of new studies, especially meta-analyzes and experimental or quasi-experimental studies, together with patients affected by other serious diseases - such as cardiovascular, pulmonary or neurological - which actions are also palliative applicable

Cuidados paliativos no Brasil: revisão integrativa da literatura científica / Palliative care in Brazil: an integrative review of scientific literature

O objetivo deste estudo foi apresentar uma revisão integrativa da literatura científica nacional sobre cuidados paliativos na assistência a portadores de doenças graves, evidenciando, principalmente, o papel das equipes multidisciplinares. Foram recuperadas, a partir de critérios de localização e seleção, 12 artigos veiculados nas bases de dados PePSIC, SciELO e LILACS, todos publicados entre 2000 e 2011. De modo geral, tais artigos são exploratórios, descritivos e qualitativos, e foram desenvolvidos junto a amostras de tamanho reduzido constituídas essencialmente por pacientes oncológicos ou profissionais de saúde inseridos em serviços de cuidados paliativos. Sugere-se, portanto, o desenvolvimento de novos estudos, sobretudo meta-análises e estudos experimentais ou quase-experimentais, junto a pacientes acometidos por outras doenças graves - tais como doenças cardiovasculares, pulmonares ou neurológicas - às quais ações de cuidados paliativos também são aplicáveis.(AU)

The aim of this study was to present an integrative review of the national scientific literature about palliative care in the assistance of patients with serious diseases, showing mainly the role of multidisciplinary teams. 12 articles published in the databases PePSIC, SciELO and LILACS between 2000 and 2011 were recovered with location and selection criteria. Generally, such articles are exploratory, descriptive and qualitative, and they were developed with the small samples constituted essentially of cancer patients or health professionals placed in hospice services. It is suggested, therefore, the development of new studies, especially meta-analyzes and experimental or quasi-experimental studies, together with patients affected by other serious diseases - such as cardiovascular, pulmonary or neurological - which actions are also palliative applicable.(AU)