PALLIATIVE CARE IN CHILDHOOD LEUKEMIA: A HUMANIZED AND CHILD-CENTERED APPROACH

Abstract

Leukemia, especially Acute Lymphoblastic Leukemia (ALL), is the most common hematological cancer in childhood and poses significant challenges due to the intensity of treatment and the impact on the life of the child and family. In advanced or refractory cases, palliative care becomes essential, aiming not only at symptom control but also at promoting dignity, comfort, and quality of life. This approach seeks to prevent and alleviate physical, emotional, social, and spiritual suffering, respecting the specificities of child development and considering the child as an active subject in the care process. The study presents the following guiding question: How is palliative care provided in childhood leukemia with a humanized and child-centered approach? Its objectives are: To analyze the importance of a humanized and child-centered approach in providing palliative care to pediatric patients with leukemia, considering physical, emotional, social, and spiritual aspects; This study aims to describe multidisciplinary strategies used to promote quality of life and comfort for children in the palliative care phase, as well as to identify the challenges faced by the nursing team and the impact of empathetic communication and family support on the experience of palliative treatment. It is a narrative literature review, a method that aims to provide an overview of a topic, exploring and discussing existing literature comprehensively, without the need to follow rigid search and selection criteria. The review was conducted in six interconnected stages, following a specific sequence: formulating the research question, literature search, data collection, critical analysis of included studies, and discussion of results. The review revealed that physical management includes controlling pain, fatigue, nausea, dyspnea, and other symptoms, using pharmacological and non-pharmacological strategies, with a multidisciplinary approach. In the emotional sphere, children face fears, uncertainties, and changes in self-image; interventions such as play therapy, art therapy, and music therapy help in the expression of feelings and strengthening resilience. Socially, it is fundamental to maintain family ties, school continuity, and inclusion in activities compatible with the clinical condition, avoiding isolation. The spiritual dimension should also be considered, respecting beliefs and values as coping resources. Psychosocial needs involve family support, clear communication and active listening, as well as humanizing the hospital environment through play, which contributes to treatment adherence, anxiety reduction, and improved quality of life. The multidisciplinary team works in an integrated manner to ensure continuous and personalized care. Finally, strategies such as rigorous symptom control, complementary therapies, effective communication, and family involvement are fundamental to ensuring comfort and dignity for the child with leukemia in the palliative phase, promoting humanized and comprehensive care.