O brincar e a criança com leucemia em tratamento oncológico hospitalar

Abstract

The study in question aimed to understand childhood phenomena through the investigation of the experiences of eight Northeastern children, of both genders, aged between six and eleven, who are facing serious physical comorbidities due to a diagnosis of leukemia and the need for hospital-based oncological treatment. Winnicottian psychoanalytic studies were used as a theoretical framework. The general objective of the research was to investigate and analyze the play of these children in the hospital environment, with specific objectives being: 1) to understand, through play in the hospital environment, the childhood experiences in the face of the impact caused by leukemia; and 2) to understand, from the family perspective, the interferences of the disease in the routine and play of the child from diagnosis to oncological treatment in the hospital environment. This study was approved by the Ethics Committee of the Federal University of Alagoas and was organized as a qualitative exploratory-descriptive research conducted in the field, within the premises of a pediatric oncology outpatient clinic located in a Northeastern capital. In addition to the children undergoing treatment, their respective caregivers participated in the research, and participatory interventions were conducted with both groups, individually, in five stages. The first two stages consisted of: 1) administration of a sociodemographic questionnaire to caregivers accompanying the hospital treatment; and 2) recorded semi-structured individual interviews. The final three stages were conducted with the children undergoing treatment and included: 3) presentation of the research proposal and the ludic box; 4) playtime with hospital materials adapted into toy formats; and finally, 5) individual application of the Drawing-Story Procedure with Theme (PDE-T). Data analysis followed the methodological path proposed by Minayo, using thematic analysis. Based on the results, two general categories were developed for data discussion. The first category encompassed the content presented by the caregivers, highlighting their perspectives on the impact of the disease and the repercussions of play on the sick child. The second category was structured based on the representations of the children undergoing oncological treatment, revealing their hospital experiences that emerged during interactions with the researcher. The encounters provided caregivers with a space for exchange and psychic elaboration in the face of the difficulties arising from the child's illness. For the children undergoing treatment, the environment provided an opportunity to act actively, recreating their experiences and directing them through play and speech, despite the existing adversities. Despite the physical illness and the disruptions it causes in the lives of children with leukemia, the research findings indicate the existence of creative outlets for them to reshape their ways of living, finding new formats for their play and constructing imaginary stories and experiences. The possibilities of adaptation and creative engagement in their own worlds demonstrate that, despite being physically ill, there are signs of psychological well-being in these children.