Protocolo clínico de cuidados paliativos pediátricos

Abstract

Pediatric palliative care represents a comprehensive and humanized approach aimed at children and adolescents facing chronic, progressive, limiting, or life-threatening illnesses, whether or not they have curative possibilities, as well as their families. According to the World Health Organization (WHO), the goal of palliative care is to promote quality of life through the prevention and relief of physical, psychological, social, and spiritual suffering, regardless of the stage of the disease. Thus, PPCs are proposed when the child and/or adolescent receives a diagnosis of the aforementioned illnesses, alongside clinical treatment and, if possible, curative treatment. The documents analyzed for the creation of this clinical protocol, including the Palliative Care Manual of the Sírio-Libanês Hospital (2023), the Report of the Working Group on Pediatric Palliative Care (Portugal, 2014), the ISGH Protocol (2014), and the guidelines of the Brazilian Society of Pediatrics (2021), emphasize the importance of the early integration of this palliative practice into curative treatment, aiming to guarantee continuous, multidisciplinary care centered on the child and their family, thus avoiding the prolongation of their suffering. International scientific literature, such as studies published in CA: A Cancer Journal for Clinicians (KAYE et al., 2015), Cancer Medicine (CHENG et al., 2019), and Clinical and Experimental Pediatrics (MARINO et al., 2023), reinforces that the late initiation of palliative care is still detrimental to the patient and family, especially in oncological cases and chronic neurological diseases. The implementation of public policies, referral networks, and qualified teams is considered fundamental to expanding access, equity, and death with dignity. Pediatric palliative care, when instituted upon diagnosis of life-threatening or chronic conditions, aims to bring well-being to the child and their family. This is done by controlling symptoms, avoiding unnecessary procedures that cause more harm than good and that consequently will not change the prognosis. Along with this, emotional and psychological

support is also offered to the patient and their family throughout the course of the illness and also in the days after death. In summary, pediatric palliative care is characterized as a broad field of interdisciplinary action that goes beyond medical treatment, promoting respect for the dignity, autonomy, and comfort of the child and their family, with a positive impact on quality of life, family satisfaction, and the humanization of care provided, especially in the final moments of life.