SOCIAL REPRESENTATIONS OF ADOLESCENTS ON THE PROCESS OF HAVING CANCER*

Purpose: To describe the social representations of adolescents about the cancer disease process. Method: A descriptive study with a qualitative approach, based on the Theory of Social Representations, conducted with 31 adolescents undergoing cancer treatment in a public hospital in Belém do Pará. The study was performed with individual interviews, submitted to inductive thematic analysis. Results: Three thematic categories were identified: cancer as a psychosocial disease; the experience of falling ill and suffering cancer; and coping with the body changes resulting from the disease. Conclusion: The study contributed to the understanding of the social representations about cancer in adolescence, supporting the nurse in the construction of knowledge with the adolescent with cancer, for a better quality care. DESCRIPTORS: Nursing; Nursing care; Health of the adolescent; Oncology; Social Psychology. HOW TO REFERENCE THIS ARTICLE: Costa MSCR, Silva SED da, Ramos AMPC, Panzetti TMN, Santana ME de. Social representations of adolescents on the process of having cancer. Cogitare enferm. [Internet]. 2019 [access “insert day, monh and year”]; 24. Available at: http://dx.doi. org/10.5380/ce.v24i0. 62807. 1Nurse. Doctoral student in Oncology and Medical Sciences. Nurse at the Department of Public Health of the State of Pará and of the João de Barros Barreto University Hospital, Federal University of Pará. Belém, PA, Brazil. 2Nurse. PhD in Nursing Philosophy. Professor at the Federal University of Pará. Belém, PA, Brazil. 3Nurse. PhD in Genetics and Molecular Biology. Lecturer at the Federal University of Pará and at the University of Amazonia. Belém, PA, Brazil. 4Nurse. PhD student in Health Sciences and Education. Professor at the State University of Pará. Belém, PA, Brazil. 5Nurse. PhD in Nursing Basics. Lecturer at the Federal University of Pará and at the State University of Pará. Belém, PA, Brazil. *Article extracted from the master’s dissertation entitled “Having cancer and its repercussions for self-care: a study of Social Representations”. State University of Pará, 2013. This work is licensed under a Creative Commons Attribution 4.0 International License. dx.doi. org/10.5380/ce.v24i0. 62807 Cogitare enferm. 24: e62807, 2019 Marta Solange Camarinha Ramos Costa1, Silvio Éder Dias da Silva2, Aline Maria Pereira Cruz Ramos3, Tatiana Menezes Noronha Panzetti4, Mary Elizabeth de Santana5 REPRESENTAÇÕES SOCIAIS DE ADOLESCENTES SOBRE O PROCESSO DE ADOECER E ADOLESCER COM CÂNCER RESUMO Objetivo: descrever as representações sociais de adolescentes sobre o processo de adoecimento de câncer. Método: estudo descritivo, com abordagem qualitativa, embasado na Teoria das Representações Sociais, com 31 adolescentes em tratamento oncológico em um hospital público, em Belém do Pará. Realizado com entrevistas individuais, submetidas à análise temática indutiva. Resultados: identificaram-se três categorias temáticas: o câncer como doença psicossocial; a vivência do adoecer e adolescer com câncer; e o enfrentamento das alterações corporais advindas do adoecimento. Conclusão: o estudo contribuiu para a compreensão das representações sociais sobre o câncer na adolescência, subsidiando o enfermeiro na construção de conhecimentos junto ao adolescente com câncer, para assistência de maior qualidade. DESCRITORES: Enfermagem; Cuidados de enfermagem; Saúde do adolescente; Oncologia; Psicologia social. Marta Solange Camarinha Ramos Costa | Silvio Éder Dias da Silva | Aline Maria Pereira Cruz Ramos | Tatiana Menezes Noronha Panzetti | Mary Elizabeth de Santana ARTIGO ORIGINAL / ARTÍCULO ORIGINAL REPRESENTACIONES SOCIALES DE LOS ADOLESCENTES SOBRE EL PROCESO DE PADECER CÁNCER RESUMEN: Objetivo: describir las representaciones sociales de los adolescentes sobre el proceso de padecer cáncer. Método: estudio descriptivo con enfoque cualitativo basado en la Teoría de las Representaciones Sociales y realizado con 31 adolescentes en tratamiento oncológico en un hospital público de Belém do Pará. El estudio se efectuó con entrevistas individuales, sometidas a análisis temático inductivo. Resultados: se identificaron tres categorías temáticas: el cáncer como enfermedad psicosocial; la experiencia de padecer cáncer en la adolescencia y cómo hacer frente a los cambios corporales devenidos por la enfermedad. Conclusión: el estudio contribuyó a comprender las representaciones sociales sobre el cáncer en la adolescencia, ayudando al enfermero a elaborar conocimientos junto con el adolescente que padece cáncer, para brindar una asistencia de mayor calidad. DESCRIPTORES: Enfermería; Cuidados de enfermería; Salud del adolescente; Oncología; Psicología social. dx.doi. org/10.5380/ce.v24i0. 62807 Cogitare enferm. 24: e62807, 2019 Cogitare enferm. 24: e62807, 2019 Social representations of adolescents on the process of having cancer INTRODUCTION Adolescence is the period of life that marks the transition between childhood and adulthood. For this phase several chronological limits are considered; for legal purposes, the Statute of the Child and Adolescent conceptualizes the adolescent as the person who is between 12 and 18 years old. Among other definitions, this study used the concept of the World Health Organization (WHO), adopted by the Ministry of Health (Ministério da Saúde, MS), which limits adolescence to the second decade of life, that is 10-19 year old age group. (1) In general, adolescence is already marked by the natural difficulties of this stage of life, with physical, emotional and socio-affective modifications; however, by adding a serious context such as the diagnosis of cancer, everything can become even more difficult. In Brazil, the José Alencar Gomes da Silva National Cancer Institute (Instituto Nacional de Câncer, INCA) estimates, for the 2018-2019 biennium, the occurrence of approximately 600,000 new cases of cancer per year, of this total, 12,500 cases should occur in children and adolescents up to 19 years old, and in 2015 alone there were 35,000 cancer deaths in this age group, which confirms the magnitude of the problem in the country. (2) Usually, the oncological diagnosis transforms the adolescent’s daily life, and a new routine is offered, full of challenges and overcomings during the treatment, whose repercussions have a great impact on social and personal relationships. In this complexity of care, it is important that nurses assume their role in the process of care; it is essential, in addition to deep knowledge and constant updates on the disease, that the professional has much sensitivity, overcoming the mechanistic aspect of their duties, providing individualized care to address the real need of adolescents with cancer. (3) Nursing care should spread not only to the treatment itself, but also to the social aspects of the disease, considering that the adolescent is inserted in a context of his family and community, reflecting a holistic care, in addition to the hospital institution. A more refined understanding of the social representations of adolescents with cancer contributes to comprehensive care, respecting their individualities and specificities. (3) Thus, cancer can be considered as a psychosocial object because it is part of the cognitive realm of the individuals, who share experiences with their social group. Therefore, the health-disease process is a legitimate object for the use of the Social Representation Theory (SRT), as it is present in the daily life of each individual and it establishes links through this consensual knowledge with his or her group. (4) The social representations of cancer are anchored in social experiences, derived from their own personal experiences, throughout the process of illness and cancer treatment. Faced with an unfamiliar situation, everyone benefits from their previous knowledge and experiences shared with their social group. (5) Thus, the SRT applied well to this study, since Social Representation (SR) is “a form of knowledge, socially elaborated and shared, with a practical objective, and that contributes to the construction of a common reality to a social group”. (6:22) Hence the suitability for studies that aim to understand the meanings of the diseases to certain social groups;(6) in this case, adolescents with cancer, favoring the establishment of integration, adherence to treatment and relationships with people, especially if we consider that SR on cancer is strongly anchored in the social stigma that the disease still carries. In this context, this study aimed to describe the social representations of adolescents about the cancer disease process.