Comunicação do diagnóstico de infecção pelo HIV em pediatria: revisão de escopo

Abstract

Introduction: In the pediatric field, the diagnosis of HIV infection in childhood is understood as a difficult communication, as it is a permanent serological condition immersed in a stigmatizing context. This indicates that family members and professionals use different strategies for such communication, aiming to minimize failures and negative associations with the situation. However, there is a gap in the elements that make up the communicative process of this diagnosis. Objective: to map how the diagnosis of HIV infection occurs in pediatrics. Method: scope review according to the guidelines of the Joanna Briggs Institute. The inclusion criteria were original articles whose participants were the child, family and/or health professional, whose theme was the communication of the diagnosis of HIV infection, published from 2011 and in Portuguese, English or Spanish. Considering that communication can extend to the teaching and, sometimes, investigations include both participants, there was a need, during the study, for inclusion of HIV adolescents infected in childhood. In January 2020, the following sources were accessed: PubMed, CINAHL, Scopus, WoS, ASSIA, PsycINFO, ERIC, Sociological Abstracts, Edubase and LILACS, BDENF and IndexPsi by VHL, in addition to the reference list of the included studies. Results: 64 articles were included and the results organized from the elements of the communicative process such as sender, receiver, message, context, channel and effect. The emitters were health professionals and family members and the recipients were family members, children and adolescents. The message was the diagnosis of HIV infection for the child and sometimes happening in adolescence. The main context that family members and professionals analyzed to communicate refers to the preparation of children or adolescents. As a communication channel, professionals and family members used physical materials and other strategies and evaluated the amount of information and the quality of the content. In the vast majority, the effects were beneficial for those involved, and the negative effects occurred when there was a delay in communication and it happened in adolescence. The noises occurred, especially when the family members were the emitters and the professionals recognized that they had committed failures due to the lack of preparation for the situation. Final thoughts: it is important that the services establish conditions to have an appropriate context for the communication of bad news in pediatrics. Moreover, health professionals must develop skills to support family members as senders of this message. It is noteworthy that the use of communication strategies appropriate for the age group is positive, as well as the monitoring of the effects of this communication by a multidisciplinary team, being the procedural communication early and timely, avoiding noise and failures, as they can generate negative effects. Further studies are necessary especially to assess the communication failures of the diagnosis of HIV infection in the children’s experience.