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Introducción: El cáncer se considera una enfermedad amenazante para la vida que implica la posibilidad de que el niño fallezca prematuramente. Existe poca información desde la visión del paciente pediátrico sobre su experiencia psicológica en momentos de amenaza vital. El presente trabajo pretende ampliar este conocimiento a través de la experiencia vivida en momentos de amenaza vital de un niño superviviente de cáncer. Paciente y métodos: Paciente de 9 años al que le diagnosticaron un osteosarcoma en el fémur. Se trata de un estudio de caso en el que se realizó un análisis fenomenológico interpretativo con los datos obtenidos a través de una entrevista semiestructurada. Resultados: Se evidencia que los principales sentimientos en el momento de amenaza vital fueron miedo, tristeza e impotencia. Uno de los factores desencadenantes fue pensar en la posibilidad de tener que separarse de sus padres. Esta experiencia tuvo impacto en su vida e influyó en su identidad. Para hacer frente a esta situación difícil utilizó estrategias de afrontamiento de aproximación, como la conexión emocional, y de evasión como la distracción, el humor y el olvido. Discusión: Las reacciones emocionales frente a la posibilidad de amenaza vital y el impacto que esta tuvo en la vida del menor se pueden interpretar dentro del modelo del Estrés Traumático Médico Pediátrico. Conocer la experiencia desde el punto de vista del paciente pediátrico y la forma de afrontarla puede ayudar a reforzar o adaptar las intervenciones de la práctica clínica. (AU)

Introduction: Cancer is considered a life-threatening disease as it implies the probability that the child will die prematurely. There is little information from the pediatric patient's perspective about their psychological experience in life-threatening situations. This study aims to expand knowledge in this area by presenting the experience of a child cancer survivor in lifethreatening situations. Patient and methods: a 9-year-old patient who was diagnosed with osteosarcoma in the femur. A case study design followed, in which the information was collected through a semi-structured interview, and an interpretative phenomenological analysis was carried out with the resulting data. Results: The main feelings experienced in life-threatening situations were fear, sadness and impotence. One of the trigger factors was to think about the possibility of being separated from his parents. This experience had an impact on his life and shaped his identity. To deal with this difficult situation, he used approach coping strategies, such as emotional connection, and avoidance strategies such as distraction, humor, and forgetting. Discussion: The emotional reactions to the experience and the impact that this had on the child's life can be interpreted within the Pediatric Medical Traumatic Stress model. Knowing the experience from the point of view of the pediatric patient, together with his or her way of coping with it, can help to reinforce or adapt the interventions in clinical practice. (AU)

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OBJECTIVE: The purpose of this systematic review is to describe the elements of the psychological experience of pediatric oncology patients facing life-threatening situations and the corresponding care needs. METHODS: The study design is a systematic review following the PRISMA standard of qualitative, quantitative, and mixed-methods research. The review was conducted using multiple databases, including Scopus, Web of Science, PubMed, and PsycINFO. The risk of bias of the articles was evaluated with the "Critical Appraisal Skills Programme." RESULTS: A total of 21 articles met inclusion criteria. The analysis of the evidence revealed that the psychological experience involves changes in relationships, thoughts about death, emotional changes, physical symptoms, spiritual changes, and feelings of uncertainty. SIGNIFICANCE OF RESULTS: The care needs identified are maintaining normality, controlling physical and psychological symptoms, and that maintaining hope is an important aspect for children. Whether or not the children want to talk about death is another important aspect that needs to be reflected upon, and it would be appropriate to consider, on an individual level, involving patients in the discussion on the diagnosis and treatment of the illness. Future research should be conducted from the children's perspective since most existing research is from the perspective of the family members or health professionals. Furthermore, it is recommended to take into account qualitative approaches that provide more detailed information on the patients' subjectivity.

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