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Se presenta una propuesta de intervención de enfermería de práctica avanzada (EPA) en oncología. OBJETIVO: Implementar un programa de acompañamiento para pacientes con cáncer de cabeza y cuello. PROPUESTA: Realizar un levantamiento del proceso y descripción del flujo que debe transitar el paciente oncológico desde la sospecha, diagnóstico, tratamiento, seguimiento y derivación a cuidados paliativos. En segunda instancia, crear e implementar una consulta de enfermería que pueda responder a las necesidades de atención de salud en forma holística de la persona con diagnóstico oncológico de cáncer de cabeza y cuello, tanto en las personas que se encuentran en fase sospecha y confirmación diagnóstica (consulta de ingreso) y en el proceso de seguimiento del sobreviviente (después de finalizado el tratamiento oncológico), a través de una puesta en marcha escalonada, con períodos de evaluación en cada uno de ellos. CONCLUSIONES: La heterogeneidad de la persona diagnosticada con cáncer de cabeza y cuello representa un desafío y se considera a la EPA un profesional para manejar casos complejos. El camino hacia este nuevo rol será paulatino, y requiere una transición tanto por el equipo de salud, los pacientes y las propias enfermeras dentro del marco legal vigente.
This paper presents a proposal for an advanced practice nursing intervention (APN) in oncology. OBJECTIVE: To implement a support program for patients with head and neck cancer. PROPOSAL: To carry out a survey of the process and description of the flow that the oncology patient must go through from suspicion, diagnosis, treatment, follow-up and referral to palliative care. Secondly, to create and implement a nursing consultation that can respond to the health care needs in a holistic manner of the person with an oncological diagnosis of head and neck cancer, both in people who are in the suspicion and diagnostic confirmation phase (admission consultation) and in the follow-up process of the survivor (after the end of oncological treatment), through a staggered implementation, with evaluation periods in each of them. CONCLUSIONS: The heterogeneity of the person diagnosed with head and neck cancer represents a challenge and the APN is considered a professional to manage complex cases. The journey towards this new role will be gradual, and requires a transition both by the health team, the patients and the nurses themselves within the current legal framework.
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ABSTRACT Introduction Instruments to manage adverse effects of endocrine therapy with Aromatase inhibitors (AI) may improve adherence and persistence to treatment and Health-Related Quality of Life (HRQL). The 31-item Cervantes Scale (CS-31) is an HRQL questionnaire with particularities of the perimenopausal and postmenopausal period that could be an appropriate instrument to assess HRQL in Breast Cancer (BC) survivors. Objective This study aimed to perform additional validation of the CS-31 for BC survivors undergoing adjuvant endocrine therapy. Methods This prospective study was performed at three time points named T0, T1, and T2: initial, intermediate, and final follow-up period, respectively, totaling 24 months of follow-up. At each time point, the participants completed the CS-31, Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F), and Hospital Anxiety and Depression Scale (HADS). The internal consistency, construct validity, responsiveness analyses, and known-group validity of CS-31 were evaluated. Results This study included 89 postmenopausal women diagnosed with hormone receptor-positive early BC in adjuvant endocrine therapy with AI. The internal consistency was good (Cronbach's alpha = 0.89). Construct validity received a positive rating, with 100% of results consistent with prior hypotheses. A prospective improvement in HRQL was identified for the CS-31 Global Score and FACIT-F Total Score and for most of their domains. Furthermore, women with anxiety and depression by HADS presented worse HRQL by CS-31. Conclusion The authors identified that the CS-31 seems to be appropriate for use in oncology medical routine and may help to monitor adverse effects and HRQL of BC survivors during adjuvant endocrine therapy.
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Objetivo: analisar fatores facilitadores e dificultadores autorreferidos por trabalhadores da saúde para o retorno ao trabalho após o diagnóstico de câncer. Método: estudo descritivo transversal realizado com trabalhadores de enfermagem submetidos a tratamento de câncer, de dois hospitais públicos entre março e dezembro de 2019. Coletara-se dados sociodemográficos, do Índice para Capacidade de Trabalho e do Functional Assessment of Cancer Illness Therapy General, analisados por estatística descritiva. Protocolo aprovado pelo Comitê de Ética em Pesquisa. Resultados: entre os participantes, 81,9% eram do sexo feminino e 54,6% técnicos de enfermagem. A dor foi o principal dificultador (81,9%) e, para todos, o apoio de chefes e colegas de trabalho o principal facilitador. Identificou-se excelente capacidade para o trabalho em 45,5% e qualidade de vida média de 56. Conclusão: para o retorno ao trabalho ser possível, é necessário oferecer suporte ao trabalhador, tanto em função dos efeitos do tratamento do câncer quanto da necessidade de apoio.
Objective: to analyze facilitating and hindering factors self-reported by health workers in returning to work after a cancer diagnosis. Method: cross-sectional descriptive study carried out with nursing workers undergoing cancer treatment in two public hospitals between March and December 2019. Sociodemographic data were collected, from the Work Capacity Index and the Functional Assessment of Cancer Illness Therapy General, analyzed by descriptive statistics. Protocol approved by the Research Ethics Committee. Results: among the participants, 81.9% were female and 54.6% were nursing technicians. Pain was the main obstacle (81.9%) and, for everyone, support from bosses and co-workers was the main facilitator. Excellent work capacity was identified in 45.5% and an average quality of life of 56. Conclusion: for a return to work to be possible, it is necessary to offer support to the worker, both due to the effects of cancer treatment and the need of support.
Objetivo: analizar los factores facilitadores y obstaculizadores autodeclarados por trabajadores de la salud en el regreso al trabajo después de un diagnóstico de cáncer. Método: estudio descriptivo transversal realizado con trabajadores de enfermería en tratamiento oncológico, en dos hospitales públicos, entre marzo y diciembre de 2019. Se recolectaron datos sociodemográficos, del Functional Assessment of Cancer Illness Therapy General (Evaluación Funcional de la Terapia para Enfermedad Oncológica), analizados mediante estadística descriptiva. El Comité de Ética en Investigación aprobó el Protocolo. Resultados: entre los participantes, el 81,9% consistía en mujeres y el 54,6% en técnicos de enfermería. El dolor fue el principal obstáculo (81,9%) y, para todos, el apoyo de jefes y compañeros de trabajo fue el principal facilitador. Se identificó una excelente capacidad de trabajo en un 45,5% y una calidad de vida promedio de 56. Conclusión: para que el retorno al trabajo sea posible, es necesario ofrecer soporte al trabajador, tanto por los efectos del tratamiento del cáncer como por la necesidad de apoyo.
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ABSTRACT This study aims to investigate up-to-date scientific information about physical activity, COVID-19, and childhood cancer. This study is an integrative review. Research was conducted in the Science Direct database, using keywords in three different combinations. In total, 50 publications classified as the most relevant of each keyword combination were selected, 26 eligible publications were reached from August 2019 to July 2021, of which nine were duplicates. When exclusion criteria were applied, 11 complete studies were selected. The level of physical activity (PA) of children diagnosed with cancer or those who survived cancer is low. Changes due to the COVID-19 pandemic include the decrease in the level of PA and the increase in the use of technological devices. The minimum PA recommendations for this population vary but some evidence supports its importance and benefits in minimizing the adverse effects arising from cancer and from the performed medical treatment. Exercise-based interventions should be chosen and carried out considering the type of cancer and the stage of treatment the child is in due to the evidence of its effectiveness.
RESUMEN Este estudio tiene como objetivo investigar, en la base de datos ScienceDirect, la información científica actualizada sobre actividad física, COVID-19 y cáncer infantil, mediante una revisión integradora, en la cual se utilizaron las palabras clave en tres combinaciones diferentes. Se seleccionaron cincuenta publicaciones clasificadas como las más relevantes de cada combinación, y se alcanzaron 26 publicaciones elegibles en el periodo entre agosto de 2019 y julio de 2021, de las cuales nueve fueron textos duplicados. Al aplicar los criterios de exclusión, se seleccionaron 11 artículos completos. El nivel de actividad física (AF) de los niños diagnosticados de cáncer o supervivientes de cáncer es bajo, y entre los cambios provocados por la pandemia de la COVID-19 se encuentran la disminución del nivel de AF y el aumento en el uso de dispositivos tecnológicos. Las recomendaciones mínimas de AF para esta población varían entre sí, sin embargo, existe evidencia que respalda su importancia y los beneficios en la minimización de los efectos adversos derivados del propio cáncer y del tratamiento médico realizado. Las intervenciones basadas en ejercicios, para la cual ya existe evidencia de efectividad, deben elegirse y llevarse a cabo teniendo en cuenta el tipo de cáncer y la etapa de tratamiento en la que se encuentra el niño.
RESUMO O objetivo deste trabalho é investigar, na base de dados Science Direct, informações científicas sobre atividade física, covid-19 e câncer infantojuvenil, através de uma revisão integrativa, utilizando três combinações de palavras-chave. Cinquenta publicações mais relevantes de cada combinação de palavras-chave foram selecionadas, e chegou-se a 26 artigos elegíveis no período compreendido entre agosto de 2019 e julho de 2021, dos quais nove eram textos duplicados. Aplicando-se os critérios de exclusão, foram selecionados 11 estudos completos. Constatou-se que o nível de atividade física (AF) de crianças com câncer ou sobreviventes do câncer é baixo e que entre as mudanças causadas pela pandemia de covid-19 estão a diminuição do nível de AF e o aumento do uso de dispositivos tecnológicos. As recomendações mínimas de AF para essa população variam, entretanto há evidências que sustentam sua importância e seus benefícios ao minimizar os efeitos adversos oriundos do próprio câncer e do tratamento médico realizado. As intervenções baseadas em exercícios, para as quais já há evidência de eficácia, devem ser escolhidas e realizadas a partir do tipo de câncer e na fase do tratamento em que a criança está.
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Objective:To explore the mediating effect of self-advocacy between posttraumatic growth and social isolation among female breast cancer survivors, so as to provide reference for the establishing nursing intervention strategies for social isolation.Methods:A random samplingsurvey was conducted, a total of 220 female breast cancer survivors from May to December 2021in Tianjin Cancer Hospital Airport Hospital were recruited by convenience sampling method. They were investigated by the general information questionnaire, General Alienation Scale, Posttraumatic Growth Inventory and Female Self-advocacy in Cancer Survivorship, respectively.Results:A total of 203 valid questionnaires were collected. The score of posttraumatic growth was (60.91 ± 12.04) points, self-advocacy was (59.56 ± 12.19) points, social isolation was (36.52 ± 7.79) points of female breast cancer survivors. The Posttraumatic Growth Inventory scores of each dimension in female breast cancer survivors were positively correlated with the scores of female self-advocacy of each dimension in cancer survivorship ( r values were 0.219-0.686, all P<0.01); each dimension of the General Alienation Scale scores were negatively correlated with the scores of Posttraumatic Growth Inventory and Female Self-advocacy in Breast Cancer Survivorship ( r values were -0.804 to -0.202, all P<0.01). The posttraumatic growth of female breast cancer survivors affected social alienation through self-advocacy, which showed the mediating effect of self-advocacy accounts for 32.8% of total effect. Conclusions:Self-advocacy plays a mediating role in the relationship between posttraumatic growth and social isolation. Nurses can improve the level of self-advocacy of female breast cancer survivors and promote posttraumatic growth, so as to decrease social isolation.
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Resumo Objetivo Traduzir, adaptar transculturalmente e validar o conteúdo do Treatment Summary and Survivorship Care Plan (TSSCP-S) para sobreviventes brasileiras de câncer de mama. Métodos Estudo metodológico, quantitativo, executado de acordo com as etapas de tradução, compatibilização e retrotradução, construção de consenso de opiniões de um grupo de especialistas para a validação de conteúdo, de acordo com a Técnica Delphi e avaliação do usuário. Resultados O plano traduzido e adaptado transculturalmente foi avaliado por 10 profissionais, entre estes, enfermeiros, médicos, psicológos, nutricionista e fisioterapeuta, possuidores de titulação, produção científica, conhecimento e tempo de atuação na temática e o consenso foi obtido em duas rodadas. O instrumento apresentou coeficiente de validade de conteúdo de 83,3% na segunda rodada da Delphi. Na avaliação dos domínios conteúdo, clareza, utilidade, responsividade cultural e socioecológica, a concordância foi de 93,3%. O perfil sóciodemográfico e clínico das usuárias foi heterogêneo, contribuindo para os ajustes culturais necessários, com consenso final de 93,9%. Conclusão O plano de cuidados foi traduzido para o português do Brasil, adaptado transculturalmente e seus conteúdos foram validados, considerando as políticas de saúde nacionais.
Resumen Objetivo Traducir, adaptar transculturalmente y validar el contenido del Treatment Summary and Survivorship Care Plan (TSSCP-S) para sobrevivientes brasileñas de cáncer de mama. Métodos Estudio metodológico, cuantitativo, ejecutado de acuerdo con las etapas de traducción, compatibilización y retrotraducción, construcción de consenso de opiniones de un grupo de especialistas para la validación de contenido, de acuerdo con el método Delphi y evaluación del usuario. Resultados El plan traducido y adaptado transculturalmente fue evaluado por diez profesionales, entre ellos enfermeros, médicos, psicólogos, nutricionista y fisioterapeuta, con titulación académica, producción científica, conocimiento y tiempo de actuación en la temática, y el consenso se obtuvo en dos rondas. El instrumento presentó un coeficiente de validez de contenido del 83,3 % en la segunda ronda de Delphi. En la evaluación de los dominios contenido, claridad, utilidad, responsividad cultural y socioecológica, la concordancia fue del 93,3 %. El perfil sociodemográfico y clínico de las usuarias fue heterogéneo, lo que contribuye a los ajustes culturales necesarios, con consenso final del 93,9 %. Conclusión El plan de cuidados fue traducido al portugués de Brasil, adaptado transculturalmente y sus contenidos fueron validados, considerando las políticas sanitarias nacionales.
Abstract Objective To translate, cross-culturally adapt and validate the content of the Treatment Summary and Survivorship Care Plan (TSSCP-S) for Brazilian breast cancer survivors. Methods Methodological, quantitative study performed according to the steps of translation, compatibility and back-translation, construction of consensus of opinions in a group of experts for content validation, according to the Delphi technique and user evaluation. Results The translated and cross-culturally adapted plan was evaluated by ten professionals, including nurses, physicians, psychologists, nutritionists and physical therapists with a degree, scientific production, knowledge and time working on the subject. Consensus was obtained in two rounds. The instrument presented a content validity coefficient of 83.3% in the second round of Delphi. In the evaluation of content, clarity, usefulness, cultural and socioecological responsiveness domains, agreement was 93.3%. The sociodemographic and clinical profile of users was heterogeneous, contributing to the necessary cultural adjustments, with a final consensus of 93.9%. Conclusion The care plan was translated into Brazilian Portuguese, cross-culturally adapted and its contents were validated considering national health policies.
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ABSTRACT Objective: to cross-culturally adapt and assess the content validity evidence of the Cognitive Symptom Checklist-Work-21 for the Brazilian context. Method: a psychometric study of cross-cultural adaptation, covering the stages of translation, reconciliation, back-translation, intercultural equivalence assessment and content validity evidence analysis, considering Content Validity Ratio parameters in breast cancer survivors. Results: the translations were equivalent to the original version. Colloquial expressions were modified, tense, verbal adjusted, and two items containing multiple commands were separated. The final version now contains 22 items, presenting semantic, conceptual, idiomatic and experimental equivalences. The pre-test indicated good understanding and ease in the response process. Conclusion: the final version was defined as "Lista de verificação de sintomas cognitivos relacionados ao trabalho - 22 itens", showing good linguistic equivalence and strong evidence of content validity in the Brazilian context.
RESUMEN Objetivo: realizar la adaptación transcultural y evaluar las evidencias de validez de contenido del Cognitive Symptom Checklist-Work-21 para el contexto brasileño. Método: estudio psicométrico de adaptación transcultural, abarcando las etapas de traducción, reconciliación, retrotraducción, evaluación de equivalencia intercultural y análisis de evidencias de validez de contenido, considerando parámetros de Content Validity Ratio en sobrevivientes de cáncer de mama. Resultados: las traducciones fueron equivalentes a la versión original. Se modificaron las expresiones coloquiales, se tensaron, se ajustaron las verbales y se separaron dos ítems que contenían múltiples comandos. La versión final ahora contiene 22 ítems, presentando equivalencia semántica, conceptual, idiomática y experimental. El pre-test indicó buena comprensión y facilidad en el proceso de respuesta. Conclusión: la versión final fue definida como "Lista de verificação de sintomas cognitivos relacionados ao trabalho - 22 itens", mostrando buena equivalencia lingüística y fuerte evidencia de validez de contenido en el contexto brasileño.
RESUMO Objetivo: realizar a adaptação transcultural e avaliar as evidências de validade de conteúdo do Cognitive Symptom Checklist-Work-21 para o contexto brasileiro. Método: estudo psicométrico de adaptação transcultural, abrangendo as etapas de tradução, reconciliação, retrotradução, avaliação de equivalência intercultural e análise das evidências de validade de conteúdo, considerando parâmetros de Content Validy Ratio em sobreviventes de câncer de mama. Resultados: as traduções demonstraram equivalência à versão original. Expressões coloquiais foram modificadas, o tempo verbal ajustado, e dois itens contendo múltiplos comandos foram separados. A versão final passou a conter 22 itens, apresentando equivalências semântica, conceitual, idiomática e experimental. Os valores de CVR mantiveram-se acima de 0,87. O pré-teste indicou boa compreensão e facilidade no processo de resposta. Conclusão: a versão final foi definida como "Lista de verificação de sintomas cognitivos relacionados ao trabalho - 22 itens", apresentando boa equivalência linguística e fortes evidências de validade de conteúdo no contexto brasileiro.
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Introduction: Around the World, Breast cancer has become one of the common cancers among women. Prevalence and mortality of Breast cancer in India are 18 lakh & 12.7 per lakh cases respectively. One of the important reasons behind late presentation & high death rate is the lack of breast cancer awareness. Objectives: To assess the barriers in diagnosis and treatment among breast cancer patients and to explore the perception about cancer prevention among them. Methods: A qualitative study was done among women with confirmed breast cancer who were admitted to KIMS, Hubballi, and Cancer hospital, Navanagar in April 2019. Data collection was done by the In-depth interview method and analyzed as per qualitative study protocol standards. Results: The data was collected among 14 participants. Themes were generated accordingly. The findings showed lack of awareness, myths, financial constraints, negligence were the major barriers to the early presentation of breast cancer. Conclusion: This study showed barriers such as lack of awareness, negligence, fear, financial constraints, myths and misconceptions, social stigma, lack of family support. Measures taken to reduce mortality by early diagnosis and treatment.
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Resumen Con el advenimiento de tratamientos multidisciplinarios y de alta calidad, la supervivencia global a cinco años por cáncer en la población pediátrica ha mejorado considerablemente, llegando a ser hasta de 80% en países de altos ingresos. En Colombia también ha habido un aumento progresivo de la supervivencia global a 5 años, particularmente para las neoplasias hematológicas. En consecuencia, el número de supervivientes de cáncer infantil ha aumentado de forma importante en los últimos años y junto con ellos la aparición de eventos adversos tardíos relacionados con mayor morbilidad y riesgo de muerte prematura en la edad adulta. Aunque se han venido implementando estrategias de seguimiento a supervivientes de cáncer infantil en países de altos ingresos, en Colombia se han realizado pocos esfuerzos para la implementación de estas estrategias. De hecho, la práctica común en la mayoría de los centros de tratamiento consiste en dar de alta al niño que cumple 5 años de seguimiento oncológico, sin instrucciones precisas para dicho seguimiento. El objetivo del presente trabajo es argumentar sobre la necesidad de diseñar e implementar estrategias de seguimiento para supervivientes de cáncer infantil en el contexto colombiano.
Abstract With the advent of high-quality multidisciplinary treatments, the overall 5-year cancer survival in the pediatric population has improved considerably, reaching up to 80% in high-income countries. In Colombia, there has also been a progressive increase in overall 5-year survival, particularly for hematologic malignancies. Consequently, the number of childhood cancer survivors has increased significantly in recent years and, together with them, the occurrence of late adverse events related to increased morbidity and risk of premature death in adulthood. Although follow-up strategies have been implemented for childhood cancer survivors in high-income countries, few efforts have been made in Colombia to implement these strategies. In fact, the common practice in most treatment centers is to discharge children who have had 5 years of cancer follow-up, without precise instructions for long-term follow-up. This paper aims to argue about the need to design and implement follow-up strategies for survivors of childhood cancer in the Colombian context.
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Child , Total Quality Management , Mortality, Premature , Cancer Survivors , Neoplasms , Health Strategies , Aftercare , SurvivorshipABSTRACT
Objective:To understand the current situation of female cancer survivors′ self-advocacy and analyze its influencing factors.Methods:Convenience sampling was used. From August to November 2021, 243 female cancer survivors from 10 tertiary A hospitals in Jiangsu Province were selected as the research objects. The general information questionnaire and the Female Self-Advocacy in Cancer Survivorship (FSACS)were used for the survey. Multiple stepwise linear regression was used to analyze the influencing factors of female cancer survivors′ self-advocacy rights.Results:The self-advocacy score of this group of female cancer survivors was (82.42±10.42); the results of multiple stepwise linear regression analysis showed that education level was an influencing factor for female cancer survivors′self-advocacy ( P<0.05), but age, marital status, number of children, work status, family monthly income, reimbursement method, illness time, disease diagnosis, and disease stage had nothing to do with female cancer survivors′ self-advocacy( P>0.05). Conclusions:Female cancer survivors′ self-advocacy is affected by their educational level.It is recommended that medical staff pay attention to patients with low education level, provide personalized guidance according to their conditions, and encourage them to actively obtain external information, seek effective communication and external support, so as to improve Self-advocacy ability.
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The lifetime incidence of cancer in women is about 50%, with some gynecological cancers increasing, and the prevalence of depression in patients is assumed to be about 12-25%1）. Depression is thought to affect not only suicide but also death from cancer2）, and it is important to provide psychological care to patients as survivors from the time they are diagnosed with cancer. Psychotropic drugs are often chosen for treatment, but side effects such as extrapyramidal symptoms, drowsiness, and constipation are observed, and the quality of life of cancer patients can be increasingly compromised.In this article, we report on seven cases of gynecological cancer survivors who experienced significant efficacy of kososan for the depression and anxiety resulting from stress they felt during various processes such as diagnosis, notification, treatment, recurrence, and best supportive care (BSC). Kososan is a qi-regulating formula, and its efficacy in improving depression has been described since ancient times. In particular, it can be widely used for qi problems of women with a deficiency pattern, and its application to gynecological cancer treatment is considered to be very useful.
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ABSTRACT Objective To unveil the existential movement of being a woman survivor of breast cancer. Method Qualitative, phenomenological, with Heideggerian analytics from 15 interviews, between October2020 and January2021 in a teaching hospital in Minas Gerais. The construction of seven Meaning Units was followed by comprehensive methodical moments. Results The being-there-woman-survivor-of-breast-cancer showed itself in the ways of being of everyday life, occupied in manuality of tasks inside and outside the home, moved by impersonality and impropriety. The fear of death, gossip, curiosity and ambiguity were revealed that led to decadence, experienced in the world of treatment and follow-up, enabling being-with. The anguish that announced itself fleetingly was followed by the decadence that most of the time the presence remains. Conclusion The need to structure a specialized and interdisciplinary line of care is reinforced, in which care centered on active and qualified listening encompasses multidimensionality, envisioning women in aspects that permeate cancer survival.
RESUMEN Objetivo Develar el movimiento existencial de ser mujer sobreviviente de cáncer de mama. Métodos Cualitativa, fenomenológica, con analítica heideggeriana a partir de las entrevistas de 15 mujeres, entre Octubre/2020 a Enero/2021en un hospital de Minas Gerais. A la construcción de las siete Unidades de Significado le siguieron momentos comprensivos. Resultados El ser-ahí-mujer-sobreviviente-de-cáncer-de-mama se manifestó en los modos de ser de la vida cotidiana, ocupada en la manualidad, de que haceres dentro y fuera del hogar, impulsados por la impersonalidad y la impropiedad. Se revelaron el miedo a la muerte, las habladurías, la curiosidad y la ambigüedad que la llevaron a la decadencia, experimentada en el mundo del tratamiento y seguimiento, posibilitando el estar-con. A la angustia que se anunciaba fugazmente le siguió la decadencia que la mayor parte del tiempo permanece la presencia. Conclusiones Se refuerza la necesidad de estructurar una línea de atención especializada e interdisciplinaria, en la que la atención centrada en la escucha activa y calificada abarque la multidimensionalidad, vislumbrando a la mujer en los aspectos que permean la supervivencia al cáncer.
RESUMO Objetivo Desvelar o movimento existencial do ser mulher sobrevivente ao câncer de mama. Métodos Qualitativo, fenomenológico, com analítica heideggeriana a partir de 15 entrevistas, entre outubro de 2020 e janeiro de 2021, em um hospital de ensino mineiro. À construção das Unidades de Significação, seguiram-se momentos metódicos compreensivos. Resultados O ser-aí-mulher-sobrevivente-ao-câncer-de-mama se mostrou na cotidianidade, ocupada na manualidade dos afazeres dentro e fora de casa, movida pela impessoalidade e impropriedade. Desvelou-se o temor da morte, falatório, curiosidade e ambiguidade que a conduziram à decadência,vivenciada no mundo do tratamento e do seguimento, possibilitando ser-com. À angústia que se anunciou fugaz, seguiu-se a decadência que na maior parte das vezes a presença se mantém. Conclusões Reforça-se a necessária estruturação de linha de cuidados especializada e interdisciplinar, em que o cuidado centrado na escuta ativa e qualificada abarque a multidimensionalidade, vislumbrando a mulher nos aspectos que permeiam a sobrevivência ao câncer.
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Abstract Objective: to understand the transition from disease to survival of adolescents who had experienced cancer. Method: qualitative study, developed with the theoretical framework of symbolic interactionism, conducted with 14 adolescent cancer survivors treated at an outpatient clinic after cancer therapy, in the city of São Paulo. Individual in-depth interviews were performed and recorded, and the data were analyzed and interpreted using the methodological framework of the thematic analysis. Results: four themes were identified: going back to school, being able to live like other adolescents, living in the present moment, and seeking a purpose in life. Conclusion: the transition from disease to cancer survival was full of insecurities, difficulties, and challenges. After the disease, survivors acquire new values and new priorities in life, a reconstruction of the self. They also feel thankful to God and the people who were part of their treatment journey.
Resumo Objetivo: conhecer a transição da doença para a sobrevivência de adolescentes que vivenciaram o câncer. Método: estudo de abordagem qualitativa, desenvolvido por meio do referencial teórico Interacionismo Simbólico, realizado com 14 adolescentes sobreviventes de câncer atendidos em um ambulatório de pacientes fora de terapia na cidade de São Paulo (SP). Foram realizadas e gravadas entrevistas individuais e em profundidade e os dados foram analisados e interpretados pelo referencial metodológico da análise temática. Resultados: quatro temas foram identificados: voltando para a escola; podendo viver como outros adolescentes; vivendo o agora e buscando um propósito na vida. Conclusão: a transição da doença para a sobrevivência do câncer se revelou cheia de inseguranças, dificuldades e desafios. Após a doença, os sobreviventes adquirem novos valores e novas prioridades de vida; uma reconstrução do self; além do sentimento de gratidão a Deus e às pessoas que participaram da trajetória percorrida durante o tratamento.
Resumen Objetivo: conocer la transición entre la enfermedad y la supervivencia de adolescentes que han sufrido cáncer. Método: estudio con enfoque cualitativo, desarrollado a través del referencial teórico del Interaccionismo Simbólico, realizado con 14 adolescentes supervivientes de cáncer atendidos en un ambulatorio, sin terapia, de la ciudad de São Paulo (SP). Se realizaron y grabaron entrevistas en profundidad individuales y los datos fueron analizados e interpretados utilizando el marco metodológico de análisis temático. Resultados: se identificaron cuatro temas: regreso al colegio; poder vivir como otros adolescentes; viviendo el presente y buscando un propósito en la vida. Conclusión: la transición entre la enfermedad y la supervivencia del cáncer se mostró llena de inseguridades, dificultades y desafíos. Después que termina la fase de la enfermedad, los supervivientes adquieren nuevos valores y prioridades en la vida; una reconstrucción del Self; además del sentimiento de gratitud hacia Dios y las personas que participaron del camino recorrido durante el tratamiento.
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Humans , Adolescent , Emotions , Ambulatory Care Facilities , Cancer Survivors , Neoplasms/therapyABSTRACT
RESUMO O objetivo deste estudo é analisar e refletir criticamente sobre a sobrevivência ao câncer infantojuvenil, incluindo aspectos conceituais, repercussões, cuidados de sobrevivência e desafios. Estudo teórico e reflexivo, fundamentado na literatura científica sobre a temática e na experiência dos pesquisadores. A sobrevivência ao câncer infantojuvenil é conceituada como o processo de viver além do diagnóstico oncológico. Uma pessoa é considerada sobrevivente de câncer desde o diagnóstico até o final da vida e tem risco elevado de desenvolver efeitos físicos, psicossociais e econômicos. Portanto, cuidados de sobrevivência devem minimizar, na medida do possível, essas repercussões ao longo da vida. Esses cuidados incluem um plano de ações para rastreamento e tratamento dos efeitos persistentes da terapêutica, prevenção de doenças e promoção de comportamentos saudáveis, não se restringindo ao monitoramento da recorrência oncológica. No contexto nacional, desafios persistem, como a escassez de políticas que orientem os cuidados de sobrevivência de qualidade, abrangentes e coordenados. Apesar destes desafios, o enfermeiro ocupa posição privilegiada e é competente para implementar cuidados de sobrevivência e gerenciamento dos efeitos relacionados ao tratamento oncológico.
RESUMEN El objetivo de este estudio es analizar y reflexionar críticamente acerca de la supervivencia al cáncer infantojuvenil sobre todo en los aspectos conceptuales, repercusiones, cuidados de supervivencia y desafíos. Se trata de estudio teórico y reflexivo sobre el tema con fundamentación en la literatura científica y en la experiencia de los investigadores. La supervivencia al cáncer infantojuvenil se define como el proceso de vivir más allá del diagnóstico oncológico. A uno se le considera superviviente de cáncer desde su diagnóstico hasta el final de su vida con riesgos elevados de desarrollar efectos físicos, psicosociales y económicos. Por lo tanto, cuidados de supervivencia deben minimizar, cuando posible, esas repercusiones a lo largo de la vida. Esos cuidados incluyen un plan de acciones para búsqueda y tratamiento de los efectos persistentes de la terapéutica, prevención de enfermedades y fomento de comportamientos sanos, sin restricción del monitoreo de la recurrencia oncológica. En el contexto nacional persisten desafíos como la escasez de políticas que orienten los cuidados de supervivencia con calidad y que sean amplios y ordinados. A pesar de ello, el enfermero ocupa posición privilegiada y es competente para implementar cuidados de supervivencia y supervisión de los efectos del tratamiento oncológico.
ABSTRACT The aim of this study is to analyze and critically reflect on childhood cancer survival, including conceptual aspects, repercussions, survival care, and challenges. This is a theoretical and reflective study, based on the scientific literature on the subject and on the researchers' experience. Childhood cancer survival is conceptualized as the process of living beyond the oncological diagnosis. A person is considered a cancer survivor from the diagnosis until the end of life and is at high risk of experiencing physical, psychosocial, and economic effects. Therefore, survival care shall minimize, as far as possible, these impacts throughout life. Such care includes an action plan to track and treat the persistent effects of therapy, preventing diseases and promoting healthy behaviors, not being restricted to monitoring oncological recurrence. In the national setting, challenges persist, such as the scarcity of policies to guide comprehensive, good quality, and coordinated survival care. Despite these challenges, the nurse occupies a privileged position and is competent to implement survival care and manage the effects related to cancer treatment.
Subject(s)
Oncology Nursing , Child , Adolescent , Cancer SurvivorsABSTRACT
INTRODUCTION@#Fear of cancer recurrence (FCR) among cancer survivors is a persistent and distressing psychosocial concern that affects recovery and quality of life. The prevalence of FCR in Singapore is unknown. This cross-sectional study was designed to examine FCR and identify factors associated with FCR in mixed-cancer survivors locally.@*METHODS@#Cancer survivors in remission (n = 404) were assessed for: FCR using the Fear of Cancer Recurrence Inventory (FCRI); emotional distress using the Hospital Anxiety and Depression Scale; and quality of life using the World Health Organization Quality of Life-BREF. Clinical and severe/pathological FCR was determined based on the severity scale of FCRI, known as FCRI-Short Form. Multivariate logistic regression was performed to examine factors associated with FCR.@*RESULTS@#The mean score on the FCRI was 59.5 ± 30.4. 43.6% of cancer survivors had clinical FCR and 32.1% had severe/pathological FCR. Younger age (odds ratio [OR] 0.952, 95% confidence interval [CI] 0.911-0.995, p < 0.05), higher educational status (OR 2.55, 95% CI 1.15-5.65, p < 0.05) and higher levels of emotional distress (OR 1.17, 95% CI 1.10-1.24, p < 0.001) were significantly associated with severe/pathological levels of FCR.@*CONCLUSION@#The present study is the first to determine levels of FCR among cancer survivors in Singapore. While the total FCR scores were similar to those of international studies, severe/pathological levels of FCR were found to be four times higher. These findings highlight a problem that is not widely recognised or acknowledged, but which deserves greater attention.
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ABSTRACT Objectives: to analyze school (re)inclusion of an adolescent cancer survivor before/after participatory health education with adolescents. Methods: qualitative and participatory research that included data from the medical record of an adolescent rhabdomyosarcoma survivor and Talking Map dynamics (to diagnose the demand for learning and assess changes). The body-knowledge dynamics were applied in the educational intervention. In a public school in Rio de Janeiro, the adolescent (reference case) and nine people (four teachers and five teenagers) generated empirical materials, which became the content analysis objects. Results: strangeness to changes in an adolescent cancer survivor's body image, bullying, and acceptance were problematized in educational body-knowledge dynamics through relationships between changes and barriers to welcoming. The participatory educational process was essential in raising awareness by promoting re-inclusive actions. Conclusions: participatory-problematizing education contributed to constructing a new collective identity and improvement in school interaction among peers.
RESUMEN Objetivos: analizar la (re)inclusión escolar de adolescentes sobrevivientes de cáncer antes/después de la educación participativa en salud con adolescentes. Métodos: investigación cualitativa y participativa, que incluyó datos de la historia clínica de un adolescente sobreviviente de rabdomiosarcoma y la dinámica Mapa Falante (para diagnosticar la demanda de aprendizaje y evaluar cambios). En la intervención educativa se aplicó la dinámica cuerpo-conocimiento. En una escuela pública de Río de Janeiro, el adolescente (caso de referencia) y nueve personas (cuatro profesores y cinco adolescentes) generaron materiales empíricos, objeto de análisis de contenido. Resultados: el alejamiento de los cambios en la imagen corporal de un adolescente sobreviviente de cáncer, el bullying y la aceptación se problematizaron en la dinámica educativa cuerpo-conocimiento a través de las relaciones entre cambios y barreras de recepción. El proceso educativo participativo fue fundamental en la sensibilización a la hora de promover acciones reinclusivas. Conclusiones: la educación participativa-problematizadora contribuyó a la construcción de una nueva identidad colectiva y al mejoramiento de la convivencia escolar entre pares.
RESUMO Objetivos: analisar a (re)inclusão escolar de adolescente sobrevivente de câncer antes/depois da educação em saúde participativa com adolescentes. Métodos: pesquisa qualitativa e participatória, que incluiu dados do prontuário de uma adolescente sobrevivente de rabdomiossarcoma e da dinâmica Mapa Falante (para diagnosticar a demanda de aprendizagem e avaliar mudanças). Na intervenção educativa, aplicou-se a dinâmica corpo-saber. Em uma escola pública do Rio de Janeiro, a adolescente (caso referência) e nove pessoas (quatro professores e cinco adolescentes) geraram materiais empíricos, objeto da análise de conteúdo. Resultados: o estranhamento às mudanças na imagem corporal de adolescente sobrevivente de câncer, bullying e aceitação foram problematizados na dinâmica educativa corpo-saber através das relações entre as mudanças e barreiras ao acolhimento. O processo educativo participativo foi essencial na tomada de consciência ao promover ações reinclusivas. Conclusões: a educação participativa-problematizadora contribuiu para a construção de uma nova identidade coletiva e melhoria na convivência escolar entre pares.
Subject(s)
Adolescent , Humans , Bullying , Cancer Survivors , Neoplasms , Schools , Brazil , Health EducationABSTRACT
Introdução: Sobreviventes do câncer de cavidade oral (SCCO) em controle normalmente apresentam inúmeras sequelas derivadas do tratamento oncológico, o que pode comprometer sua alimentação e, por extensão, o atendimento às diretrizes de alimentação e peso adequado emitidas pelo Fundo Mundial para Pesquisa do Câncer/Instituto Americano de Pesquisa para o Câncer (WCRF/AICR). Objetivo: Avaliar o perfil alimentar e o estado nutricional de sobreviventes de câncer de cavidade oral e verificar o grau de sua adesão, as diretrizes de alimentação saudável e peso corporal emitidas pela WCRF / AICR. Método: Estudo transversal que avaliou o estado nutricional pela Avaliação Subjetiva Global produzida pelo paciente (ASG-PPP) e índice de massa corporal (IMC) de 20 pacientes. Dados como condição social e histórico clínico foram coletados em prontuário. O consumo alimentar foi avaliado por meio de um diário alimentar de 30 dias. Os dados alimentares e o peso corporal receberam um escore de pontos conforme maior ou menor grau de adesão às recomendações WCRF / AICR. Resultados: 80% dos pacientes encontravam-se com desnutrição moderada ou suspeita de desnutrição pela ASG-PPP. Pelo IMC, 10% dos participantes estavam desnutridos, 45% eutróficos e 35% apresentavam sobrepeso. Foi encontrado escore médio 2,64 ±0.55 de adesão às recomendações de peso adequado e alimentação saudável, demonstrando atendimento de menos de 50% das recomendações WCRF / AICR. Conclusão: Os pacientes SCCO do presente estudo apresentam risco de desnutrição ou estão com desnutrição moderada; e possuem alta sintomatologia, que impacta negativamente na ingestão alimentar e na adesão às recomendações da WCRF / AICR. (AU)
Introduction: Survivors of oral cavity cancer (OCC) under control usually have numerous sequelae resulting from oncological treatment, which can compromise their diet and, by extension, meet the guidelines for diet and proper weight issued by the World Cancer Research Fund International-WCRF and the American Institute for Cancer Research-AICR. Objective: To evaluate the dietary profile and nutritional status of oral cancer survivors and verify the degree of their adherence, the guidelines for healthy eating and body weight issued by WCRF/AICR. Method: Cross-sectional study which assessed the nutritional status by the Subjective Global Assessment produced by the patient (PG-SGA) and body mass index (BMI) of 20 patients. Data such as social condition and clinical history were collected from medical records. Food consumption was assessed using a 30-day food diary. Food data and body weight received a score of points according to a greater or lesser degree of adherence to WCRF/AICR recommendations. Results: 80% of patients were moderately malnourished or suspected of malnutrition by PG-SGA. According to BMI 10% of participants were malnourished, 45% eutrophic and 35% were overweight. An average score of 2.64 ± 0.55 adherence to the recommendations of adequate weight and healthy eating was found, showing compliance with less than 50% of the WCRF/AICR recommendations. Conclusion: Survivor patients of OCC patients from the present study are at risk of malnutrition or have moderate malnutrition; and have high symptomology, which negatively impacts food intake and adherence to recommendations of WCRF/AICR. (AU)
Subject(s)
Humans , Mouth Neoplasms , Nutritional Status , Eating , Diet, Healthy , Cancer Survivors , Xerostomia , Body Weight , Cross-Sectional Studies , MalnutritionABSTRACT
Background: Cancer survivorship results in an increased number of physical and psychosocial health issues. Engaging in physical activity in natural environments is often thought of as restorative. Despite the potential benefits of engaging in physical activity in natural environments there are no sustainable community-based programs for cancer survivors that employ this form of physical activity. This study aims to evaluate the impact of an 8-week trail-walking (TW) program on anxiety in a population of adult cancer survivors. Methods: The TW program consisted of two trail walks per week for 8 weeks led by a hiking guide. Individuals were eligible to participate if they were 19 years or older, were a cancer survivor, were not on active immunotherapy, and had medical clearance from their physician for physical activity. While 12 participants signed up for the program, 9 participants (N = 9, 8 F, 1 M) completed the program. A mixed methodology included preand-post quantitative program surveys and post-program interviews. Questionnaires measured generalized anxiety, sleep disturbances, self-efficacy, self-esteem, psychological well-being and depression as well as pre-and-post hike state anxiety. Data was analysed using paired t-tests. Interviews were transcribed verbatim and an inductive thematic analysis was conducted to consolidate meaning and identify themes using NVivo 11 software. Results: Average attendance was 74% of the 16 hikes. There was no significant reduction in the primary outcome of generalized anxiety (p = .38). There was a significant reduction in perceived stress after 8-weeks (p = .03) and a significant reduction in state anxiety after TW (p < .001). None of the other secondary outcomes were statistically significant (p > .05). Four overarching themes, or benefits, emerged from qualitative data analysis: (a) benefits of program design (b) physical benefits, (c) psychological benefits, and (d) social benefits. Conclusions: These findings demonstrate the utility of a TW program for cancer survivors in order to promote physical, psychological and social health. Feasibility of a TW program would be contingent on access to natural areas for TW and an instructor-led program with other cancer survivors.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Anxiety , Walking , Exercise Therapy , Cancer Survivors/psychologyABSTRACT
@#Introduction: The number of breast cancer survivors in developing Asian countries is still lacking compared to Western countries. Health-related quality of life (HRQoL) of cancer patients is one of the significant predictors of survival. Hence, this study was conducted to determine HRQoL status among breast cancer survivors of different diagnosis duration in East Coast of Peninsular Malaysia. Methods: Cross-sectional data were collected for 128 breast cancer survivors, aged 37 to 72 years who were recruited by using purposive sampling method at two main government hospitals in Kelantan (n=67) and Terengganu (n=61). The validated European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (EORTC QLQ–C30) and Breast Cancer Supplementary Measure (EORTC QLQ-BR23) which had been translated into the Malay language were used to measure HRQoL. Independent t-test was used to compare HRQoL status among short term (≤5 years duration since diagnosis) and long term (>5 years duration since diagnosis) breast cancer survivors. Results: Overall, our breast cancer survivors reported good HRQoL, with high scores for global health status, functional status and low symptoms scores. Long term breast cancer survivors had better social functioning compared to short term survivors (p=.038). Nevertheless, there was no significant difference found for other HRQoL status between short and long term breast cancer survivors. Conclusion: Breast cancer survivors in East Coast of Peninsular Malaysia generally experienced good HRQoL. The relatively similar HRQoL status between long-term and short-term survivors indicated a constant HRQoL profile among survivors throughout their survivorship.
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ABSTRACT Objective To assess the outcome of an educational nutritional intervention in the quality of diet of women with breast cancer in adjuvant treatment. Methods Women with breast cancer and admitted for surgical treatment were divided in an intervention group (n=18) and a comparison group (n=78), and participated in a nonrandomized clinical trial. Participants were assessed before and after the treatment and/or intervention. A food frequency questionnaire was applied and the quality of diet was calculated using the Brazilian Healthy Eating Index Revised. The educational nutritional intervention lasted 12 months and was carried out through phone calls twice a month, personal meetings, and monthly handouts. It oriented an intake of at least 400g of vegetables and fruits per day and at most 500g of red/processed meat per week. Results We observed a significant improvement in the diet quality of the intervention group (+5.7). Nutritional education in the intervention group reached its objectives, with a rise in the intake of vegetables and fruits reflecting a significant increase in the score of total fruits (+1.9) and whole fruits (+1.1), and a decrease in the score of meat, eggs, and legumes (-3.3) by means of a reduction in the intake of red/processed meat (p<0.05). Also, a rise in the punctuation of calories from solid fats, alcohol, and added sugar was observed (+5.0, p<0.05) due to lower intake of these components. The comparison group presented no significant differences. Conclusion The nutritional intervention contributed to improving the quality of the diet during breast cancer treatment and possibly altered these women's prognoses.
RESUMO Objetivo O estudo objetivou analisar o impacto de uma intervenção nutricional educativa na qualidade da dieta de mulheres com câncer de mama em tratamento adjuvante. Métodos Mulheres com câncer de mama admitidas para tratamento cirúrgico, divididas em grupo intervenção (n=18) e grupo comparação (n=78), participaram de um ensaio clínico não randomizado. As participantes foram avaliadas antes e após o tratamento e/ou intervenção. Um questionário de frequência alimentar foi aplicado, e a qualidade da dieta foi calculada pelo Índice de Qualidade da Dieta Revisado. A intervenção nutricional educativa ocorreu por meio de ligações quinzenais, encontros presenciais e materiais informativos, durante 12 meses, com orientações visando à ingestão de pelo menos 400g/dia de vegetais e frutas, e não mais que 500g/semana de carne vermelha/processada. Resultados O grupo de intervenção melhorou significativamente a qualidade da dieta (+5,7). Além disso, houve aumento da ingestão de frutas e vegetais, representado por elevação significativa na pontuação de frutas totais (+1,9) e frutas integrais (+1,1) e redução considerável na pontuação de carnes, ovos e leguminosas (-3,3), a qual se deu pela diminuição do consumo de alimentos embutidos e carne bovina (p<0,05). Ainda, observou-se aumento na pontuação do componente que avalia as quilocalorias provenientes das gorduras sólidas, bebidas alcoólicas e açúcar de adição (+5,0, p<0,05) devido ao menor consumo desses alimentos. O grupo comparação não apresentou diferenças significativas. Conclusão A intervenção nutricional contribuiu para melhorar a qualidade da dieta durante o tratamento para câncer de mama e, possivelmente, o prognóstico dessas mulheres.