Impact of mobile applications on adherence to cancer treatment: a systematic review and meta-analysis protocol.

INTRODUCTION: The number of patients taking oral chemotherapy is increasing around the world. It is essential to maximise the adherence to oral chemotherapy to improve the overall survival and life expectancy of the patients. In this systematic review and meta-analysis, we aim to evaluate the effectiveness of mobile applications in improving the adherence to oral chemotherapy and adjuvant hormonal therapy in cancer survivors. METHODS AND ANALYSIS: MEDLINE, Embase, LILACS, clinicaltrials.gov, Scopus and the Cochrane Central Register of Controlled Trials will be searched for randomised or quasi-experimental studies published between January 2009 and July 2019. This systematic review and meta-analysis will include studies investigating the use of mobile applications by cancer survivors to aid adherence to oral chemotherapy and adjuvant hormonal therapy. Patient education, reminder tools, calendars, pillboxes and electronic reminders will not be evaluated. The primary outcome will be the improvement in adherence to anticancer drugs. The secondary outcomes will be an improvement in the overall survival and life expectancy, improved quality of life and control of cancer-related symptoms. Three independent reviewers will select the studies and extract data from the original publications. The risk-of-bias will be assessed using the Cochrane risk-of-bias tool. Data synthesis will be performed using the Review Manager software (RevMan V.5.2.3). To assess heterogeneity, we will compute the I2 statistics. Additionally, a quantitative synthesis will be performed if the included studies are sufficiently homogenous. ETHICS AND DISSEMINATION: This study will be a review of the published data, and thus, ethical approval is not required. Findings of this systematic review will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42018102172.

Pain and quality of life in breast cancer patients

OBJECTIVE: To evaluate the influence of pain on quality of life in breast cancer patients. METHODS: A cross-sectional study of 400 patients, including 118 without metastasis, 160 with loco-regional metastasis and 122 with distant metastasis. The instruments used were the European Organization for Research and Treatment for Cancer Quality of Life Questionnaire-Core 30 and the Breast Cancer-specific 23 and short McGill Pain Questionnaire. RESULTS: In total, 71.7% of patients reported pain. The most frequent sensory descriptor used by patients was 'jumping.' In the evaluative dimension, the main descriptor chosen was troublesome. The Global Health self-assessment showed pain to be inversely correlated with quality of life: the group without metastasis had a mean score of 55.3 (SD=24.8) for those in pain, which rose to 69.7 (SD=19.2) for those without pain (p=0.001). Subjects with loco-regional metastasis had score of 59.1 (SD=21.3) when in pain, and those without pain had a significantly higher score of 72.4 (SD=18.6) (p<0.001). Patients from the distant metastasis group showed similar results with a mean score of 48.6 (SD=23.1) for those in pain and 67.6 (SD=20.4) for those without pain (p=0.002). Regarding the association of pain intensity and quality of life, patients with distant metastasis and intense pain had the worst scores for quality of life with a functional scale mean of 49.9 (SD=17.3) (p<0.009), a Symptom Scale score of 50.0 (SD=20.1) (p<0.001) and a Global Health Scale score of 39.7 (SD=24.7) (p<0.006). CONCLUSIONS: Pain compromises the quality of life of patients with breast cancer, particularly those with advanced stages of the disease.

Quality of life in breast cancer survivors.

OBJECTIVE: To evaluate the influence of functional capacity (FC) and how it affects quality of life (QoL) in breast cancer survivors. METHOD: A total of 400 breast cancer survivors were studied - 118 without metastasis, 160 with locoregional metastasis and 122 with distant metastasis. The European Organization for Research and Treatment for Cancer Quality of Life Questionnaire--Core 30 (EORTC QLQ-C30), Breast Cancer-Specific (EORTC QLQ-BR23), and the Karnofsky Performance Scale (KPS) were used to evaluate FC and QoL. RESULTS: Women with distant metastases presented lower KPS 75.3 (SD=12.5) (p<0.001). For QLQ-C30, the mean of the Functional Scale for patients with distant metastasis was 57 (SD=19) (p<0.001), and the mean of the Symptom Scale for patients with distant metastasis was 37 (SD=20) (p<0.001). Both the scales for pain and fatigue showed the highest mean in the groups. For the Global Health Scale, patients without metastasis scored a mean of 62 (SD=24) points, while those with locoregional metastases scored a mean of 63 (SD=21.4), and distant metastasis scored 51.3 (SD=24) points. In the group with distant metastases, 105 (87%) had pain, and the average KPS was 74 (SD=12.0) (p=0.001). CONCLUSION: Breast cancer was associated with decreased FC, compromised QoL in women with locoregional and distant metastases compared to those without metastasis.

Quality of life in breast cancer survivors / Qualidade de vida em sobreviventes do câncer de mama

Summary Objective: To evaluate the influence of functional capacity (FC) and how it affects quality of life (QoL) in breast cancer survivors. Method: A total of 400 breast cancer survivors were studied - 118 without metastasis, 160 with locoregional metastasis and 122 with distant metastasis. The European Organization for Research and Treatment for Cancer Quality of Life Questionnaire--Core 30 (EORTC QLQ-C30), Breast Cancer-Specific (EORTC QLQ-BR23), and the Karnofsky Performance Scale (KPS) were used to evaluate FC and QoL. Results: Women with distant metastases presented lower KPS 75.3 (SD=12.5) (p<0.001). For QLQ-C30, the mean of the Functional Scale for patients with distant metastasis was 57 (SD=19) (p<0.001), and the mean of the Symptom Scale for patients with distant metastasis was 37 (SD=20) (p<0.001). Both the scales for pain and fatigue showed the highest mean in the groups. For the Global Health Scale, patients without metastasis scored a mean of 62 (SD=24) points, while those with locoregional metastases scored a mean of 63 (SD=21.4), and distant metastasis scored 51.3 (SD=24) points. In the group with distant metastases, 105 (87%) had pain, and the average KPS was 74 (SD=12.0) (p=0.001). Conclusion: Breast cancer was associated with decreased FC, compromised QoL in women with locoregional and distant metastases compared to those without metastasis.

Resumo Objetivo: Avaliar a influência da capacidade funcional (CF) sobre a qualidade de vida (QV) de mulheres sobreviventes de câncer de mama. Método: 400 mulheres sobreviventes de câncer de mama foram avaliadas -118 sem metástases, 160 com metástases locorregionais e 122 com metástases a distância. Para avaliar a capacidade funcional e a qualidade de vida, os seguintes instrumentos foram utilizados: European Organization for Research and Treatment for Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), Breast Cancer-Specific (EORTC QLQ-BR23) e Karnofsky Performance Scale (KPS). Resultados: Mulheres com metástases a distância apresentaram menor KPS 75,3 (DP=12,5) (p<0,001). Quanto ao QLQ-C30, a média da escala funcional para pacientes com metástases a distância foi de 57 (DP=19) (p<0,001). A média da escala de sintomas das pacientes com metástase a distância foi de 37 (DP=20) (p<0,001). A escala de dor e fadiga apresentou a maior média nos grupos. Em relação à Escala Global de Saúde, as pacientes sem metástase tinham uma média de 62 (DP=24); com metástase locorregional, 63 (DP=21,4); e com metástase a distância, 51,3 (DP=24). Para o grupo com metástase a distância, 105 (87%) tiveram dor, e a média do KPS foi de 74 (DP=2,0) (p=0,001). Conclusão: O câncer de mama foi associado com diminuição da capacidade funcional, comprometendo a qualidade de vida das mulheres sobreviventes do câncer de mama com metástases locorregional ou a distância, quando comparadas àquelas sem metástases.

Pain and quality of life in breast cancer patients.

OBJECTIVE: To evaluate the influence of pain on quality of life in breast cancer patients. METHODS: A cross-sectional study of 400 patients, including 118 without metastasis, 160 with loco-regional metastasis and 122 with distant metastasis. The instruments used were the European Organization for Research and Treatment for Cancer Quality of Life Questionnaire-Core 30 and the Breast Cancer-specific 23 and short McGill Pain Questionnaire. RESULTS: In total, 71.7% of patients reported pain. The most frequent sensory descriptor used by patients was 'jumping.' In the evaluative dimension, the main descriptor chosen was troublesome. The Global Health self-assessment showed pain to be inversely correlated with quality of life: the group without metastasis had a mean score of 55.3 (SD=24.8) for those in pain, which rose to 69.7 (SD=19.2) for those without pain (p=0.001). Subjects with loco-regional metastasis had score of 59.1 (SD=21.3) when in pain, and those without pain had a significantly higher score of 72.4 (SD=18.6) (p<0.001). Patients from the distant metastasis group showed similar results with a mean score of 48.6 (SD=23.1) for those in pain and 67.6 (SD=20.4) for those without pain (p=0.002). Regarding the association of pain intensity and quality of life, patients with distant metastasis and intense pain had the worst scores for quality of life with a functional scale mean of 49.9 (SD=17.3) (p<0.009), a Symptom Scale score of 50.0 (SD=20.1) (p<0.001) and a Global Health Scale score of 39.7 (SD=24.7) (p<0.006). CONCLUSIONS: Pain compromises the quality of life of patients with breast cancer, particularly those with advanced stages of the disease.

Aspectos relacionados à ocorrência de violência ocupacional nos setores de urgência de um hospital / Aspectos relacionados à la ocurrencia de violencia ocupacional en los sectores de urgencia de un hospital / Aspects related to the occurrence of workplace violence in hospital emergency rooms

Objective: Analyzing the aspects related to the occupational violence in the urgency sectors of a hospital in Natal, Rio Grande do Norte. Method: an exploratory and descriptive study, using a quantitative approach. For data collection was used a validated questionnaire, which surveyed were nursing teams of selected sectors. Results: Among the 86 subjects, 87.2% were women, 49.4% had high school completed and 46.5% were married. The occurrence of violence was considered normal by 82.9 and 91.8% of subjects reported never having participated in some training on how to act at the moment of the violence act. Conclusion: it is necessary the construction of national and institutional policies that act on violence, also minimizing its invisibility since the teaching in graduation of these professionals until the workplace.

Objetivo: Analisar os aspectos relacionados à violência ocupacional nos setores de urgência de um hospital situado em Natal, Rio Grande do Norte. Método: Estudo exploratório e descritivo, com abordagem quantitativa. Para a coleta de dados foi utilizado um questionário validado, cujos pesquisados eram as equipes de enfermagem dos setores selecionados. Resultados: Dentre os 86 questionados, 87,2% eram mulheres, 49,4% tinham ensino médio completo e 46,5% eram casados. A ocorrência da violência foi considerada normal por 82,9% e 91,8% dos sujeitos relataram nunca ter participado de algum treinamento sobre como agir no momento do ato de violência. Conclusão: É necessária a construção de políticas nacionais e institucionais que atuem sobre a violência, além da minimização da sua invisibilidade desde o ensino na graduação destes profissionais, até o ambiente laboral.

Objetivo: Analizar los aspectos de la violencia ocupacional en los sectores de un hospital de emergencia en Natal, Rio Grande do Norte. Método: Estudio exploratorio y descriptivo, con enfoque cuantitativo. Para recopilar los datos, se utilizó un cuestionario validado, cuyos encuestados eran el personal de enfermería de los sectores seleccionados. Resultados: De los 86 sujetos, el 87,2% eran mujeres, el 49,4% habían completado la escuela secundaria y el 46,5% estaban casados. La ocurrencia de la violencia fue considera normal por 82,9% y el 91,8% de los sujetos reportaron nunca haber participado en algún tipo de formación sobre cómo actuar en el momento de los actos de violencia. Conclusión: Es necesaria la construcción de políticas nacionales e institucionales que aborden la violencia, además, disminuir su invisibilidad desde la enseñanza en la graduación de estos profesionales, hasta el lugar de trabajo.

A utilização de imagens na construção de conhecimento dos paradigmas que permeiam o modelo atual de atenção à saúde / Use of images in the knowledge construction of paradigms that permeate the current health care model

Objetivo: relatar a experiência vivenciada na sala de aula com a utilização de imagens para construção de uma análisereflexiva sobre os paradigmas que permeiam os modelos de atenção à saúde vigente. Método: relato de experiência deuma atividade acadêmica, intitulada os paradigmas que permeiam o modelo de atenção à saúde no país, da Disciplina deAnálise Crítica da Prática de Enfermagem do Programa de Pós-Graduação em Enfermagem da UFRN. Como dispositivosmetodológicos utilizaram-se texto base e imagens desenhadas à mão sobre a temática abordada. Resultados: a práticaeducativa baseada no depósito de informações foi substituída por uma prática dialógica, onde os envolvidos tinham umpapel ativo na construção do saber. Uma temática densa que relaciona tipos de paradigmas e modelos de saúde pôde sertrabalhada de maneira flexível, tornando o espaço enriquecedor para construção de conhecimentos. Conclusão: a práticapossibilitou aproximação do grupo com questões reflexivas propostas durante o processo de ensino-aprendizagem,permitindo a participação dos discentes, os quais contribuíram de forma significativa, trazendo exemplos de sua práticaprofissional e buscando respaldo científico para argumentações. A experiência validou a utilização de estratégias quecontribuem para compreensão de temas complexos.

Publicações sobre dor oncológica no período de 2000 a 2008: estudo de revisão sistemática de literatura / Publications on oncologic pain in the period from 2000 to 2008: systematic review study / Publicaciones sobre el dolor oncológico en el período de 2000 a 2008: estúdio de revisíón sistemática de la literatura

Objetivos: caracterizar as produções científicas de 2000 a 2008 sobre dor oncológica na Portal da Biblioteca Virtual em Saúde (BIREME) quanto ao método de pesquisa, idioma, ano de publicação, periódico relacionando a avaliação e o controle da dor. Metodologia: pesquisa bibliográfica realizada por meio de artigos científicos disponíveis na BIREME, utilizando os descritores "dor" e "câncer" tendo como critérios de inclusão textos completos sobre o tema investigado, publicados entre 2000 a 2008, em português, inglês ou espanhol. Resultados: 41,2% dos artigos foram de revisão da literatura, em português (53%). As publicações ocorreram principalmente nos anos de 2003 (29%). Os periódicos que mais publicaram estudos foram a Latino-americana de Enfermagem e a Revista Escola de Enfermagem USP, ambas com 18%. O objeto de estudo mais pesquisado foi a avaliação e controle da dor (41,2%). Conclusão: a dor oncológica constitui um problema mundial, merecendo atenção dos profissionais. Portanto, é necessário investir mais em estudos sobre a temática com a finalidade de promover o cuidado e resgatar a qualidade de vida desses pacientes.(AU)

Objectives: to characterize scientific production on oncologic pain on Portal da Biblioteca Virtual em Saúde (BIREME) from 2000 to 2008 regarding research method, language, year of publication, listed publication relating to pain evaluation and control. Methodology: bibliographic research performed through scientific articles available on BIREME, using "pain" and "cancer" descriptors on complete papers on the researched theme, published between 2000 and 2008, in Portuguese, English or Spanish. Results: 41.2% of the articles were literature revisions, in Portuguese (53%). Publications took place predominantly in the year 2003 (29%). The publications that included the most studies were Latino-americana de Enfermagem and Revista Escola de Enfermagem USP, both with 18%. The most researched study object was pain evaluation and control (41.2%). Conclusion: oncologic pain constitutes a worldwide problem, deserving the professionals' attention. It is thus necessary to invest more on studies on the theme aiming to promote care and restore these patients' quality of life.(AU)

Objetivos: caracterizar las producciones científicas de 2000 a2008 sobre dolor oncológico en la Portal da Biblioteca Virtual em Saúde (BIREME), cuanto al método de investigación, idioma, año de Publicación, periódico relacionado a la evaluación y al control del dolor. Metodología: investigaciones bibliográficas realizadas através de artículos científicos disponibles en la BIREME, utilizando los descriptores "dolor" y "cáncer" teniendo como criterios de inclusión textos completos sobre el tema investigado, publicados entre 2000 a 2008; en portugués ,inglés o español. Resultados: 41,2% de los artículos, era la revisión de la literatura en portugués (53%). Las publicaciones ocurrieron principalmente en el año de 2003 (29%). Los periódicos que mas publicaron estudios fueron; Latino-americana de Enfermería y la Revista Escuela de Enfermería USP, ambas con l8%. El objetivo del estudio más tratado es la investigación y control del dolor (41,2%). Conclusión: el dolor oncológico constituye un problema mundial, mereciendo atención de los profesionales. Por tanto, es necesario investir más en estudios sobre el tema con la finalidad de promover el cuidado y rescatar la calidad de vida de esos pacientes.(AU)