Avaliação de técnicas fisioterapêuticas no tratamento do linfedema pós-cirurgia de mama em mulheres / Evaluation of physiotherapeutic techniques for treating lymphedema following breast cancer surgery in women

OBJETIVO GERAL: Verificar, em um grupo de mulheres submetidas à cirurgia por câncer de mama, a efetividade do tratamento do linfedema, por um período de até dois anos. OBJETIVO ESPECíFICO: Avaliar o volume do braço tratado aos 6, 12, 18 e 24 meses após o tratamento do linfedema. MÉTODO: As participantes foram atendidas em um serviço de reabilitação especializado e submetidas ao tratamento do linfedema, com drenagem linfática manual, enfaixamento compressivo funcional, orientações de autocuidado, automassagem, uso da braçadeira elástica e exercício. Pelas medidas do volume dos membros, nos períodos determinados, 36 mulheres foram avaliadas após a fase intensiva, 22 após 6 meses, 15 após 12 meses, 6 após 18 meses e 11 aos 24 meses. A adesão às estratégias de autocuidado e exercícios foi avaliada através de um questionário. Testes estatísticos foram usados para buscar correlação entre redução do linfedema e alguns fatores como idade, escolaridade, grau do linfedema, tipo de cirurgia, entre outros. RESULTADOS: Houve redução do linfedema e essa se manteve ao longo dos períodos estudados. Não houve correlação entre redução do linfedema e fatores como idade, estado civil, escolaridade, tipo de cirurgia, índice de massa corporal, grau do linfedema, radioterapia, circunferência, hipertensão arterial ou limitação articular e não houve adesão às estratégias de autocuidado com o braço, realização de exercícios, automassagem e uso de braçadeira elástica pela maioria das mulheres. CONCLUSÕES: É importante realizar novas pesquisas que analisem o papel de cada uma dessas orientações na evolução do linfedema após a fase intensiva do tratamento, de forma sistemática e controlada.

GENERAL OBJECTIVE: To verify the effectiveness of lymphedema treatment over a two-year period, in a group of women who underwent breast cancer surgery. Specific objective: To evaluate the volume of the treated arm at 6, 12, 18 and 24 months after the lymphedema treatment. METHOD: The participants were attended at a specialized rehabilitation service. They underwent lymphedema treatment consisting of manual lymphatic drainage and functional compressive bandaging and received guidance regarding self-care, self-massage, elastic sleeve use and exercise. They were evaluated by means of limb volume measurement at the following times: thirty-six women after the intensive phase, twenty-two after six months, fifteen after twelve months, six after eighteen months and eleven after twenty-four months. Adherence to the self-care strategies and exercises was evaluated by means of a questionnaire. Statistical tests were used to seek correlations between lymphedema reduction and some factors such as age, schooling, lymphedema grade, type of surgery, etc. RESULTS: There was a reduction in lymphedema and this was maintained throughout the period analyzed. There was no correlation between lymphedema reduction and factors such as age, marital status, schooling, type of surgery, body mass index, lymphedema grade, radiotherapy, circumference, arterial hypertension or joint limitation. Moreover, most of the women did not adhere to the self-care strategies, arm exercises, self-massage and elastic sleeve use. CONCLUSION: It is important to conduct new studies, for systematic and controlled analysis of the role of this guidance in relation to lymphedema evolution following the intensive phase of treatment.

[Building the meaning of disease recurrence: experience of women with breast cancer]. / Construindo o significado da recorrência da doença: a experiência de mulheres com câncer de mama.

Regarding recurrence as a possibility in the lives of women with breast cancer, this work aimed at identifying how they construct the meaning of such possibility from their own existence. The study was based on the conceptions of symbolic interactionism and the content analysis of interviews with 12 mastectomized women was used. The possibility of recurrence was present in the lives of the women under study. It was configured by the uncertainty that they experienced and represented in the thematic units identified in their accounts when they stated to be "living with a stigmatizing disease", "experiencing a negative feeling" and "facing prejudice".

[The practice of breastfeeding in a group of Brazilian women: a movement of accommodation and resistance]. / A prática do aleitamento materno em um grupo de mulheres brasileiras: movimento de acomodação e resistência.

Actions to stimulate breastfeeding are directed to assist children's needs and do not contemplate woman in her specificities. The present study aimed at understanding the meanings women give to their experiences and demands in the practice of breastfeeding. 20 women that were experiencing breastfeeding for the first time were interviewed. Data analysis were based on the feminist theory. Authors found breast feeding as a feminine process socially determined. Women showed accommodation as they felt the act of breast feeding as donation, a sacrifice and dedication as well as resistance when they justified weaning affirming the lack of physiological capacity for breastfeeding.

[Experiences of women in cesium brachytherapy]. / Vivência de mulheres submetidas à cesiomoldagem.

The objective of the present study was to determine the main difficulties and problems experienced by patients submitted to sealed internal radiotherapy as well as to provide guidance for nurses to better perceive the difficulties experienced by the patients and act as an element of support while giving care. The problems and difficulties observed and reported by the patients were mainly related to the impositions of treatment, such as isolation, prohibition of visits, hospitalization, bed confinement, restriction of movements, use of the intracavity system, measures of radiological protection, use of a delay bladder tube, and limited personal hygiene. Fear related to treatment and anesthesia, partial or absent orientation and skin lesions were the complaints voiced by most of the patients in the present study. The role of the nurse is important in planning nursing care in sealed internal radiotherapy, especially when nurses understand the problems and difficulties experienced by women submitted to this treatment.

[Women and health: their concerns]. / Mulher e saúde: suas preocupações.

This investigation is part of a transcultural research project on women and health, which has as its conceptual framework women's life experiences. This research is qualitative in nature, and the methodology utilized is a content analysis of the documented discourses of a group of lower class women in Ribeirão Preto (SP). The results demonstrate that for these women, health is much more than the absence of disease". Their health concerns are biological, interpersonal, social and economic in nature, and are based more upon their personal experiences and social perceptions than on the concept of health and disease. The importance of this research is its relevance for quality nursing care which takes into consideration the many aspects of being a woman.