Palliative care in the treatment of women with breast cancer: A scoping review.

OBJECTIVES: Recent studies on the quality of life in women with breast cancer show a high prevalence of signs and symptoms that should be the focus of palliative care (PC), leading us to question the current role they play in addressing breast cancer. Therefore, the objective of this review is to map the scope of available literature on the role of PC in the treatment of women with breast cancer. METHODS: This is a methodologically guided scoping review by the Joanna Briggs Institute and adapted to the PRISMA Extension for Scoping Reviews (PRISMA-ScR) Checklist for report writing. Systematic searches were conducted in 8 databases, an electronic repository, and gray literature. The searches were conducted with the support of a librarian. The study selection was managed through the RAYYAN software in a blind and independent manner by 2 reviewers. The extracted data were analyzed using the qualitative thematic analysis technique and discussed through textual categories. RESULTS: A total of 9,812 studies were identified, of which only 136 articles and 3 sources of gray literature are included in this review. In terms of general characteristics, the majority were published in the USA (35.7%), had a cross-sectional design (44.8%), and were abstracts presented at scientific events (19.6%). The majority of interventions focused on palliative radiotherapy (13.6%). Thematic analysis identified 14 themes and 12 subthemes. SIGNIFICANCE OF RESULTS: Our findings offer a comprehensive view of the evidence on PC in the treatment of breast cancer. Although a methodological quality assessment was not conducted, these results could guide professionals interested in the topic to position themselves in the current context. Additionally, a quick synthesis of recommendations on different palliative therapies is provided, which should be critically observed. Finally, multiple knowledge gaps are highlighted, which could be used for the development of future studies in this field.

Palliative care in the treatment of women with breast cancer: a scoping review protocol.

INTRODUCTION: Currently, breast cancer ranks first among female malignancies; hence, there are strong recommendations for the early inclusion of these patients in palliative care. Palliative care aims to alleviate symptoms improving the quality of life of dying patients, an essential component of breast cancer care. This study aimed to map and synthesise the available evidence on palliative care for women with breast cancer and to discuss the review results with stakeholders. METHODS: A scoping review protocol is presented in this article, consisting of two phases. In the first phase, a scoping review study will be conducted adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines and guided by the Joanna Briggs Institute Manual for Evidence Synthesis. Nine databases, an electronic repository, a trial register website, grey literature and additional sources will be searched. A focus group discussion with six stakeholders will occur in the second phase. The analysis will be performed through inductive and manifest content analysis using the IRaMuTeQ V.0.7 alpha software. ETHICS AND DISSEMINATION: The scoping review protocol did not require ethical approval. However, the study's second phase has been approved by the institutional review board of Maternidade Escola Assis Chateaubriand/MEAC/UFC. The findings will be disseminated through professional networks, conference presentations and publications.

Palliative Care in Breast Cancer During the COVID-19 Pandemic: A Scoping Review.

BACKGROUND: The COVID-19 pandemic has harmed the provision of palliative care (PC) services for women with breast cancer due to all the restrictions that came along with the virus. OBJECTIVE: To map the available evidence on the situation of PC in breast cancer during the COVID-19 pandemic. METHODS: A scoping review was carried out based on the methodology proposed by the Joanna Briggs Institute. The search was conducted in nine databases, one electronic repository, and one library, using controlled vocabularies. RESULTS: Twenty-nine articles and seven documents were included. The majority (11.4% each) were published in the United Kingdom, Italy, and the United States, 38.9% addressed palliative radiotherapy (RT), and 47.2% consisted of recommendations. From the content analysis, five categories were obtained focused on the recommendations on changes in palliative treatment guidelines and the response of PC teams to the evolving crisis. CONCLUSIONS: The evidence pointed to the management of general PC, palliative RT, palliative chemotherapy, management of metastatic breast cancer, and use of technologies in palliative care. No recommendations were found to manage frequent symptoms in PC, indicating the need to develop primary studies that investigate these aspects in detail in this vulnerable group. IMPLICATIONS: The results contained in this document can provide professionals working in this field of care with a global view of how other teams have dealt with the pandemic, thereby identifying the best guidelines to apply in their reality, taking into account the clinical and social situation of each patient.

Telenursing in the sexual function of women with breast cancer: A study protocol.

INTRODUCTION: Most women with breast cancer have sexual function problems related to cancer diagnosis and treatment. These problems harm the quality of life and relationships. However, most patients do not receive care or guidance regarding sexuality from healthcare providers. This study aimed to test the effect of telenursing counseling on sexual functioning in women undergoing breast cancer treatment. METHODS: This randomized clinical trial was conducted at 2 reference hospitals for cancer treatment. One hundred eight women with stage I-IV breast cancer undergoing treatment (surgery, chemotherapy, radiotherapy or hormone therapy) with a partner will be included in this study. The study was authorized by the Ethics Committee of the Federal University of Ceará (Opinion number: 46,13,609) and the Maternity School Assis Chateaubriand (Opinion number: 47,42,687). Patients will be allocated to the following groups: the control group, which will not receive an active intervention, and the intervention group, which will receive 3 telenursing counseling sessions for 6 weeks. The levels of sexual function in these patients before the intervention, soon after the intervention and at 12 weeks were compared and analyzed. All data will be collected and analyzed by the JASP program. RESULTS: Differences in levels of sexual function among women allocated to the control and intervention groups in the analyzed periods. CONCLUSION: This evidence-based nursing care strategy can be used to improve the sexual function of breast cancer patients and consequently their quality of life and marital relationship.

Lower urinary tract symptoms in female prison inmates: prevalence and impact on quality of life.

INTRODUCTION AND HYPOTHESIS: The objective was to estimate the prevalence and assess the impact of lower urinary tract symptoms (LUTS) on the quality of life of incarcerated women. METHODS: Cross-sectional study conducted with 307 incarcerated women from the state of Ceará, Brazil, from June to September 2018. To identify the prevalence of symptoms, an instrument was developed according to the recommendations of the International Continence Society. To assess the frequency, intensity, and impact of the identified symptoms on quality of life, the International Consultation on Incontinence Questionnaire-Short Form and King's Health Questionnaire were applied. RESULTS: The profile of the inmates was mostly young women (mean = 32.9 ± 11.8 years), Black, who had been in prison for a mean of 17.3 ± 12.0 months. Approximately half (n = 152, 49.5%) presented with storage complaints, with emphasis on urinary incontinence (n = 61, 19.9%), nocturia (n = 55, 17.9%), and urinary urgency (n = 45, 14.7%). Among the voiding symptoms (n = 71, 23.1%), dysuria (n = 39, 12.7%), and recurrent UTI (n = 44, 14.3%) were the most frequent. The complaint of incomplete bladder emptying (19.5%) was mentioned by 60 of the inmates. Sociodemographic data and environmental conditions were mainly associated with storage symptoms (p = 0.019). Women from prisons 2 and 3 presented with a greater impact on the quality of life. CONCLUSIONS: The high prevalence of LUTS in female inmates, together with unhealthy toileting behaviors within the prison units, indicate that incarceration might play a role in the occurrence of these symptoms, while also affecting quality of life. The acknowledgement and investigation of these symptoms is important for improving health care in prisons.