RESUMO
Endocrine therapy (ET) for hormone receptor-positive (HR+) breast cancer can contribute to gynecologic symptoms (GS) that impact vaginal health, sexual function, and quality of life (QoL). A cross-sectional study was conducted at St. Michael's Hospital in Toronto, Canada between July 2017 and June 2018 to examine the occurrence and frequency of GS among HR+ breast cancer patients on ET, patient-provider communication, female sexual dysfunction (FSD), and QoL. A Treatment Experience questionnaire was developed for this study and the Female Sexual Function Index (FSFI) and Menopause-Specific Quality of Life questionnaire (MENQOL) were also administered. Of 151 patients surveyed, 77 (51.0%) were on tamoxifen and 74 (49.0%) on an aromatase inhibitor. Most patients (84.1%, 95% confidence interval [CI] 77.3% to 89.5%) experienced at least one GS "all the time" or "often", or one or more infections, in the past year. Only 44 (31.9%) patients reported that their oncologist had ever previously asked them about experiencing GS. The prevalence of FSD was 61.2% (95% CI 46.2% to 74.8%) among 49 sexually active patients that completed the FSFI. Symptoms captured in the MENQOL's vasomotor domain were deemed most bothersome. Side effect management and patient-provider communication should be prioritized to optimize GS, vaginal health, and sexual function of ET users.
Assuntos
Neoplasias da Mama , Qualidade de Vida , Inibidores da Aromatase/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Estudos Transversais , Feminino , Humanos , MenopausaRESUMO
As the world struggled with the COVID-19 pandemic, the provision of cancer care, along with all health services, moved more intentionally toward using virtual strategies. The implementation of virtual care had to happen quickly in an effort to provide safe care for individuals and avoid prolonged delays in patient care. Since then, the practice of virtual care and the involvement of oncology nurses in its delivery has evolved. However, there remains little evidence to guide oncology nurses in virtual care and establish best practices. A virtual workshop was held as part of the 2021 Annual Conference of the Canadian Association of Nurses in Oncology to explore the types of involvement oncology nurses have with virtual care, the barriers and facilitators of virtual care, and suggestions for the design of practice standards to guide oncology nurses in this arena of practice. This paper reports the findings of the workshop and shared implications for future priorities.
RESUMO
Owing to a shift in social attitudes and human rights standards, health inequities experienced by gender minorities are gaining an increasing spotlight globally. Transgender (trans) is an umbrella term used to describe individuals who have a dissimilar sex, gender identity and/or gender expression than what was designated at birth. Recently, studies have sought to identify health disparities and barriers to care among this population. While oncology-focused research remains limited, the social determinants of trans health elicits a significant impact on transgender people across the cancer continuum and, thus, requires further examination. The purpose of this paper is to explore the issue of trans health inequity in the context of Canadian cancer care highlighting current clinical practice, as well as gaps in research, provider education and health care policy. The paper will conclude with recommendations for policy development and a reflection on the oncology nurse's role in advocating for change.
RESUMO
Avec l'évolution des attitudes sociales et des normes relatives aux droits de la personne, les inégalités que connaissent les minorités de genre en matière de santé attirent de plus en plus l'attention, partout dans le monde. L'appellation transgenre (ou trans) est un terme générique servant à décrire les individus qui adoptent un sexe, une identité ou une expression de genre différent de celui qui leur avait été attribué à la naissance. Récemment, des études ont cherché à identifier les disparités et les obstacles liés aux soins de santé chez cette population. La recherche en oncologie demeure limitée, et puisque les déterminants sociaux de la santé des personnes transgenres touchent assez fortement cette population tout au long du continuum du cancer, la question doit être approfondie. Cet article a pour but d'explorer la question des inégalités en santé vécues par les personnes transgenres dans le contexte de soins du cancer au Canada. Il traite de la pratique clinique actuelle, des lacunes en recherche, de l'éducation des fournisseurs et des politiques de soins de santé. L'article se termine sur des recommandations en faveur du développement des politiques et propose une réflexion sur le rôle de l'infirmière en oncologie dans la promotion du changement.
