[Incidence and management of chemotherapy-induced nausea and vomiting in women with breast cancer]. / Ocorrência e manejo de náusea e vômito no tratamento quimioterápico em mulheres com câncer de mama.

The objective of this study was to analyze the incidence of chemotherapy-induced nausea and vomiting in women with breast cancer and identify strategies used by them to control these signs and symptoms. Data for this cross-sectional study were collected through interviews during the last cycle of chemotherapy, between August 2011 and March 2012, in a university hospital in the State of São Paulo. The sample consisted of 22 women between the ages of 31 and 70, of whom 77.3% reported nausea and 50% vomiting during treatment. Regarding symptom management, 82% of the women reported having received some information centered on the use of prescribed medication. However, 27.3% did not know what medication they had taken. We concluded that there is a lack of systematic care and institutional protocol to guide professionals in providing standardized information to women so they can better control nausea and vomiting.

Fertility preservation counseling for women of reproductive age diagnosed with cancer: an integrative review.

This integrative review synthesizes the scientific evidence on fertility preservation counseling prior to oncological treatment for women of reproductive age diagnosed with cancer. Bibliographic research was conducted on databases PubMed, CINAHL, LILACS, EMBASE, Scopus, and Web of Science. The structured search strategy for the review question was "counseling AND antineoplastic agents AND fertility preservation". The use of controlled descriptors and keywords was adapted for each database. Study selection through the Rayyan platform was independent and blinded. The final sample comprised seven studies emphasizing the importance of clarifying factors related to the risk of infertility due to oncological treatment and fertility preservation techniques, such as success rate, pregnancy rate, cost, available options, and side-effects, as well as discussing the possibilities of adoption and surrogacy. This review provided evidence reinforcing the importance of counseling for fertility preservation, promoting motherhood for women who face oncological treatment. Organized networks linking oncology and reproductive medicine units are crucial to facilitate patient referral between these services and interprofessional communication.

Accessibility to prenatal care at the Street Outreach Office: nurse perceptions in northern Brazil.

OBJECTIVES: to understand nurse perspectives regarding homeless pregnant women's accessibility to prenatal care. METHODS: a qualitative study, with analysis based on the concept of accessibility. Semi-structured interviews were carried out with 11 nurses who work at the Street Outreach Office in northern Brazil. RESULTS: nurses are faced with geographic barriers and dangerous situations in border regions, recognizing that there is a context of physical, sexual and psychological violence that involves homeless pregnant women who seek care at the Street Outreach Office. Street Outreach Office nurses' work occurs in conjunction with other services in the Health Care Network. The implementation of educational measures is a powerful strategy, as is establishing links with women. FINAL CONSIDERATIONS: the Street Outreach Office's work provides meetings with pregnant women on site in the territory, which can provide geographic and socio-organizational accessibility to prenatal care.

[Nausea, vomiting and quality of life in women with breast cancer receiving chemotherapy]. / Náuseas, vômitos e qualidade de vida de mulheres com câncer de mama em tratamento quimioterápico.

The aim of this study was to assess the quality of life (QoL) of women with breast cancer during chemotherapy and to identify the incidence of nausea and vomiting during the treatment Data were assessed with the application of the instrument of the European Organization for Research and Treatment of Cancer, EORTC-QLQ-C30 Portuguese version and breast cancer module BR-23, which was applied before, in the middle and in the end of the treatment. The participants were 79 women, of which 93% had nausea and 87% had vomited at least once during the treatment. QoL showed a slight decrease during treatment. Cronbach's alpha for each application of the questionnaires was 0.890492, 0.936392 and 0.937639. The availability of treatment information and guidelines on the management of nausea and vomiting is crucial for the proper management of the toxicities of chemotherapy.

Dermatological toxicity in women with breast cancer undergoing chemotherapy treatment.

This study aimed to analyze the occurrence of skin toxicity caused by drugs used in the protocol of neoadjuvant and adjuvant chemotherapy among women with breast cancer. Patient records of 72 women who were subject to this therapy between 2003 and 2006 were assessed. Of the 558 cycles of chemotherapy, 152 adverse events were registered. There were 37 registrations of dermatological toxicity, of those, 20 were extravasations that affected 17 women. Nine reports of hardened local injury, local fibrosis, pain, and hyperemia were registered during neoadjuvancy. In adjuvancy, among the 11 extravasations registered there were reports of hardened local injury, fibrosis and local pain. Lack of follow-up records for both periods was observed. Registration of the events and reports by the nursing team are essential to monitor the sites of venous puncture during the chemotherapy treatment, besides measuring and making a photographic record of the site.

Is there agreement between evaluators that used two scoring systems to measure acute radiation dermatitis?

To analyze the agreement between the nurses evaluating radiodermatitis that used the Radiation Therapy Oncology Group (RTOG) and the World Health Organization (WHO) scales.A prospective and longitudinal study conducted in 2016 to 2017, in a university hospital. We analyzed 855 images of irradiated sites of 100 breast cancer women during radiotherapy. In order to evaluate the agreement between 3 observers that evaluated theses irradiated sites Krippendorff's alpha and weighted kappa were obtained and analyzed.The pairwise agreement among the evaluators was fair and moderate (RTOG scale: 0.408, 95% confidence interval, CI 0.370-0.431; WHO scale: 0.559, 95% CI 0.529-0.590). In addition, the general agreement rates were 10.2% and 29.2%, respectively. When assessing the overall absolute agreement between the evaluators according with different phototypes and types of surgery, there was a fair agreement according to the RTOG scale when evaluating patients with phototype V or VI and mastectomy (3.7% and 8.8%, respectively).The RTOG and WHO scales should be used with caution in clinical practice to identify the prevalence of radiodermatitis and the severity. Another point of caution is that skin phototype and the type of surgery may influence the analysis outcome. An illustrative scale was designed and proposed, by our group, aiming to improve accuracy and agreement between evaluators that will be tested in subsequent clinical studies.

Consentimento livre e esclarecido em participantes de pesquisa clínica / Free and informed consent in clinical research participants / Consentimiento libre e informado en participantes de investigación clínica

Objetivo: avaliar o processo de consentimento dos participantes de pesquisa clínica. Método: estudo exploratório, retrospectivo e quantitativo, desenvolvido em hospital de referência nacional em oncologia entre maio de 2016 e janeiro de 2017. Foi elaborado formulário e submetido a teste piloto. Utilizou-se o índice de legibilidade de Flesch-Kincaid (ILFK) na avaliação dos Termos de Consentimento Livre e Esclarecido (TCLE). Realizou-se análise descritiva e univariada. Resultados: o cálculo do ILFK revelou que 100% dos TCLEs apresentaram leitura muito difícil. A idade do participante foi estatisticamente significante nas questões sobre ajuda na leitura do TCLE antes da assinatura (p=0,02), dificuldade de leitura do TCLE (p=0,04) e se assinou o TCLE antes de iniciar a participação (p=0,02). A escolaridade apresentou significância quanto à questão sobre indenizações (p=0,02), e o sexo, quanto à questão de ajuda de familiar para a leitura do TCLE (p=0,01). Conclusão: percebeu-se a necessidade em estabelecer padrões que proporcionem tomada de decisão consciente e própria do participante, considerando a escolaridade, necessidades pessoais, crenças e costumes.

Objective: to evaluate the consent process of clinical research participants. Method: exploratory, retrospective and quantitative study, developed in a national reference hospital in oncology between May 2016 and January 2017. Form was prepared and submitted to pilot test. The Flesch-Kincaid readability index (FKRI) was used in the evaluation of the Informed Consent Forms (ICF). Descriptive and univariate analysis was performed. Results: the calculation of the FKRI revealed that 100% of ICFs had very difficult reading. The age of the participant was statistically significant in questions about help in reading the ICF before signing (p=0.02), difficulty reading the ICF (p=0.04) and signed the ICF before starting the participation (p=0.02). Education was significant in relation to the issue of compensation (p=0.02), and sex to the question of family help for reading the ICF (p=0.01). Conclusion: it was perceived the need to establish standards that provide conscious decision making of the participant, considering education, personal needs, beliefs and customs.

Genitourinary symptoms and quality of life of women with breast cancer undergoing chemotherapy / Síntomas genitourinarios y calidad de vida de mujeres con cáncer de mama en quimioterapia / Sintomas geniturinários e qualidade de vida de mulheres com câncer de mama em tratamento quimioterápico

ABSTRACT This study aimed to compare genitourinary symptoms and quality of life in women with breast cancer before and after chemotherapy treatment. This is a prospective and analytical study carried out with 60 women treated at a hospital in the state of Paraná. Sociodemographic data, menopausal status, climacteric symptoms, quality of life, and pelvic floor strength and resistance were collected. Descriptive statistics, t-tests, Shapiro-Wilk, Cochran, Factorial Analysis of Variance for Repeated Measures and Fishers least significance difference were used for data analysis. Participants suffered genitourinary alterations, such as reduced strength and resistance of the pelvic floor muscles, urinary incontinence and vulvovaginal atrophy, regardless of the evaluated factors (type of chemotherapy, parity, and menopausal status). Therefore, greater attention and discussion by multidisciplinary health teams is necessary, as these symptoms can be reduced and managed if recognized early.

RESUMEN Este estudio tuvo como objetivo comparar los síntomas genitourinarios y la calidad de vida en mujeres con cáncer de mama antes y después del tratamiento con quimioterapia. Se trata de un estudio prospectivo y analítico realizado con 60 mujeres que recibieron atención en un hospital del estado de Paraná (Brasil). Se recogieron datos sociodemográficos, estado menopáusico, síntomas climatéricos, calidad de vida y fuerza y resistencia del suelo pélvico. Se utilizaron estadísticas descriptivas, pruebas t de Shapiro-Wilk y de Cochran, análisis factorial de varianza para medidas repetidas y LSD-Fisher para el análisis de datos. Las participantes sufrieron alteraciones genitourinarias, como disminución de la fuerza y resistencia de los músculos del suelo pélvico, incontinencia urinaria y atrofia vulvovaginal, independientemente de los factores evaluados (tipo de quimioterapia, paridad y estado menopáusico). Se concluye que es necesaria una mayor atención y discusión por parte de los equipos de salud multidisciplinarios, ya que estos síntomas pueden reducirse y manejarse si se reconocen a tiempo.

RESUMO Este estudo teve como objetivo comparar os sintomas geniturinários e a qualidade de vida de mulheres com câncer de mama antes e após o tratamento quimioterápico. Trata-se de um estudo prospectivo e analítico realizado com 60 mulheres atendidas em um hospital no estado do Paraná. Foram coletados dados sociodemográficos, status menopausal, sintomas do climatério, qualidade de vida e força e resistência do assoalho pélvico. Utilizou-se estatística descritiva, assim como os testes t, de Shapiro-Wilk, de Cochran, análise da variância fatorial para medidas repetidas e método LSD de Fisher para análise dos dados. As participantes sofreram alterações geniturinárias como redução de força e resistência dos músculos do assoalho pélvico, incontinência urinária e atrofia vulvovaginal independente dos fatores avaliados (tipo de quimioterapia, paridade e status menopausal). Entende-se que é necessário que haja maior atenção e discussão por parte das equipes multiprofissionais de saúde, pois esses sintomas, se reconhecidos precocemente, podem ser reduzidos e gerenciados.

Acesso e acessibilidade ao rastreamento de câncer em mulheres brasileiras com lesão medular / Acceso y accesibilidad al rastreo de cáncer en mujeres brasileñas con lesión medular / Access and accessibility to cancer screening for Brazilian women with spinal cord injury

Resumo Objetivo identificar e analisar a acessibilidade e o acesso de mulheres brasileiras com lesão medular para a realização de exames preventivos do câncer de mama e colo de útero. Método estudo quantitativo e transversal desenvolvido em plataforma virtual. Realizadas análises estatísticas descritivas e de associação entre as variáveis qualitativas por meio do teste exato de Fisher. Quando identificada a associação (p<0,05), foi realizada a regressão logística. Resultados participaram 120 mulheres brasileiras com lesão medular com idades entre 25 e 67 anos; 85,83% foram ao ginecologista após a lesão medular, 79,17% realizaram a citologia e 52,50%, a mamografia. Observou-se que as mulheres que utilizavam a saúde suplementar apresentaram maior probabilidade de terem ido ao ginecologista do que as usuárias do serviço público. Aquelas com companheiro e as de maior idade apresentaram maior probabilidade de terem realizado o exame de citologia. Para a mamografia, aquelas de maior idade e que utilizavam a saúde suplementar apresentaram maiores chances de terem realizado o exame de mamografia após a lesão medular. Conclusão mulheres com lesão medular buscam a realização de exames de rastreamento. Entretanto, encontram dificuldades relacionadas à estrutura física, aos equipamentos, transporte, profissionais da saúde, assim como dificuldades sociodemográficas e quanto ao serviço de saúde utilizado.

Resumen Objetivo este estudio tuvo como objetivo identificar y analizar la accesibilidad y el acceso de mujeres brasileñas con lesión medular para la realización de exámenes preventivos de cáncer de mama y de cuello uterino. Método se desarrolló un estudio cuantitativo y transversal, realizado en un entorno virtual. Los análisis estadísticos descriptivos y la asociación entre variables cualitativas se realizaron mediante la prueba exacta de Fisher, cuando se identificó una asociación se realizó una regresión logística. Resultados participaron 120 mujeres brasileñas con lesión medular, la edad de las participantes varió de 25 a 67 años. Con relación al rastreo, el 85,83% de las mujeres acudió al ginecólogo tras la LM, el 79,17% se sometió a citología y el 52,50% a mamografía. Se observó que las mujeres que utilizaban un seguro médico privado tenían más probabilidades de haber visto a un ginecólogo que las usuarias del servicio público. Las que tenían pareja y mayores tenían más probabilidades de someterse a citología oncótica. Para la mamografía, las que eran mayores y que usaban un seguro médico privado tenían más probabilidades de someterse al examen después de la LM. Conclusión las mujeres con LM buscan pruebas de detección. Sin embargo, enfrentan dificultades relacionadas con la estructura física, equipamientos, transporte, profesionales de la salud, así como dificultades sociodemográficas relacionadas con el tipo de servicio de salud utilizado.

Abstract Objective to identify and analyze the accessibility and accessibility of Brazilian women with spinal cord injury to preventive examinations for breast and cervical cancer. Method quantitative and cross-sectional study developed in a virtual platform. Descriptive statistical analysis was performed, as well as association analysis between qualitative variables using Fisher's exact test. When identified the association (p<0.05), logistic regression was performed. Results a total of 120 Brazilian women with spinal cord injury, aged between 25 and 67 years participated in the study; 85.83% visited a gynecologist after the spinal cord injury, 79.17% underwent cytology and 52.50% underwent mammography. It was observed that women who used the supplementary health plan were more likely to have visited a gynecologist than those who used the public service. Those who had a partner and were older were more likely to have undergone the cytology exam. For mammography, those who were older and who used supplementary health care were more likely to have had mammography exams after the spinal cord injury. Conclusion women with spinal cord injury seek screening tests. However, they encounter difficulties related to the physical structure, equipment, transportation, health professionals, as well as socio-demographic difficulties and difficulties regarding the health service used.

Conhecimento de acadêmicos de enfermagem sobre a vacina contra o papilomavírus humano / Conocimientos de académicos de enfermería sobre la vacuna contra el virus del papiloma humano / Nursing students' knowledge on the human papillomavirus vaccine

Resumo Objetivo Avaliar o conhecimento entre acadêmicos de enfermagem sobre a vacina contra o papilomavírus humano e comparar os resultados obtidos entre estudantes do primeiro e do último ano de graduação. Métodos Estudo descritivo, transversal, quantitativo, realizado entre maio e junho de 2019. Aplicado questionário a 179 estudantes do curso de Enfermagem de uma universidade pública do estado de São Paulo, contendo dados sociodemográficos e outro sobre o conhecimento do papilomavírus humano e a vacina contra o mesmo. Dados foram analisados através do programa Statistical Packcage for Social Science. Resultados 82,4% dos estudantes do primeiro ano e 95,5% do último responderam que sabiam o que é o papilomavírus humano, e afirmaram ser um vírus sexualmente transmissível. Lacunas de conhecimento foram identificadas, quanto à finalidade do exame citopatológico, aos fatores de risco relacionados à infecção e relacionados à vacina, como número de doses e possíveis riscos e benefícios da mesma. Conclusão Apesar de os acadêmicos demonstrarem conhecimento quanto ao papilomavírus humano, sua transmissibilidade e relação direta com o câncer do colo do útero, ainda apresentaram dúvidas importantes que devem ser sanadas, quanto à finalidade do exame citopatológico, aos fatores de risco para infecção pelo vírus e em relação à vacina contra o papilomavírus humano.

Resumen Objetivo Evaluar los conocimientos de académicos de enfermería sobre la vacuna contra el virus del papiloma humano y comparar los resultados obtenidos de estudiantes del primer y del último año de carrera. Métodos Estudio descriptivo, transversal, cuantitativo realizado entre mayo y junio de 2019. Cuestionario aplicado a 179 estudiantes de la carrera de Enfermería de una universidad pública del estado de São Paulo, que contenía datos sociodemográficos, y otro sobre conocimientos del virus del papiloma humano y su vacuna. Los datos fueron analizados a través del programa Statistical Packcage for Social Science. Resultados El 82,4 % de los estudiantes de primer año y el 95,5 % del último respondieron que sabían lo que es el virus del papiloma humano y afirmaron que es un virus sexualmente transmisible. Se identificaron vacíos de conocimiento respecto a la finalidad del estudio citológico, a los factores de riesgo relacionados con la infección y con la vacuna, como número de dosis y sus posibles riesgos y beneficios. Conclusión A pesar de que los académicos demostraron conocimientos respecto al virus del papiloma humano, su transmisión y relación directa con el cáncer de cuello uterino, también presentaron dudas importantes que deben ser aclaradas sobre la finalidad del estudio citológico, los factores de riesgo de la infección por el virus y sobre la vacuna contra el virus del papiloma humano.

Abstract Objective To assess nursing students' knowledge on the human papillomavirus vaccine and compare the results obtained among students of the first and last year of graduation. Methods This is a descriptive, cross-sectional, quantitative study, conducted between May and June 2019. A questionnaire was applied to 179 nursing students from a public university in the state of São Paulo, containing sociodemographic data and another on knowledge of human papillomavirus and the vaccine against it. Data were analyzed using the Statistical Packcage for Social Science. Results 82.4% of first-year students and 95.5% of last-year students answered that they knew what human papillomavirus is, claiming to be a sexually transmitted virus. Knowledge gaps were identified regarding the purpose of cytopathological examination, risk factors related to infection and related to the vaccine, such as number of doses and possible risks and benefits of it. Conclusion Although students demonstrated knowledge on human papillomavirus, its transmissibility and direct relationship with cervical cancer, they still presented important doubts that should be answered, regarding the purpose of the cytopathological examination, the risk factors for infection by the virus and in relation to the vaccine against the human papillomavirus.

Câncer durante a gravidez: análise dos casos com ênfase nos resultados obstétricos e neonatais / Cáncer durante el embarazo: análisis de casos con énfasis sobre resultados obstétricos y neonatales / Cancer during pregnancy: analysis of cases with emphasis on obstetric and neonatal results

Objetivos: Conhecer as interferências do câncer no processo gestacional e seu desfecho, identificar as neoplasias mais frequentemente diagnosticadas em mulheres no período reprodutivo. Métodos: Foram coletadas, informações dos prontuários de mulheres que vivenciaram o câncer, durante a gestação, no período de 2011 a 2018, acompanhadas em um hospital de referência. Resultados: Os cânceres mais prevalentes, durante a gestação foram: mama, colo do útero, leucemia e linfoma, 64,29% das grávidas estavam no segundo trimestre. A faixa etária foi de 27 a 44 anos, 80% receberam quimioterapia, 73,68% apresentaram complicações na gestação/puerpério, 42,11% das mulheres foram a óbito. Observaram-se 70,59% recém-nascidos pré-termo, 56,25% baixo peso, ocorrência de dois abortos espontâneos e um natimorto. Conclusão: Neoplasias associadas à gravidez têm aumentando em incidência e, contribuindo para a mortalidade indireta na gravidez e no pós-parto. Desca-se a abordagem multidisciplinar, centrada no bem-estar maternofetal, além de incluir a mulher e a família no processo(AU)

Objectives: To know how cancer interferes with pregnancy , to identify the most frequently diagnosed neoplasms in women in the reproductive period. Methods: Information was collected from the medical records of women who experienced cancer during pregnancy, from 2011 to 2018, and were treated at a reference hospital. Results: The most prevalent cancers during pregnancy were breast, cervix, leukemia and lymphoma. 64.29% of pregnant women were in the second trimester. The age range was between 27 and 44 years. 80% of these weomen received chemotherapy, 73.68% had complications during pregnancy / postpartum, and 42.11% died. There were 70.59% preterm newborns, 56.25% underweight, two spontaneous abortions and one stillbirth. Conclusion: The incidence of neoplasms associated with pregnancy have increased and contributed to indirect mortality in pregnancy and postpartum. The multidisciplinary approach is centeredon mother-fetus well-being, in addition to including women and family in the process(AU)

Objetivos: Conocer las interferencias del cáncer en el proceso gestacional y su desenlace, identificar las neoplasias más frecuentemente diagnosticadas en mujeres en período reproductivo. Métodos: Se recopiló información de las historias clínicas de mujeres que experimentaron cáncer durante el embarazo, de 2011 a 2018, acompañadas en un hospital de referencia. Resultados: Los cánceres más prevalentes durante el embarazo fueron: mama, cérvix, leucemia y linfoma, el 64,29% de las gestantes estaban en el segundo trimestre. El rango de edad fue de 27 a 44 años, el 80% recibió quimioterapia, el 73,68% presentó complicaciones durante el embarazo/puerperio, fallecieron el 42,11% de las mujeres. Hubo 70,59% de recién nacidos prematuros, 56,25% de bajo peso, dos abortos espontáneos y un mortinato. Conclusión: Las neoplasias asociadas al embarazo han aumentado en incidencia, contribuyendo a la mortalidad indirecta en el embarazo y posparto. El enfóque se centra en el punto de vista multidisciplinario, dirigido al bienestar materno-fetal, además de incluir a la mujer y la familia en el proceso(AU)

Integrative review of factors related to the nursing diagnosis nausea during antineoplastic chemotherapy.

Objective: to identify factors related to the nursing diagnosis nausea among cancer patients undergoing chemotherapy. Method: integrative review conducted in four electronic databases (PUBMED, EMBASE, CINAHL and LILACS) using the key words: neoplasia, antineoplastic agents and nausea. Results: only 30 out of 1,258 papers identified met the inclusion criteria. The most frequent related factors were: being younger than 50 years old, motion sickness, being a woman, emetogenic potential of the chemotherapy, anxiety, conditioned stimulus, and expecting nausea after treatment. Conclusion: this review's findings, coupled with the incidence of nausea among cancer patients undergoing chemotherapy, reveal an important difference between evidence found and that used by NANDA International, Inc. Even though it provides an appropriate definition of related factors, it does not mention chemotherapy, despite the various studies addressing the topic using different designs and presenting various objectives and outcomes.

Fertilidade e contracepção em mulheres com câncer em tratamento quimioterápico / Fertilidad y anticoncepción en mujeres con cáncer en tratamiento quimioterápico / Fertility and contraception in women with cancer treatment undergoing chemotherapy

RESUMO Objetivo identificar em mulheres em idade reprodutiva, com câncer e durante o tratamento quimioterápico, as orientações sobre preservação de fertilidade e planejamento reprodutivo e conhecer as informações fornecidas pela equipe de saúde. Métodos estudo descritivo, realizado com mulheres na pré-menopausa, com diagnóstico de câncer e em tratamento quimioterápico. A coleta de dados foi realizada com apoio de um instrumento com informações sociodemográficas, sobre o câncer e seus tratamentos, informações referentes a preservação de fertilidade e uso de métodos contraceptivos antes e após o diagnóstico do câncer. A análise dos dados foi feita por meio de estatística descritiva. Resultados a média de idade das 49 participantes foi de 38,2 anos (DP=6,1) e 79,6% estavam em tratamento devido ao câncer de mama. Quanto as informações recebidas sobre a importância do planejamento reprodutivo, 77,6% das participantes referiram que foram orientadas e 59,2% receberam tais orientações da equipe médica. Entretanto, em relação ao aconselhamento sobre métodos para manter a fertilidade, apenas, 6,1% das participantes foram orientadas. Conclusão e Implicações para a prática Deve-se considerar a relevância do aconselhamento especializado e a da manutenção de tomada de decisões ativas da mulher sobre a preservação de sua fertilidade.

RESUMEN Objetivo identificar en mujeres en edad reproductiva, con cáncer y durante el tratamiento de quimioterapia, las orientaciones sobre preservación de la fertilidad y planificación reproductiva y conocer las informaciones proporcionadas por el equipo de salud. Métodos estudio descriptivo, realizado con mujeres premenopáusicas diagnosticadas con cáncer y sometidas a quimioterapia. La recolección de datos se realizó con apoyo de un instrumento con información sociodemográfica sobre el cáncer y sus tratamientos, información sobre la preservación de la fertilidad y uso de métodos anticonceptivos antes y después del diagnóstico del cáncer. El análisis de los datos se realizó mediante estadística descriptiva. Resultados la media de edad fue de 38,2 años (DE= 6,1), y 79,6% estaban en tratamiento para el cáncer de mama. Cuanto a la información recibida sobre la importancia de la planificación reproductiva, 77,6% de los participantes informaron que estaban orientados y 59,2% recibió orientación del equipo médico. Sin embargo, con respecto al asesoramiento sobre métodos para mantener la fertilidad, solo 6,1% de las participantes recibieron asesoramiento. Conclusión e Implicaciones para la práctica Debe tenerse en cuenta la importancia de la asesoría experta y el mantenimiento de una toma de decisiones activa por parte de las mujeres para preservar su fertilidad.

ABSTRACT Objective to identify in women of reproductive age, with cancer and during chemotherapy treatment, the guidelines on fertility preservation and reproductive planning and to know the information provided by the health team. Methods descriptive study, conducted with premenopausal women diagnosed with cancer and undergoing chemotherapy. Data collection was performed with the support of an instrument with sociodemographic information about cancer and its treatments, information regarding the preservation of fertility and the use of contraceptive methods before and after cancer diagnosis. Data analysis was performed using descriptive statistics. Results the average age of the 49 participants was 38.2 years (SD=6.1) and 79.6% were being treated for breast cancer. Regarding the information received about the importance of reproductive planning, 77.6% of participants reported that they were oriented and 59.2% received such guidance from the medical team. However, regarding counseling on methods to maintain fertility, only 6.1% of participants were counseled. Conclusion and Implications for practice consideration should be given to the importance of expert counseling and the maintenance of active decision making by women about preserving their fertility.

Tecnologias em saúde aplicadas na reabilitação de mulheres com câncer de mama: revisão de escopo / Health technologies applied in the rehabilitation of women with breast cancer: scoping review

Objetivo: Identificar as tecnologias em saúde na reabilitação física de mulheres que desenvolveram alterações no membro superior homolateral após a cirurgia para o câncer de mama. Método: Trata-se de uma Scoping literature review. Realizou-se a busca nas bases de dados LILACS, PubMed e Web of Science e o mecanismo de busca Google Scholar. Os descritores utilizados foram: Breast neoplasms, Biomedical technology e Rehabilitation. Resultados: Foram selecionados 33 estudos. Entre as tecnologias leve-duras, a mais utilizada foram os programas de exercícios físicos, tanto para a limitação da amplitude de movimentos do membro superior quanto para o linfedema, sendo estas as mais estudadas. Já as tecnologias duras mais avaliadas foram acupuntura, terapia de laser de baixo nível e plataformas de exercício on line, sendo empregadas, principalmente, para complicações como dor e linfedema. Destaque para a inter-relação entre as diferentes tecnologias, e como estas compõem a assistência prestadas às mulheres com câncer de mama durante a reabilitação física. Conclusão: A maioria dos estudos utilizaram as tecnologias leve-duras, com destaque para os programas de exercícios, e a associação de diferentes tecnologias, de intensidade variadas, empregadas com bons resultados físicos. Além de atuarem no estímulo ao autocuidado e na orientação das mulheres quanto a autogestão das complicações, promovendo a autonomia, confiança e retomada de seus papéis sociais.

Objective: To identify health technologies in the physical rehabilitation for women who developed changes on the same side upper limb after surgery for breast cancer. Method: This is a Scoping literature review. The search was performed in the LILACS, PubMed and Web of Science databases and the Google Scholar search engine. The descriptors used were: Breast neoplasms, Biomedical technology and Rehabilitation. Results: Thirty-three studies were selected. Among the soft-hard technologies, the most frequently used were the physical exercise programs, both for limiting the range of motion of the upper limb and for lymphedema, these being the most studied. The most evaluated hard technologies were acupuncture, low level laser therapy and online exercise platforms, being used mainly for complications such as pain and lymphedema. We Highlight the interrelationship between different technologies and how they provide assistance to women with breast cancer during physical rehabilitation. Conclusion: Most studies used light-hard technologies, with emphasis on exercise programs, and the association of different technologies of varying intensities are used with good physical results. It was also observed that the avalilables technologies stimulate self-care and guide women regarding self-management of complications, promoting autonomy, confidence and resumption of their social roles.

Barriers for the inclusion of sexuality in nursing care for women with gynecological and breast cancer: perspective of professionals.

AIM: qualitative study, which aimed to identify the barriers that influence nursing care practices related to the sexuality of women with gynecological and breast cancer. METHODS: the study was conducted with 16 professionals of the nursing area (nurses, nursing technicians and nursing assistants) from two sectors of a university hospital situated in the state of São Paulo, Brazil. The data was collected using semi-structured, in-depth individual interviews. All the interviews were recorded and the participants' responses were identified and categorized using Content Analysis. RESULTS: three major themes were identified. These are as follows: 1) barriers related to the biomedical model; 2) barriers related to institutional dynamics and 3) barriers related to the social interpretations of sexuality. CONCLUSIONS: the results of this study showed that the systematized inclusion of this issue in nursing care routines requires changes in the health paradigm and in the work dynamic, as well as reflection on the personal values and social interpretations related to the topic. A major challenge is to divest sexuality of the taboos and prejudices which accompany it, as well as to contribute to the nursing team being more aware of the difficulties faced by women with gynaecological and breast cancer.

A prática sexual de mulheres jovens em tratamento para o câncer de mama / La práctica sexual de mujeres jóvenes en tratamiento para el cáncer de mama / The sexual practice of young women in treatment for breast cancer

Resumo Objetivo compreender como ocorre a prática sexual (PS) de mulheres jovens com câncer de mama. Método pesquisa qualitativa, utilizando o Interacionismo Simbólico e a Teoria Fundamentada nos Dados. A coleta de dados ocorreu entre outubro de 2017 e agosto de 2019, em dois Centros de Alta Complexidade em Oncologia, seguindo-se um roteiro semiestruturado para entrevista. A pergunta norteadora foi: "Fale-me como era e como ficou agora sua vida sexual após o diagnóstico do câncer". Participaram 13 mulheres com companheiro sexual desde o diagnóstico da doença. Resultados primeiro diagrama: a prática sexual é afetada devido ao diagnóstico e tratamentos para a doença; segundo diagrama: fatores que contribuem para sua retomada são o apoio social e afetivo (principalmente); diagrama da categoria central: o companheiro (apoio afetivo) é o protagonista da rede de relacionamentos. Conclusão A PS é afetada pela doença/tratamentos e sua retomada ocorre mediante apoio do companheiro. Implicações para a prática: É necessário abordar sobre PS na assistência em saúde, evitando o distanciamento do casal, diminuindo as angústias e dúvidas das mulheres nesta condição.

Resumen Objetivo Comprender cómo ocurre la práctica sexual (PS) de mujeres jóvenes con cáncer de mama. Método Investigación cualitativa; que utilizó el Interaccionismo Simbólico y la Teoría Fundamentada en Datos. La recopilación de datos tuvo lugar entre octubre de 2017 y agosto de 2019 en dos centros de alta complejidad en oncología, utilizando un guion semiestructurado para las entrevistas. La pregunta guía fue: "Dime cómo era y cómo está tu vida sexual después del diagnóstico de cáncer". Participaron trece mujeres con pareja sexual desde el diagnóstico de la enfermedad. Resultados Primer diagrama: la práctica sexual se ve afectada debido al diagnóstico y los tratamientos para la enfermedad; Segundo diagrama: los factores que contribuyen a su reanudación son el apoyo social y afectivo (principalmente); Diagrama de categoría central: el compañero (soporte afectivo) es el protagonista de la red de relaciones. Conclusión La PS es afectada por la enfermedad/los tratamientos y su continuación se produce con el apoyo de la pareja. Implicaciones para la práctica: Es necesario abordar la EP en la atención médica, evitando el alejamiento entre la pareja, reduciendo la angustia y las dudas de las mujeres en esta condición.

Abstract Objective To understand how the sexual practice (SP) of young women with breast cancer occurs. Method: Qualitative research; that used Symbolic Interactionism and Grounded Theory. Data collection took place between October/2017 and August/2019 in two Centers of High Complexity in Oncology, using a semi-structured guide for interviews. The guiding question was: "Tell me what it was like and what your sex life is like now after the cancer diagnosis". Participated thirteen women with a sexual partner since the diagnosis of the disease. Results: First diagram: sexual practice is affected due to diagnosis and treatments for the disease; Second diagram: factors that contribute to its resumption are social and (mainly) affective support; Central category diagram: the companion (affective support) is the protagonist of the relationship network. Conclusion: SP is affected by the disease/treatments and its resumption occurs with the support of the partner. Implications for practice: It is necessary to address SP in health care, avoiding the distance between of the couple, reducing the anxieties and doubts of women in this condition.

Manejo de mulheres com atipias no exame citopatológico de colo uterino na atenção primária à saúde / Manejo de mujeres con atipias en estudio citopatológico de cuello uterino en atención primaria / Management of women with atypias in the cervical cytopathological test in primary health care

RESUMO Objetivo: identificar a conduta dos profissionais de saúde no manejo de mulheres com atipias no exame citopatológico, atendidas em Unidades de Atenção Primária à Saúde. Método: estudo documental, retrospectivo, com 175 mulheres que apresentaram exames citopatológicos com atipias, entre 2006 e 2014, num município do estado de São Paulo, com análise descritiva dos dados. Resultados: 157 (90%) mulheres retornaram à unidade para verificar o resultado do exame. Entre as com atipias, 103 (86%) receberam manejo adequado, porém 85 (83%) repetiram o exame em tempo menor que o preconizado. Entre as que precisaram de colposcopia, 30 (79%) receberam manejo adequado. Conclusão: o manejo de mulheres com atipias foi adequado, porém o índice de positividade baixo, escassez de registros em prontuários e temporalidade inadequada para repetição do exame citopatológico demonstram um programa de rastreamento oportunístico, podendo ocasionar baixa cobertura da população alvo, alto índice de detecção tardia, e super-rastreamento.

RESUMEN: Objetivo: Determinar la conducta de los profesionales de salud para manejo de mujeres con atipias en examen citopatológico, atendidas en Unidades de Atención Primaria de Salud. Método: Estudio documental, retrospectivo, con 175 mujeres con estudios citopatológicos mostrando atipias, entre 2006 y 2014, en municipio del estado de São Paulo, con análisis descriptivo de datos. Resultados: 157 (90%) mujeres volvieron a la unidad para verificar el resultado del estudio. Entre las que presentaron atipias, 103 (86%) recibieron manejo adecuado, aunque 85 (83%) repitieron el estudio en tiempo inferior al recomendado. De las que precisaron colposcopia, 30 (79%) recibieron manejo adecuado. Conclusión: El manejo de mujeres con atipias resultó adecuado, aunque el bajo índice de positividad, escasez de registros en historias clínicas y temporalidad inadecuada de reiteración del estudio demuestran programación oportuna del seguimiento, determinando potencial baja cobertura de la población objetivo, alto índice de detección tardía y sobreseguimiento.

ABSTRACT Objective: to identify the conduct of health professionals in managing women with atypias in the cervical cytopathological test who received care in primary healthcare units. Methods: documentary and retrospective study carried out with 175 women who had atypias in their cervical cytopathological tests between 2006 and 2014 in a municipality in the state of São Paulo, Brazil, with descriptive analysis of collected data. Results: 157 (90%) women went back to the unit to check the test result. Among those with atypias, 103 (86%) were properly managed, but 85 (83%) repeated the test within a period shorter than the advocated one. In the group of women who needed a colposcopy, 30 (79%) were properly managed. Conclusion: the management of women with atypias was adequate, but the low positivity rate, the lack of patient records, and the inadequate time to repeat the cervical cytopathological test indicated an opportunistic screening program, which may lead to low coverage of the target population, high late detection rate, and overscreening.

Rastreamento de câncer em mulheres deficientes: uma revisão integrativa / Cancer screening in women with disabilities: an integrative review

Para tentar reduzir a morbidade e mortalidade por câncer, têm sido utilizadas estratégias de diagnóstico precoce e de rastreamento da doença. Para que as ações de rastreamento sejam eficazes, devem ser disponibilizadas a toda população. Entretanto não é essa a realidade de mulheres com deficiência. Objetivo: Identificar como tem sido realizado o rastreamento de câncer em mulheres com deficiência. Método: Foi realizada uma revisão integrativa da literatura com buscas realizadas nas bases de dados Pubmed, LILACS e Web of Science. Resultados: Foram incluídos 25 artigos, e pode-se observar que mulheres com deficiência apresentaram barreiras para o acesso aos serviços de saúde: escolaridade, renda, nível de incapacidade, estado civil, estar inserido em sistema de saúde privado, idade, ter um cuidador, falta de adaptação dos serviços para pessoas com deficiência e falta de conhecimento dos profissionais e das próprias mulheres. Como consequência dessas barreias, as mulheres com deficiência apresentam menor probabilidade de realizarem os exames de rastreamento. Conclusão: As mulheres com deficiência são menos propensas a comporem os programas de rastreamento do câncer de mama e colo do útero, mesmo entre países desenvolvidos.

Seeking to reduce cancer morbidity and mortality, screening strategies have been used. For screening actions to be effective, they must be available to the entire population. However, this is not the reality of women with disabilities. Objective: To identify how cancer screening has been performed in women with disabilities. Method: Integrative review with searches performed in the Pubmed, LILACS and Web of Science databases. The PICO strategy was adopted to elaborate the research question, the Mesh descriptors adjusted according to the database. Results: 25 articles were included. Women with disabilities have barriers to access the health services, among them: education, income, level of disability, marital status, not being in private health care, age, having a caregiver, lack of adaptation of services for people with disabilities and lack of knowledge of professionals and women themselves about the importance of screening. Because of these barriers, these women are less likely to have screening tests. Conclusion: Women with any type of disability are less likely to be part of breast and cervical cancer screening programs, even among developed countries.

Profile of women with lymphedema after breast cancer treatment / Perfil de mujeres con linfedema en post tratamiento de cáncer de mama / Perfil de mulheres com linfedema no pós-tratamento de câncer de mama

ABSTRACT Objective: To identify the profile of women with lymphedema after breast cancer treatment. Methods: This is a descriptive, retrospective and quantitative study with data from medical records of women with lymphedema who began treatment between 2010 and 2015 in a rehabilitation center. An instrument was used for data collection to characterize the participants and analysis was performed by means of descriptive statistics, the Chi-Square test and Fisher's exact test. Results: 235 women with a mean age of 56.8 years were included, with an association between lymphedema and age (p = 0.016). It was observed that 76.6% of the sample had some comorbidity associated with breast cancer, especially hypertension (48.1%). They underwent radical surgery (60%), axillary lymphadenectomy (77.9%), sentinel lymph node biopsy (16.6%) and radiotherapy (74%). Treatments carried out for lymphedema were decongestant therapy and complementary treatments with 95.7% of adherence of women to therapies. Conclusion and implications for practice: Women with lymphedema presented risk factors such as radical surgery, axillary lymphadenectomy and radiotherapy, and good adherence to the required treatments of lymphedema. Knowing the profile of this population is crucial to the treatment choice.

RESUMEN Objetivo: Identificar el perfil de mujeres con linfedema después del tratamiento del cáncer de mama. Métodos Estudio descriptivo, retrospectivo y cuantitativo con datos de fichas médicas de mujeres con linfedema que fueron atendidas entre 2010 y 2015 en un núcleo de rehabilitación. Para la recogida de datos fue utilizado instrumento para caracterizar a las participantes y el análisis fue hecho por medio de estadística descriptiva con las pruebas de Chi-Cuadrado y Fisher. Resultados: Fueron incluidas 235 mujeres con edad media de 56,8 años, habiéndose encontrado asociación entre linfedema y edad (p = 0,016). Se observó que 76,6% de la muestra presentó alguna comorbilidad asociada al cáncer de mama con destaque para la hipertensión (48,1%). Fueron sometidas a cirugía radical (60%), a linfadenectomía axilar (77,9%), a biopsia del linfonodo centinela (16,6%) y a radioterapia (74%). Los tratamientos para cuidados con el linfedema fueron la terapia descongestiva y tratamientos complementarios con adhesión de 95,7% de las mujeres a las terapias. Conclusión e Implicaciones para la práctica: Las mujeres con linfedema presentaron factores de riesgo como cirugía radical, linfadenectomía axilar y radioterapia; se encontró buena adhesión a los tratamientos necesarios para el control del linfedema. Conocer el perfil de esta población es primordial para seleccionar los tratamientos.

RESUMO Objetivo: Identificar o perfil de mulheres com linfedema após tratamento do câncer de mama. Métodos: Estudo descritivo, retrospectivo e quantitativo com dados de prontuários de mulheres com linfedema que iniciaram atendimento entre 2010 e 2015 em um núcleo de reabilitação. Para coleta de dados foi utilizado instrumento para a caracterização das participantes e análise por meio de estatística descritiva e teste de Qui-Quadrado e Fisher. Resultados: Foram incluídas 235 mulheres com média de idade de 56,8 anos havendo associação entre linfedema e idade (p =0,016). Observou-se que 76,6% da amostra apresentaram alguma comorbidade associada ao câncer de mama com destaque para hipertensão (48,1%). Foram submetidas a cirurgia radical (60%), linfadenectomia axilar (77,9%), biopsia do linfonodo sentinela (16,6%) e radioterapia (74%). Os tratamentos para cuidados com o linfedema foram terapia descongestiva e tratamentos complementares com adesão de 95,7% das mulheres às terapias. Conclusão e Implicações para a prática: As mulheres com linfedema apresentaram fatores de risco como cirurgia radical, linfadenectomia axilar e radioterapia, e boa adesão aos tratamentos necessários para controle do linfedema. Conhecer o perfil dessa população é primordial para eleição de tratamentos.

Neutropenia: occurrence and management in women with breast cancer receiving chemotherapy.

OBJECTIVES: to identify the prevalence, and describe the management of, neutropenia throughout the chemotherapy treatment among women with breast cancer. METHODS: observational study, cycles of chemotherapy. 116 neutropenic events were recorded, and 63.3% of the patients presented neutropenia at some point of their treatment, 46.5% of these presenting grade II. The management used was temporary suspension between the cycles and the mean number of delays was 6 days. The study was prospective and longitudinal, where the evaluation of the hematological toxicities was undertaken at each cycle of chemotherapy, whether neoadjuvant or adjuvant. RESULTS: 79 women were included, who received 572 cycles. However, the reasons for the suspensions were the lack of a space in the chemotherapy center, followed by neutropenia. CONCLUSION: neutropenia is one of the most common and serious adverse events observed during the chemotherapy. Nursing must invest in research regarding this adverse event and in management strategies for organizing the public health system, so as to offer quality care.