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Objetivo: analisar pesquisas que adotaram como objeto os benefícios do programa navegação de pacientes e a assistência de enfermagem. Método: Trata-se de uma revisão integrativa utilizando a estratégia PICO (Paciente, Intervenção, Comparação e Desfecho). Bases de dados selecionadas: LILACS, Medline, IBECS, BDENF e SCIELO, entre 2015 e 2020. Descritores de busca: Enfermagem; Navegação de pacientes; Oncologia; Assistência. Resultados: Foram analisados 11 artigos, nos quais pode-se verificar que os benefícios relativos à inserção do programa de navegação de pacientes e da enfermagem dentro dos serviços de oncologia foram: reestruturação de ambos buscando a padronização e diretrizes; agilidade no tratamento; além do empoderamento da família/cliente no seguimento dos processos/tratamentos. Conclusões: No Brasil, há poucos estudos relacionados a implementação do programa de navegação a da assistência em enfermagem na oncologia. Porém, a literatura existente trouxe como promissores os benefícios ao cliente/família e à instituição, além da agilidade nos processos inerentes ao tratamento(AU)
Objective: to analyze research that adopted the benefits of the patient navigation program and nursing care as their object. Method: This is an integrative review using the PICO strategy (Patient, Intervention, Comparison and Outcome). Selected databases: LILACS, Medline, IBECS, BDENF and SCIELO, between 2015 and 2020. Search descriptors: Nursing; Patient navigation; Oncology; Assistance. Results: 11 articles were analyzed, in which it can be verified that the benefits related to the insertion of the navigation program for patients and nursing within the oncology services were: restructuring of both seeking standardization and guidelines; agility in treatment; in addition to the empowerment of the family/client in following the processes/treatments. Conclusions: In Brazil, there are few studies related to the implementation of the navigation program and nursing care in oncology. However, the existing literature brought as promising benefits to the client/family and the institution, in addition to the agility in the processes inherent to the treatment(AU)
Objetivo: analizar las investigaciones que adoptaron como objeto los beneficios del programa de navegación del paciente y los cuidados de enfermería. Método: Se trata de una revisión integradora que utiliza la estrategia PICO (Paciente, Intervención, Comparación y Resultado). Bases de datos seleccionadas: LILACS, Medline, IBECS, BDENF y SCIELO, entre 2015 y 2020. Descriptores de búsqueda: Enfermería; Navegación del paciente; Oncología; Asistencia. Resultados: Se analizaron 11 artículos, en los cuales se puede constatar que los beneficios relacionados con la inserción del programa de navegación para pacientes y enfermería dentro de los servicios de oncología fueron: reestructuración de ambos buscando estandarización y lineamientos; agilidad en el tratamiento; además del empoderamiento de la familia / cliente en el seguimiento de los procesos / tratamientos. Conclusiones: En Brasil, existen pocos estudios relacionados con la implementación del programa de navegación y cuidados de enfermería en oncología. Sin embargo, la literatura existente trajo como beneficios prometedores para el cliente / familia y la institución, además de la agilidad en los procesos inherentes al tratamiento.(AU)
Subject(s)
Nursing , Universal Access to Health Care Services , Patient Navigation , Medical OncologyABSTRACT
Introducción: Identificar y describir los beneficios del sistema de navegación de las pacientes con sospecha de cáncer de mama. Identificar y describir las barreras a nivel personal de las usuarias y a las que se enfrentan institucionalmente hasta la obtención del diagnóstico definitivo. Material y Métodos: Estudio cualitativo fenomenológico. Se emplearon guías de observación y se realizaron entrevistas a profundidad para el recojo de información. Se recopilaron las experiencias de ocho personas, tres fueron personal de salud, y cinco pacientes. El personal de salud incluyo dos médicos varones y una ex navegadora en un hospital de la seguridad social de Lima. Resultados: Las pacientes que fueron acompañadas por la navegadora manifiestan que su apoyo les permitió transitar su etapa de enfermedad con mayor facilidad, tanto a nivel emocional como en lo relacionado a procesos institucionales. Las principales barreras percibidas institucionales son i) infraestructura y procesos hospitalarios ii) ineficiente seguimiento y monitoreo de pacientes. Desde el lado de la usuaria i) obligaciones familiares y domésticas ii) miedos y desconocimiento de la enfermedad iii) experiencias previas en el sistema de salud. Conclusiones: La navegación de pacientes permite un acompañamiento logístico y emocional que favorece la experiencia de la paciente. Las dificultades halladas a nivel hospitalario, lejos de desaparecer, logran ser reducidas, aligerando así el peso de algunos procesos institucionales que deben cargar las pacientes.
Objetives: To identify and to describe the main benefits of the navigation system from the perspective of patients with suspected breast cancer. Identify and describe the barriers at the personal level of the users and those that they face institutionally until the definitive diagnosis is obtained. Material and Methods: A qualitative study was carried out between January and March 2020. Observation and in-depth interviews were the information gathering tools used. The experiences of five patients and three members of the health personnel were collected in one hospital of Lima. Results: The patients who were accompanied by the navigators state that their support allowed them to go through their stage of illness with greater ease, both emotionally and bureaucratically. The main perceived institutional barriers are i) infrastructure and hospital processes ii) inefficient follow-up and monitoring of patients. From the user side i) family and domestic obligations ii) fears and ignorance of the disease iii) previous experiences in the health system. Conclusions: Patient navigation allows logistical and emotional support that favours the experience of the patient. The difficulties encountered at the hospital level, far from disappearing, manage to be reduced, thus lightening the bureaucratic burden that patients must carry. There is an emotional bond between the patients and the navigators. The level of these affective relationships is mainly related to the reality of the patient, specifically to her social support network
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BACKGROUND/AIMS: Uninsured individuals have lower rates of screening colonoscopy (SC), and little is known regarding the pathology results obtained when they undergo colonoscopies. Since 2004, we have participated in a program that offers SC to uninsured New Yorkers; herein, we report our findings. METHODS: Uninsured, average-risk patients who were at least 50 years of age underwent SC at our institution between April 2004 and June 2011. We analyzed polyp pathology, location, size, incidence of adenomas, and incidence of adenomas with advanced pathology (AAP) with respect to ethnicity, gender, and age. RESULTS: Out of 493 referrals, 222 patients completed the colonoscopies. Polyps were identified in 21.2% of all patients; 14% had adenomas, and 4.5% had AAP. The rates of adenomas among African-Americans, Hispanics, and Whites were 24.3%, 12.1%, and 11.6%, respectively, and the corresponding rates of AAP were 10.8%, 3.5%, and 2.3%. Differences in the polyp type, location, and AAP did not reach statistical significance with respect to ethnicity or gender. Patients aged 60 and older were found to have a higher rate of advanced adenomas compared with younger patients (8.6% vs 2.6%, p=0.047). CONCLUSIONS: Further efforts to fund screening colonoscopies for uninsured individuals will likely result in the identification of advanced lesions of the colon before they progress to colorectal cancer.