Skills Required in the Care of Cancer Patients Who Undergo Surgery in the Hospital-Home Transition.

It is essential to recognize what care is required by patients undergoing surgery in the transition from hospital to home to provide guidance for plans for release and follow-up and to achieve patient adherence to these plans. The objective of this study is to describe the skills required for the care of cancer patients who undergo surgery after hospital discharge. An exploratory-type descriptive approach was adopted, including 290 cancer patients who underwent surgery at a reference center in Bogotá, Colombia. Hospital discharge was followed by 4 weeks of telephone follow-up to investigate the skills required for care on the basis of the CUIDAR tool. The participants had a mean age of 59.3 years, with the majority being female and having low levels of education. The most prevalent type of cancer found was breast cancer, followed by colon and rectal, prostate, stomach, cervical, lung, and ovarian cancer. The first follow-up identified needs for care in most of the CUIDAR dimensions, predominantly instrumentation, knowledge, and anticipation. The fourth follow-up, which found reduced needs, focused on knowledge of diet and eating, physical activity, the management of sadness and anxiety, a permanent telephone hotline, and sharing with loved ones. Cancer patients who underwent surgery require skills for at-home care that need to be addressed in hospital discharge programs and with structured telephone follow-up. Telephone follow-up interventions need to be consolidated in hospital release or hospital discharge programs that address these care needs.

Validación de la Escala Competencia para el Cuidado en el Hogar en Adultos con Cáncer / Validation of the Competency Scale for Cancer Patient in-Home Care / Validação da Escala de Competências para Cuidados na Casa em Adultos com Câncer

Resumen Introducción Las competencias para el cuidado de adultos con cáncer en tratamiento son fundamentales para lograr adecuados procesos de transición hospital-hogar y comportamientos de automanejo en salud. Objetivo validar la estructura factorial hipotética de la escala competencia para el cuidado en el hogar en adultos con diagnóstico de cáncer que se encuentran en tratamiento activo. Materiales y Métodos estudio transversal de validación de instrumentos en el que participaron 250 adultos con diagnóstico de cáncer en tratamiento, se utilizó la técnica de análisis factorial confirmatorio utilizando el método de componentes principales y rotación varimax y el alfa de Cronbach para determinar la confiabilidad. Resultados se obtiene una versión de la escala competencia para el cuidado en adultos con cáncer, con 17 items y 5 aspectos (factores): aprender, anticipar, autoregular, armonizar y apoyar. El alfa de Conbrach de la escala es de 0.764. Conclusiones la escala competencia para el cuidado-5A retoma los planteamientos de la teoría de automanejo individual y familiar, evalúa de forma integral las habilidades requeridas en personas con cáncer para facilitar la transición hacia la autogestión del cuidado en el hogar.

Abstract Introduction Caregiving competencies for cancer patients under treatment are fundamental to achieve an adequate hospital-home transition and health self-management behaviors. Objective To validate the hypothetical factor structure of the competency scale for in-home care of cancer patients who are undergoing active cancer treatment. Methodology A cross-sectional study instrument validation was conducted with 250 cancer patients under treatment. The confirmatory factor analysis technique was used to determine reliability by using the principal component analysis method, varimax rotation and Cronbach's alpha. Results A version of the Competency Scale for Cancer Patient In-Home Care was administered containing 17 items and 5 approaches: learning, anticipating, self-regulating, harmonizing, and supporting. Cronbach's alpha of the scale was 0.764. Conclusions The 5-A Competency Scale for Cancer Patient In-Home Care takes up the approaches of the individual and family self-management theory and comprehensively assesses the skills required by cancer patients to facilitate the transition to caregiving self-management at home.

Resumo Introdução As competências para o cuidado de adultos com câncer em tratamento são fundamentais para o alcance de processos adequados de transição hospital-casa e comportamentos de autogestão em saúde. Objetivo validar a estrutura fatorial hipotética da escala de competência para atenção domiciliar em adultos com diagnóstico de câncer que estão em tratamento ativo. Materiais e Métodos estudo transversal de validação de instrumento do qual participaram 250 adultos com diagnóstico de câncer em tratamento, utilizando-se a técnica de análise fatorial confirmatória, utilizando o método de componentes principais e rotação varimax e o alfa de Cronbach para determinar a confiabilidade. Resultados obteve-se uma versão da escala de competências para cuidar de adultos com câncer, com 17 itens e 5 aspectos (fatores): aprender, antecipar, autorregular, harmonizar e apoiar. O alfa de Conbrach da escala é 0,764. Conclusões a escala de competência para o cuidado-5A retoma as abordagens da teoria da autogestão individual e familiar, avaliam de forma abrangente as habilidades requeridas nas pessoas com câncer para facilitar a transição em direção a autogestão do cuidado no lar.

Efecto de una intervención educativa para cuidadores familiares de personas con cáncer en cirugía / Effect of an educational intervention for family caregivers of individuals with cancer in surgery

OBJETIVO: Evaluar el efecto de una intervención educativa en cuidadores familiares de adultos con cáncer que se encuentran en postoperatorio de cirugía oncológica, para fortalecer la competencia de cuidado en el hogar y disminuir la sobrecarga. MÉTODO: Se trata de un abordaje cuantitativo cuasi-experimental con grupo de intervención y grupo control; se incluyeron 290 cuidadores familiares de pacientes intervenidos por cirugía, se aplicó la intervención educativa desde el ingreso hasta seis semanas después del egreso, se realizó medición antes y después de la competencia para el cuidado en el hogar y de la sobrecarga de cuidado. RESULTADOS: En el grupo intervenido se obtuvo impacto positivo y estadísticamente significativo en la competencia para el cuidado en el hogar y disminución de sobrecarga. CONCLUSIONES: La intervención educativa es una estrategia que aumenta la competencia para cuidar en el hogar, y disminuye la sobrecarga en cuidadores de personas con cáncer sometidos a cirugía

OBJECTIVE: To evaluate the effect of an educational intervention on family caregivers of adults with cancer who are in the postoperative period of oncological surgery, to strengthen the competence of home care and reduce overload. METHOD: This was a quasi-experimental quantitative approach with intervention group and control group; 290 family caregivers of patients undergoing surgery were included, educational intervention was applied from admission to six weeks after discharge, measurement was made before and after competence for home care and care overload. RESULTS: In the group intervened, a positive and statistically significant impact was obtained in the competence for home care and decreased overload. CONCLUSIONS: The educational intervention is a strategy that increases skills for care at home, and reduces the burden on caregivers of people with cancer undergoing surgery

Percepción de comportamiento de cuidado de enfermería en adultos con terapia renal de diálisis peritoneal y hemodiálisis / Perception of nursing caring behavior in adults treated with renal therapy for peritoneal dialysis and hemodialysis

Objetivo: Describir y comparar la percepción del comportamiento del cuidado de enfermería que tienen los pacientes en hemodiálisis y diálisis peritoneal en una unidad renal de Bogotá. Material y Método: Estudio descriptivo comparativo realizado con 92 pacientes en terapia renal distribuidos en dos grupos: hemodiálisis (50) diálisis peritoneal (42). Se utilizó el instrumento comportamiento profesional de cuidado de Horner. Para el análisis se acudió a estadística descriptiva, medidas de tendencia central y de dispersión; e inferencial mediante pruebas no paramétricas para comparación de grupos. Resultados: Se obtuvo alto puntaje en los comportamientos de cuidado brindados por enfermería en los dos grupos de pacientes. Los dos grupos perciben en su orden atributos de interacción familia -paciente, cortesía, relación y compromiso, en el cuidado brindado por enfermería. Es ligeramente mayor la percepción dada por los que se encuentran en diálisis peritoneal, sin ser estadísticamente significativa la diferencia frente a los de hemodiálisis. Conclusiones: Los pacientes en terapia renal de hemodiálisis y diálisis peritoneal reconocen altos comportamientos de cuidado de enfermería. Se requiere mantener el componente técnico y el conocimiento teórico propios del quehacer en las unidades renales, y fortalecer las relaciones de confianza, respeto y empatía que la enfermera(o) puede brindar de acuerdo a sus condiciones y las ofrecidas por la institución

Objective: To describe and compare the perception of nursing caring behavior in adults treated with renal therapy for peritoneal dialysis and hemodialysis in a renal unit in Bogotá. Material and Method: Descriptive and comparative study with a sample of 92 patients receiving real therapy distributed in two groups: hemodialysis (n=52) and peritoneal dialysis (n=42). The Professional Performance for Caring Scale of Horner was used. Descriptive statistics were used for the analysis, central tendency and dispersion measures; as well as inferential statistics by non-parametric tests for comparison between the groups. Results: High scores on the caring behavior offered by nursery services were observed for the two groups of patients. Both groups perceive the interactions between different factors such as family- patient relationships, courtesy, relationship and commitment in the care offered by nursing services. The perception of the group of patients treated with peritoneal dialysis was slightly greater, but statistically significant differences between the groups were not observed. Conclusions: Patients treated with renal therapy for peritoneal dialysis and hemodialysis acknowledge high levels of care in the nursing services provided. It is necessary to maintain the technical and theoretical components common to renal unities, as well as strengthen the relationships based on trust, respect and empathy that the nurse can offer according to his/her conditions as well as those provided by the institution

Follow-up of Gastrectomized Patients due to Gastric Cancer in a Cancer Center of Bogota, Colombia / Seguimiento de pacientes gastrectomizados por cáncer gástrico en un centro oncológico de Bogotá, Colombia / Seguimento de pacientes gastrectomizados por câncer gástrico em um centro de oncológico em Bogotá, Colômbia

ABSTRACT Objective: To determine the perceived burden and functional status of gastric cancer patients with gastrectomy in a center of cancer in Bogota (Colombia) between 2013 and 2016. Materials and methods: Retrospective description of patients intervened by gastrectomy distributed in three groups: Patients with gastrectomy from 1 to 12 months of surgical intervention, 13 to 14 months and 25 to 36 months. For this, it was used the disease burden perception instrument and the Karnofsky scale. Results: 127 patients were included. 63 from 1 to 12 months, 43 from 13 to 24 months, and 21 from 25 to 36 months of intervention. Gastric adenocarcinoma of intestinal pattern stage III and II predominate. More than 50 % of the patients required total gastrectomy and received adjuvant chemotherapy. The majority of participants performed regular activities with mild signs and symptoms, presented low overall perceived burden and functional performance without statistically significant differences between groups. Patients from 1 to 12 months of intervention reported greater levels of physical discomfort. Conclusions: In patients with gastrectomy for gastric cancer, physical symptoms persist such as emotional disturbances, economic difficulties and limitations in the work role, findings to be included in follow-up programs.

RESUMEN Objetivo: evaluar el seguimiento de pacientes gastrectomizados por cáncer gástrico en un centro de oncología en Bogotá, entre 2013 y 2016, y determinar el estado funcional y la percepción de la carga de enfermedad. Material y métodos: descripción retrospectiva de pacientes intervenidos por gastrectomía, distribuidos en tres grupos: de 1 a 12 meses de seguimiento luego de la intervención, de 13 a 14 meses, y de 25 a 36 meses. Se utilizó un instrumento de percepción de carga de enfermedad crónica validado y la escala de Karnofsky. Resultados: se incluyeron 127 pacientes: 63 a un año, 43 a 2 años y 21 a 3 años. Predomina el adenocarcinoma gástrico de patrón intestinal. Más del 50 % requirió gastrectomía total, más quimioterapia adyuvante, y estaba en estadios II y III. La mayoría realiza actividad normal con signos y síntomas leves, con una carga de enfermedad percibida global baja y un estado funcional sin diferencias significativas entre los grupos. Los pacientes con seguimiento de 1 a 12 meses reportaron un mayor malestar físico. Conclusiones: en pacientes gastrectomizados por cáncer gástrico, persisten síntomas físicos, alteraciones emocionales, dificultades económicas y limitación en el rol laboral, hallazgos por ser incluidos en los programas de seguimiento.

RESUMO Objetivo: Avaliar o seguimento de pacientes gastrectomizados emum centro de referêncianacidade de Bogotá entre 2013 e 2016, determinando o status funcional e a percepção da carga da doença. Material e métodos: Descriçãoretrospropectiva dos pacientes intervencionados por gastrectomiadistribuídosemtrês grupos, que têm entre 1 a 12 meses de intervençãocirúrgica, 13 a 14 meses e 25 a 36 meses. Utilizamos o instrumento de percepção da carga de doençascrônicas, desenhado, avaliado e a escala de Karnofsky. Resultados: 127 pacientes foramacompanhados por gastrectomia por câncer gástrico; 63 emum ano, 43 em 2 anos e 21em 36 meses. Do ponto de vista histopatológico, predomina o adenocarcinoma gástrico intestinal. Mais de 50 % necessitaram de gastrectomia total, além de quimioterapia adjuvante e corresponderamaosestágios II e III. A maioria dos pacientes commonitorizaçãoactividade normal realizada sinais e sintomas leves comumabaixa carga global percebida e um estado funcional, semdiferenças significativas entre os grupos namonitorização de doentesacompanhados durante 1 a 12 meses relatados maisdesconforto físico. Conclusões: Nos pacientes gastrectomizados por câncer gástrico, a percepção de sobrecarga da doença é baixa. Alguns sintomas físicos persistem, disturbios emocionais e dificuldades econômicas, bem como limitação no papel do trabalho, achados a serem considerados no desenvolvimento de programas de acompanhamento.

Development of student competencies for palliative care.

AIM: Identify the palliative care learning needs of healthcare students and determine the acceptability of an innovative learning strategy for palliative care named competencia para cuidar en el hogar-paliar (CUIDAR-PALIAR) aimed to increase students' competencies. METHODS: A single-group mixed methods design was used. A questionnaire was designed and semi-structured interviews were used to determine the palliative care competencies of undergraduate students; 90 students participated in the strategy. FINDINGS: The learning needs of students are: approaches to death and loss, how to intervene with the patient's family, understanding of the palliative care context, management of the patient's pain and symptoms and the development of therapeutic communication skills. CONCLUSION: The strategy is highly accepted by students, and statistically significant increases in palliative care were observed before and after the intervention. These preliminary results justify future interventions due to the potential effect of the strategy CUIDAR-PALIAR in the development of competencies for palliative care in undergraduate students.

Vivir después de una gastrectomía: experiencia de pacientes con cáncer gástrico / Life after a gastrectomy: Experience of patients with gastric cancer

Objetivo: Describir la experiencia de pacientes con cáncer gástrico intervenidos mediante gastrectomía. Método: Estudio cualitativo con 17 adultos intervenidos mediante gastrectomía total en un centro de atención oncológica de Bogotá (Colombia). El abordaje fue fenomenológico utilizando el análisis propuesto por Colaizzi. Se identificaron códigos descriptores, códigos nominales y categorías o temas centrales. Se utilizaron entrevistas en profundidad y se acudió al muestreo teórico. Resultado: A partir de 165 códigos descriptores, emergen 27 códigos nominales que conforman 6 temas que describen la experiencia de la persona que ha presentado una gastrectomía total: 1) una nueva oportunidad, 2) un cuerpo extraño, 3) añorando sentirme útil, 4) entendiendo otros tratamientos, 5) percibiendo molestias y síntomas, y 6) comiendo lo que pueda. Conclusiones: El paciente intervenido de una gastrectomía total se enfrenta a una experiencia como sobreviviente del cáncer que le implica entender cómo manejar las molestias físicas, la adaptación a la dieta, la dificultad económica y el desempleo. Conocer la vivencia como una nueva oportunidad y los requerimientos de otros tratamientos implica contar con una red de apoyo social, emocional y espiritual. Es fundamental consolidar programas de seguimiento a sobrevivientes que respondan de manera oportuna a sus necesidades

Objective: To describe the experience of patients with gastric cancer who have undergone gastrectomy. Method: Qualitative study with 17 adults who underwent total gastrectomy in a cancer care centre in Bogotá, Colombia. The approach was phenomenological using the analysis proposed by Colaizzi. Descriptive codes, nominal codes and categories were identified as central issues. In-depth interviews were used and theoretical saturation sampling. Result: From 165 descriptive codes, 27 nominal codes emerged that make up 6 subjects that describe the experience of the person who has undergone total gastrectomy: 1) a new opportunity, 2) a foreign body, 3) yearning to feel useful, 4) understanding other treatments, 5) sensing discomfort and symptoms, and 6) eating what I can. Conclusions: The patient who has undergone total gastrectomy faces an experience as a cancer survivor that involves understanding how to manage physical discomfort, adaptation to diet, economic difficulty and unemployment. Viewing the experience as a new opportunity, and the requirements of other treatments implies having a social, emotional and spiritual support network. It is essential to consolidate monitoring programmes for survivors that respond in a timely manner to their needs

Life after a gastrectomy: Experience of patients with gastric cancer. / Vivir después de una gastrectomía: experiencia de pacientes con cáncer gástrico.

OBJECTIVE: To describe the experience of patients with gastric cancer who have undergone gastrectomy. METHOD: Qualitative study with 17 adults who underwent total gastrectomy in a cancer care centre in Bogotá, Colombia. The approach was phenomenological using the analysis proposed by Colaizzi. Descriptive codes, nominal codes and categories were identified as central issues. In-depth interviews were used and theoretical saturation sampling. RESULT: From 165 descriptive codes, 27 nominal codes emerged that make up 6 subjects that describe the experience of the person who has undergone total gastrectomy: 1) a new opportunity, 2) a foreign body, 3) yearning to feel useful, 4) understanding other treatments, 5) sensing discomfort and symptoms, and 6) eating what I can. CONCLUSIONS: The patient who has undergone total gastrectomy faces an experience as a cancer survivor that involves understanding how to manage physical discomfort, adaptation to diet, economic difficulty and unemployment. Viewing the experience as a new opportunity, and the requirements of other treatments implies having a social, emotional and spiritual support network. It is essential to consolidate monitoring programmes for survivors that respond in a timely manner to their needs.

Duelo en el cuidador del niño fallecido por cáncer: revisión exploratoria / Grief in the caregiver of the child dead by cancer: scoping review

El objetivo de esta revisión fue sintetizar el abordaje metodológico de estudio e integrar los hallazgos del proceso de duelo en cuidadores de niños fallecidos por cáncer. Se realizó una revisión exploratoria de literatura de 19 estudios publicados en revistas indexadas entre el 2010 y 2017. Los hallazgos fueron tratados con técnicas de codificación abierta inductiva. Los resultados evidenciaron un abordaje mayormente cualitativo, con participación de padre y madre, con un año entre la muerte del niño y el ingreso al estudio. Los resultados de los estudios revelaron que debido a que el duelo se vive como respuesta a la ruptura física del vínculo con el niño, es a través del trabajo sobre vínculos que el duelo puede superarse. Los vínculos clave son los que se tienen con el niño fallecido, con los hijos vivos, con el cónyuge, con la familia y el equipo de salud; por lo que se requiere acompañamiento continuo y compasivo al cuidador desde el momento del diagnóstico del niño con cáncer, que permita construir vínculos asertivos. Posterior a la muerte del niño, es necesario mantener la continuidad del cuidado y propender por que el cuidador participe en grupos de apoyo.

The aim of this review was to synthesize the methodological approach that has been studied and integrate the findings of the grief process in caregivers of children who died of cancer. A scoping review was conducted of 19 studies published in journals indexed between 2010 and 2017. The findings were treated with open inductive coding techniques. The results showed a mostly qualitative approach, involving mother and father, with one year between the death of the child and the entry into the study. The results of the studies revealed that because grief is lived as a response to the physical rupture of the bond with the child, it is through the work on bonds that grief can be overcome.The key bonds are those with the deceased child, with the living children, with the spouse, with the family and the health team. Therefore, continuous and compassionate accompaniment of the caregiver is required from the moment of the diagnosis of the child with cancer, which allows the construction of assertive bonds. After the death of the child, it is necessary to maintain the continuity of care and encourage the caregiver to participate in support groups.

Perfill de pacientes con cáncer en un centro de oncología en Bogotá / Profile of Cancer Patients at an Oncology Center in Bogotá / Perfil de pacientes com câncer em um centro de oncologia em Bogotá

Introducción: La experiencia de vivir con un cáncer repercute significativamente en la vida, pues afecta todo el ser, lo que demanda de enfermería comprender las características del cuidado de las personas y de sus seres queridos para poderlo cuidar. Objetivo: Describir y comparar la caracterización para el cuidado de los pacientes con cáncer. Método: Estudio descriptivo comparativo realizado con 131 pacientes con cáncer atendidos en tres servicios oncológicos, determinando el perfil sociodemográfico, la carga percibida y la apropiación de las tecnologías para el cuidado. El análisis se realizó utilizando estadística descriptiva, la comparación con prueba chi cuadrado y de Kruskal-Wallis. Resultados: Predomina el género femenino, edad promedio de 54 años (DE: 17,4), baja dependencia y estado cognitivo intacto, baja escolaridad, falta de ocupación laboral, nivel socioeconómico bajo y alto nivel de apoyo familiar. La percepción de bienestar es positiva en el aspecto físico, social y espiritual, para la mayoría. La apropiación de las tecnologías es media. Excepto por algunas variaciones, los pacientes presentan condiciones comunes para el cuidado. Conclusión: Los pacientes perciben apoyo, en especial familiar, bienestar físico, social y espiritual, excepto psicológico, lo que permite planear un cuidado de enfermería que garantice mejor acceso, seguridad y continuidad.

Introduction: The experience of living with cancer impacts significantly the life as it affects the whole being. In the nursing practice all this demands to understand the care characteristics of people living with cancer and their beloved ones in order to be able to care them. Objective: To describe and compare the characterization of care for cancer patients. Method: This is a comparative descriptive study conducted using 131 cancer patients who received health care in three oncologic services; it is intended to determine the sociodemographic profile, the measured load and the appropriation of care technologies. The analysis was carried out by using descriptive statistics and comparisons based on chi-square and Kruskal-Wallis tests. Results: Most of the patients were women with an average age of 54 years (SD: 17.4); they showed low drug-dependence, intact cognitive condition, and low schooling levels; many of them lacked a job and had a low socio-economic status but with strong family support. The well-being perception was positive regarding the physical, social, and spiritual aspects for most of the patients. There was a mean appropriation of technologies. Except for some variations, the patients show some conditions requiring a common care. Conclusion: Patients perceive support, especially from their families, with physical, social and spiritual wellbeing, but not psychological well-being. This allows to plan the nursing care so as to ensure a better access, safety and continuity.

Introdução: A experiência de conviver com cancro afeta significativamente a vida, pois magoa o ser tudo, e isso demanda da enfermagem compreender as carateristicas do cuidado das pessoas e seus seres queridos para puderem cuidá-los. Objetivo: Descrever e comparar a caracterização para o atendimento de pacientes com cancro. Método: Estudo descritivo comparativo realizado com 131 pacientes com cancro atendidos em três serviços oncológicos, determinando o perfil sociodemográfico, a sobrecarga percebida e a apropriação das tecnologias para o cuidado. A análise foi feita mediante estatística descritiva, a comparação com teste qui-quadrado e de Kruskal-Wallis. Resultados: Predomina o género feminino, idade média de 54 anos (SD: 17,4), baixa dependência e estado cognitivo intacto, baixa escolaridade, falta de ocupação laborai, baixas rendas e alto nível de apoio familiar. A percepção de bem-estar é positiva no aspecto físico, social e espiritual, para a maioria. A apropriação das tecnologias é média. Com exceção de algumas variações, os pacientes apresentam condições comuns para o cuidado. Conclusão: Os pacientes percebem apoio, em especial familiar, bem-estar físico, social e espiritual, exceto psicológico, o que permite planejar um cuidado de enfermagem garantindo melhor acesso, segurança e continuidade.

Grupos de síntomas en pacientes con cáncer gástrico gastrectomizados y su impacto sobre el estado de desempeño / Symptom cluster in patients with gastric cancer who have undergone a postgastrectomy and its impact on the performance status

Objetivo: identificar los síntomas y el estado de desempeño en pacientes cáncer gástrico sometidos a gastrectomía. Método: estudio descriptivo que contó con 240 pacientes con cáncer gástrico sometidos a gastrectomía en dos hospitales de oncología en Bogotá (Colombia). Se utilizó un instrumento que mide síntomas y la escala de Karnofsky. Resultados: se identificaron 5 clúster de síntomas, así molestias físicas asociadas con el tratamiento del cáncer gástrico; sufrimiento emocional en relación consigo mismo; molestias físicas-independencia y energía; sufrimiento emocional en relación con los demás; molestias físicas que afectan de manera especial la identidad e intercambio. Dos de los cinco clúster influyen el estado de desempeño del paciente. Conclusiones: se requieren generar intervenciones en la transición y egreso hospitalario de adultos con cáncer gástrico posgastrectomizados que incluyan como eje central la valoración e intervención sobre los síntomas emocionales y físicos, lo que redundará en mejoramiento de su desempeño

Objective: to identify the symptoms and the performance status in patients with gastric cancer, who have undergone a gastrectomy and the influence of the symptom groups on their performance status. Methods: 240 patients with gastric cancer where included, who had been practiced gastrectomy with some time longer than 30 days after the oncologic surgery, and even 48 months in two centers in Bogotá, Colombia. A structured instrument, which measures symptoms and Karnofsky's scale were used. Results: 5 clusters of symptoms were identified: Physical complaints associated with treatment of gastric cancer; emotional suffering in relation to self; physical complaints-independence and energy; emotional suffering in relation to others; physical complaints that particularly affect the identity. Two of the five clusters have influenced the performance status. Conclusion: this study contributes to the need of creating assistance in hospital staying and leaving in adult patients with gastric cancer, who have gone gastrectomy, which includes as the central focus the assessment and intervention of emotional and physical symptoms

"Reencontrándome a través de la diálisis peritoneal": un abordaje fenomenológico / "Reencountering me through peritoneal dialysis": a phenomenological approach

Objetivo: Describir la experiencia de personas con enfermedad renal crónica en terapia de diálisis peritoneal que asisten a una unidad renal de Huila-Colombia. Material y Método: Investigación cualitativa fenomenológica descriptiva, se realizaron entrevistas en profundidad a 16 participantes que cumplieron los criterios de inclusión. El análisis se realizó a partir del abordaje de Collaizzi. Resultados: 361 descripciones significativas, 94 unidades de significado, y 6 temas comunes: enfrentando la realidad, pérdidas, corporalidad, limitaciones, soporte y ganancias, describen la experiencia. Conclusiones: Padecer una enfermedad renal crónica terminal representa la lucha que tiene el paciente frente a los cambios en su aspecto físico, el auto reconocimiento y las limitaciones que tiene el servicio de salud del país, sin embargo, se refleja también, la transformación tras aceptar la condición, involucrando la terapia dialítica a su vida, permitiendo reencontrarse a través de ella

Objective: To describe the experience of people with chronic kidney disease in peritoneal dialysis therapy attending a renal unit in Huila-Colombia. Materials and methods: Descriptive phenomenological qualitative research. In-depth interviews were conducted with 16 participants who met the inclusion criteria. The analysis was made based on the Collaizzi approach. Results: 361 significant descriptions, 94 units of meaning, and 6 common themes: facing reality, losses, corporality, limitations, support and gains, describe the experience. Conclusions: Having a terminal chronic kidney disease represents the patient’s struggle against changes in physical appearance, self-recognition and the limitations of the country’s health service. However, the transformation is also reflected after accepting the condition, involving dialysis therapy to the patient’s life, allowing them to rediscover themselves

Looking for Control at the End of Life Through the Bond: A Grounded Theory on the Hospital Discharge Process in Palliative Care.

The hospital-to-home transition in palliative care is a vital process that requires continuity of care through the discharge process. However, little is known about the perceptions of patients with cancer and their family caregivers during this important palliative care transition in the Colombian health care context. The purpose of this study was to explore the experiences of the patient-family caregiver dyad in palliative care during the transition process between hospital and home in a health care institution in Bogota, Colombia. Using a grounded constructivist theory design, 30 patients with cancer receiving palliative care and 30 family caregivers participated in this study. The data were collected through 36 dyad interviews conducted in either the hospital or home of the participants. For the analysis, the constructivist analytical method was used. Findings revealed that "Looking for control at the end of life through the bond" was the main category of the study. This category could be further elaborated into 4 categories: (1) yearning for home; (2) recognizing burden; (3) experiencing uncertainty, a lack of control; and (4) achieving control. By understanding the patient and family caregiver perspective of care during the hospital-to-home transition, health care systems have the possibility to implement care programs in palliative care with an innovative educational component for health care professionals.

Competencia para el cuidado en el hogar y carga en cuidadores familiares de adultos y niños con cáncer

Objetivo. Describir y comparar la competencia para el cuidado en el hogar y la carga de los cuidadores familiares de niños con cáncer, con la de cuidadores familiares de adultos con cáncer. Método. Estudio cuantitativo, exploratorio y comparativo con 160 cuidadores familiares de personas con cáncer en tratamiento activo en dos centros de atención oncológica en Bogotá, Colombia (2016), quienes una vez caracterizados respondieron el instrumento de competencia para el cuidado en el hogar (CUIDAR) y la escala de sobrecarga para el cuidado. Resultados. Las características de los cuidadores familiares de niños y adultos con cáncer guardan semejanzas en género, ocupación, nivel educativo y apoyos con los que se cuenta. Los cuidadores de niños experimentan mayor carga para el cuidado en comparación con los de adultos con cáncer, y tienen una competencia mayor para el cuidado en el hogar y en las dimensiones conocimiento, disfrutar y anticipación. Conclusiones. Se requiere focalizar aún más el apoyo a cuidadores familiares, según el receptor de cuidado. Programas para fortalecer la competencia de cuidado en el hogar y disminuir la carga son necesarios para atender y responder a la necesidad de los cuidadores familiares de personas con cáncer. Financiación. Facultad de Enfermería. Universidad Nacional de Colombia.

Objective. To describe and compare the home care competency and the burden of family caregivers of children with cancer, with that of family caregivers of adults with cancer. Method. Quantitative, exploratory and comparative study with 160 family caregivers of people with cancer in active treatment in two oncology care centers in Bogotá -Colombia (2016), who once characterized answered the competence instrument for home care (CUIDAR) and the care burden scale. Results. The characteristics of family caregivers of children and adults with cancer have similarities in gender, occupation, educational level and available assistance. Child caregivers experience a greater care burden in comparison with those of adults with cancer, and have a greater competence for home care and in the dimensions of knowledge, enjoyment and anticipation. Conclusions. It is necessary to focus even more the support to family caregivers, according to the receiver of care. Programs to strengthen home care competency and reduce the burden are necessary to meet and respond to the needs of family caregivers of people with cancer. Financing. Nursing School. National university of Colombia.

Objetivo. Descrever e comparar a competência para cuidar em casa e a carga dos cuidadores familiares de crianças com câncer, com aquela dos cuidadores familiares de adultos com câncer. Método. Estudo quantitativo, exploratório e comparativo com 160 cuidadores familiares de pessoas com câncer em tratamento ativo em dois centros de atenção oncológica em Bogotá, Colômbia (2016), que uma vez caracterizadas responderam o instrumento de competência para cuidados em casa (CUIDAR) e a escala de sobrecarga para atendimento. Resultados. As características dos cuidadores familiares de crianças e adultos com câncer apresentam semelhanças em gênero, ocupação, nível educacional e suporte disponível. Os cuidadores de crianças vivenciam maior carga de cuidado quando comparados aos cuidadores de adultos com câncer, e possuem maior competência para o cuidado em casa e nas dimensões conhecimento, desfrutar e antecipação. Conclusões. É necessário focar ainda mais o apoio aos familiares cuidadores, de acordo com o receptor de cuidados. Programas para fortalecer a competência do cuidado em casa e reduzir a carga são necessários para atender e responder às necessidades dos cuidadores familiares de pessoas com câncer. Financiamento. Escola de Enfermagem. Universidade Nacional de Colômbia.

Perfil y carga de la enfermedad de personas con cáncer gástrico sometidas a gastrectomía / Profile and disease burden of gastric cancer patients undergoing gastrectomy

Resumen Introducción. Los tratamientos quirúrgicos del cáncer gástrico implican adaptaciones a un nuevo estilo de vida ligado a las limitaciones que pueden ocasionar carga. Objetivos. Determinar el perfil y la carga de adultos con cáncer gástrico que han sido sometidos a gastrectomía en una institución de oncología en Bogotá. Materiales y métodos. Estudio de abordaje cuantitativo y corte transversal que incluyó 60 pacientes con cáncer gástrico post gastrectomía, en su mayoría hombres de estratos socioeconómicos bajos y mínimos niveles de escolaridad, con una edad promedio de 56.33 años. Se utilizó una encuesta de caracterización y el instrumento carga de la enfermedad para el paciente. Resultados. Predomina el adenocarcinoma gástrico intestinal avanzado y la gastrectomía total como cirugía de elección que genera mayor carga. Se identifica alta carga emocional por angustia, tristeza e incertidumbre y baja carga física por síntomas como molestias gastrointestinales, agotamiento y debilidad. Las dificultades económicas y la alteración del rol laboral generan carga sociofamiliar y cultural. Hay relación inversa y estadísticamente significativa entre el estado funcional del paciente y el agotamiento, la fatiga, la alteración del equilibrio y las alteraciones del sueño. Conclusiones. Los sobrevivientes de cáncer gástrico post grastectomía presentan cargas emocionales, sociofamiliares y culturales que requieren ser atendidas.

Abstract Introduction: Surgical treatment for gastric cancer involves adaptations to a new lifestyle associated to limitations that generate a burden. Objectives: To determine the profile and burden in adults with gastric cancer who have undergone gastrectomy in an oncology institution of Bogotá. Materials and methods: Quantitative cross-sectional study that included 60 patients with gastric cancer after gastrectomy, mostly men of low socioeconomic strata and minimum schooling level, with an average age of 56.33 years. A characterization survey and burden of disease as instrument were used for the patients. Results: Advanced gastric adenocarcinoma and total gastrectomy, as the surgery of choice that generates the greatest burden, are predominant. High emotional load is reflected as anguish, sadness, uncertainty and low physical burden due to symptoms such as gastrointestinal discomfort, exhaustion and weakness. Economic difficulties and the alteration of the work role create a socio-familial and cultural burden. There is an inverse and statistically significant correlation between the functional status of the patient and exhaustion, fatigue, alteration of balance and sleep disorders. Conclusions: Survivors of gastric cancer present an emotional, socio-familial and cultural burden after grastostomy that needs to be addressed.

Effect of the programme Plan de egreso on chronically ill patients and their family caregivers. / Efecto del programa Plan de egreso en la díada persona con enfermedad crónica y sus cuidadores familiares.

OBJECTIVE: To determine the effect of the programme Hospitalisation discharge plan for patients with chronic diseases and family caregivers to strengthen their home care competence -CUIDAR- and reduce the caregiver burden. METHOD: Quasi-experimental study approach with intervention group. Participants were 62 patients and their caregivers who consulted with a health care institution in the city of Girardot (Colombia). The intervention was carried out for one month, during which, measurements were performed before and after the programme. RESULTS: Most patients were elderly, diagnosed with diabetes, hypertension or COPD, 35% of them with some degree of dependency. The caregivers were mostly women, between the ages of 35 and 59 years old, domestic caregivers, and responsible for caring for their patients for between 13-24hours a day. At the start of the programme the competency for care was low in both patients and caregivers, after the intervention there was a general increase in care and a statistically significant change. Also, at the beginning, 48% of caregivers had some level of burden, and after the study only 27% reported burden with care. CONCLUSIONS: The Hospitalisation discharge plan is a strategy that increases the home care competency of the patient and the caregiver, and decreases the caregiver burden.

Estrategias para el Aprendizaje Significativo del Cuidado Humano en Enfermería / Strategies for meaningful learning in nursing care

Con el propósito de describir y analizar las pedagógías usadas para el aprendizaje significativo en la enseñanza de la epistemología del Cuidado de Enfermería, se presenta el desarrollo de la aplicación de la estrategia de Smith y Liehr que sustenta el uso de abordajes metodológicos innovadores para la enseñanza de aspectos humanísticos y filosóficos del cuidado humano en la disciplina de enfermería. La estrategia que permite la enseñanza de la epistemología de enfermería con un enfoque reflexivo y de aprendizaje significativo fue estructurada para su aplicación con estudiantes de posgrado en asignaturas del componente de fundamentación disciplinar. Esta herramienta se considera de utilidad para la enseñanza de la enfermería, porque facilita la construcción del conocimiento en los participantes con el uso de experiencias significativas, la indagación constante y el análisis reflexivo de la fundamentación en enfermería y su reflejo en la práctica con el compañamiento de un docente experto,que direcciona el proceso..(AU)

In order to describe and analyze the pedagogical strategies used for meaningful learning in Nursing Care epistemology teaching, the development of the application of the Smith and Liehr strategy that supports the use of innovative methodological approaches to nursing teaching humanistic and philosophical aspects of human care in the discipline of nursing. The strategy that allows the teaching of nursing epistemology with a reflexive and meaningful learning approach was structured for its application with postgraduate students in subjects of the disciplinary foundation component. This tool is considered useful for teaching nursing, because it facilitates the construction of knowledge in the participants with the use of meaningful experiences, constant inquiry and reflective analysis of the foundation in nursing and its reflection in practice with the accompaniment of an expert teacher, who directs the process..(AU)

Diseño, validez facial y de contenido del instrumento carga de la enfermedad crónica para el paciente - GPCP-UN / Design, facial and content validation of the instrument “ Burden of chronic illness for the patient - gcpc-UN

Objetivo: Diseñar y realizar validación facial y de contenido del instrumento Carga de la Enfermedad Crónica para el Paciente . Método: Estudio descriptivo desarrollado entre los años 2012 - 2015, en las siguientes fases: 1) Revisión de la literatura. 2) Recuento y evaluación y de síntomas, quejas y preocupaciones expresadas por 1850 pacientes con seguimiento de un año. 3) Construcción del instrumento 4) Prueba de comprensibilidad y ajuste semántico 5) Pruebas de validez facial y de contenido con expertos. Resultados. El instrumento Carga de la Enfermedad Crónica para el Paciente - GCPC-UN consta de 49 ítems. Cada situación que se asocia con la enfermedad es medida en términos de la frecuencia, la intensidad y el nivel en que es considerada amenazante o peligrosa. Conclusiones. El Instrumento permite valorar integralmente el impacto que la situación de enfermedad crónica genera a la persona con la enfermedad. Los resultados de sus pruebas de comprensibilidad, validez facial y contenido, avalan su aplicación en el contexto colombiano y son base para nuevas investigaciones en el campo

Objective: To design and perform facial and content validation of the instrument Burden of Chronic Illness for the Patient - GCPC UN. Method: Descriptive study developed between the years 2012 - 2015, in the following phases: 1) Review of the literature. 2) Count and evaluation of symptoms, complaints and concerns expressed by 1850 patients with a follow up of one year. 3) Construction of the instrument 4) Proof of comprehensibility and semantic adjustment 5) facial and content validation with experts. Results: The instrument “Burden of Chronic Illness for the Patient - GCPC- UN” consists of 49 items divided into three dimensions: the psychological and spiritual suffering, with 15 items; the discomfort and physical distress, with 19 items; and the altered cultural and family patterns with 15 items; 1 final question that gives options for other problems was included. Each situation associated with the disease is measured in terms of frequency, intensity and the level in which it is considered threatening or dangerous. Conclusions: The Instrument “Burden of Chronic Illness for the Patient - GCPC UN” can fully assess the impact of chronic Illness for the person with a chronic disease. The results of the tests of comprehensibility, as well as the facial and content validity tests support the instrument “Burden of Chronic Illness for the Patient - GCPC UN” for its application in the Colombian context and are the basis for further research in the field

Encuesta de satisfacción con el cuidado de la salud en las personas con enfermedad crónica / Survey of satisfaction with health care in people with chronic disease

Objetivo Desarrollar y validar la Encuesta de satisfacción con el cuidado de la salud para personas con enfermedad crónica no trasmisible (ECNT), para ser utilizada en el contexto Latinoamericano. Método: Estudio metodológico desarrollado entre 2012 y 2014. Para ello se cumplieron tres fases: 1) Revisión de la literatura relacionada con la satisfacción con el cuidado en situaciones de ECNT. 2) Estructuración de la propuesta preliminar de la «Encuesta de satisfacción con el cuidado de personas con enfermedad crónica», conocida como GCPC-UN-ESU. 3) validez fácil y de contenido con expertos 4) Prueba de campo en la aplicación a 111 personas con ECNT. Resultados: La encuesta GCPC-UN-ESU contiene 19 ítems y 4 dimensiones: satisfacción con los cuidados, con la educación en salud, con la calidad en el servicio prestado y el nivel de fidelización con el servicio. La encuesta en conjunto valora de manera integral la percepción de satisfacción con el cuidado de la salud por parte de las personas con ECNT, puede ser autodiligenciada. Conclusiones. La encuesta CPC-UN ESU fue validada y mostró contar con las variables necesarias para determinar el nivel de satisfacción de las personas con ECNT en el contexto de América Latina. Esta herramienta constituye una respuesta a las demandas de acreditación de los servicios en esta región (AU)

Objective: To develop and validate the survey of satisfaction with health care in people with non-communicable chronic diseases(NCDs), for use in the Latin American context. Method: This is a methodological study developed between 2012 and 2014, as part of the Latin American Network for Chronic Patient Care, under the Program for the Reduction of the burden of chronic disease in Colombia. Three stages were met: 1) Review of the literature on satisfaction with care in chronic diseases situations. 2) Structuring the preliminary proposal of the «Survey of satisfaction with health care in people with chronic disease» known as GCPC-UN-ESU and 3) facial validity and experts review 4) Test application to 111 people with NCDs. Results: The GCPC-UN-ESU, survey contains 19 items and 4 dimensions: satisfaction with care, with health education and with the quality of the service provided and the level of loyalty to the service. The survey holistically perceived satisfaction with health care by people with NCDs and it can be personally developed. Conclusions: The CPC-A ESU survey was validated and it had the necessary variables in order to determine the level of satisfaction of people with NCDs in the Latin American context. This tool is a response to the demands of accreditation services in this región (AU)

PERCEPCIÓN DEL CUIDADO DE ENFERMERÍA DADO A LOS PACIENTES CON CÁNCER HOSPITALIZADOS / PERCEPTION OF NURSING CARE GIVEN TO CANCER PATIENTS HOSPITALIZED / PERCEPÇÃO DO CUIDADO DE ENFERMAGEM DADO PARA OS PACIENTES COM CÂNCER HOSPITALIZADOS

El objetivo principal de este artículo es describir el estado del arte sobre la percepción del cuidado de enfermería a pacientes oncológicos hospitalizados. Para esto, se hizo una revisión integrativa realizada en 16 bases de datos entre 1994 y 2014, teniendo en cuenta los descriptores percepción, relación enfermero-paciente, hospitalización y oncología, con sus respectivas traducciones al inglés y orientada por el descriptor boleano AND. Se encontraron de esta manera 52 publicaciones sobre la relación enfermera-paciente oncológico hospitalizado; asimismo, se evidenció que estas han ido en incremento, particularmente en la última década. La mayor parte de las publicaciones son de tipo cualitativo, revisiones o reflexiones. Al revisar en conjunto la productividad académica, se identificaron múltiples formas de abordar esta relación desde el punto de vista conceptual; sin embargo, parece ser su condición de reciprocidad la que resulta más enriquecedora para las partes, lo que permite que los sujetos que intercambian en medio del cuidado de la vida cuando se tiene un cáncer crezcan como personas y ganen en introspección. Así pues, la relación enfermera-paciente con cáncer hospitalizado es un punto central para poder comprender y cualificar las prácticas de cuidado de esta población. Se hace necesario desarrollar estrategias de medición y cualificación de esta interacción.

The main objective of this article is to describe the state of the art on the perception of nursing care for hospitalized cancer patients. For this, an integrative review was performed in 16 databases between 1994 and 2014, taking into account the perception descriptors, nurse-patient relationship, hospitalization, and oncology, with their translations in English and directed by the descriptor Boolean AND. Thus found 52 publications on nurse-patient relationship hospitalized cancer; also it became clear that these have been increasing, particularly in the last decade. Most of the publications are qualitative, revisions or reflections. In reviewing overall academic productivity, multiple ways to approach this relationship from a conceptual point of view were identified; however, it seems to be its condition of reciprocity that is most enriching parts, allowing subjects exchanged between life care when you have cancer grow as people and win in introspection. So the nurse-patient relationship with hospital cancer is central to understanding and to qualify care practices of this population. It is necessary to develop measurement strategies and qualification of this interaction.

O objetivo principal deste pressente artigo é descrever o estado da arte sobre a percepção do cuidado de enfermagem para pacientes oncológicos hospitalizados. Para isto, foi feita uma revisão integrativa realizada em 16 bases de dados entre 1994 e 2014, tendo em conta aos descritores: percepção, relação enfermeiro-paciente, hospitalização e oncologia, com sua correspondente tradução para inglês e dirigido pelo descritor Booleano AND. É assim que foram achadas 52 publicações sobre a relação enfermeiro-paciente oncológico hospitalizado; do mesmo, ficou claro que estes têm vindo a aumentar, particularmente na última década. A maioria das publicações é de tipo qualitativo, de revisões ou de reflexões. Ao rever em conjunto a produtividade acadêmica, foram identificadas múltiplas maneiras de abordar este relacionamento a partir do ponto de vista conceitual; no entanto, parece ser sua condição de reciprocidade aquela que resulta mais enriquecedora para as partes, permitindo-lhe que os indivíduos que intercambiam no meio do cuidado da vida quando se tem um câncer que possam crescer como pessoas e possam ganhar em introspecção. Assim, então, a relação enfermeiro-paciente com câncer hospitalizado é um eixo fundamental para puder compreender e puder qualificar as práticas de cuidado dessa população. Faz-se necessário desenvolver estratégias de medição e de qualificação dessa interação.