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

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

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

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

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

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

Perfil sociodemográfico familiar e clínico de crianças com cardiopatia congênitaatendidas em uma instituição hospitalar / Sociodemographic and clinical profile of children with congenital heart disease assisted at a hospital institution / Perfil sociodemográfico familiar y clínico de niños com cardiopatía congénita asistidos en una institución hospitalaria

Conhecer o perfil sociodemográfico familiar e clínico de crianças com cardiopatia congênita atendidas em uma instituição hospitalar. Métodos: Estudo descritivo, transversal, desenvolvido no ambulatório de cardiologia pediátrica de um hospital em Fortaleza-CE, durante o período de março a agosto de 2012. Contemplou uma amostra não aleatória por conveniência de 80 pais de crianças cardiopatas entre 5 e 12 anos. Obtiveram-se informações a partir de dados primários de prontuário e por questionários, abordando as características sociodemográficas dos pais, dados familiares e condições clínicas das crianças. Resultados: Quanto aos dados sociodemográficos dos pais, 77 (96,2%) dos acompanhantes eram do sexo feminino, 50 (62,5%) estavam casados ou em união estável, 39 (48,7%) tinham entre 10 e 12 anos de estudo, e 69 (82,6%) relataram renda familiar entre 1 e 2 salários mínimos. Na amostra de crianças estudada, 43 (53,8%) eram do sexo feminino. A mediana das idades das crianças foi de 8,4 anos, variando entre 5 e 13 anos. Quanto à idade do diagnóstico, 44 (55,0%) ocorreram em idade inferior a 6 meses, independentemente do tipo da cardiopatia. Detectou-se que 19 (23,75%) tinham parentesco com a cardiopatia. Conclusão: Os pais acompanhantes de crianças com cardiopatia eram predominantemente mães, de baixo nível econômico e com escolaridade satisfatória. Houve predominância do diagnóstico precoce, principalmente nas crianças com cardiopatia do tipo cianótica...

To characterize the sociodemographic and clinical profile of children with congenital heart disease assisted at a hospital institution. Methods: A descriptive, crosssectional study conducted in the pediatric cardiology outpatient clinic of a hospitalin Fortaleza, CE, Brazil, in the period from March to August 2012. It comprised a nonrandom convenience sample of 80 parents of children with heart disease aged 5 to 12 years. Information was obtained from primary data of medical records and through questionnaires covering the parentâ??s sociodemographic characteristics, family data and the childrenâ??s clinical aspects. Results: Regarding socioeconomic data, 77 (96.2%) caregivers were female, 50 (62.5%) were married or in a stable relationship, 39 (48.7%) had 10-12 years of formal education, and 69 (82.6%) reported a household income between 1 and 2 minimum wages. In the sample of children studied, 43 (53.8%) were female. The median age of the children was 8.4 years, ranging from 5-13 years. As to the age at the heart disease diagnosis, 44 (55%) occurred under the age of 6 months, regardless of the type of cardiopathy. It was detected that 19 (23.75%) were related to the disease. Conclusion: Childrenâ??s caregivers were predominantly their mothers, with low income and satisfactory schooling. Early diagnosis was predominant, mainly among the children with cyanotic cardiopathy...

Conocer el perfil socio demográfico familiar y clínico de niños con cardiopatía congénita asistidos en una institución hospitalaria. Métodos: Estudio descriptivo, transversal, desarrollado en el ambulatorio de cardiología pediátrica de un hospital de Fortaleza-CE, en el período entre marzo y agosto de 2012. Se incluyó una muestra no aleatoria por conveniencia de 80 padres de niños cardiópatas con edad entre los 5 y 12 años. Se obtuvo informaciones a partir de datos primarios del historialclínico y a través de cuestionarios incluyendo las características socio demográficas de los padres, datos familiares y condiciones clínicas de los niños. Resultados: Respecto a los datos sócio demográficos de los padres, 77 (96,2%) de ellos eran del sexo femenino, 50 (62,5%) eran casados o vivían en unión estable, 39 (48,7%) habían estudiado durante 10 y 12 años y 69 (82,6%) relataron una renta familiar entre 1 y 2 ingresos mínimos. En La muestra de niños estudiada, 43 (53,8%) eran del sexo femenino. La mediana de las edades de los niños fue de 8,4 anos, variando entre los 5 y 13 años. Respecto a la edad del diagnóstico, 44 (55,0%) se dieron en edad inferior a 6 meses, independiente Del tipo de cardiopatía. Se detecto que 19 (23,75%) tenían algún familiar con cardiopatía. Conclusión: Los padres que estaban con los niños cardiópatas eran en su mayoría madres con bajo nivel económico y escolaridad satisfactoria. Hubo predominio Del diagnostico precoz principalmente en los niños con cardiopatia del tipo cianótica...

Promoción de la salud: la calidad de vida en las prácticas de enfermería / Health promotion: the quality of life in nursing practices

El objetivo fue reflexionar sobre la calidad de vida (CV) ofrecida en las prácticas de Enfermería con miras a la Promoción de la Salud, discutida desde la I Conferencia Internacional sobre Atención Primaria de Salud en Alma-Ata (1978), reforzada más tarde en las Conferencias sobre Promoción de la Salud y que tiene relación directa con la calidad de vida. Esta es entendida como la percepción de la persona sobre su vida, en el contexto cultural y social, asociada con los deseos, objetivos, expectativas e influenciada por el estado de salud. El enfermero desempeña papel importante en todos los niveles de atención, siendo profesional estratégico para proporcionar cambios en el estilo de vida de las personas que promueven la salud, por lo tanto, la calidad de vida, a través de su cuidado y del "empoderamiento" de la persona y su familia. Algunas experiencias confirman la intervención de enfermería con los pacientes con ciertas afecciones crónicas, individuales o colectivas, que promueven la salud. Es necesario sensibilizar cada vez más el personal de salud y de Enfermería, en particular, a promover la salud en el contexto del Sistema Único de Salud (SUS), para colaborar a la mejora de la calidad de vida de la sociedad (AU)

This study aimed to reflect on the quality of life provided in nursing practices seeking Health Promotion, a discussion that happens since the International Conference on Primary Health Care in Alma-Ata (1978), later reinforced in the Conferences on Health Promotion and that is directly related to the quality of life. This is understood as the perception that someone has about their life in the cultural and social context, associated with desires, goals and expectations, and influenced by health conditions. The nurse plays an important role in all levels of care, being an essential professional to promote changes in the lifestyle of the people that promote health and consequently in the quality of life, through their care and "empowerment" of the person and their family. Some experiments confirm the health promotion of nursing practices with patients with certain chronic conditions, individual or collective. We conclude that it is necessary to increasingly sensitize the health and nursing staff, especially for health promotion in the context of SUS, who collaborate to improve the quality of life of society (AU)

[Characteristics of a gynecology clinic in the inland region of Ceará (Brazil)]. / Características de una consulta ginecológica del interior de Ceará, en Brasil.

OBJECTIVE: To identify the strategies (interactive and educational) used by physicians and nurses in gynecology consultations and the length of consultations. METHOD: We performed an exploratory descriptive study. A questionnaire was used to interview 5 health professionals working in a gynecology clinic (3 physicians and 2 nurses). A total of 141 women who attended the clinic between July and August 2004 in a health district of the inland region of the State of Ceará in Brazil were also interviewed. RESULTS: Of the 141 women, 130 (92.2%) had sufficient education to understand the information given during the consultation. Eighty patients (56.7%) attended the service for gynecological disorders, the most frequent of which were pelvic pain (45%), followed by pruritus and discharge (33.8%). A total of 14.2% attended for cervical and breast cancer prevention. All 5 health professionals performed the Pap test and one health professional provided an educational leaflet during the consultation. The health professionals believed that the women understood half of the explanations given during the consultation and attributed this lack of understanding to their low educational level. The mean length of the consultation ranged from 2 to 7.5 minutes. CONCLUSIONS: Few women attended the clinic for cervical and breast cancer prevention. This finding could be related to the way in which the health professionals carried out the consultation and its length.

Características de una consulta ginecológica del interior de Ceará, en Brasil / Characteristics of a gynecology clinic in the inland region of Ceará (Brazil)

Objetivo. Identificar las estrategias utilizadas (elementos interactivos y educativos) y la duración de la consulta ginecológica desarrolladas por los profesionales médicos y de enfermería. Método. Estudio descriptivo exploratorio en el que se utilizó un cuestionario para entrevistar a 5 profesionales de la consulta ginecológica, 3 médicos y 2 enfermeras; también se entrevistó a 141 mujeres que acudieron a la consulta ginecológica entre julio y agosto de 2004 en una unidad de salud del interior del Estado de Ceará de Brasil. Resultados. De las 141 mujeres, 130 (92,2%) presentaron un grado de escolaridad satisfactorio para la comprensión de las informaciones que se les dieron durante la consulta. Un 56,7% (80) acudieron a la consulta por algún problema ginecológico, entre ellos, dolor pélvico (45%), seguido de prurito más flujo (33,8%). Un 14,2% acudió para la prevención del cáncer de cuello uterino y de mama. Los 5 profesionales de la consulta ginecológica (100%) indicaron realizar el examen de Papanicolau y 1 de los profesionales distribuyó folletos educativos en el momento de la consulta. Los profesionales consideraron que menos de la mitad de lo que se explicaba durante la consulta era entendido por las mujeres, e indicaron como causa el bajo nivel de escolaridad. La media del tiempo de consulta de los profesionales osciló entre 2 y 7,5 min. Conclusiones. Son pocas las mujeres que acuden a la consulta ginecológica para la prevención del cáncer de cuello uterino y de mama, lo que puede estar relacionado con la forma en que los profesionales realizan las consultas y el tiempo dispensado para su realización

Objective. To identify the strategies (interactive and educational) used by physicians and nurses in gynecology consultations and the length of consultations. Method. We performed an exploratory descriptive study. A questionnaire was used to interview 5 health professionals working in a gynecology clinic (3 physicians and 2 nurses). A total of 141 women who attended the clinic between July and August 2004 in a health district of the inland region of the State of Ceará in Brazil were also interviewed. Results. Of the 141 women, 130 (92.2%) had sufficient education to understand the information given during the consultation. Eighty patients (56.7%) attended the service for gynecological disorders, the most frequent of which were pelvic pain (45%), followed by pruritus and discharge (33.8%). A total of 14.2% attended for cervical and breast cancer prevention. All 5 health professionals performed the Pap test and one health professional provided an educational leaflet during the consultation. The health professionals believed that the women understood half of the explanations given during the consultation and attributed this lack of understanding to their low educational level. The mean length of the consultation ranged from 2 to 7.5 minutes. Conclusions. Few women attended the clinic for cervical and breast cancer prevention. This finding could be related to the way in which the health professionals carried out the consultation and its length

Palliative care to the cancer patient: reflections according to Paterson and Zderad's view.

This reflective study presents the approach of the Nursing Palliative Care to the cancer patient without therapeutic possibility according to the Paterson and Zderad's Humanistic Nursing Theory. The palliative care aims to provide the patient without therapeutic possibility and his family better quality of life. When the nurse, in addition to delivering palliative care to the cancer patient, uses the Humanistic Theory, (s)he starts to recognize each person as a singular existence. This recognition permits one to understand the person's meaning in the process of his(er) disease.

Teoría humanística: análisis dimensional del concepto de salud / Humanistic theory: dimensional analysis of the concept of health

En este artículo se presenta un análisis crítico sobre el concepto de saludde la Teoría Humanística de Enfermería de Paterson y Zderad, teniendo comobase teórica el Modelo de Análisis del Concepto Dimensional de Schatzman.El concepto de salud de la Teoría Humanística de Enfermería siguiólos presupuestos del concepto de salud de la Organización Mundial de laSalud (OMS). Sin embargo, la idea de salud desde la teoría, no está solamenterelacionada con la falta de enfermedad, sino que se entiendecomo un equilibrio entre bienestar y mejoría. Desde esta perspectiva, lasalud no es un fenómeno aislado, sino el resultado de diversas interaccionescon la vida, considerándose incluida la histórica del sujeto, su modo de sentirlas experiencias, etc. Es esta visión articulada de las experiencias delindividuo lo que posibilita un cuidado más allá del modelo asistencial predominante,en el que el principal objetivo es la curación y no el cuidadode la persona

This paper describes a critical analysis on the concept of health in the HumanisticNursing Theory advocated by Paterson and Zderad, taking as theoreticalbasis the Model of the Dimensional Concept of Schatzman. The conceptof health in the Humanistic Nursing Theory followed the preassumptionsof the World Health Organisation (WHO). However, the idea of healthbased on theory is not only related to the absence of disease, but also itis also understood to be a balance between wellness and improvement. Fromthis perspective, health is not an isolated phenomenon, but rather the resultof different interactions with life itself, including the background of thesubject and the way he or she perceives past-lived experiences. It is this articulatedvision of the individual’s experiences that creates a type of careextending beyond the predominant healthcare model, in which the main objective is healing and not the care of the individual (AU)

Beneficio de la terapia grupal en la rehabilitación de mujeres mastectomizadas / Benefit of group therapy in the rehabilitation of mastectomatized women

Introducción: El significado que tienen los senos para la mujer tanto en el aspecto físico como en el elemental y ante la pérdida de uno o ambos senos se presentara estados de ansiedad, angustia y miedo. Las acciones terapéuticas grupales pueden ofrecer una alternativa de apoyo y beneficio. Objetivo: Analizar los resultados de las actividades grupales con mujeres mastectomizadas. Material y métodos: estudio realizado en la Universidad Fortaleza Ceara, con mujeres integrantes del grupo Grupo de Enseñanza, Pesquisa Auto-Ayuda y Asistencia a la Mujer Mastectomizada (GEPAM). Los datos fueron colectados en un grupo de mujeres de diferentes edades organizados de acuerdo al método de análisis de contenido y agrupados en categorías. Resultados: Los sentimientos presentados en las mujeres fueron el miedo, la rabia, el rechazo y la culpa. Los beneficios de la actividad de grupo apuntados por las mujeres fueron relacionados con cambios en la apariencia física, en los cuidados personales, en actitudes frente a situaciones estresantes; aumento de la independencia funcional, mejoría de la calidad de vida. Los factores más influyentes fueron la socialización y la comunicación desarrollada por el grupo. Discusión: Acontecieron cambios significativos en la vida de las mujeres con relación a auto-imagen y auto-estima.

The present study aimed at to analyze the benefits of activities group with mastectomized women. This work took place in the Department of Nursing of UFC, with integral women of the group GEPAM (Group of Teaching, Research, Self Help, and Attendance to the Women Mastectomized). The collection of data was accomplished in the period of July to October of 2000. The sample consisted, on average, from 10 to 17 participant women, of the group and it didn't take in to account the race, sex, civil status and age group and only, the fact of they be integral of the group. The data were organized in agreement with the analysis of content of the speeches contained in a category. We noticed that the feelings commonly presented by these women they involved the fear, the rage, the rejection and the blame. They were pointed as benefits of an activity therapeutic group the changes in the physical appearance and personal cares, changes of attitudes front to streeful situations, increase of the functional independence, it gets better of the life quality. The factors that had an influence were the socialization and the communication among the group. Before the discoveries, we understood that happened significant changes in the women's life.