RESUMO
RESUMO Objetivo: descrever, na perspectiva do enfermeiro, as causas de abandono das usuárias em tratamento do adenocarcinoma cervical e analisar as propostas para diminuir esse abandono. Método: o estudo é descritivo, qualitativo, do tipo investigação narrativa. Participaram sete enfermeiros assistencialistas, atuantes em uma unidade de alta complexidade oncológica, na cidade de Macapá, capital do estado do Amapá, Brasil. O estudo foi realizado no período de três a 20 de dezembro de 2019. Os dados foram submetidos à análise temática categorial. Resultados: emergiram duas categorias: principais causas de abandono das usuárias em tratamento do adenocarcinoma cervical e estratégias do enfermeiro para a diminuição do abandono do tratamento pelas usuárias. Conclusão: para favorecer o resgate das usuárias, os enfermeiros participantes propõem consulta de Enfermagem e um plano de ação multiprofissional, respeitando as singularidades de cada mulher.
ABSTRACT Objective: to describe, from the perspective of nurses, the causes of dropout of users in treatment for cervical adenocarcinoma and analyze the proposals to reduce this dropout. Method: the study is descriptive, qualitative, of narrative research type. Seven care nurses, working in a high complexity oncology unit in the city of Macapá, capital of the state of Amapá, Brazil, participated. The study was conducted in the period from December three to 20, 2019. Data were submitted to categorical thematic analysis. Results: two categories emerged: main causes of dropout of users in treatment for cervical adenocarcinoma and nurse strategies for the reduction of treatment dropout by users. Conclusion: to promote the rescue of the users, the participating nurses propose a Nursing consultation and a multi-professional action plan, respecting the singularities of each woman.
RESUMEN Objetivo: describir, desde el punto de vista del enfermero, las causas de abandono de las usuarias en el tratamiento del adenocarcinoma de cuello uterino y analizar las propuestas para disminuir dicho abandono. Método: El estudio es una investigación descriptiva, cualitativa y narrativa. Participaron siete enfermeros asistenciales, que trabajan en una unidad de oncología de alta complejidad en la ciudad de Macapá, capital del estado de Amapá, Brasil. El estudio se realizó en el periodo comprendido entre el 3 y el 20 de diciembre de 2019. Los datos se sometieron a un análisis categórico temático. Resultados: surgieron dos categorías: principales causas de abandono de las usuarias en el tratamiento del adenocarcinoma cervical y estrategias de los enfermeros para reducir el abandono del tratamiento por parte de las usuarias. Conclusión: para favorecer el resguardo de las usuarias, los enfermeros participantes proponen una consulta de Enfermería y un plan de acción multiprofesional, resaltando las singularidades de cada mujer.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Pacientes Desistentes do Tratamento/psicologia , Adenocarcinoma/psicologia , Neoplasias do Colo do Útero/psicologia , Enfermeiras e Enfermeiros/psicologia , Brasil , Adenocarcinoma/enfermagem , Neoplasias do Colo do Útero/enfermagem , Pesquisa Qualitativa , Cooperação e Adesão ao Tratamento/psicologia , Apoio Familiar/psicologiaRESUMO
ABSTRACT Objective: Patients with lung cancer experience different feelings and reactions, based on their family, social, cultural, and religious backgrounds, which are a source of great distress, not only for the patients but also for their family caregivers. This study aimed to evaluate the impact that lung cancer stage and quality of life (QoL) of lung cancer patients have on caregiver burden. Methods: This was a prospective cross-sectional study. Consecutive patient-caregiver dyads were selected and asked to complete the Hospital Anxiety and Depression Scale and the Medical Outcomes Study 36-item ShortForm Health Survey (SF-36). Family caregivers also completed the Caregiver Burden Scale. Group-based modeling was used in order to identify patients with early- or advanced-stage cancer (IA to IIIA vs. IIIB to IV) plus non-impaired or impaired QoL (SF36 total score > 50 vs. ≤ 50). Patient-caregiver dyads were stratified into four groups: early-stage cancer+non-impaired QoL; advanced-stage cancer+non-impaired QoL; early-stage cancer+impaired QoL; and advanced-stage cancer+impaired QoL. Results: We included 91 patient-caregiver dyads. The majority of the patients were male and heavy smokers. Family caregivers were younger and predominantly female. The burden, QoL, level of anxiety, and level of depression of caregivers were more affected by the QoL of the patients than by their lung cancer stage. The family caregivers of the patients with impaired QoL showed a higher median burden than did those of the patients with non-impaired QoL, regardless of disease stage. Conclusions: Caregiver burden is more affected by patient QoL than by lung cancer stage.
RESUMO Objetivo: Pacientes com câncer de pulmão vivenciam diferentes sentimentos e reações, dependendo de sua formação familiar, social, cultural e religiosa, que são fonte de grande sofrimento, não só para os pacientes mas também para seus cuidadores familiares. Este estudo objetivou avaliar o impacto do estágio do câncer de pulmão e da qualidade de vida (QV) dos pacientes com câncer de pulmão na sobrecarga do cuidador. Métodos: Estudo prospectivo transversal. Díades paciente-cuidador foram selecionadas consecutivamente e solicitadas a preencher a Hospital Anxiety and Depression Scale e o Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). Os cuidadores familiares também preencheram a Caregiver Burden Scale. Utilizou-se a modelagem de grupos para identificar pacientes com câncer em estágio inicial ou avançado (IA a IIIA vs. IIIB a IV) mais QV não comprometida ou comprometida (pontuação total no SF36 > 50 vs. ≤ 50). As díades paciente-cuidador foram estratificadas em quatro grupos: câncer em estágio inicial+QV não comprometida; câncer em estágio avançado+QV não comprometida; câncer em estágio inicial+QV comprometida; e câncer em estágio avançado+QV comprometida. Resultados: Foram incluídas 91 díades paciente-cuidador. A maioria dos pacientes era do sexo masculino e grande fumante. Os cuidadores familiares eram mais jovens e predominantemente do sexo feminino. A sobrecarga, QV, nível de ansiedade e nível de depressão dos cuidadores foram mais afetados pela QV dos pacientes do que pelo estágio do câncer de pulmão. Os cuidadores familiares dos pacientes com QV comprometida apresentaram maior mediana de sobrecarga do que os dos pacientes com QV não comprometida, independentemente do estágio da doença. Conclusões: A sobrecarga do cuidador é mais afetada pela QV do paciente do que pelo estágio do câncer de pulmão.
Assuntos
Humanos , Masculino , Feminino , Adenocarcinoma/enfermagem , Adenocarcinoma/psicologia , Cuidadores/psicologia , Família/psicologia , Neoplasias Pulmonares/enfermagem , Neoplasias Pulmonares/psicologia , Qualidade de Vida , Brasil , Estudos Transversais , Estadiamento de Neoplasias , Estudos Prospectivos , Fatores Sexuais , Inquéritos e QuestionáriosRESUMO
OBJECTIVE:: Patients with lung cancer experience different feelings and reactions, based on their family, social, cultural, and religious backgrounds, which are a source of great distress, not only for the patients but also for their family caregivers. This study aimed to evaluate the impact that lung cancer stage and quality of life (QoL) of lung cancer patients have on caregiver burden. METHODS:: This was a prospective cross-sectional study. Consecutive patient-caregiver dyads were selected and asked to complete the Hospital Anxiety and Depression Scale and the Medical Outcomes Study 36-item ShortForm Health Survey (SF-36). Family caregivers also completed the Caregiver Burden Scale. Group-based modeling was used in order to identify patients with early- or advanced-stage cancer (IA to IIIA vs. IIIB to IV) plus non-impaired or impaired QoL (SF36 total score > 50 vs. ≤ 50). Patient-caregiver dyads were stratified into four groups: early-stage cancer+non-impaired QoL; advanced-stage cancer+non-impaired QoL; early-stage cancer+impaired QoL; and advanced-stage cancer+impaired QoL. RESULTS:: We included 91 patient-caregiver dyads. The majority of the patients were male and heavy smokers. Family caregivers were younger and predominantly female. The burden, QoL, level of anxiety, and level of depression of caregivers were more affected by the QoL of the patients than by their lung cancer stage. The family caregivers of the patients with impaired QoL showed a higher median burden than did those of the patients with non-impaired QoL, regardless of disease stage. CONCLUSIONS:: Caregiver burden is more affected by patient QoL than by lung cancer stage. OBJETIVO:: Pacientes com câncer de pulmão vivenciam diferentes sentimentos e reações, dependendo de sua formação familiar, social, cultural e religiosa, que são fonte de grande sofrimento, não só para os pacientes mas também para seus cuidadores familiares. Este estudo objetivou avaliar o impacto do estágio do câncer de pulmão e da qualidade de vida (QV) dos pacientes com câncer de pulmão na sobrecarga do cuidador. MÉTODOS:: Estudo prospectivo transversal. Díades paciente-cuidador foram selecionadas consecutivamente e solicitadas a preencher a Hospital Anxiety and Depression Scale e o Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). Os cuidadores familiares também preencheram a Caregiver Burden Scale. Utilizou-se a modelagem de grupos para identificar pacientes com câncer em estágio inicial ou avançado (IA a IIIA vs. IIIB a IV) mais QV não comprometida ou comprometida (pontuação total no SF36 > 50 vs. ≤ 50). As díades paciente-cuidador foram estratificadas em quatro grupos: câncer em estágio inicial+QV não comprometida; câncer em estágio avançado+QV não comprometida; câncer em estágio inicial+QV comprometida; e câncer em estágio avançado+QV comprometida. RESULTADOS:: Foram incluídas 91 díades paciente-cuidador. A maioria dos pacientes era do sexo masculino e grande fumante. Os cuidadores familiares eram mais jovens e predominantemente do sexo feminino. A sobrecarga, QV, nível de ansiedade e nível de depressão dos cuidadores foram mais afetados pela QV dos pacientes do que pelo estágio do câncer de pulmão. Os cuidadores familiares dos pacientes com QV comprometida apresentaram maior mediana de sobrecarga do que os dos pacientes com QV não comprometida, independentemente do estágio da doença. CONCLUSÕES:: A sobrecarga do cuidador é mais afetada pela QV do paciente do que pelo estágio do câncer de pulmão.
Assuntos
Adenocarcinoma/enfermagem , Adenocarcinoma/psicologia , Cuidadores/psicologia , Família/psicologia , Neoplasias Pulmonares/enfermagem , Neoplasias Pulmonares/psicologia , Qualidade de Vida , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Estadiamento de Neoplasias , Estudos Prospectivos , Fatores Sexuais , Inquéritos e QuestionáriosRESUMO
PURPOSE/OBJECTIVES: To investigate how familial communication about prostate cancer (PCa) risk and screening affects sons of men with PCa. RESEARCH APPROACH: Qualitative grounded theory. SETTING: Southern California. PARTICIPANTS: 17 Latino sons of PCa survivors. METHODOLOGIC APPROACH: The team conducted semistructured interviews and follow-up interviews. Therefore, the sample includes 25 transcripts. Data were analyzed with a mix of a priori topical codes and grounded theory techniques. FINDINGS: Sons were in need of information about familial risk and screening options. They became sensitized to PCa, desired information, and held protective intentions. Hopeful intentions came up against cultural taboos around sex, reproductive health, and intimacy that limited discussions between fathers and sons. Fathers were a valued source of information but play various roles, which affect sons' screening intentions. Open communication between father and son promoted awareness of screening and familial risk. CONCLUSIONS: Uncertainty about familial risk and screening options, especially early detection strategies, was exacerbated by cultural taboos around PCa. Fathers could have been primary and credible advocates for shared decision making, but sons had difficulty learning from their fathers' experience. INTERPRETATION: FINDINGS from the study can help inform community-based interventions with Latino families, help to culturally tailor health messaging, and sensitize clinicians to a group that needs concerted counseling about PCa risk and screening.
Assuntos
Adenocarcinoma/psicologia , Barreiras de Comunicação , Cultura , Relações Pai-Filho , Hispânico ou Latino/psicologia , Homens/psicologia , Núcleo Familiar/psicologia , Neoplasias da Próstata/psicologia , Adenocarcinoma/genética , Adulto , Atitude Frente a Saúde , Tomada de Decisões , Detecção Precoce de Câncer/psicologia , Escolaridade , Seguimentos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Renda , Los Angeles , Masculino , México/etnologia , Neoplasias da Próstata/genética , Pesquisa Qualitativa , Risco , Sexualidade , TabuRESUMO
BACKGROUND: Quality of life questionnaires (QLQ) QLQ-STO22 and QLQ-OES18 are currently available to measure Health-related quality of life (HRQL) in patients with Esophageal (EC) or Gastric cancer (GC). The QLQ-OG25 integrates questions from both questionnaires to be useful for EC, Esophagogastric junction carcinoma (EGJC), and GC. Our aim was to validate the Mexican-Spanish version. PATIENTS AND METHODS: The translation procedure followed European Organization for Research and Treatment of Cancer (EORTC) guidelines. QLQ-C30 and QLQ-OG25 instruments were completed by patients with EC, EGJC, and GC. Patients were divided into three groups: (1) palliative treatment; (2) treatment with curative intent, and (3) survivors. Reliability and validity tests were performed. RESULTS: One-hundred sixty-three patients were included: 62 women and 101 men (mean age, 54.9 years; range, 22-82 years). Sixty-nine, seventy-three, and twenty-one patients were allocated into groups 1, 2, and 3, respectively. Questionnaire compliance rates were high and were well accepted. Group 3 patients reported better functional HRQL scores and lower symptom scores than patients in groups 2 and 1. Scales in the QLQ-C30 and QLQ-OG25 distinguished among other clinically distinct groups of patients. Cronbach's α coefficients of all multi-item scales of the QLQ-OG25 instrument were >0.7 (range, 0.7-0.83). Multitrait scaling analysis demonstrated good convergent and discriminant validity, even adjusting by location. Test-retest scores were consistent. CONCLUSION: The Mexican-Spanish version of the EORTC QLQ-OG25 questionnaire is reliable and valid for HRQL measurement in patients with esophagogastric cancer and can be used in clinical trials in the Mexican community.
Assuntos
Adenocarcinoma/psicologia , Neoplasias Esofágicas/psicologia , Junção Esofagogástrica/fisiopatologia , Psicometria/instrumentação , Qualidade de Vida , Neoplasias Gástricas/psicologia , Inquéritos e Questionários , Adenocarcinoma/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Esofágicas/terapia , Feminino , Nível de Saúde , Humanos , Idioma , Masculino , México , Pessoa de Meia-Idade , Cuidados Paliativos , Psicometria/estatística & dados numéricos , Reprodutibilidade dos Testes , Perfil de Impacto da Doença , Neoplasias Gástricas/terapia , Sobreviventes/psicologia , Traduções , Adulto JovemRESUMO
BACKGROUND: Psychosocial adaptation is a measurement that represents the patient's adjustment to those changes involved in their illness. We undertook this study to search for individual characteristics and clinical aspects associated with successful psychosocial adjustment in patients with colorectal cancer (CRC) undergoing (CT) chemotherapy or chemoradiotherapy (CRT). METHODS: Seventy-five patients with CRC treated with CT or CRT in a cancer center were included. Psychosocial Adjustment to Illness Scale Self-Reporting (PAIS-SR) questionnaire was used as a measurement of psychosocial adjustment. RESULTS: Psychosocial adaptation was successful in 18 patients (24%) and unsuccessful in 57 patients (76%). Young patients, married patients and males showed lower psychosocial adaptation to disease. This is associated with the decrease in sexual relations, economic resources and psychological symptoms. Patients complained that they were unsatisfied due to the lack of disease and treatment information offered by the heath care team. CONCLUSIONS: In the process of adaptation, clinical features such as tumor location and treatment scheme are considered basic, as well as age, education, marital status. Areas such as sexuality, interpersonal and family relationships, economic status and emotional state of patients affected by the disease and treatments provide a deep complexity in the study of the psychosocial adaptation process in patients with CRC.
Assuntos
Adaptação Psicológica , Adenocarcinoma/psicologia , Neoplasias Colorretais/psicologia , Atividades Cotidianas , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/economia , Adenocarcinoma/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Quimiorradioterapia/psicologia , Quimioterapia Adjuvante/psicologia , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/economia , Neoplasias Colorretais/terapia , Efeitos Psicossociais da Doença , Estudos Transversais , Tratamento Farmacológico/psicologia , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Terapia Neoadjuvante/psicologia , Cuidados Paliativos/psicologia , Educação de Pacientes como Assunto , Satisfação do Paciente , Estudos de Amostragem , Comportamento Sexual , Apoio Social , Adulto JovemRESUMO
OBJECTIVE: Determine the effectiveness of surgical treatment and / or adjuvant to improve the quality of life in patients with colon cancer compared to rectal cancer. MATERIAL AND METHODS: Cohort study that evaluated 27 patients diagnosed with colon adenocarcinoma (Group A= 12) and rectum (Group B= 15) resectable treated at the Institute Regional of Neoplastic Diseases of Trujillo since the 1 January 2008 until 31 July 2009. RESULTS: The overall life quality, as assessed by the QLQ-C 30 at 3 months postoperatively was 67.86 +/- 17.90 points vs. 68.50 +/- 11.94 points respectively for the patients of groups A and B (p = 0.934).The social function was better in patients undergoing surgery for Group A than Group B , (37.50 + 13.36 points vs. 60.00 + 13.69 points, p = 0.018). Body image at 3 months assessed by the QLQ-CR-29 had an average score of 28.12 +/- 6.12 points and 50.00 +/- 25.00 points for Group A y B respectively (p = 0.034). The Group A patients had a mean score at 6 months for sexual function of 33.33 +/- 12.91 points, while Group B patients this average score was 65.00 +/- 22.36 points (p = 0.016). CONCLUSIONS: Both surgeries for colon and rectal cancer are as effective in improving the overall quality of life of these patients, however the social function, body image, and sexual function is better in colon surgery.
Assuntos
Adenocarcinoma/psicologia , Neoplasias do Colo/psicologia , Procedimentos Cirúrgicos do Sistema Digestório/psicologia , Pacientes/psicologia , Qualidade de Vida , Neoplasias Retais/psicologia , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/radioterapia , Adenocarcinoma/cirurgia , Idoso , Imagem Corporal , Quimioterapia Adjuvante/psicologia , Neoplasias do Colo/tratamento farmacológico , Neoplasias do Colo/radioterapia , Neoplasias do Colo/cirurgia , Terapia Combinada/psicologia , Humanos , Pessoa de Meia-Idade , Especificidade de Órgãos , Peru , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/psicologia , Radioterapia Adjuvante/psicologia , Neoplasias Retais/tratamento farmacológico , Neoplasias Retais/radioterapia , Neoplasias Retais/cirurgia , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/psicologia , Comportamento Social , Inquéritos e QuestionáriosRESUMO
A mucocele is one of the more commonly encountered disorders of the oral mucosa. It develops when a minor salivary duct is injured or blocked, resulting i n the escape of mucus into the adjacent submucosal connective tissue. We present two cases that were clinically diagnosed as mucoceles that were removed because of patient anxiety. However, histological examination revealed dissimilar and medically significant pathologies. Oral cysticercosis and salivary gland adenocarcinoma are rare diseases of the oral mucosa. It is important to consider these and other uncommon diagnoses when evaluating an oral nodule presumed to be a mucocele. We will discuss the natural history and pathogenesis of these disease processes.
Assuntos
Adenocarcinoma/diagnóstico , Cisticercose/diagnóstico , Erros de Diagnóstico , Doenças Labiais/diagnóstico , Mucocele/diagnóstico , Neoplasias das Glândulas Salivares/diagnóstico , Adenocarcinoma/psicologia , Adenocarcinoma/cirurgia , Adulto , Idoso , Ansiedade , Biópsia , Costa Rica , Cisticercose/cirurgia , Humanos , Doenças Labiais/parasitologia , Doenças Labiais/cirurgia , Masculino , Cirurgia de Mohs , Porto Rico , Neoplasias das Glândulas Salivares/psicologia , Neoplasias das Glândulas Salivares/cirurgia , Glândulas Salivares Menores , ViagemRESUMO
Health-related quality of life (HRQL) is a fundamental outcome in surgical oncology and culturally valid tools are essential for this purpose. Our aim was to validate the Mexican-Spanish versions of the European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire QLQ-C30 and the QLQ-STO22 disease-specific questionnaire module in Mexican patients with gastric cancer (GC). The translation procedure followed EORTC guidelines. Both instruments were completed by patients with GC and analyses were performed within three clinically distinct groups: (1) patients undergoing palliative treatment, (2) patients undergoing treatment with curative intent, and (3) GC survivors. Tests for reliability and validity were performed. One hundred and fifty patients (mean age 54.2 years) completed both questionnaires. Sixty-seven, 55, and 28 patients were allocated to groups 1, 2, and 3, respectively. Compliance rates were high, and questionnaires were well-accepted. Survivors of treatment for GC reported better functional HRQL scores and lower symptom scores than patients in group 2 who were currently undergoing treatment. Patients selected for potentially curative treatment had better HRQL than group 1 (palliative treatments). Scales in the QLQ-C30 and QLQ-STO22 distinguished between other clinically distinct groups of patients. Cronbach's alpha coefficients of 14 scales of both questionnaires were >0.7. Multitrait scaling analysis demonstrated good convergent and discriminant validity. Test-retest scores were consistent. We conclude that the Mexican-Spanish versions of EORTC QLQ-C30 and QLQ-C22 questionnaires are reliable and valid for HRQL measurement in patients with GC and are therefore recommended for use in clinical trials of Mexican community.
Assuntos
Adenocarcinoma/psicologia , Idioma , Qualidade de Vida , Perfil de Impacto da Doença , Neoplasias Gástricas/psicologia , Inquéritos e Questionários/normas , Adenocarcinoma/terapia , Feminino , Nível de Saúde , Humanos , Masculino , México , Pessoa de Meia-Idade , Psicometria , Neoplasias Gástricas/terapia , Sobreviventes , TraduçõesRESUMO
OBJECTIVE: To assess the quality of life of patients with lung cancer and to compare it with that of individuals without cancer. METHODS: The Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) was administered to 57 patients diagnosed with lung cancer, treated at the Lung Cancer Outpatient Clinic of the Hospital São Paulo, and to a control group of 57 individuals recruited from the Extra Penha workout group. The Mann-Whitney test was used to compare the groups, domain by domain. The first model of logistic regression was adjusted for male gender, nonsurgical treatment, Karnofsky performance status and smoking, which were included as predictors. The second model was adjusted for each SF-36 domain in order to identify increases in the proportions of patients in stage IIIB or IV. RESULTS: The lung cancer group and the control group presented the following mean scores, respectively, for the SF-36 domains: role limitations due to physical health problems, 29.39 +/- 36.94 and 82.89 +/- 28.80; role limitations due to emotional problems, 42.78 +/- 44.78 and 86.55 +/- 28.77; physical function, 56.49 +/- 28.39 and 89.00 +/- 13.80; vitality, 61.61 +/- 23.82 and 79.12 +/- 17.68; bodily pain, 62.72 +/- 28.72 and 81.54 +/- 19.07; general health, 62.51 +/- 25.57 and 84.47 +/- 13.47; emotional well-being, 68.28 +/- 23.46 and 82.63 +/- 17.44; and social functioning, 72.87 +/- 29.20 and 91.67 +/- 17.44. The logistic regression model showed that role limitations due to physical health problems, physical function and emotional well-being were predictors of stages IIIB and IV. CONCLUSIONS: The patients with lung cancer had a poorer quality of life, especially regarding physical aspects, than did the control subjects.