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Objective: To analyze whether the COVID-19 pandemic had an impact on the screening, diagnosis and treatment of breast cancer in women up to 50 years of age in the state of Pará. Methods: Retrospective, cross-sectional study with a quantitative approach, using data from the Information Technology Department of the Brazilian Unified Health System. (DATASUS). The number of exams carried out in the pre-pandemic (2018-2019) and pandemic (2020-2021) period was analyzed based on the percentage variation, application of the chi-square test and G test for the time of exams and start time of treatment. Results: During the pandemic period, there was a greater number of screening mammograms (+3.68%), cytological (+23.68%), histological (+10.7%) and a lower number of diagnostic mammograms (-38.7%). The time interval for carrying out the exams was up to 30 days for screening and diagnostic exams and more than 60 days to start treatment during the pandemic period. Conclusion: Although the results indicate an increase in the number of screening and diagnostic procedures for breast cancer during the pandemic period, with the exception of diagnostic mammography, when considering probability values, the study points out that statistically the COVID-19 pandemic did not interfere with actions of breast cancer, in women over 50 years of age, in the state of Pará. Considering the autonomy of nursing and its role in public health, it is up to the professionals who are in charge of primary care programs to implement contingency plans in periods of crisis so that the population is not left unassisted.

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Objective. To analyze whether the COVID-19 pandemic had an impact on the screening, diagnosis and treatment of breast cancer in women up to 50 years of age in the state of Pará. Methods. Retrospective, cross-sectional study with a quantitative approach, using data from the Information Technology Department of the Brazilian Unified Health System. (DATASUS). The number of exams carried out in the pre-pandemic (2018-2019) and pandemic (2020-2021) period was analyzed based on the percentage variation, application of the chi-square test and G test for the time of exams and start time of treatment. Results. During the pandemic period, there was a greater number of screening mammograms (+3.68%), cytological (+23.68%), histological (+10.7%) and a lower number of diagnostic mammograms (-38.7%). The time interval for carrying out the exams was up to 30 days for screening and diagnostic exams and more than 60 days to start treatment during the pandemic period. Conclusion. Although the results indicate an increase in the number of screening and diagnostic procedures for breast cancer during the pandemic period, with the exception of diagnostic mammography, when considering probability values, the study points out that statistically the COVID-19 pandemic did not interfere with actions of breast cancer, in women over 50 years of age, in the state of Pará. Considering the autonomy of nursing and its role in public health, it is up to the professionals who are in charge of primary care programs to implement contingency plans in periods of crisis so that the population is not left unassisted.

Objetivo. Analizar si la pandemia de COVID-19 tuvo impacto en el tamizaje, diagnóstico y tratamiento del cáncer de mama en mujeres de 50 años y más del Estado do Pará-Brasil. Métodos. Estudio retrospectivo, transversal, con abordaje cuantitativo, en el que se utilizaron los datos del Departamento de Informática del Sistema Único de Salud de Brasil (DATASUS). Se comparó el número de exámenes realizados y el tiempo para el inicio de tratamiento en los períodos prepandémico (2018-2019) y pandémico (2020-2021). Resultados. Se observó un mayor número de mamografías de cribado (+3.68%), citologías (+23.68%) e histologías (+10.7%) y un menor número de mamografías diagnósticas (-38.7%) en el período pandémico. El tiempo para la realización de las pruebas fue de hasta 30 días para el cribado y diagnóstico y de más de 60 días para el inicio del tratamiento durante el período pandémico. Conclusión. Aunque los resultados indican un aumento del número de procedimientos de cribado y diagnóstico del cáncer de mama en el periodo pandémico, con la excepción de la mamografía diagnóstica, cuando consideramos los valores de p) el estudio muestra que la pandemia COVID-19 estadísticamente no interfirió en las acciones preventivas contra el cáncer de mama en mujeres de 50 años y más en el estado de Pará. Teniendo en cuenta la autonomía de la enfermería y su papel en la salud pública, corresponde a los profesionales responsables de los programas de atención primaria implementar planes de contingencia en tiempos de crisis para no dejar desatendida a la población.

Objetivo. Analisar se a pandemia da COVID-19 repercutiu no rastreamento, diagnóstico e tratamento do câncer de mama em mulheres paraenses a partir de 50 anos. Métodos. Estudo retrospectivo, transversal, de abordagem quantitativa, com utilização de dados do Departamento de Informática do Sistema Único de Saúde brasileiro. (DATASUS). Analisou-se o número de exames realizados no período pré-pandemia (2018-2019) e pandêmico (2020-2021) com base na variação percentual, aplicação do teste qui quadrado e teste G para o tempo de realização de exames e tempo de início de tratamento. Resultados. Observou-se no período pandêmico maior quantitativo de mamografias de rastreamento (+3.68%), citológicos (+23.68%), histológicos (+10.7%) e menor registro de mamografias diagnósticas (-38.7%). O intervalo de tempo para realização dos exames foi de até 30 dias para os exames de rastreamento e diagnóstico e tempo maior que 60 dias para início de tratamento no período pandêmico. Conclusão. Embora os resultados indiquem aumento no quantitativo de procedimentos de rastreamento e diagnósticos para o câncer de mama no período pandêmico, com exceção da mamografia diagnóstica, ao considerarmos os valores de probabilidade, o estudo aponta que estatisticamente a pandemia da COVID-19 não interferiu nas ações do câncer de mama, em mulheres a partir de 50 anos, no Estado do Pará. Considerando a autonomia da enfermagem e sua atuação na saúde pública, cabe aos profissionais que estão à frente dos programas da atenção básica implementar planos de contingência em períodos de crise para que a população não fique desassistida.

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Objetivo: Conhecer o acesso e aguardo pela estomização de pessoas adoecidas por câncer colorretal no nível terciário do Sistema Único de Saúde. Materiais e Métodos: Estudo etnográfico fundamentado na Sociologia da Saúde, com 8 familiares e 14 adoecidos em Centro de Alta Complexidade em Oncologia, Brasil. Os dados foram coletados entre outubro de 2018 a março de 2019, com observação participante e não participante, registro em diário de campo e entrevista semiestruturada. Os depoimentos e notas etnográficas após triangulação foram submetidos a análise indutiva de conteúdo em seis etapas. Resultados: Apreenderam-se "A história do adoecimento entrecortada pelas dificuldades" e "As perdas no processo de paciência-resiliência no percurso". Discussão: Em busca de validações biomédicas foram reportados três tipos de acesso ao sistema médico, assim como os subsentidos "paguei no particular" e atraso diagnóstico mobilizaram via oficial e não oficial no Sistema Único de Saúde. O capital social foi analisado como premente no adoecimento, uma rede de contatos sem a qual o acesso dos usuários é impactado. No nível terciário enquanto aguardam pela estomização desvelou-se a resiliência não como recurso heroico, mas como recurso pessoal e coletivo diante do percurso dificultoso e da semi-reclusão na instituição total onde vivenciam medos, fadiga e dores. Conclusão:O acesso contou com mobilização relacional e uma gama de vias até a internação com parte do percurso na saúde suplementar, já o aguardo pela estomização mitiga a paciência ao passo que torna a resiliência um recurso benéfico na espera pela programação cirúrgica.

Introduction: The access of people with colorectal cancer to surgical treatment with stomization implies a difficult itinerary through the network of care, and when accessing the tertiary level in an apprehensive preoperative waiting. Objetive: To know the access and waiting for stomization of people sick with colorectal cancer at the tertiary level of the Brazilian Unified Health System. Materials and Methods:Ethnographic study based on the Sociology of Health, with 8 relatives and 14 patients in a High Complexity Oncology Center, Brazil. Data were collected between October 2018 to March 2019, with participant and non-participant observation, field diary recording, and semi-structured interview. Statements and ethnographic notes after triangulation were subjected to inductive content analysis in six steps. Results:"The history of illness interspersed with difficulties" and "The losses in the process of patience-resilience along the way" were apprehended. Discussion: Three types of access were reported, as well as the sub-meanings "I paid privately" and the diagnostic delay mobilized by official and unofficial means in the Unified Health System. Social capital is pressing, a network without which users' access is impacted. At the tertiary level while waiting for stomization, resilience was unveiled not as a heroic resource, but as a personal and collective resource. Conclusion: The access counted on relational mobilization and a range of paths to hospitalization with part of the journey in supplementary health, while the waiting for stomization mitigates patience making resilience a beneficial resource in the wait for surgical programming.

Introducción: El acceso de las personas con cáncer colorrectal al tratamiento quirúrgico con estomización implica un difícil itinerario a través de la red asistencial, y al acceder al nivel terciario en una aprensiva espera preoperatoria. Objetivo: Conocer el acceso y el aguante de las personas afectadas por el cáncer colorrectal en el nivel terciario del Sistema Único de Salud. Materiales y Métodos: Estudio etnográfico basado en la Sociología de la Salud, con 8 familiares y 14 pacientes en Centro Oncológico de Alta Complejidad, Brasil. Los datos se recogieron entre octubre de 2018 y marzo de 2019, con observación participante y no participante, registro de diario de campo y entrevista semiestructurada. Los testimonios y las notas etnográficas, tras la triangulación, se sometieron a un análisis de contenido inductivo en seis etapas. Resultados: Se aprende "La historia del adoctrinamiento entrecortado por las dificultades" y "Las pérdidas en el proceso de pacificación-resiliencia en el curso". Discusión: Se reportaron tres tipos de acceso, así como los subsentidos "pagué en el privado" y el atraso diagnóstico se movilizaron vía oficial y no oficial en el Sistema Único de Salud. El capital social es apremiante, una red de contactos sin la cual el acceso de los usuarios se ve afectado. En el nivel terciario, mientras aguantan por la estomatología, la resistencia se revela no como un recurso heroico, sino como un recurso personal y colectivo. Conclusión: El acceso a la movilización relacional y a una gama de vías hasta la internación con parte del curso en la salud suplementaria, ya que la espera por la estomización mitiga la pacificación haciendo de la resiliencia un recurso benéfico en la espera por el programa quirúrgico.

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The purposes of this research was to identify the social representations of women on breast mastectomy and to analyze the implications of these social representations to care for self-care. This is a qualitative study using the Theory of Social Representations as theoretical reference. For data collection it was employed two techniques: the free association of ideas and observation. For data analysis the thematic analysis was used. The research resulted in two thematic units: the breast and its representations of social change in the body and social representations of women mastectomy: implications for self care. In the study, showed that women objected care of the breasts through the realization of self-examination.

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This research aims to identify women's social representations of women regarding cervical cancer and describe the relationship of these social representations with preventive care. The study used a qualitative-exploratory approach, with the theory of social representations as the theoretical-conceptual support. Data collection was performed using two techniques: the free association of words and the semi-directed interview with open questions. The thematic analysis technique was used for data interpretation. The research resulted in two thematic units: cervical cancer: an early treatable wound and the screening test: taking because of fearing. It was observed that women have great fear of having cervical cancer and, therefore, recognize the importance of the screening test and see it as an act of self-care towards their health.

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This article presents a reflection about care, self-care and caring for oneself and establishes these issues' relations with the paradigms of totality and simultaneity. On the first part of the text, care and its general aspects are contextualized; the second part discusses about care in Martin Heidegger's philosophical perspective; the third part explores self-care on Dorothea Orem's conception; the fourth part considers Michel Foucault's care of oneself. And finally, the fifth part aims to establish the relationship between the concepts of self-care and care of oneself, and the totality and simultaneity paradigms. Self-care and care of oneself are connected to the objectivism of the totality, and to the subjectivism of the simultaneity. These subjects lead nursing to comprehend such paradigmatic inheritance and its implications on the nursing care.

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Nursing care to patients after total laryngectomy should be based on scientific knowledge. Evidence-based practice is a type of approach that stimulates the use of research results in clinical practice. This study presents a systematic review that aimed to identify the main treatments for pharyngocutaneous fistulae after total laryngectomy. Articles were selected from five databases: Pubmed, Cinahl, Biomednet Research Tools, Cochrane Library and Lilacs. The review sample consisted of 37 articles. After analyzing the articles included in the review, results showed that conservative treatment is commonly used for pharyngocutaneous fistulae, recommending intensive hygiene and wound treatment. The use of research results in clinical practice will grant greater consistency to nurses' actions in care for patients with pharyngocutaneous fistulae.

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This study aims at implementing the teaching-learning strategy for families of patients in chronic conditions. It considers the importance of evaluating the needs and abilities of family members in order to prepare them to manage that situation appropriately, as well as to be able to provide adequate home care. A diagnostic evaluation of a family member/caretaker was conducted during the hospitalization of a patient with congestive cardiac insufficiency. During the diagnosis "knowledge deficit" was identified. Thus, a teaching plan was elaborated for such caretaker with the purpose of preparing him/her for home care. During implementation, formative evaluations were conducted with the purpose of learning about the efficacy of the strategies employed and the summative in the patient's home. The importance of nurses' resorting to the teaching-learning strategy in order to guide the family member/caretaker in the process of caring for people with chronic conditions was certified. The aim is promoting life, in spite of the disease, since the quality of such care will prevent aggravating recurrence and consequent re-hospitalizations.

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