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BACKGROUND: The appearance of the new coronavirus, SARS-CoV-2, in Wuhan - China, in 2019 led to the declaration of a COVID-19 pandemic by the World Health Organization. Peru confirmed its first case on March 6, 2020, prompting a significant change in medical care. PURPOSE: Our objective was to determine the impact of the COVID-19 pandemic on cancer treatment in Peru. METHODS: A retrospective analysis of hospital data from the National Institute of Neoplastic Diseases revealed substantial decreases in oncological treatments in 2020 compared to 2019. RESULTS: Oncological treatments involving bone marrow transplantation had a greater impact between the months of April and September, at -100% (p=0.003). However, treatments involving surgery in April (-95% [p≤0.001]), radiotherapy in May (-76% [p=0.002]) and chemotherapy in June (-71% [p≤0.001]) also showed significant impacts. Comparative analysis with international data revealed similar trends in cancer care interruptions in different countries. However, variations in the magnitude of the impact were observed, influenced by regional health policies and the severity of the pandemic. CONCLUSIONS: The findings underscore the challenges cancer care providers face during public health crises, requiring adaptive strategies to ensure continued access to essential treatments. Addressing these challenges requires comprehensive public health responses to mitigate the impact of future crises on cancer care systems.
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COVID-19 , Neoplasias , Humanos , COVID-19/epidemiologia , Peru/epidemiologia , Neoplasias/terapia , Neoplasias/epidemiologia , Estudos Retrospectivos , SARS-CoV-2 , PandemiasRESUMO
Los pacientes con cáncer experimentan además del impacto de la enfermedad, el impacto económico, y este es más evidente en los pacientes con escasos recursos económicos, los motivos son multifactoriales. OBJETIVO: describir la percepción sobre el impacto económico en los pacientes bolivianos con cáncer en el Hospital de Clínicas Universitario- La Paz. MÉTODOS: el diseño es cualitativo exploratorio, muestreo por bola de nieve, se realizaron entrevistas a profundidad dirigidas a pacientes con cáncer del hospital de Clínicas Universitario de La Paz- Bolivia entre diciembre de 2018 a febrero de 2019. RESULTADOS: se entrevistaron a 11 pacientes y 9 familiares. Se han identificado el impacto de los gastos en los pacientes con cáncer en las siguientes categorías: Ahorros y deudas, vivienda, trabajo, familia, tratamiento, esfera psicológica, gastos a futuro, y en el cuidado de otros enfermos en la casa. Las percepciones son variables, algunos pacientes muestran mayor preocupación por su economía que por su enfermedad, relatan además el cambio que significó en su económica recibir el diagnóstico de cáncer en distintas áreas. CONCLUSIÓN: se ha encontrado, en el presente trabajo, que la percepción del impacto económico para los pacientes con cáncer es multidimensional. Se ha evidenciado además, que el impacto depende del estadio de la enfermedad y del contexto social que vive el paciente, siendo este variable y dando como resultado necesidades de acompañamiento variable por parte de los equipos oncológicos
Cancer patients experience, is about disease´s and economic impact, and this impact is more evident in patients with limited economic resources in low-income countries, the reasons are multifactorial. OBJECTIVE: describe the perception of the economic impact on Bolivian patients with cancer at the Hospital de Clínicas Universitario-La Paz. METHODS: the design is qualitative and exploratory, sampling was by snowball, in-depth interviews were conducted at cancer patients at the Clínicas Universitario de La Paz hospital - Bolivia between December 2018 and February 2019. RESULTS: 11 patients and 9 family members were interviewed. The impact of expenses on cancer patients has been identified in the following categories: Savings and debts, housing, work, family, treatment, psychological sphere, future expenses, and caring for other patients at home. Perceptions are variable, some patients show more significant concern about their finances than about their illness, and they also report the change that receiving the diagnosis of cancer meant in their finances in different areas. CONCLUSION: in this investigation, the perception of economic impact on cancer patients is multidimensional. It has also been shown that the impact depends on the stage of the disease, and the social context in which the patient lives, this being variable and resulting in variable support needs from the oncology teams
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Humanos , Gastos em Saúde , Estresse FinanceiroRESUMO
BACKGROUND: The World Health Organization recommends incorporating patient-reported experience measures and patient-reported outcome measures to ensure care processes. New technologies, such as mobile apps, could help report and monitor patients' adverse effects and doubts during treatment. However, engaging patients in the daily use of mobile apps is a challenge that must be addressed in accordance with the needs of people. OBJECTIVE: We present a qualitative case study documenting the process of identifying the information needs of breast cancer patients and health care professionals during the treatment process in a Chilean cancer institution. The study aims to identify patients' information requirements for integration into a mobile app that accompanies patients throughout their treatment while also providing features for reporting adverse symptoms. METHODS: We conducted focus groups with breast cancer patients who were undergoing chemotherapy (n=3) or who completed chemotherapy between 3 months and 1 year (n=1). We also surveyed health care professionals (n=9) who were involved in patient care and who belonged to the oncology committee of the cancer center where the study took place. Content analysis was applied to the responses to categorize the information needs and the means to satisfy them. A user interface was designed according to the findings of the focus groups and was assessed by 3 trained information system and user interaction design experts from 2 countries, using heuristic evaluation guidelines for mobile apps. RESULTS: Patients' information needs were classified into 4 areas: an overview of the disease, information on treatment and day-to-day affairs, assistance on the normality and abnormality of symptoms during treatment, and symptoms relevant to report. Health care professionals required patients to be provided with information on the administrative and financial process. We noted that the active involvement of the following 4 main actors is required to satisfy the information needs: patients, caregivers, social network moderators, and health professionals. Seven usability guidelines were extracted from the heuristic evaluation recommendations. CONCLUSIONS: A mobile app that seeks to accompany breast cancer patients to report symptoms requires the involvement of multiple participants to handle the reports and day-to-day information needs. User interfaces must be designed with consideration of the patient's social conventions and the emotional load of the disease information.
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Neoplasias da Mama , Aplicativos Móveis , Humanos , Feminino , Neoplasias da Mama/terapia , Pesquisa Qualitativa , Pacientes , Grupos FocaisRESUMO
The aim of this study was to identify the main therapeutic classes prescribed to ovarian cancer patients and the potential drug interactions (PDI) during hospitalization. This descriptive retrospective work was carried out in a referral gynecological cancer hospital from the Brazilian public health system. The first 24â h inpatients' prescriptions were evaluated to obtain the pharmacological profile data. Clinical and epidemiological characteristics were collected through the analysis of electronic medical records. A total of 236 patients were included in the study, of which 154 (65.25%) had PDI, with a mean of 1.43 ± 1.76 interactions per patient. The main therapeutic classes prescribed were analgesics and antiemetics (35%), compatible with the oncologic supportive care. All PDI identified (n = 331) were categorized by severity, using the Micromedex database, resulting in: 1.51% contraindicated, 67.67% major, 24.77% moderate, and 6.04% minor. The more prevalent PDI were ondansetron/tramadol (22.05%) and metoclopramide/tramadol (7.25%), both major. An association between PDI and polypharmacy was observed, which did not occur between age or length of stay. Ongoing prescription review by the pharmaceutical team is necessary to identify, monitor, and manage PDI-related adverse events and carry out required interventions with patients, physicians, and nurses. Taken together the data showed that even in a specialized hospital, the complexity of the pharmacotherapy can cause harm to the ovarian cancer patient. The clinical pharmacist acting in a multidisciplinary team is important for improving patient safety in oncology services.
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Neoplasias Ovarianas , Tramadol , Humanos , Feminino , Interações Medicamentosas , Estudos Retrospectivos , Hospitalização , Neoplasias Ovarianas/tratamento farmacológicoRESUMO
Telehealth is the delivery of many health care services and technologies to individuals at different geographical areas and is categorized as asynchronously or synchronously. The coronavirus disease 2019 (COVID-19) pandemic has caused major disruptions in health care delivery to breast cancer (BCa) patients and there is increasing demand for telehealth services. Globally, telehealth has become an essential means of communication between patient and health care provider. The application of telehealth to the treatment of BCa patients is evolving and increasingly research has demonstrated its feasibility and effectiveness in improving clinical, psychological and social outcomes. Two areas of telehealth that have significantly grown in the past decade and particularly since the beginning of the COVID-19 pandemic are telerehabilitation and teleoncology. These two technological systems provide opportunities at every stage of the cancer care continuum for BCa patients. We conducted a literature review that examined the use of telehealth services via its various modes of delivery among BCa patients particularly in areas of screening, diagnosis, treatment modalities, as well as satisfaction among patients and health care professionals. The advantages of telehealth models of service and delivery challenges to patients in remote areas are discussed.
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OBJECTIVE: To explore the meaning of palliative care as perceived by the family caregiver and the patient with advanced cancer. METHOD: Information was collected through in-depth interviews and field diaries to conduct this qualitative research study, with an interpretative phenomenological approach. We adopted Heidegger's perspective for the development of hermeneutic interpretation, and therefore followed the stages of intentionality, reduction, and constitution. We used Bardin's constructs of pre-analysis, coding, categorisation, and interpretation for the discourse analysis. RESULTS: Seventeen patient-family caregiver dyads were considered. The perceptions of palliative nursing care focused on transpersonal relationships and the discourses referred to a lack of closeness between nursing staff and the patient. This was mainly expressed as a lack of emotional understanding and unmet needs. Themes were drawn from these findings based on developing a transpersonal relationship as a priority, including meeting needs and providing the empathic accompaniment that is fundamental for emotional well-being. CONCLUSION: From the perspective of the dyads, palliative care covers intangible aspects of care. This requires nursing staff to work collaboratively with colleagues, with other health professionals and interprofessionally, including the institutions involved in care. Further work is required to implement these actions.
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Enfermagem de Cuidados Paliativos na Terminalidade da Vida , Neoplasias , Cuidadores , Humanos , Neoplasias/terapia , Cuidados Paliativos , Qualidade de VidaRESUMO
PURPOSE: We investigated whether self-compassion and mindfulness are associated with quality of life in patients undergoing antineoplastic chemotherapy. METHODS: A cross-sectional survey of 183 patients (100% response rate) undergoing chemotherapy was conducted at a Brazilian hospital between August and December 2019. A questionnaire was administered by the research team, collecting clinical and demographic data as well as responses to the Self-compassion scale, Mindful Attention Awareness Scale, and the Functional Assessment of Cancer Therapy-General instrument. Data analysis comprised descriptive and inferential statistics, with multiple regression and Spearman's rank-order correlation testing for associations between quality of life, self-compassion and mindfulness. RESULTS: Mean scores for the study variables were 4.23 (SD = 0.63) for self-compassion, 69.05 (SD = 13.27) for mindfulness, and 80.25 (SD = 12.62) for quality of life. Significant positive correlations were observed between quality of life and self-compassion (r = 0.466, p < 0.001), as well as for quality of life and mindfulness (r = 0.325, p < 0.001). Higher levels of self-compassion and mindfulness were associated with better quality of life. CONCLUSIONS: This research suggests merit in further studies of self-compassion and mindfulness either as predictor variables or for direct causal effect on quality of life in cancer patients undergoing antineoplastic chemotherapy. We recommend that future studies incorporate an intervention and experimental design.
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Empatia , Atenção Plena/estatística & dados numéricos , Neoplasias/tratamento farmacológico , Qualidade de Vida/psicologia , Autoimagem , Idoso , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
To evaluate the nutritional profile of cancer patients treated at an oncology center in South Brazil.This is a descriptive, exploratory and sectional study that was developed in a process that involved 100 patients aged between 18 and 75 years old, suffering from cancer.The anthropometric variables studied were weight, height, Body Mass Index (BMI), arm circumference (AC), arm muscle circumference (AMC),triceps skinfold (TSF) and corrected arm muscle area (cAMA). For subjective nutritional assessment, we used the Patient-Generated Subjective Global Assessment (PG-SGA). Nearly half of the patients evaluated had a critical need for nutritional intervention. There was a statistically significant association between cAMA and marital status, age and gender; between AC and age, gender and staging; between AMC and staging; between BMI and marital status and age; and between TSF and marital status. Patients diagnosed with IV stage had the lowest values for nutritional variables. There was no significant association between nutritional status of patients obtained by the PG-SGA instrument and sociodemographic characteristics. Malnutrition should be diagnosed as soon as possible,aiming at early intervention and improving survival and quality of life. Therefore, early nutritional assessment in cancer patients is required, combining subjective and objective methods.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Institutos de Câncer/organização & administração , Avaliação Nutricional , Neoplasias/diagnóstico , Qualidade de Vida/psicologia , Sobrevida , Pesos e Medidas Corporais/instrumentação , Índice de Massa Corporal , Estado Nutricional , Desnutrição/diagnóstico , Intervenção Médica PrecoceRESUMO
Resumo A espiritualidade como ferramenta aos cuidados paliativos de pacientes oncológicos vem sendo cada vez mais abordada no contexto acadêmico, como integrante da qualidade de vida. Este estudo analisa de que forma a espiritualidade pode influenciar positivamente no tratamento oncológico e em cuidados paliativos, e contribuir com a melhora da qualidade de vida destes pacientes. Foram selecionados 29 artigos nacionais que evidenciaram a espiritualidade como variável positiva no enfrentamento aos cuidados paliativos, tanto para paciente quanto familiares e equipe multidisciplinar. A espiritualidade é utilizada como ferramenta pela equipe de cuidados paliativos como auxiliadora na compreensão do impacto causado pelo diagnóstico e cuidado integral do paciente, possibilitando ao profissional psicólogo intervir sobre o paciente e sua rede. Ao paciente e sua família, a espiritualidade atua como estratégia de enfrentamento e conforto. Este estudo encontrou limitações acerca de pesquisas com pacientes infantis/adolescestes e sua família.
Abstract The spirituality as a tool in palliative healthcare of oncology patients, has been increasingly studied and approached in the academic context, as an integrant of life quality improvement. The present study aimed to analyze how spirituality can positively influence oncology treatment and palliative care and contribute to the quality of life improvement of these patients. Through this literature review and the inclusion criteria, there had been 29 articles selected. Spirituality is used as a tool by the CP team as an aid to understanding de impact caused by the diagnosis and full-time patient care, it enables the psychologist professional to assist and intervene fully about the patient and its network; on the patient and his family, the spirituality acts as a coping strategy, safety, and comfort. The present study has found limitations around the study in children, adolescents, and their network.
Resumé La spiritualité en tant qu'outil de soins palliatifs des patients atteints de cancer est de plus en plus abordée dans le contexte académique, dans le cadre de la qualité de vie. La présente étude visait à analyser comment la spiritualité peut influencer positivement le traitement du cancer et les soins palliatifs et contribuer à améliorer la qualité de vie de ces patients. Grâce à cette revue de la littérature, 29 articles ont été sélectionnés. La spiritualité est utilisée comme outil par l'équipe de soins palliatifs pour aider à comprendre l'impact provoqué par le diagnostic et la prise en charge globale du patient, permettant au psychologue professionnel d'intervenir sur le patient et son réseau; pour le patient et sa famille, la spiritualité agit comme une stratégie d'adaptation et de confort. La présente étude a révélé des limites concernant la recherche avec des patients enfants / adolescents et leur famille.
Resumen La espiritualidad como herramienta para los cuidados paliativos del paciente oncológico se ha abordado cada vez más en el contexto académico como parte de la calidad de vida. El presente estudio tuvo como objetivo analizar cómo la espiritualidad puede influir positivamente en el tratamiento del cáncer y los cuidados paliativos, así como contribuir a mejorar la calidad de vida de estos pacientes. Se seleccionaron 29 artículos brasileños que abordaron la espiritualidad como una variable positiva en el afrontamiento a los cuidados paliativos tanto para los pacientes como sus familias y el equipo multidisciplinario. La espiritualidad es utilizada por el equipo de cuidados paliativos como herramienta de ayuda en la comprensión del impacto que ocasiona el diagnóstico y la atención integral del paciente, permitiendo al psicólogo profesional intervenir sobre el paciente y su red. Para el paciente y su familia, la espiritualidad actúa como estrategia de afrontamiento y consuelo. El presente estudio encontró limitaciones con respecto a la investigación con pacientes niños/adolescentes y su familia.
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Cuidados Paliativos/psicologia , Doente Terminal , Terapias EspirituaisRESUMO
El presente estudio se centra en la importancia que tiene la interacción comunicativa entre médico y paciente durante el tratamiento del cáncer. El peso de la interacción recae en la comunicación efectiva desarrollada en las prácticas lingüísticas dentro de la medicina clínica. Aquí se aborda la comunicación en salud y se explica el grado de comprensión que el paciente oncológico tiene en torno a cuatro conceptos elementales: cáncer, metástasis, tipos de tumores y tipos de terapia, los que se expresaron para ellos en tres tipos de definiciones: técnica, acomodada y coloquial. Para esto se aplicó una encuesta sociolingüística mixta a 50 pacientes en el Hospital Barros Luco, en donde se observó que más del 50% de los pacientes comprende toda la información cuando esta se explica de manera técnica y, más del 70% incluso 80% comprende toda la información cuando se explica de una manera acomodada a la valoración del contexto, situación e interlocutores. Los resultados también indican que los médicos, según los pacientes entrevistados, explican con un lenguaje de código cerrado y, en ocasiones, simplemente no entregan la información. Según los resultados se puede concluir que la información previa junto con la experiencia comunicativa, entendida como una práctica social, ayudan a construir y representar una nueva realidad sociolingüística que coopera para que los pacientes oncológicos logren entender la información verbal, así como también el nuevo contexto social en el que se encuentran.
The present study focuses on the importance of the communicative interaction between doctor and patient during cancer treat-ment. The weight of the interaction falls on the effective communication developed in linguistic practices within clinical medicine. Here, health communication is addressed, and the degree of understanding that the cancer patient has around four elementary concepts been explained: cancer, metastasis, types of tumors, and types of therapy, which were expressed for them in three types of definitions: technical, well-off and colloquial. For this, a mixed sociolinguistic survey was applied to 50 patients at the Barros Luco Hospital, where it was observed that more than 50% of patients understand all the information when it is explained tech-nically, and more than 70% even 80% understand all the information when it is explained in a way adapted to the assessment of the context, situation, and interlocutors. The results also indicate that the doctors, according to the patients interviewed, explain with a closed code language and sometimes, simply do not provide the information. According to the results, it can be concluded that the previous information together with the communicative experience, understood as a social practice, help to build and represent a new sociolinguistic reality that cooperates so that cancer patients can understand verbal information, as well as the new context social where they are.
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Pacientes , Inquéritos e Questionários , Comunicação em Saúde , Linguística , Neoplasias , Medicina Clínica , Formação de Conceito , CompreensãoRESUMO
The relationship between cytomegalovirus (CMV), a severe complication in immunocompromised patients, and graft-versus-host disease (GVHD) has already been reported but remains without complete elucidation, especially concerning oral lesions. Considering that antimicrobial photodynamic therapy (aPDT) has an antimicrobial effect and photobiomodulation therapy (PBM) provides analgesia and modulation of inflammatory processes, the present study aimed to report a clinical case in which oral CMV reactivation following acute GVHD was treated by a combination of aPDT and PBMT concomitantly with conventional drug treatment. Intense and uninterrupted oral pain and consequent impairment of the patient's oral functions were present due to ulcerated lesions in the tongue, soft palate, and labial mucosa. After 72 hours from the first laser session, a marked decrease in the severity of the lesions and pain relief was observed. All oral lesions were repaired within 30 days. Based on this case report, when used concomitantly with conventional drug treatment, the combination of aPDT and PBMT seems to play a crucial role in treating CMV associated with GVHD.
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Anti-Infecciosos , Infecções por Citomegalovirus , Doença Enxerto-Hospedeiro , Fotoquimioterapia , Anti-Infecciosos/uso terapêutico , Citomegalovirus , Infecções por Citomegalovirus/tratamento farmacológico , Doença Enxerto-Hospedeiro/tratamento farmacológico , Humanos , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêuticoRESUMO
The article is devoted to the review of the most developed systems of registration and control of patients suffering from oncological diseases. The creation of registries is based on the public health needs of countries in monitoring, storing and analyzing national data on such serious chronic diseases as cancer. The world and national experience in creating data storage systems shows the need to unify the information collection, to consolidate sources, and to use high quality information technologies that make it possible to exchange, analyze, protect and store data. In European countries and the USA, registries have specialized websites and provide information on epidemiology, trends, forecasts, and survival rate. This information is public.
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Humanos , Institutos de Câncer/estatística & dados numéricos , Literatura de Revisão como Assunto , Registros Eletrônicos de Saúde , Acesso a Medicamentos Essenciais e Tecnologias em SaúdeRESUMO
Objective: To evaluate the use of photobiomodulation therapy (PBM-T) in patients undergoing chemotherapy and/or radiotherapy and affected by oral mucositis (OM). Background: Few clinical studies have evaluated PBM-T, particularly in combination with photodynamic therapy (PDT), for the treatment of OM. Methods: Thirty-one patients were divided by convenience into two groups. One received PBM-T (n = 17) alone, consisting of low-intensity laser (LIL) irradiation (wavelength 660 nm, continuous mode, spot energy 4 J, energy density 142 J/cm2, irradiation time 40 s per spot), once weekly for 4 weeks. The other (n = 14) received a combination of PBM-T and PDT, with curcumin as photosensitizer. Patients were instructed to rinse their mouth with 20 mL of curcumin solution for 5 min. The oral cavity was irradiated with a blue light-emitting diode (power 1200 mV, wavelength 468 nm) for 5 min. LIL was applied as in the PBM-T group. After treatment, OM severity was reassessed. The results were analyzed by the Wilcoxon and Mann-Whitney tests. Results: Both PBM-T alone and PBM-T+PDT yielded significant reductions in OM grade (p < 0.01). PDT+PBM-T resulted in a significantly shorter healing time compared with PBM-T alone (p = 0.0321). Conclusions: Within the parameters of this study, PBM-T+PDT was an effective method to accelerate the OM healing process.
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Terapia com Luz de Baixa Intensidade , Neoplasias/complicações , Fotoquimioterapia , Estomatite/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Curcumina/uso terapêutico , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/patologia , Neoplasias/terapia , Fármacos Fotossensibilizantes/uso terapêutico , Estomatite/etiologia , Estomatite/patologia , Resultado do TratamentoRESUMO
Introdução: A Fadiga relacionada ao câncer (FRC) é um sintoma comum e tratável que interfere em diversos aspectos da qualidade de vida¹. Essa fadiga caracteriza-se por uma sensação difusa e persistente de cansaço não aliviado com o repouso e estima-se que 60 a 90% dos pacientes apresentam fadiga (6). A alta ocorrência de fadiga pode comprometer a performance dos pacientes, e uma forma de avaliação é através do índice de Karnofsky que descreve os níveis crescentes de atividade e independência. Objetivo: Correlacionar o índice de fadiga através da Escala de Piper-Revisada com o nível de performance funcional através da Escala de Karnofsky em paciente com doença oncológica Métodos: âEstudo de coorte observacional descritivo quantitativo, do qual participaram 40 indivíduos. O estudo foi desenvolvido em 2 fases: (1) primeira avaliação na internação; (2) segunda avaliação na alta Hospitalar. Os indivíduos foram avaliados aplicando o índice de Karnofsky e Escala de Fadiga de Piper-revisada. Resultados: Observamos na amostra, um aumento da fadiga na alta hospitalar quando comparada com a avaliação da admissão. Já na comparação entre fadiga e performance foi encontrada relação inversamente proporcional moderada significante, ou seja, quanto menor a fadiga, maior a performance do paciente. Demais variáveis foram sem significância. Conclusão: O índice de fadiga afeta diretamente o grau de performance de indivíduos com doença oncológica.(AU)
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Humanos , Masculino , Feminino , Sistema Único de Saúde , Brasil , Saúde Pública , Fadiga Muscular , OncologiaRESUMO
Introdução: A Fadiga relacionada ao câncer (FRC) é um sintoma comum e tratável que interfere em diversos aspectos da qualidade de vida¹. Essa fadiga caracteriza-se por uma sensação difusa e persistente de cansaço não aliviado com o repouso e estima-se que 60 a 90% dos pacientes apresentam fadiga (6). A alta ocorrência de fadiga pode comprometer a performance dos pacientes, e uma forma de avaliação é através do índice de Karnofsky que descreve os níveis crescentes de atividade e independência. Objetivo: Correlacionar o índice de fadiga através da Escala de Piper-Revisada com o nível de performance funcional através da Escala de Karnofsky em paciente com doença oncológica Métodos: âEstudo de coorte observacional descritivo quantitativo, do qual participaram 40 indivíduos. O estudo foi desenvolvido em 2 fases: (1) primeira avaliação na internação; (2) segunda avaliação na alta Hospitalar. Os indivíduos foram avaliados aplicando o índice de Karnofsky e Escala de Fadiga de Piper-revisada. Resultados: Observamos na amostra, um aumento da fadiga na alta hospitalar quando comparada com a avaliação da admissão. Já na comparação entre fadiga e performance foi encontrada relação inversamente proporcional moderada significante, ou seja, quanto menor a fadiga, maior a performance do paciente. Demais variáveis foram sem significância. Conclusão: O índice de fadiga afeta diretamente o grau de performance de indivíduos com doença oncológica.(AU)
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Humanos , Masculino , Feminino , Sistema Único de Saúde , Brasil , Saúde Pública , Fadiga Muscular , OncologiaRESUMO
ABSTRACT Biochemical markers produced by the affected organ or body in response to disease have gained high clinical value due to assess disease development and being excellent predictors of morbidity and mortality. The aim of this study is to analyze different biochemical markers in critically cancer patients and to determine which of them can be used as predictors of mortality. This is a prospective, cross-sectional study conducted at a University Hospital in Porto Alegre - RS. Screening was done to include patients in the study. Serum biochemical markers obtained in the first 24 hours of Intensive Care Unit hospitalization were analyzed. A second review of medical records occurred after three months objected to identify death or Unit discharged. A sample of 130 individuals was obtained (control group n = 65, study group n = 65). In the multivariate model, serum magnesium values OR = 3.97 (1.17; 13.5), presence of neoplasia OR = 2.68 (95% CI 1.13; 6.37) and absence of sepsis OR = 0.31 (95% CI 0.12; 0.79) were robust predictors of mortality. The association of solid tumors, sepsis presence and alteration in serum magnesium levels resulted in an increased chance of mortality in critically ill patients.
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Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Biomarcadores Tumorais/sangue , Estado Terminal/mortalidade , Neoplasias/mortalidade , Prognóstico , Estudos Transversais , Valor Preditivo dos Testes , Estudos Prospectivos , Unidades de Terapia Intensiva/estatística & dados numéricos , Neoplasias/patologia , Neoplasias/sangueRESUMO
The aim of this study was to evaluate, analyze and understand distress levels experienced during chemotherapy treatment, comparing men and women. The sample was composed of 328 patients recruited from an Oncology center. Data collection included the application of the Distress Thermometer at three stages of chemotherapy: beginning, middle and end. Incidence of distress decreased in both genders over the course of assessments. Comparatively, the incidence was higher among women, who also reported the highest number of problems in the practical, family, emotional, spiritual and physical domains. The results corroborate the international literature on the subject. Clinical interest of systematic assessment of distress was confirmed to develop routines of therapeutic monitoring adapted to the specific needs of cancer patients.
A presente investigação teve por objetivo avaliar, analisar e compreender os níveis de distress vivenciados durante o tratamento quimioterápico, comparando-se homens e mulheres. A amostra foi constituída de 328 pacientes, recrutados em um centro especializado em Oncologia. A coleta de dados envolveu a aplicação do Termômetro de Distress em três etapas da quimioterapia: início, meio e fim. Constatou-se queda dos escores de distress, em ambos os gêneros, no decorrer das avaliações. Comparativamente, a incidência foi maior entre as mulheres, as quais também reportaram maior número de problemas, nos domínios prático, familiar, emocional, espiritual e físico. Os resultados obtidos corroboram a literatura internacional. Comprovou-se o interesse clínico da avaliação sistemática do distress para estruturação de rotinas de acompanhamento terapêutico ajustadas às necessidades específicas de pacientes com câncer.
El objetivo de esta investigación fue evaluar, analizar y comprender los niveles de distress experimentados durante el tratamiento con quimioterapia, comparando hombres y mujeres. La muestra fue constituida por 328 pacientes reclutados en un centro especializado en oncología. Para recopilar los datos fue aplicado el Termómetro de Distress en tres etapas de la quimioterapia: principio, medio y final. La incidencia de distress en ambos sexos cayó en el curso de la evaluación. En comparación, la incidencia fue mayor entre las mujeres, que también reportaron el mayor número de problemas en los campos práctico, familiar, emocional, espiritual y físico. Los resultados obtenidos corroboran la literatura internacional. Se comprobó la importancia clínica de la evaluación sistemática del distress para estructurar las rutinas de acompañamiento terapéutico adaptadas a las necesidades específicas de los pacientes con cáncer.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Saúde de Gênero , Identidade de Gênero , Neoplasias/psicologia , Pacientes , Estresse Psicológico , Avaliação do Impacto na SaúdeRESUMO
The aim of this study was to evaluate, analyze and understand distress levels experienced during chemotherapy treatment, comparing men and women. The sample was composed of 328 patients recruited from an Oncology center. Data collection included the application of the Distress Thermometer at three stages of chemotherapy: beginning, middle and end. Incidence of distress decreased in both genders over the course of assessments. Comparatively, the incidence was higher among women, who also reported the highest number of problems in the practical, family, emotional, spiritual and physical domains. The results corroborate the international literature on the subject. Clinical interest of systematic assessment of distress was confirmed to develop routines of therapeutic monitoring adapted to the specific needs of cancer patients.(AU)
A presente investigação teve por objetivo avaliar, analisar e compreender os níveis de distress vivenciados durante o tratamento quimioterápico, comparando-se homens e mulheres. A amostra foi constituída de 328 pacientes, recrutados em um centro especializado em Oncologia. A coleta de dados envolveu a aplicação do Termômetro de Distress em três etapas da quimioterapia: início, meio e fim. Constatou-se queda dos escores de distress, em ambos os gêneros, no decorrer das avaliações. Comparativamente, a incidência foi maior entre as mulheres, as quais também reportaram maior número de problemas, nos domínios prático, familiar, emocional, espiritual e físico. Os resultados obtidos corroboram a literatura internacional. Comprovou-se o interesse clínico da avaliação sistemática do distress para estruturação de rotinas de acompanhamento terapêutico ajustadas às necessidades específicas de pacientes com câncer.(AU)
El objetivo de esta investigación fue evaluar, analizar y comprender los niveles de distress experimentados durante el tratamiento con quimioterapia, comparando hombres y mujeres. La muestra fue constituida por 328 pacientes reclutados en un centro especializado en oncología. Para recopilar los datos fue aplicado el Termómetro de Distress en tres etapas de la quimioterapia: principio, medio y final. La incidencia de distress en ambos sexos cayó en el curso de la evaluación. En comparación, la incidencia fue mayor entre las mujeres, que también reportaron el mayor número de problemas en los campos práctico, familiar, emocional, espiritual y físico. Los resultados obtenidos corroboran la literatura internacional. Se comprobó la importancia clínica de la evaluación sistemática del distress para estructurar las rutinas de acompañamiento terapéutico adaptadas a las necesidades específicas de los pacientes con cáncer.(AU)
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Pacientes , Neoplasias/psicologia , Saúde de Gênero , Identidade de Gênero , Estresse Psicológico , Avaliação do Impacto na SaúdeRESUMO
Este artículo se centra en el enfermo con cáncer en situación terminal. Trata de los cuidados que requiere la persona que tras haber realizado un recorrido hospitalario en búsqueda de salud es considerada incurable y dirigida a cuidados paliativos (CP) para procurarle bienestar y ayudarle a morir. En la geografía española estos enfermos son atendidos en unidades o servicios de cuidados paliativos (SCP). El objetivo principal en cuidados paliativos es cuidar. Cuidar es aliviar y acompañar al paciente, y dar soporte a los familiares durante el proceso de salud/enfermedad/atención/ muerte del paciente. En el cuidado es importante tratar el cuerpo enfermo. Por lo que prevalece aquello que acontece al afectado y que queda inscrito en su cuerpo. De la misma manera que en la enfermedad incurable el dolor y el sufrimiento marcan un itinerario y trazan unas huellas perceptibles en el mismo. Estos signos pueden resultar una señal que le alerta de la proximidad ala muerte. Aunque los avances científicos han influido, positivamente, en el control del dolor, en algunos casos existen momentos críticos en que se producen situaciones de descontrol y desesperación de quienes lo padecen.
This article focuses on patients with cancer during the terminal phase. It deals with the care that individuals need after trying to seek health solutions in different hospitals when the disease is deemed incurable and they then require palliative care (PC) to obtain welfare and assist them to die. In the Spanish health system these patients are cared for in palliative care units or services. The main objective of palliative care is to give comfort. Comforting is destined to alleviate and support patients and families during the process of health / disease / care / patient death. During this period, it is important to care for the ailing body. Similarly, when a disease is incurable, the pain and suffering runs its inexorable course and leaves perceptible traces. These signs can be an indication that death is nigh. Although scientific advances have produced positive results in the control of pain, in some cases there are critical moments when situations of misery and despair arise for the terminal patients.