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Azeredo-da-Silva AF, Zanotto BS, Martins F, Navarro N, Alencar R, Medeiros C. Health care accessibility and mobility in breast cancer: a Latin American perspective. BMC Health Serv Res 2024; 24:764. [PMID: 38918823 PMCID: PMC11197349 DOI: 10.1186/s12913-024-11222-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 06/19/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Latin America (LATAM) encompasses a vast region with diverse populations. Despite publicly funded health care systems providing universal coverage, significant socioeconomic and ethno-racial disparities persist in health care access across the region. Breast cancer (BC) incidence and mortality rates in Brazil are comparable to those in other LATAM countries, supporting the relevance of Brazilian data, with Brazil's health care policies and expenditures often serving as models for neighboring countries. We evaluated the impact of mobility on oncological outcomes in LATAM by analyzing studies of patients with BC reporting commuting routes or travel distances to receive treatment or diagnosis. METHODS We searched MEDLINE (PubMed), Embase, Cochrane CENTRAL, LILACS, and Google Scholar databases. Studies eligible for inclusion were randomized controlled trials and observational studies of patients with BC published in English, Portuguese, or Spanish and conducted in LATAM. The primary outcome was the impact of mobility or travel distance on oncological outcomes. Secondary outcomes included factors related to mobility barriers and access to health services. For studies meeting eligibility, relevant data were extracted using standardized forms. Risk of bias was assessed using the Newcastle-Ottawa Scale. Quantitative and qualitative evidence synthesis focused on estimating travel distances based on available data. Heterogeneity across distance traveled or travel time was addressed by converting reported travel time to kilometers traveled and estimating distances for unspecified locations. RESULTS Of 1142 records identified, 14 were included (12 from Brazil, 1 from Mexico, and 1 from Argentina). Meta-analysis revealed an average travel distance of 77.8 km (95% CI, 49.1-106.48) to access BC-related diagnostic or therapeutic resources. Nonetheless, this average fails to precisely encapsulate the distinct characteristics of each region, where notable variations persist in travel distance, ranging from 88 km in the South to 448 km in the North. CONCLUSION The influence of mobility and travel distance on access to BC care is multifaceted and should consider the complex interplay of geographic barriers, sociodemographic factors, health system issues, and policy-related challenges. Further research is needed to comprehensively understand the variables impacting access to health services, particularly in LATAM countries, where the challenges women face during treatment remain understudied. TRIAL REGISTRATION CRD42023446936.
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Affiliation(s)
| | - Bruna Stella Zanotto
- HTAnalyze Consultoria e Treinamento Ltda, Rua João Abbott, 109, Petrópolis, Porto Alegre, RS, 90460-150, Brazil
| | - Flavia Martins
- Produtos Roche Químicos e Farmacêuticos S/A, Rua Doutor Rubens Gomes Bueno, 691, Santo Amaro, São Paulo, SP, 04730-000, Brazil
| | - Nádia Navarro
- Produtos Roche Químicos e Farmacêuticos S/A, Rua Doutor Rubens Gomes Bueno, 691, Santo Amaro, São Paulo, SP, 04730-000, Brazil
| | - Rafaela Alencar
- Produtos Roche Químicos e Farmacêuticos S/A, Rua Doutor Rubens Gomes Bueno, 691, Santo Amaro, São Paulo, SP, 04730-000, Brazil
| | - Clarissa Medeiros
- Produtos Roche Químicos e Farmacêuticos S/A, Rua Doutor Rubens Gomes Bueno, 691, Santo Amaro, São Paulo, SP, 04730-000, Brazil.
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Sánchez-Bandala MA, Rubio AP, Abeldaño Zuñiga RA. Trajectories of Cancer Care in Latin America: A Scope Review: Trayectorias de atención al cáncer en América Latina. Una revisión de alcance. Value Health Reg Issues 2023; 38:47-60. [PMID: 37473586 DOI: 10.1016/j.vhri.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 04/10/2023] [Accepted: 06/14/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVES In recent decades there has been a development of research on cancer care trajectories in Latin America; however, the diversity of theoretical-methodological uses of this approach can be confusing and difficult for the academic and professional community to use. To analyze studies that have been carried out in Latin America on cancer care trajectories to propose a typology of the approaches developed and synthesize key findings. METHODS A scope review of studies published in journals indexed in PubMed, LILACS, and SciELO databases in the period 2006-2021 was conducted. RESULTS 22 articles were analyzed. A typology of descriptive, evaluative, and interpretative approaches was proposed. From the key findings, the following were identified: the importance of pleasure and the feeling of power in the development of risky practices; the role of popular explanatory models for the identification of abnormality and the search for attention; the interaction of various personal, interpersonal, organizational, and structural barriers that limited timely diagnosis and continuity of treatment; the sequential or parallel use of different forms of care, public and private; and the importance of social support networks. CONCLUSIONS The proposed typology clarifies the different uses of the approach. The informative synthesis evidences problematic knots regarding multiple barriers to access and allows us to propose as priorities in future research the study of types of cancer, stages, and populations that have been scarcely addressed, as well as the diversification of methodological approaches.
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Affiliation(s)
| | | | - Roberto Ariel Abeldaño Zuñiga
- Division of Postgraduate Studies, Universidad de la Sierra Sur, Miahuatlán de Porfirio Díaz, Oaxaca, México; Faculty of Social Sciences, University of Helsinki, Finland
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Catissi G, de Oliveira LB, da Silva Victor E, Savieto RM, Borba GB, Hingst-Zaher E, Lima LM, Bomfim SB, Leão ER. Nature Photographs as Complementary Care in Chemotherapy: A Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6555. [PMID: 37623141 PMCID: PMC10454289 DOI: 10.3390/ijerph20166555] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/20/2023] [Accepted: 06/27/2023] [Indexed: 08/26/2023]
Abstract
The incidence of cancer cases is increasing worldwide, and chemotherapy is often necessary as part of the treatment for many of these cases. Nature-based interventions have been shown to offer potential benefits for human well-being. OBJECTIVE This study aims to investigate the outcome of nature images on clinical symptom management related to chemotherapy. METHODS A randomized clinical trial was conducted in an outpatient cancer unit of a private hospital in Brazil, with 173 participants over the age of 18 who were undergoing chemotherapy and had signed an informed consent form. The intervention consisted of the presentation of a 12-min video featuring nature images categorized under the themes of Tranquility, Beauty, Emotions Up, or Miscellany. Images were sourced from the e-Nature Positive Emotions Photography Database (e-NatPOEM), a publicly available collection of affectively rated images. Sociodemographic and clinical data, as well as the participants' connection to nature, were investigated. The Positive Affect/Negative Affect Scale (PANAS) and the Edmonton Symptom Assessment System (ESAS) were applied pre- and post-intervention. RESULTS Data showed very strong evidence of a reduction in negative affect for the intervention group (p < 0.001) and moderate evidence for the control group (p = 0.034). There was also a significant reduction in the intervention group for pain (p < 0.001), tiredness (p = 0.002), sadness (p < 0.001), anxiety (p < 0.001), and appetite (p = 0.001). The Beauty video had the best performance, while the Tranquility video showed no significant improvement in any of the symptoms evaluated. These findings suggest that images of nature may be a valuable tool to help control clinical and psychological symptoms in cancer patients undergoing chemotherapy.
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Affiliation(s)
- Giulia Catissi
- Albert Einstein Israeli Faculty of Health Sciences, Hospital Israelita Albert Einstein, São Paulo 05651-901, Brazil;
| | | | - Elivane da Silva Victor
- Albert Einstein Education and Research Center, Hospital Israelita Albert Einstein, São Paulo 05651-901, Brazil; (E.d.S.V.); (R.M.S.); (S.B.B.)
| | - Roberta Maria Savieto
- Albert Einstein Education and Research Center, Hospital Israelita Albert Einstein, São Paulo 05651-901, Brazil; (E.d.S.V.); (R.M.S.); (S.B.B.)
| | - Gustavo Benvenutti Borba
- Department of Electronics-DAELN, Graduate School on Biomedical Engineering—PPGEB, Federal University of Technology-Paraná—UTFPR, Curitiba 80230-901, Brazil;
| | | | | | - Sabrina Bortolossi Bomfim
- Albert Einstein Education and Research Center, Hospital Israelita Albert Einstein, São Paulo 05651-901, Brazil; (E.d.S.V.); (R.M.S.); (S.B.B.)
| | - Eliseth Ribeiro Leão
- Albert Einstein Education and Research Center, Hospital Israelita Albert Einstein, São Paulo 05651-901, Brazil; (E.d.S.V.); (R.M.S.); (S.B.B.)
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Touré M, Pavic M, Poder TG. Second Version of the Short Form 6-Dimension Value Set Elicited From Patients With Breast and Colorectal Cancer: A Hybrid Approach. Med Care 2023; 61:536-545. [PMID: 37308990 DOI: 10.1097/mlr.0000000000001880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Quality-adjusted life-year instruments help comparison among programs by capturing their effects in terms of utility. Generic instruments are applicable to everyone, and for this reason, they are known to lack sensitivity when measuring gains in some domains. Specific instruments tend to fill this gap but, in domains like cancer, existing instruments are either nonpreferences-based or based on the general population's preferences. PATIENTS AND METHODS This study describes the development of a new value set for a well-known and highly used generic instrument, the Second Version of the Short Form 6-Dimension, to better consider the preferences of patients with cancer. In this aim, a hybrid approach combining the time trade-off and the discrete choice experiment was used. The population of interest was the Quebec population, Canada, with breast or colorectal cancer. Their preferences were elicited in 2 periods: before (T1) and 8 days after the beginning of a chemotherapy procedure (T2). RESULTS A total of 2808 observations for the time trade-off and 2520 observations for the discrete choice experiment were used. The parsimonious model encompassing the 2 periods was the preferred model. The new value set allows a greater utility range than the EQ-5D-5L and the Second Version of the Short Form 6-Dimension reference value sets and helps in better considering patients experiencing severe health situations. A good correlation between these 2 instruments and other specific cancer instruments (ie, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, QLU-C10D, and Functional Assessment of Cancer Therapy-General) was observed. Significative differences in utility values were also noted within periods and types of cancer.
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Affiliation(s)
- Moustapha Touré
- Department of Economics, Business School, Université de Sherbrooke, Sherbrooke
- Centre de Recherche de l'IUSMM, CIUSSS de l'Est de L'île de Montréal, Montréal
| | - Michel Pavic
- Department of Medicine Faculté de médecine et des sciences de la santé, Université de Sherbrooke
- Centre de recherche du CHUS, CIUSSS de l'Estrie - CHUS, Sherbrooke
| | - Thomas G Poder
- Centre de Recherche de l'IUSMM, CIUSSS de l'Est de L'île de Montréal, Montréal
- Centre de recherche du CHUS, CIUSSS de l'Estrie - CHUS, Sherbrooke
- Department of Management, Evaluation and Health Policy, School of Public Health, Université de Montréal, Montréal, QC, Canada
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Zubair HM, Khan MA, Gulzar F, Alkholief M, Malik A, Akhtar S, Sharif A, Akhtar MF, Abbas M. Patient Perspectives and Side-Effects Experience on Chemotherapy of Non-Small Cell Lung Cancer: A Qualitative Study. Cancer Manag Res 2023; 15:449-460. [PMID: 37255669 PMCID: PMC10226488 DOI: 10.2147/cmar.s396751] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 05/03/2023] [Indexed: 06/01/2023] Open
Abstract
Purpose This study aimed to explore patients' experiences of palliative chemotherapy for non-small cell lung cancer (NSCLC), how patients adapt to their new and challenging life after chemotherapy, their beliefs, and their quality of life. Patients and Methods The study used an exploratory descriptive qualitative approach that was designed to explore the experiences and side effects of NSCLC patients on chemotherapy in Pakistan. The study was designed to obtain a deeper understanding of 22 NSCLC patients' experiences, using a face-to-face approach and interviews were conducted. Patients who have completed chemotherapy agreed to participate in semi-structured interviews. Results The data were arranged into five themes: hospital facilities and environment, patient's beliefs in alternative treatments, presenting a positive/negative face, life is for living, and health insurance coverage. The major complaints related to bad experiences of chemotherapy-induced side effects, but these patients still managed to complete the full course of their respective chemotherapy. Additionally, the current study revealed the real experience of patients with NSCLC which had been less studied. The patient's experience was summarized into four themes and several subthemes. Conclusion This study aid healthcare providers when deciding on treatment options that will improve shared decision-making between clinicians and treatment outcomes.
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Affiliation(s)
| | - Muhammad Arslan Khan
- Department of Pharmacy Services, The University of Lahore Teaching Hospital, Lahore, Pakistan
| | - Faisal Gulzar
- Faculty of Pharmacy, The University of Lahore, Lahore, Pakistan
| | - Musaed Alkholief
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Abdul Malik
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Suhail Akhtar
- Department of Biochemistry, A.T. Still University of Health Sciences, Kirksville, MO, USA
| | - Ali Sharif
- Department of Pharmacology, Institute of Pharmacy, Lahore College for Women University, Lahore, Pakistan
| | - Muhammad Furqan Akhtar
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore Campus, Lahore, Pakistan
| | - Muhammad Abbas
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Islamabad, Pakistan
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Salha LA, Silva JCS, Martins CA, Araújo CSDC, da Silva EAS, Alves AG, de Paula CR, de Lima FHA, de Moura VS, de Menezes JE, Brasil VV, Barbosa MA. Caregivers of Individuals with Cancer in the COVID-19 Pandemic: A Phenomenological Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010185. [PMID: 35010444 PMCID: PMC8751169 DOI: 10.3390/ijerph19010185] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/15/2021] [Accepted: 12/21/2021] [Indexed: 05/22/2023]
Abstract
Caregivers of individuals with cancer in the COVID-19 pandemic are faced with the demands of cancer and the health needs produced by it, along with their own health and self-care needs, and the uncertainties of expectations and risks. A qualitative analytical phenomenological study with caregivers of individuals with cancer registered at the state referral hospital supplying medications, who answered the sociodemographic assessment questionnaires and semi-structured questions about their feelings and perceptions in the COVID-19 pandemic. Bardin's content analysis was used, with methodological quality assessed using SRQR Standards for Reporting Qualitative Research and the MAXQDA software. Most of the caregivers are women, married, Catholic, of low income and education, aged between 30 and 60 years, optimistic, comply with health guidelines regarding social distancing, use of masks, and routine hand hygiene, do not practice regular physical activities, mention concern for their own physical and financial survival, and that of their family. The main need identified in the affective sphere was to reframe contact with family members, seeking to strengthen the bonds of affection. The feeling of emotional vulnerability shows the importance of building effective public policies for social support consistent with the improvement of health care for this population.
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Affiliation(s)
- Leila Abou Salha
- Faculty of Medicine, Federal University of Goiás, Goiania 74605-050, Brazil; (J.C.S.S.); (C.A.M.); (E.A.S.d.S.); (F.H.A.d.L.); (V.S.d.M.); (M.A.B.)
- Correspondence:
| | - Julio Cesar Souza Silva
- Faculty of Medicine, Federal University of Goiás, Goiania 74605-050, Brazil; (J.C.S.S.); (C.A.M.); (E.A.S.d.S.); (F.H.A.d.L.); (V.S.d.M.); (M.A.B.)
| | - Cleusa Alves Martins
- Faculty of Medicine, Federal University of Goiás, Goiania 74605-050, Brazil; (J.C.S.S.); (C.A.M.); (E.A.S.d.S.); (F.H.A.d.L.); (V.S.d.M.); (M.A.B.)
| | | | - Edinamar Aparecida Santos da Silva
- Faculty of Medicine, Federal University of Goiás, Goiania 74605-050, Brazil; (J.C.S.S.); (C.A.M.); (E.A.S.d.S.); (F.H.A.d.L.); (V.S.d.M.); (M.A.B.)
| | - Angela Gilda Alves
- Faculty of Nursing, Federal University of Goiás, Goiania 74605-080, Brazil; (C.S.d.C.A.); (A.G.A.); (V.V.B.)
| | | | - Flavio Henrique Alves de Lima
- Faculty of Medicine, Federal University of Goiás, Goiania 74605-050, Brazil; (J.C.S.S.); (C.A.M.); (E.A.S.d.S.); (F.H.A.d.L.); (V.S.d.M.); (M.A.B.)
| | - Veidma Siqueira de Moura
- Faculty of Medicine, Federal University of Goiás, Goiania 74605-050, Brazil; (J.C.S.S.); (C.A.M.); (E.A.S.d.S.); (F.H.A.d.L.); (V.S.d.M.); (M.A.B.)
| | - José Elmo de Menezes
- Federal Institute of Education, Science, and Technology of Goiás, Pontifical Catholic University of Goiás, Goiania 74605-900, Brazil;
| | - Virginia Visconde Brasil
- Faculty of Nursing, Federal University of Goiás, Goiania 74605-080, Brazil; (C.S.d.C.A.); (A.G.A.); (V.V.B.)
| | - Maria Alves Barbosa
- Faculty of Medicine, Federal University of Goiás, Goiania 74605-050, Brazil; (J.C.S.S.); (C.A.M.); (E.A.S.d.S.); (F.H.A.d.L.); (V.S.d.M.); (M.A.B.)
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Fonseca BDP, Albuquerque PC, Saldanha RDF, Zicker F. Geographic accessibility to cancer treatment in Brazil: A network analysis. LANCET REGIONAL HEALTH. AMERICAS 2021; 7:100153. [PMID: 36777653 PMCID: PMC9903788 DOI: 10.1016/j.lana.2021.100153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Geographic accessibility to healthcare services is a fundamental component in achieving universal health coverage, the central commitment of the Brazilian Unified Health System (SUS). For cancer patients, poor accessibility has been associated with inadequate treatment, worse prognosis, and poorer quality of life. Methods We explored nationwide healthcare data from the SUS health information systems, and mapped the geographic accessibility to cancer treatment in two time-frames: 2009-2010 and 2017-2018. We applied social network analysis (SNA) to estimate the commuting route, flow, and distances travelled by cancer patients to undergo surgical, radiotherapy, and chemotherapy treatment. Findings A total of 12,751,728 treatment procedures were analyzed. Overall, more than half of the patients (49·2 to 60·7%) needed to travel beyond their municipality of residence for treatment, a fact that did not change over time. Marked regional differences were observed, as patients living in the northern and midwestern regions of the country had to travel longer distances (weighted average of 296 to 870 km). Cancer care hubs and attraction poles were mostly identified in the southeast and northeast regions, with Barretos being the main hub for all types of treatment throughout time. Interpretation Important regional disparities in the accessibility to cancer treatment in Brazil were revealed, suggesting the need to review the distribution of specialized care in the country. The data presented here contribute to ongoing research on improving access to cancer care and can provide reference to other countries, offering relevant data for oncological and healthcare service evaluation, monitoring, and strategic planning. Funding This work was funded by the Oswaldo Cruz Foundation - Fiocruz (Inova - no. 8451635123 to BPF) and the National Council for Scientific and Technological Development - CNPq (no. 407060/2018-9 to BPF); Coordination for the Improvement of Higher Education Personnel - CAPES (scholarship to PCA, Finance Code 001); and Instituto Nacional de Ciência e Tecnologia de Inovação em Doenças de Populações Negligenciadas (INCT-IDPN). Resumo A acessibilidade geográfica aos serviços de saúde é um componente fundamental para o alcance da cobertura universal de saúde, compromisso central do Sistema Único de Saúde (SUS). Para pacientes com câncer, a baixa acessibilidade aos serviços especializados tem sido associada ao tratamento inadequado, piora no prognóstico e na qualidade de vida.Neste estudo, dados de saúde dos sistemas de informação em saúde do SUS foram utilizados para mapear a acessibilidade geográfica ao tratamento do câncer em dois períodos: 2009-2010 e 2017-2018. Aplicamos a análise de redes sociais (ARS) para estimar os fluxos de deslocamento e as distâncias percorridas por pacientes com câncer para receberem tratamento cirúrgico, radioterápico e quimioterápico.Um total de 12.751.728 procedimentos de tratamento foram analisados. Em geral, mais da metade dos pacientes (49,2 a 60,7%) precisaram se deslocar de seus municípios de residência para receber tratamento, fato que não mudou comparando os dois períodos de tempo analisados. Foram observadas importantes diferenças regionais no acesso. Pacientes residentes das regiões norte e centro-oeste do país tiveram que percorrer maiores distâncias para alcançar os serviços (média ponderada = 296 a 870 km). A maioria dos hubs e polos de atração para atendimento oncológico foram identificados nas regiões Sudeste e Nordeste, sendo o município de Barretos o principal hub para todos os tipos de tratamento ao longo do tempo.As disparidades de acessibilidade para o tratamento de câncer, alertam para a necessidade de revisar a distribuição dos serviços de atenção especializada no país. A metodologia e os resultados apresentados neste estudo contribuem para as pesquisas sobre a melhoria do acesso ao tratamento do câncer e podem servir como referência para outros países, oferecendo dados relevantes para avaliação, monitoramento e planejamento estratégico de serviços oncológicos e de saúde em geral.
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Affiliation(s)
- Bruna de Paula Fonseca
- Centro de Desenvolvimento Tecnológico em Saúde (CDTS), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil,Corresponding author: Dr. Bruna Fonseca, PhD, Center for Technological Development in Health, Av. Brasil, 4036, 8 andar, prédio da Expansão, Fundação Oswaldo Cruz, CEP 21040-361 - Rio de Janeiro - RJ, Brazil.
| | - Priscila Costa Albuquerque
- Centro de Desenvolvimento Tecnológico em Saúde (CDTS), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil
| | - Raphael de Freitas Saldanha
- Plataforma de Ciência de Dados Aplicada à Saúde (PCDaS), Instituto de Informação Científica e Tecnológica em Saúde (ICICT), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil
| | - Fabio Zicker
- Centro de Desenvolvimento Tecnológico em Saúde (CDTS), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil
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Pérez Giraldo B, Arroyo Marlés LP, Nonsoque Cholo MA, Sánchez Herrera B, Guevara Lozano M. Transformar la asistencia de necesidad básica en un momento de cuidado. INVESTIGACIÓN EN ENFERMERÍA: IMAGEN Y DESARROLLO 2021. [DOI: 10.11144/javeriana.ie22.tanb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Introducción. Conocer y atender debidamente las necesidades de un ser humano en medio de su vulnerabilidad continúa siendo un reto vigente. Objetivo. Describir la transformación de la “Atención a las necesidades básicas” en un momento de cuidado de enfermería para favorecer la adaptación del paciente y su cuidador familiar durante la hospitalización, en la Clínica Universidad de La Sabana, para el periodo 2018-2019. Método. Esta es una investigación metodológica en enfermería, realizada bajo lineamientos del Modelo de Enfermería Universidad de La Sabana, que incluyó cuatro fases. Resultados. Es preciso que la atención a las necesidades básicas sea respaldada en la mejor evidencia disponible, y con un trato humanizado. Hacer visible este proceso permitió medirlo y mejorarlo. Conclusiones. Para brindar un cuidado humano y seguro, no basta la buena intención, es necesario garantizar dos condiciones; por un lado, el compromiso requerido para soportarlo con la mejor evidencia disponible, aumentando la calidad del cuidado y la calidez o tono humano; y, por otro, el respeto y reconocimiento de la dignidad de las personas, favoreciendo el vínculo con ellas y su autonomía, lo que a su vez repercute positivamente en el desarrollo de la enfermería.
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Willrich Boell JE, Flores Trindade L, Bernat Kolankiewicz AC, Cañon-Montañez W, Pituskin E, Lorenzini E. Care Transitions of Colorectal Cancer Patients from Hospital to Community: Systematic Review and Meta-analysis Protocol. REVISTA CUIDARTE 2021. [DOI: 10.15649/cuidarte.2285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective: To evaluate the effectiveness of care transition strategies from hospital-to-community compared to usual care for patients with colorectal cancer to reduce hospital stay, 30-day readmissions, and emergency room visits up to 30 days. Methods: Systematic review and meta‐analysis protocol that followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). The protocol was registered on PROSPERO (CRD42020162249). We will include studies available in the electronic databases PubMed/Medline, Embase, Cochrane CENTRAL and LILACS with care transition strategies/actions from hospital to community as the primary outcome. Eligible studies will be selected, and data will be combined and synthesized using Review Manager (RevMan 5.4) software. We will combine risk ratios or odds ratios for dichotomous data and mean differences for continuous data using a random effects model. Discussion: This review will contribute to the practice and development of effective and safe care transition strategies from hospital to community for colorectal cancer patients. There is an expectation that this review will provide much needed evidence that effective care transitions could reduce short term hospital readmission, and may thus provide added value in the care of colorectal cancer patients. Conclusion: The results of the review will be used to provide clear recommendations for hospital and primary care management to improve care transitions and, as a result, also improve integration in the healthcare system.
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Ríos Camargo NK, Urrego Mendoza ZC. Itinerarios terapéuticos: una revisión de alcance. Rev Salud Publica (Bogota) 2021. [DOI: 10.15446/rsap.v23n1.92447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo Revisar el conocimiento construido sobre el origen y definición, características, teorías y conceptos e ideas claves, campos de acción y relaciones con otros conceptos de los “itinerarios terapéuticos”.Métodos Revisión de alcance (scoping review) en bases de datos como PubMed, SciELO, LILACS, Google Scholar y en el repositorio de la Universidad Nacional de Colombia.Resultados Se incluyeron 70 documentos: 54% producidos en Brasil y solo el 23%, en Colombia; 47% publicados en portugués. En los últimos cuatro años hubo incremento en las producciones académicas del tema (39%). Los itinerarios terapéuticos aparecieron relacionados con otros conceptos como itinerarios de cuidado, itinerarios burocráticos y trayectorias vitales o de cuidado. Se les estudió en variadas poblaciones, en especial dentro de América Latina.Conclusión Se reconoce la investigación sobre itinerarios terapéuticos como base importante para construir sistemas de salud integrales acordes con la realidad de los usuarios, personas y comunidades a las que están dirigidos.
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SILVA ROGÉRIOSANTOS, TABET LÍVIAPENNA, BATISTA KATIATORRES, NAVES JULIANAFAKIR, VIANA ENEIDADEMATTOSBRITOOLIVEIRA, GUILHEM DIRCEBELLEZI. QUALITY OF LIFE IN ADULTS WITH SARCOMAS UNDER CONSERVATIVE SURGERY OR AMPUTATION. ACTA ORTOPEDICA BRASILEIRA 2020; 28:236-242. [PMID: 33144839 PMCID: PMC7580300 DOI: 10.1590/1413-785220202805230966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To understand the perception of quality of life, functionality, and psychological aspects of adults with lower limb sarcoma who underwent conservative surgery or amputation. METHODS Sociodemographic data were collected, and the following questionnaires were used: EORTC QLQ - C30 for quality of life, the Functional Assessment System (MSTS) for functionality and the Beck Depression Inventory (BDI) for depression symptoms. RESULTS The sample consisted of 45 young adults with sarcoma, divided into two groups: amputation (29) and conservative surgery (16). Most were male, single and students. Average family income before and after the disease did not differ, but those that were employed had a better perception of general quality of life, as well as those with higher family income after the disease. Regarding the type of surgery, there was a predominance of amputation; osteosarcoma was the most common histological type and the most affected region was the femur. All participants participated in social, cultural, sporting or religious activities. MSTS and Beck scale values did not differ between procedures. CONCLUSION Given the scarcity of studies on the subject at the national level, further investigations are suggested to explore aspects related to quality of life for patients with sarcomas. Level of Evidence III, Retrospective comparative study.
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Affiliation(s)
- ROGÉRIO SANTOS SILVA
- Universidade de Brasília, Brazil; Rede SARAH de Hospitais de Reabilitação, Brazil
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Hansel CG, Silva JD, Araújo STCD, Fernandes LLRA, Marins AMDF, Almeida JDRSD. Demandas no itinerário terapêutico de idosos: um estudo descritivo. ESCOLA ANNA NERY 2020. [DOI: 10.1590/2177-9465-ean-2019-0375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo Analisar as demandas no itinerário terapêutico de idosos na rede de saúde. Método Estudo descritivo, corte temporal, de abordagem qualitativa. Amostra constituída por 23 idosos, entre 70 e 79 anos em tratamento ambulatorial, entre junho de 2014 a julho de 2015. As entrevistas semiestruturadas foram realizadas individualmente, dentro da unidade que compõe o nível secundário da Rede de Atenção à Saúde. Transcrição das entrevistas e análise dos dados orientadas pelos princípios da Teoria Fundamentada nos Dados. Resultados Foram evidenciadas experiências de idas e vindas pela rede; longos e complexos caminhos e percursos; falta de humanidade e demora no atendimento. Conclusão e implicações para a prática Para os idosos, a estrutura da rede de saúde gera itinerários permeados por fluxos de incertezas com relação à sua condição de saúde e doença, atravessada também pela demora nos exames e no tratamento. O estudo indica que existe a necessidade de avaliações e intervenções de enfermagem sensíveis às vivências do idoso nos diferentes níveis de atenção.
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