Factors associated with time-to-treatment initiation of breast cancer

The present retrospective study investigated factors associated with time-to-treatment initiation of breast cancer of a cohort of 12,100 cases of health facilities qualified for high complexity in oncology within the scope of the Brazilian Public Health System (SUS) of Rio de Janeiro between 2013 and 2019. Multivariate logistic regression was used to estimate odds ratios and 95% confidence intervals. Of all cases, 82.1% were submitted to the first treatment >60 days. Patients without previous diagnosis history, higher education and in stages III and IV were less likely to have their first treatment >60 days, while treatment at a health facility outside the capital showed a higher probability. Patients with a previous diagnosis history, aged ≥50, non-white race/skin color and in stage I were more likely to be submitted to their first treatment >60 days, while subjects with higher education, treated in a health facility outside the capital and in stage IV showed a lower probability. To summarize, sociodemographic, clinical and health facility-related factors are associated with time-to-treatment initiation of breast cancer.

Effect of motivational interviewing on self-care of people with heart failure: a randomized clinical trial

OBJECTIVE

To analyze the effect of motivational interviewing on self-care for people with chronic heart failure.

METHOD

A multicenter randomized clinical trial, which divided people into an intervention group (n=59) and a control group (n=59), followed for 60 days in centers of Brazil and Uruguay. The intervention group received three consultations per motivational interviewing, with an interval of 30 days, and the control group maintained conventional follow-up in specialized clinics. The data were assessed using the Self-Care of Heart Failure Index 6.2, before and after intervention in each of the centers. They were analyzed using the mean, median, t-test, correlation analysis using the Spearman coefficient and effect of the intervention by Cohen's d.

RESULTS

One hundred and eighteen people completed the study. In view of the assessment of the effect of the motivational interviewing on self-care, compared to conventional follow-up, a medium effect on maintenance and management (Cohen's d=0.6723; 0.5086) and high on self-care confidence (Cohen's d=0.9877).

CONCLUSION

Motivational interviewing was effective in improving self-care in patients with heart failure, being a feasible strategy to be implemented in specialized clinics. Brazilian Registry of Clinical Trials (Registro Brasileiro de Ensaios Clínicos): RBR-6fp5qt.

TRADUÇÃO E ADAPTAÇÃO TRANSCULTURAL DO INSTRUMENTO SELF CARE OF HEART FAILURE INDEX 6.2 PARA USO NO URUGUAI

Objetivo: traduzir e adaptar transculturalmente o instrumento Self-Care of Heart Failure Index 6.2para uso no Uruguai.Método: estudo metodológico, realizado em clínica de cuidados multidisciplinares em insuficiênciacardíaca no Uruguai entre novembro de 2016 e setembro de 2017. Foram desenvolvidas as etapas:tradução, síntese das versões traduzidas, retrotradução, avaliação pelo comitê de experts e préteste.Para análise, utilizou-se o índice de validade de conteúdo (adequado > 0,9), percentual deconcordância (adequado ≥ 80%) e o alfa de Cronbach no pré-teste (adequado ≥ 0,70).Resultado: na primeira avaliação, seis itens apresentaram IVC < 0,9 e/ou concordância total menorque 70% e por este motivo foram alterados e posteriormente reavaliados, atingindo IVC > 0,9 e/oupercentual de concordâncias maior que 70%. A consistência interna da escala foi de0 ,78.Conclusão: a tradução e adaptação deste instrumento proporciona o desenvolvimento de estudosmulticêntricos por proporcionar as mesmas medidas de avaliação de desfechos.

A efetividade da entrevista motivacional no autocuidado de pacientes com insuficiência cardíaca: revisão sistemática

Objetivo: Determinar a efetividade da intervenção entrevista motivacional no autocuidado dos pacientes com insuficiênciacardíaca. Método: Trata-se de uma revisão sistemática, atualizada em julho de 2018, realizada nas bases MEDLINE, CINAHL,Cochrane Library, Joanna Briggs Institute Library, PubMed, LILACS e Scopus com os descritores: heart failure/insuficiênciacardíaca, motivational interviewing/entrevista motivacional, self care/autocuidado e patient compliance/cooperação dopaciente. Principais resultados: Foram identificados, inicialmente, 25 estudos em potencial para inclusão nesta revisão, noentanto, após serem aplicados os critérios de elegibilidade, 14 estudos foram encaminhados a dois revisores para avaliação metodológica, diante disso, três estudos foram selecionados após alcançarem rigor suficiente para inclusão e síntese.Conclusão: Percebe-se nos estudos, que é o impacto da comunicação na relação paciente x profissional de saúde, o quepromove um elo fundamental e diretamente relacionado ao sucesso do tratamento. A síntese dos estudos evidenciou aefetividade da intervenção Entrevista Motivacional na adesão e no autocuidado dos pacientes com insuficiência cardíaca.Palavras-chave: Insuficiência Cardíaca; Entrevista Motivacional; Autocuidado e Cooperação do Paciente. ABSTRACTObjective: To determine the effectiveness of the motivational interview intervention in the self-care of patients with heartfailure. METHODS: This is a systematic review, updated in July 2018, based on the MEDLINE, CINAHL, Cochrane Library,Joanna Briggs Institute Library, PubMed, LILACS and Scopus databases, with the descriptors: heart failure/motivationalinterviewing/interview motivational, selfcare and patient compliance. MAIN RESULTS: We initially identified 25 potentialstudies for inclusion in this review; however, after eligibility criteria were applied, 14 studies were referred to two reviewersfor methodological evaluation; three studies were selected after reaching enough accuracy for inclusion and synthesis.Conclusion: It is perceived in the studies, which is the impact of communication in the relation between patient and healthprofessional, which promotes a fundamental link directly related to the success of the treatment. The synthesis of thestudies evidenced the effectiveness of the Motivational Interview intervention in the adherence and self-care of patientswith heart failure.Keywords: Heart failure; Motivational Interview: Self-Care and Patient Compliance.