Influencia de la cultura en la experiencia del cáncer

Optimal cancer care should integrate cultural variables that influence psychosocial adjustment to the disease and its treatments. This article describes some of the most important cultural variables that may affect an individual’s response to the disease: causal attributions to cancer; family members´ role in patient care; truth-telling practices; attitudes towards pain; and attitudes towards death and dying. The article is based on others previously published. Its main purpose is to increase medical staff’s awareness of the need to understand the culturally different cancer patient in societies in which increasing immigration rates oblige some individuals to treat and confront their illness in cultural environments that are unknown to them

Group psychotherapy for breast cancer patients: a clinica approach

Este artículo describe las diferentes modalidades grupales de psicoterapia que se emplean con mujeres que padecen cáncer de mama. Además de documentar su eficacia en cuanto a mejoras en la calidad de vida, reducciones en síntomas físicos, y mejora en la adaptación psicológica global, el artículo tiene un enfoque clínico centrado en describir los pasos para llevar a cabo eficazmente un grupo para esta población de pacientes oncológicos. Se describen con detalle grupos de sesión única con el fin de facilitar una herramienta clínicamente útil para el lector, dada la eficacia de estos grupos y la facilidad para llevarlos a cabo. Igualmente se describen los grupos de larga duración y aquellos de duración limitada. Se ofrecen pautas para facilitar la organización de un grupo e intentar vencer las barreras que surgen en el proceso. Finalmente, se describen estudios que han evaluado los efectos de la participación en terapia grupal sobre la supervivencia de mujeres con cáncer de mama.This article describes the different modalities of group psychotherapies that are most frequently used with breast cancer patients. In addition to documenting the efficacy of group psychotherapy in improving patients´ quality of life, physical symptoms and global psychological adaptation, emphasis is placed on clinical aspects of this treatment modality. Guidelines to develop effective groups are described. Only-session groups are described in detail in order to provide the health professionals with instruments that are clinically useful. Long duration and time-limited groups are equally described. Guidelines are offered to facilitate group development and help overcome the barriers that arise during this process. Finally, studies evaluating the effects of group participation on survival of breast cancer patients are included

Tratamiento psicológico grupal para mujeres con cáncer de mama: una aproximación clínica

Este artículo describe las diferentes modalidades grupales de psicoterapia que se emplean con mujeres que padecen cáncer de mama. Además de documentar su eficacia en cuanto a mejoras en la calidad de vida, reducciones en síntomas físicos, y mejora en la adaptación psicológica global, el artículo tiene un enfoque clínico centrado en describir los pasos para llevar a cabo eficazmente un grupo para esta población de pacientes oncológicos. Se describen con detalle grupos de sesión única con el fin de facilitar una herramienta clínicamente útil para el lector, dada la eficacia de estos grupos y la facilidad para llevarlos a cabo. Igualmente se describen los grupos de larga duración y aquellos de duración limitada. Se ofrecen pautas para facilitar la organización de un grupo e intentar vencer las barreras que surgen en el proceso. Finalmente, se describen estudios que han evaluado los efectos de la participación en terapia grupal sobre la supervivencia de mujeres con cáncer de mama

Influencia de la cultura en la experiencia del cáncer

Optimal cancer care should integrate cultural variables that influence psychosocial adjustment to the disease and its treatments. This article describes some of the most important cultural variables that may affect an individual’s response to the disease: causal attributions to cancer; family members´ role in patient care; truth-telling practices; attitudes towards pain; and attitudes towards death and dying. The article is based on others previously published. Its main purpose is to increase medical staff’s awareness of the need to understand the culturally different cancer patient in societies in which increasing immigration rates oblige some individuals to treat and confront their illness in cultural environments that are unknown to them

Aspectos psicológicos específicos del cáncer en las mujeres

The differences in the psychosocial aspects of different types of cancer in men and women are mainly based on gender variables. However, the specific way in which gender influences adaptation to cancer is not completely defined and it has also been very poorly studied. Gender differences are not only evident in the physical impact of cancer, but also in quality of life, in the psychosocial differences, in the confronting styles and in the adaptation of the patient’s partners to the process of the disease. It is necessary to identify women’s specific psychosocial needs in more detail in order to be able to develop specific programs which keep in mind the gender differences in the way oncologic disease is confronted, as well as in the process of making clinical decisions and in the variables required to optimise their quality of life.Las diferencias en los aspectos psicosociales de diferentes tipos de cáncer en hombres y mujeres están basadas fundamentalmente en variables de género. Sin embargo, la forma concreta en la que influye el género en la adaptación al cáncer no está del todo definida, y desde luego, muy poco estudiada. Las diferencias de género no solo son evidentes en el impacto físico del cáncer sino también en la calidad de vida, en las diferencias psicosociales, en los estilos de afrontamiento y en la adaptación de las parejas de los pacientes al proceso de enfermedad. Es necesario identificar con más detalle las necesidades psicosociales específicas de la mujer con el fin de poder desarrollar programas concretos que tengan en cuenta las diferencias de género en el afrontamiento de la enfermedad oncológica, en el proceso de toma de decisiones médicas, y en las variables necesarias para la optimización de su calidad de vida

Jimmie Holland

Sin resume

The impact of conversion on the risk of major complication following laparoscopic colonic surgery: an international, multicentre prospective audit.

This is the peer reviewed version of the following article: The and E. S. o. C. c. groups (2018). "The impact of conversion on the risk of major complication following laparoscopic colonic surgery: an international, multicentre prospective audit." Colorectal Disease 20(S6): 69-89., which has been published in final form at https://doi.org/10.1111/codi.14371. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.BACKGROUND: Laparoscopy has now been implemented as a standard of care for elective colonic resection around the world. During the adoption period, studies showed that conversion may be detrimental to patients, with poorer outcomes than both laparoscopic completed or planned open surgery. The primary aim of this study was to determine whether laparoscopic conversion was associated with a higher major complication rate than planned open surgery in contemporary, international practice. METHODS: Combined analysis of the European Society of Coloproctology 2017 and 2015 audits. Patients were included if they underwent elective resection of a colonic segment from the caecum to the rectosigmoid junction with primary anastomosis. The primary outcome measure was the 30-day major complication rate, defined as Clavien-Dindo grade III-V. RESULTS: Of 3980 patients, 64% (2561/3980) underwent laparoscopic surgery and a laparoscopic conversion rate of 14% (359/2561). The major complication rate was highest after open surgery (laparoscopic 7.4%, converted 9.7%, open 11.6%, P < 0.001). After case mix adjustment in a multilevel model, only planned open (and not laparoscopic converted) surgery was associated with increased major complications in comparison to laparoscopic surgery (OR 1.64, 1.27-2.11, P < 0.001). CONCLUSIONS: Appropriate laparoscopic conversion should not be considered a treatment failure in modern practice. Conversion does not appear to place patients at increased risk of complications vs planned open surgery, supporting broadening of selection criteria for attempted laparoscopy in elective colonic resection

An international multicentre prospective audit of elective rectal cancer surgery; operative approach versus outcome, including transanal total mesorectal excision (TaTME)

IntroductionTransanal total mesorectal excision (TaTME) has rapidly emerged as a novel approach for rectal cancer surgery. Safety profiles are still emerging and more comparative data is urgently needed. This study aimed to compare indications and short-term outcomes of TaTME, open, laparoscopic, and robotic TME internationally.MethodsA pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 audit was performed. Patients undergoing elective total mesorectal excision (TME) for malignancy between 1 January 2017 and 15 March 2017 by any operative approach were included. The primary outcome measure was anastomotic leak.ResultsOf 2579 included patients, 76.2% (1966/2579) underwent TME with restorative anastomosis of which 19.9% (312/1966) had a minimally invasive approach (laparoscopic or robotic) which included a transanal component (TaTME). Overall, 9.0% (175/1951, 15 missing outcome data) of patients suffered an anastomotic leak. On univariate analysis both laparoscopic TaTME (OR 1.61, 1.02-2.48, P=0.04) and robotic TaTME (OR 3.05, 1.10-7.34, P=0.02) were associated with a higher risk of anastomotic leak than non-transanal laparoscopic TME. However this association was lost in the mixed-effects model controlling for patient and disease factors (OR 1.23, 0.77-1.97, P=0.39 and OR 2.11, 0.79-5.62, P=0.14 respectively), whilst low rectal anastomosis (OR 2.72, 1.55-4.77, P<0.001) and male gender (OR 2.29, 1.52-3.44, P<0.001) remained strongly associated. The overall positive circumferential margin resection rate was 4.0%, which varied between operative approaches: laparoscopic 3.2%, transanal 3.8%, open 4.7%, robotic 1%.ConclusionThis contemporaneous international snapshot shows that uptake of the TaTME approach is widespread and is associated with surgically and pathologically acceptable results