Incapacidade funcional de mulheres submetidas ao tratamento do câncer de mama

Breast cancer shows high incidence and mortality rates. However, a considerable increase in the survival rate is observed, so that the quality of life is now considered an important public health issue. The goal of this study is to determine the prevalence of disability and associated factors in women undergoing treatment for breast cancer. It is a cross-sectional study made with 101 women living in a city named Natal, in the state of Rio Grande do Norte, diagnosed with malignant neoplasm of the breast, who underwent cancer treatment for at least one year and still remain in clinical attendance in the Northern League against cancer. The study consisted of two phases of data collection, performed with access to the medical records of patients and individual interviews. The functional capacity was measured by a questionnaire called DASH. Variables related to socioeconomic characteristics, lifestyle, health, gynecological and obstetrical history, clinical characteristics of the tumor and therapeutic approach were also collected. The bivariate analysis was performed using Pearson's chisquare test (Fisher's Exact), calculating the prevalence ratio with an interval of confidence of 95%. The multivariate analysis was performed by Poisson regression with strong variance. It was considered the statistical significance level of 0.05. The average age of the women included in the study was 56,19 years (± 10,6), which in majority were white, married or in stable relationship, with high levels of education, with an average monthly income of 3 , 88 (± 4.5) times the minimum wage and access to the overriding public health service (50.5%). The prevalence of disability was 22,8% (95% CI 13,9 to 31,6). The ductal carcinoma was the most common diagnosis among women, affecting 78,2% of the sample. Most of the patients underwent conservative surgical approach (53,5%) with axillary approach (92,1%). Late postoperative complications were reported by 71,3% of the interviewed women. Functional capacity was associated with a statistically significant manner to the age and type of access to health services. It can be concluded that younger patients had a greater impact of the treatment of breast cancer in functionality when compared to older women. About the access to health services, women who received public clinical monitoring reported higher rates of disability, which points to the need for health services more organized in your care network, less bureaucratic and effectively resolving capacity, minimizing the impact of treatment cancer in living conditions and health of survivors of breast cancer.O câncer de mama apresenta altas taxas de incidência e atualmente observa-se aumento considerável na taxa de sobrevida, de modo que a qualidade desta sobrevivência passa a ser considerada uma importante questão de saúde pública. O objetivo do estudo foi verificar a prevalência de incapacidade funcional e seus fatores associados em mulheres sobreviventes ao tratamento do câncer de mama. Trata-se de um estudo transversal, realizado com 101 mulheres residentes no município de Natal-RN com diagnóstico de neoplasia maligna da mama, que foram submetidas ao tratamento oncológico há no mínimo um ano e que ainda permanecem em acompanhamento clínico na Liga Norte Riograndense contra o Câncer. O estudo foi composto por duas fases de coleta de dados, realizadas com o acesso aos prontuários das pacientes e com entrevistas individuais. A capacidade funcional foi aferida por meio do instrumento Disabilities of the Arm and Shoulder (DASH). Coletaram-se também variáveis relacionadas às características socioeconômicas, hábitos de vida, condições de saúde, histórico ginecológico e obstétrico, características clínicas do tumor e abordagem terapêutica. A análise bivariada foi realizada por meio do teste teste Qui-quadrado de Pearson (Exato de Fisher). A análise multivariada foi feita por meio da Regressão de Poisson com variância robusta. Considerou-se o nível de confiança de 95%. A idade média das mulheres incluídas no estudo foi de 56,19 anos (±10,6), com renda média mensal de 3,88 (±4,5) salários mínimos e com acesso ao serviço de saúde público predominante (50,5%). Em sua maioria, as pacientes foram submetidas à abordagem cirúrgica conservadora (53,5%). A prevalência de incapacidade funcional foi de 22,8% (IC95%: 13,9-31,6). A capacidade funcional mostrou-se associada de maneira estatisticamente significativa à idade e ao tipo de acesso ao serviço de saúde. Pode-se concluir que as pacientes mais jovens sofreram maior impacto do tratamento do câncer de mama na funcionalidade quando comparadas às mulheres mais idosas. Quanto ao acesso ao serviço de saúde, as mulheres que receberam acompanhamento clínico público apresentaram maior ocorrência de incapacidade funcional, o que aponta para a necessidade de serviços de saúde mais organizados na sua rede assistencial, menos burocráticos e efetivamente resolutivos, minimizando os impactos do tratamento oncológico nas condições de vida e saúde das sobreviventes do câncer de mama

Avaliação do nível de conhecimento e aplicabilidade da Classificação Internacional de Funcionalidade, Incapacidade e Saúde

RESUMO A pesquisa foi conduzida com o objetivo de avaliar o nível de conhecimento e aplicabilidade da Classificação Internacional de Funcionalidade, Incapacidade e Saúde por profissionais de saúde do município de Natal (RN). Trata-se de um estudo transversal, que avaliou 186 profissionais de saúde, mediante questionário eletrônico semiestruturado, composto de questões sobre o nível de conhecimento em relação à classificação e sua aplicabilidade. Concluiu-se que os profissionais de saúde possuem pouco conhecimento sobre a ferramenta. Além disso, os que relataram conhecê-la, dela fazem pouco uso devido às dificuldades para seu entendimento e aplicação

Spatial distribution of advanced stage diagnosis and mortality of breast cancer: Socioeconomic and health service offer inequalities in Brazil.

Breast cancer presents high incidence and mortality rates, being considered an important public health issue. Analyze the spatial distribution pattern of late stage diagnosis and mortality for breast cancer and its correlation with socioeconomic and health service offer-related population indicators. Ecological study, developed with 161 Intermediate Region of Urban Articulation (IRUA). Mortality data were collected from the Mortality Information System (MIS). Tumor staging data were extracted from the Hospital Cancer Registry (HCR). Socioeconomic variables were obtained from the Atlas of Human Development in Brazil; data on medical density and health services were collected from the National Registry of Health Institutions (NRHI) and Supplementary National Health Agency. Global Moran's Index and Local Indicator of Spatial Association (LISA) were utilized to verify the existence of territorial clusters. Multivariate analysis used models with global spatial effects. The proportion of late stage diagnosis of breast cancer was 39.7% (IC 39.4-40.0). The mean mortality rate for breast cancer, adjusted by the standard world population was 10.65 per 100,000 women (± 3.12). The proportion of late stage diagnosis presented positive spatial correlation with Gini's Index (p = 0.001) and negative with the density of gynecologist doctors (p = 0.009). The adjusted mortality rates presented a positive spatial correlation with the Human Development Index (p<0.001) and density of gynecologist doctors (p<0.001). Socioeconomic and health service offer-related inequalities of the Brazilian territory are determinants of the spatial pattern of breast cancer morbimortality in Brazil

Effects of non-invasive ventilatory support in tolerance to the effort of patients with hemodialysis

Introduction: The kidney system is responsible for the maintenance of homeostasis and in patients with Chronic Kidney Disease the kidney functions changes, contributing for the development of various complicationsthat will have adverse effects in tolerance to the physical exercise and in Quality of Life of this patients. Objective: To evaluate the Effects of non-invasive ventilatory support in tolerance to the patients physical exercise in dialysis. Methods: The patients performed two 6-minute walk tests, following an adapted protocol for treadmill, one of them without the use of non-invasive ventilatory support and the other with non-invasive ventilatory support during the walk. Besides, the patients answered a questionnaire of quality of life and the KDQOL-SFTM specific for the population under study. Results: It was noticed that there was not statistical difference in the distance recorded during the 6-minute walk tests. Regarding the quality of life, the greater impact of the disease was in relation to Professional Activity. Conclusion: In conclusion, a non-invasive ventilatory support did not cause significant effects in tolerance to the exercise of this population. However, we should take into consideration the limitations suffered during the research development

Effects of non-invasive ventilatory support in tolerance to the effort of patients with hemodialysis

Abstract Introduction The kidney system is responsible for the maintenance of homeostasis and in patients with Chronic Kidney Disease the kidney functions changes, contributing for the development of various complications that will have adverse effects in tolerance to the physical exercise and in Quality of Life of this patients. Objective To evaluate the Effects of non-invasive ventilatory support in tolerance to the patients’ physical exercise in dialysis. Methods The patients performed two 6-minute walk tests, following an adapted protocol for treadmill, one of them without the use of non-invasive ventilatory support and the other with non-invasive ventilatory support during the walk. Besides, the patients answered a questionnaire of quality of life and the KDQOL-SFTM specific for the population under study. Results It was noticed that there was not statistical difference in the distance recorded during the 6-minute walk tests. Regarding the quality of life, the greater impact of the disease was in relation to “Professional Activity”. Conclusion In conclusion, a non-invasive ventilatory support did not cause significant effects in tolerance to the exercise of this population. However, we should take into consideration the limitations suffered during the research development

Urinary Incontinence in Physically Active Older Women of Northeast Brazil

Low- and moderate-impact physical activity (PA) is associated with the prevention of urinary incontinence (UI). The objective of the cross-sectional study presented herein is to analyze the factors associated with UI in physically older active women who participate in senior community groups. The variable UI was measured by the International Consultation Incontinence Questionnaire Short Form (ICIQ-SF). Socioeconomic variables were also collected, along with data on life habits and clinical history. The multivariate analysis employed Poisson’s Regression with robust variance for factors associated with UI. Of the 106 participants evaluated, 54.7% presented UI, of which stress incontinence was more frequent, with 40.6%. UI presented a statistically significant association with dizziness/loss of balance during Activities of Daily Living (ADL) (prevalence ratio-PR 1.48; 95% CI 1.06–2.07) and nocturia (PR 1.63; 95% CI 1.05–2.55). Despite PA being a protection factor, UI presented an elevated prevalence in the older population, and therefore, other biological, social, and cultural aspects could also contribute to the occurrence of UI in this age group. Moreover, physically active older women with UI presented nocturia and dizziness/loss of balance during ADL, regardless of education levels and the number of births. These findings can help improve multi-professional programs aimed at promoting, preventing, and managing UI in the public

Self-perceived health in institutionalized elderly

Abstract This study aimed to verify health self-perception, its prevalence and associated factors in institutionalized elderl