Oral mucositis for chemotherapy and health-related quality of life of the women with breast cancer

O câncer de mama é uma doença tanto com impacto na morbimortalidade quanto na qualidade de vida de mulheres no Brasil e no mundo. A modalidade sistêmica mais utilizada para tratá-lo é a quimioterapia, que pretende ou eliminar o tumor ou reduzi-lo para intervenções cirúrgicas conservadoras como parte dos cuidados paliativos. A quimioterapia apresenta eventos adversos associados, entre eles, a mucosite oral. Sua incidência variada e dependente de fatores do próprio paciente ou do tratamento produz consequências importantes físicas, emocionais, sociais, econômicas e para a manutenção do tratamento. Todas essas repercussões afetam a qualidade de vida relacionada à saúde de maneira diversificada, visto que este é um fenômeno subjetivo ou multidimensional. Objetivo: avaliar a mucosite oral por quimioterapia e a qualidade de vida relacionada à saúde em mulheres com câncer de mama. Método: Trata-se de um estudo de coorte prospectivo, no qual três instrumentos (caracterização das participantes, QLQ-C30 e QLQ-BR23) foram aplicados no início, na metade e fim do tratamento. Concomitantemente, avaliou-se cavidade oral e dados do prontuário. Resultados: entre as 140 participantes prevaleceram mulheres pardas, média de 50, 40 anos (DP = 11,76), em união estável, com média de 2,37 filhos, com média de 8,66 anos de estudo (DP = 4,86), com renda menor de um salário mínimo (58,57%), proveniente de uma fonte de renda fixa, procediam, predominantemente, do Leste Sergipano (68,57%). Entre os comportamentos e hábitos de vida, declararam ser católicas (65,71%); inatividade física (55%), sobrepeso (35%) e obesidade (30%) predominaram, assim como, não-tabagismo (83,59%) e não-etilismo (83,57%). Quanto à clínica e terapêutica, observou-se que iniciaram o tratamento com a média de idade de 50 anos, apresentaram menarca tardia (62,13%), a minoria apresentou outra comorbidade, a maioria realizou tratamento em instituição pública, prevaleceram Carcinoma Ductal Invasivo (86%), estadios IIb e IIIa (25% ambos), Luminal B (38,5%), tratamento neoadjuvante (61%), esquema com adriamicina, ciclofosfamida e paclitaxel (44%). Sobre as condições orais, na amostra houve oscilação na integridade da gengiva, lábios, mucosa oral, aspecto da língua, xerostomia, hábitos de higiene. Na avaliação da mucosite oral, a incidência total durante o estudo foi de 85,71%, entre os momentos, predominou grau I (Momento 2 40% e Momento 3 42,1%) e a qualidade de vida relacionada à saúde geral entre o Momento 1 e 2 houve uma redução de 0,27% na média, e de 6,88% entre o Momento 2 e 3. Durante o estudo, os domínios e sintomas apresentaram oscilações apenas entre o, Momento 2 e 3. A associação entre mucosite oral e qualidade de vida relacionada à saúde foi inversa (β = - 13,44) pelo modelo de regressão linear múltipla. Conclusão: Os desfechos observados sugerem que as mulheres apresentaram semelhanças quanto aos aspectos clínicos e terapêuticos e diferenças quanto aos aspectos sociodemográficos. A incidência da mucosite oral foi maior e divergente quanto ao grau de severidade do que relatado na literatura. A qualidade de vida relacionada à saúde piorou ao longo do acompanhamento terapêuticoBreast cancer is a disease that impacts morbidity mortality as well as the quality of life of women in Brazil and worldwide. The most widely used systemic modality to treat it is chemotherapy, which aims to either eliminate the tumor or shrink it for conservative surgery or as part of palliative care. Chemotherapy has adverse events associated, among them, oral mucositis. Its incidence is varied and dependent on the patient\'s or treatment factors and it produces important physical, emotional, social and economic consequences as well as for the maintenance of the treatment. All these repercussions affect health-related quality of life in a diversified manner, as this is a subjective or multidimensional phenomenon. Objective: To evaluate chemotherapy oral mucositis and HRQoL in women with breast cancer. Method: This was a prospective cohort study, in which three instruments (participant characterization, QLQ-C30 and QLQ-BR23) were applied at the beginning, middle and at the end of treatment. Concomitantly, the oral cavity and medical record data were evaluated. Results: with 140 participants. In the sample, brown-skinned women prevailed, an average of 50.40 years old (SD = 11.76), they were in a stable relationship, with an average of 2.37 children, with an average of 8.66 years of schooling (SD = 4.86), with an income lower than one minimum wage (58.57%), coming from a fixed income source, they came predominantly from Eastern Sergipe (68.57%). Among the behaviors and lifestyle habits, they declared to be Catholic (65.71%); the physical inactivity (55%), overweight (35%) and obesity (30%) predominated, as well as, non-smoking (83.59%) and non-alcoholism (83.57%). Regarding clinical and therapeutic, it was observed that they started treatment with a mean age of 50 years old, presented late menarche (62.13%), the minority had another comorbidity, most of them were treated in a public institution, prevailed Invasive Ductal Carcinoma (86%), stages IIb and IIIa (25% both), Luminal B (38.5%), neoadjuvant treatment (61%), whit Adriamycin, cyclophosphamide and paclitaxel (44%). Regarding oral conditions, in the sample, we had in the sample oscillation in the integrity of the gum, lips, oral mucosa, tongue aspect, xerostomia, and hygiene habits. In the evaluation of oral mucositis, the total incidence during the study was 85.71%, between the moments, grade I predominated (Moment 2 40% and Moment 3 42.1%) and the general health-related quality of life between Moment 1 and 2 there was a 0.27% reduction in average, and 6.88% between Moment 2 and 3. During the study, domains and symptoms fluctuated only between Moment 2 and 3. The association between oral mucositis and HRQoL was inverse (β = - 13.44) by the multiple linear regression model. Conclusion: The observed outcomes suggest that the women had similarities in clinical and therapeutic aspects and differences in sociodemographic aspects. The incidence of oral mucositis was higher and divergent regarding the degree of severity than what was reported in the literature. Health-related quality of life worsened during follow-u

Prevalência da utilização de tecnologias leves pela equipe de enfermagem de um hospital estadual

Objective: to describe the prevalence of the use of light technologies by the nursing team of a state hospital. Methods: cross-sectional and observational study. The sample consisted of 19 Nurses and 67 Nursing Technicians. The data were collected through direct simple observation using a validated instrument. Chi-square was used to compare the use of light technologies between the nursing categories. Results: there was prevalence of nursing technicians, females, with no partner and with an employment relationship. In the “Bonding” dimension, the interventions presence and security enhancement prevailed for nursing technicians and nurses, respectively. In the “Welcoming” dimension, surveillance and security were the most used by both categories. Conclusion: evaluation of the prevalence of light technologies showed that the dimensions “Welcoming” and “Bonding” were the most used by the nursing team and that nurses use them more often than the Nursing Technicians in the studied unit

Construction and validation of a tool to Assess the Use of Light Technologies at Intensive Care Units

ABSTRACT Objective: to construct and validate a tool to assess the use of light technologies by the nursing team at Intensive Care Units. Method: methodological study in which the tool was elaborated by means of the psychometric method for construction based on the categorization of health technologies by Merhy and Franco, from the National Humanization Policy, using the Nursing Intervention Classification taxonomy to categorize the domains of the tool. Agreement Percentages and Content Validity Indices were used for the purpose of validation. Results: The result of the application of the Interrater Agreement Percentage exceeded the recommended level of 80%, highlighting the relevance for the proposed theme in the assessment, with an agreement rate of 99%. Conclusion: the tool was validated with four domains (Bond, Autonomy, Welcoming and Management) and nineteen items that assess the use of light technologies at Intensive Care Units