Health care for irregular migrants: pragmatism across Europe. A qualitative study

<p>Abstract</p> <p>Background</p> <p>Health services in Europe face the challenge of delivering care to a heterogeneous group of irregular migrants (IM). There is little empirical evidence on how health professionals cope with this challenge. This study explores the experiences of health professionals providing care to IM in three types of health care service across 16 European countries.</p> <p>Results</p> <p>Semi-structured interviews were conducted with health professionals in 144 primary care services, 48 mental health services, and 48 Accident & Emergency departments (total n = 240). Although legal health care entitlement for IM varies across countries, health professionals reported facing similar issues when caring for IM. These issues include access problems, limited communication, and associated legal complications. Differences in the experiences with IM across the three types of services were also explored. Respondents from Accident & Emergency departments reported less of a difference between the care for IM patients and patients in a regular situation than did respondents from primary care and mental health services. Primary care services and mental health services were more concerned with language barriers than Accident & Emergency departments. Notifying the authorities was an uncommon practice, even in countries where health professionals are required to do this.</p> <p>Conclusions</p> <p>The needs of IM patients and the values of the staff appear to be as important as the national legal framework, with staff in different European countries adopting a similar pragmatic approach to delivering health care to IM. While legislation might help to improve health care for IM, more appropriate organisation and local flexibility are equally important, especially for improving access and care pathways.</p

Desigualtats en càncer en àrees urbanes: mortalitat i cribratge

La població mundial ha augmentat en els darrers anys a un ritme accelerat concentrant-se majoritàriament en les grans zones urbanes. Aquest ritme de creixement ràpid, sovint va per davant de la capacitat de resposta que els responsables municipals tenen a fi de proveir dels serveis bàsics necessaris, generant-se bosses de pobresa. Si bé la urbanització comporta més oportunitats i serveis, implica també uns canvis d’hàbits en les persones perjudicials per la salut. L’entorn, tant el físic com l’ambiental en el que les persones neixen, viuen i moren, és decisiu en la salut que aquestes tenen. L’anàlisi geogràfica, permet identificar zones amb acumulació de problemes de salut i els Sistemes d’Informació Geogràfica mapejar-los. El càncer continua sent una de les principals causes de mortalitat i no només en els països rics, de manera que revesteixen d’especial importància la prevenció mitjançant la millora de l’entorn i la detecció precoç. L’objectiu d’aquesta tesi és l’estudi de les desigualtats en la mortalitat per càncer en diferents ciutats de l’Estat Espanyol, en funció de la privació del territori dividit en seccions censals i el paper que els cribratges tenen en la reducció de les desigualtats socials en la prevenció del càncer i en conseqüència de la mortalitat. Inclou fet tres estudis diferents: el primer analitza la tendència en la desigualtat segons nivell educatiu en la mortalitat per càncer en homes i dones de Barcelona entre els anys 1992 i 2003. El segon, és un estudi transversal ecològic amb la mortalitat per càncer dels anys 1996 al 2003 en 11 ciutats de l’Estat Espanyol: Barcelona, Madrid, Bilbao, Zaragoza, Alacant, Castelló, València, Vigo, Córdoba, Málaga i Sevilla. S’estudia la relació entre l’excés de mortalitat i la privació de la unitat d’anàlisi territorial (la secció censal). Per a controlar la variabilitat territorial en l’estimació del risc, l’anàlisi es va fer mitjançant models Baiesians. Finalment, el tercer estudi, a partir de les dades de les Enquestes de Salut de Barcelona dels anys 1992, 2001 i 2006, descriu i compara les desigualtats per classe social en aquests 3 períodes estudiats, quant a la realització de cribratge de càncer de mama (de tipus poblacional) i cèrvix (oportunista). A Barcelona entre 1992 i 2003 les desigualtats per càncer en general, han disminuït en els homes i han desaparegut en les dones. En les diferents ciutats espanyoles estudiades el patró de desigualtat segons gènere és similar. Les ciutats més grans (Barcelona, Madrid i Sevilla) són les que presenten les desigualtats més grans en funció del nivell de privació del territori (secció censal). En la majoria de seccions censals, es troba una bona relació entre el patró espacial de privació i el risc de morir per càncer. Els càncer de pulmó, laringe i estómac són els principals responsables de desigualtat en totes les ciutats. Altrament, a Barcelona entre 1992 i 2006 ha augmentat considerablement les dones que es fan controls regulars de càncer de mama i cèrvix, però sembla que en el cas del cribratge de tipus poblacional aquest augment ha estat més important; de la mateixa manera, la reducció de les desigualtats de classe quant a la participació de les dones en els programes de cribratge, també ha estat més gran en el cas del poblacional que l’oportunista. Els resultats obtinguts si bé són força satisfactoris, mostren importants desigualtats sobretot entre homes i dones i per causes concretes de càncer encara hi ha aspectes a millorar i continuar treballant. Cal seguir impulsant les polítiques i accions necessàries potenciadores d’entorns saludables en el sentit ampli de la paraula, que afavoreixin l’adopció d’estils de vida saludables per a les persones.La población mundial, sobretodo la de los países en vías de desarrollo, ha aumentado durante los últimos años a un ritmo bastante acelerado y concentrándose mayoritariamente en las grandes zonas urbanas. Este ritmo de crecimiento tan rápido, a menudo va por delante de la capacidad de respuesta que los responsables municipales tienen para proveir a los ciudadanos de los servicios básicos, generando este déficit, bolsas de pobreza. Si bien la urbanización comporta más oportunidades y servicios, implica también unos cambios de hábitos en las personas en ocasiones perjudiciales para la salud. El entorno, tanto físico como ambiental, en el que las personas nacen, viven y mueren, es decisivo en la salud. El análisis geogràfico, permite identificar zonas con aculumacíón de problemas de salud y los Sistemas de Información Geográfica establecer mapas. El càncer continua siendo una de las principales causas de muerte y no solo en los países ricos, de manera que reviste de especial importancia la prevención mediante la mejora del entorno y la detección precoz. El objetivo de esta tesis es el estudio de las desigualdades en la mortalidad por cáncer en diferentes ciudades del estado Español, en función de la privación socioeconómica del territorio dividido en secciones censales así como el papel que los cribados desempeñan en la reducción de las desigualdades sociales en la prevención del cáncer y en consecuencia en la mortalidad. Incluye tres estudios: el primero analiza la tendencia en la desiguadad según nivel de estudios en la mortalidad por cáncer en hombres y mujeres de Barcelona entre los años 1992 y 2003. El segundo, es un estudio transversal ecológico con la mortalidad por cáncer entre 1992 y 2003 en 11 ciudades del Estado Español: Barcelona, Madrid, Bilbao, Zaragoza, Alicante, Castellón, Valencia, Vigo, Córdoba, Málaga y sevilla. Se estudia la relación entre el exceso de mortalidad y la privación socioeconómica de la unidad de análisis territorial (la sección censal). Para controlar la variabilidad territorial en la estimación del riesgo, el análisis se hizo mediante modelos Bayesianos. Finalmente, el tercer estudio, a partir de los datos de las Encuestas de Salud de Barcelona de los años 1992, 2001 y 2006, describe y compara las desigualdades por clase social en estos 3 períodos estudiados, en cuanto a la realización de cribado de cáncer de mama (poblacional) y de cérvix (oportunista). En Barcelona entre 1992 y 2003 las desigualdades por cáncer en general, habían disminuido en los hombres y desaparecen en las mujeres. En las distintas ciudades españolas estudiadas el patrón de desigualdad según género es similar. Las ciudades más grandes (Barcelona, Madrid y Sevilla) son las que presentan las desigualdades más importantes en función de la privación socioeconómica del territorio (sección censal). En la mayoría de secciones censales, se encuentra una buena relación entre el patrón espacial de privación y el riesgo de morir por cáncer. Los cánceres de pulmón, laringe y estómago son los principales responsables de desigualdad en todas las ciudades. Por otro lado, en Barcelona entre 1992 y 2006 ha aumentado considerablemente el número de mujeres que realizan controles regulares de cáncer de mama y cérvix pero parece que en el caso del cribado de tipo poblacional (mama) este aumento ha sido más importante; del mismo modo, la reducción de las desigualdades de clase en cuanto a la participación de las mujeres en los programas de cribado, también ha sido mayor en el caso del poblacional que el oportunista. Los resultados obtenidos si bien son bastante satisfactorios, muestran importantes desigualdades de clase así como de género y por causas concretas, por lo cual hay todavía muchos aspectos sobre los que es necesario seguir trabajando. Es importante seguir impulsando las políticas y acciones necesarias potenciadoras de entornos saludables en el sentido amplio de la palabra, que favorezcan la adopción de estilos de vida saludables para las personas.The world's population, especially that of developing countries has increased in recent years at a fairly fast pace and concentrating mainly in large urban areas. This fast growth rate, is often ahead of the responsiveness that city authorities have to provide citizens with basic services, creating the deficit, pockets of poverty. While urbanization entails more opportunities and services, it also involves some lifestyle changes in people at times harmful to health. The environment, both physical environment in which people are born, live and die, is critical in health. Geographic analysis, to identify areas aculumacíón health problems and establish GIS maps. Cancer remains a leading cause of death and not just in rich countries, so that is of special importance through improved prevention and early detection environment. The objective of this thesis is the study of inequalities in cancer mortality in different Spanish cities, according to socioeconomic deprivation in census tracts divided territory and the role that screening plays in reducing social inequalities in the prevention of cancer and consequently mortality. It includes three studies: the first examines the trend in desiguadad by level of studies in cancer mortality in men and women of Barcelona between 1992 and 2003. The second is an ecological cross sectional study in cancer mortality between 1992 and 2003 in 11 Spanish cities: Barcelona, Madrid, Bilbao, Zaragoza, Alicante, Castellón, Valencia, Vigo, Cordoba, Malaga and Seville. Have studied the relationship between excess mortality and socioeconomic deprivation of the territorial unit of analysis (the census tract). To control the territorial variability in risk assessment, the analysis was done using Bayesian models. Finally, the third study, data from the Barcelona Health Survey for the years 1992, 2001 and 2006, describes and compares the social class inequalities in the 3 periods studied, regarding the performance of cancer screening breast (population) and cervical (opportunistic). In Barcelona between 1992 and 2003, overall cancer disparities had decreased in men and women disappear. In Spanish cities studied the pattern of inequality by gender is similar. The largest cities (Barcelona, Madrid and Seville) are those with major inequalities in terms of socio-economic deprivation in the area (census tract). In most census tracts, is a good relationship between the spatial pattern of deprivation and the risk of dying from cancer. Cancers of the lung, larynx and stomach are primarily responsible for inequality in all cities. On the other hand, in Barcelona between 1992 and 2006 has increased the number of women engaged in regular monitoring of breast and cervical cancer but it seems that in the case of population-based screening (breast) this increase has been more important, the same thus, the reduction in class inequalities in terms of participation of women in screening programs has also been greater in the case of the opportunistic population. Although the results are quite satisfactory, showing significant inequalities of class and gender and cause-specific, so there are still many aspects that need further work. It is important to continue to promote policies and actions necessary to promote healthy environments in the broadest sense of the word, to encourage the adoption of healthy lifestyles for people

Desigualdades socioeconómicas en el control mamográfico en mujeres españolas de 45 a 69 años de edad

OBJECTIVE: To analyse mammography screening in Spanish women aged 45 to 69 according sociodemographic variables and to describe the role of population-based breast cancer screening programmes in terms of variability of said screening. METHODS: Cross-sectional study of the 2011 National Health Survey. The study population includes women living in Spain between late 2011 and early 2012. The weighted sample analysed corresponds to 3,086 women aged 45 to 69. The dependent variables were mammograms and when the last mammogram was performed and why. Independent variables were age, social class, occupational status, country of origin, area of origin (rural/urban), health cover and years the programme had been in place. Logistic regression models were performed, with odds ratio (OR) adjusted according to age and 95% confidence intervals (95% CI). RESULTS: Approximately 91.9% indicated that they had had a mammogram before. The women who had had their last mammography screening in the previous 1 to 2 years were associated with the highest social class (OR: 1.69; 95% CI: 1.03-2.75). The reason for performing the last periodic mammogram via a population-based programme was associated with women aged between 60 and 69 years (OR: 1.51; 95% CI: 1.04-2.19). CONCLUSIONS: The results show that there are still inequalities in preventive practices. Possible risk groups need to be identified in order to promote the implementation of specific actions.Objetivo: Analizar según variables sociodemográficas el control mamográfico que realizan las mujeres españolas de 45 a 69 años de edad y describir el papel que desempeñan los programas poblacionales de cribado del cáncer de mama en cuanto a la variabilidad de los controles mamográficos. Métodos: Estudio transversal a partir de la Encuesta Nacional de Salud de 2011. La población de estudio son las mujeres residentes en España entre finales de 2011 y principios de 2012. La muestra ponderada analizada corresponde a 3.086 mujeres de 45 a 69 años de edad. Las variables dependientes fueron la realización de mamografías, la última mamografía y el motivo de su realización. Las variables independientes fueron la edad, la clase social, la situación laboral, el país de origen, el ámbito de procedencia, la cobertura sanitaria y los años de implantación del programa. Se realizaron modelos de regresión logística, obteniendo odds ratio (OR) ajustadas por edad y sus intervalos de confianza del 95% (IC95%). Resultados: Un 91,9% indicó que se había realizado una mamografía alguna vez. Las mujeres que se habían realizado el último control mamográfico entre 1 y 2 años antes se asociaron a la clase social más alta (OR: 1,69;IC95%: 1,03-2,75). El motivo de realizar la última mamografía periódica por un programa poblacional se asoció a las mujeres cuya edad era de 60-69 años (OR: 1,51; IC95%: 1,04-2,19). Conclusión: Los resultados indican que existen desigualdades sociales en la realización de prácticas preventivas. Debemos identificar posibles grupos de riesgo con el fin de impulsar la implementación de acciones específicas

Social inequalities in the use of physiotherapy in women diagnosed with breast cancer in Barcelona : DAMA cohort

This study aimed to analyze social inequalities in the use and access of physiotherapy service and its clinical and socio-economic determinants in women diagnosed with breast cancer in the hospital network of Barcelona. Data from 2235 women belonging to the mixed (prospective and retrospective) DAMA Cohort were analyzed, including demographic, socio-economic, clinical, and breast cancer treatment outcomes. To determine the influence of such variables on access to physiotherapy, different Poisson regression models with robust variance (obtaining Prevalence Ratios and confidence intervals) were estimated. Although when experiencing different chronic and acute symptoms, only between 20 and 35% of women visited physiotherapist. Two out of 3 women reported to have received insufficient information about medical care and rehabilitation. Age of women, job occupation, education level, having a mutual or private insurance, as well as outcomes related to breast cancer, appear to be factors influencing the access to physiotherapy. Social and economic inequalities exist on the access to physiotherapy by women diagnosed with breast cancer, which is generally low, and may clearly impact on their functional recovery. Promoting strategies to reduce social bias, as well as improve communication and patient information regarding physiotherapy may be of interest for a better health care in breast cancer diagnosed women

Determinantes sociales y clínicos del uso de servicios sanitarios en mujeres con cáncer de mama (Cohorte DAMA)

Data de publicació electrónica: 18-07-2018OBJECTIVE: To describe and analyse the factors associated with the use of health services (emergency departments, admissions and primary care) in women survivors of breast cancer diagnosed or treated in four university hospitals of Barcelona (Spain) between 2003 and 2013, within the framework of the Cohort DAMA project. METHOD: Descriptive design nested in a mixed cohort (Cohort Dama). We obtained sociodemographic information and information on the use of health services through a questionnaire, and on the tumour from the clinical history. Logistic regression models were performed, calculating the odds ratio of the use of health services (emergency departments, hospital admissions and primary care) raw and adjusted (aOR) by diagnostic method, the characteristics of the tumour and of the women and their 95% confidence intervals. RESULTS: The presence of chronic diseases was associated with greater use of the three levels of care. A disadvantaged economic level increases the risk of use of emergency departments and primary care but not of hospital admissions, while a higher tumour stage is associated with a greater risk of admission. By age, those under 50 had a higher risk of using emergency departments and admissions. CONCLUSIONS: The factors associated with the use of health services differ according to the level of care (aOR: 3.53 emergency departments, 1.67 admissions, 3.89 primary care) and treatment-derived complications (aOR: 1.35 emergency departments, 1.43 primary care). The presence of chronic disorders, younger age, disadvantaged social class, increases the risk of using services more than the tumour stage and treatment-derived complications. Neither the diagnostic method nor the survival time, nor the use of non-conventional therapies influence this

Desigualdades socioeconómicas en el control mamográfico en mujeres españolas de 45 a 69 años de edad

OBJECTIVE: To analyse mammography screening in Spanish women aged 45 to 69 according sociodemographic variables and to describe the role of population-based breast cancer screening programmes in terms of variability of said screening. METHODS: Cross-sectional study of the 2011 National Health Survey. The study population includes women living in Spain between late 2011 and early 2012. The weighted sample analysed corresponds to 3,086 women aged 45 to 69. The dependent variables were mammograms and when the last mammogram was performed and why. Independent variables were age, social class, occupational status, country of origin, area of origin (rural/urban), health cover and years the programme had been in place. Logistic regression models were performed, with odds ratio (OR) adjusted according to age and 95% confidence intervals (95% CI). RESULTS: Approximately 91.9% indicated that they had had a mammogram before. The women who had had their last mammography screening in the previous 1 to 2 years were associated with the highest social class (OR: 1.69; 95% CI: 1.03-2.75). The reason for performing the last periodic mammogram via a population-based programme was associated with women aged between 60 and 69 years (OR: 1.51; 95% CI: 1.04-2.19). CONCLUSIONS: The results show that there are still inequalities in preventive practices. Possible risk groups need to be identified in order to promote the implementation of specific actions.Objetivo: Analizar según variables sociodemográficas el control mamográfico que realizan las mujeres españolas de 45 a 69 años de edad y describir el papel que desempeñan los programas poblacionales de cribado del cáncer de mama en cuanto a la variabilidad de los controles mamográficos. Métodos: Estudio transversal a partir de la Encuesta Nacional de Salud de 2011. La población de estudio son las mujeres residentes en España entre finales de 2011 y principios de 2012. La muestra ponderada analizada corresponde a 3.086 mujeres de 45 a 69 años de edad. Las variables dependientes fueron la realización de mamografías, la última mamografía y el motivo de su realización. Las variables independientes fueron la edad, la clase social, la situación laboral, el país de origen, el ámbito de procedencia, la cobertura sanitaria y los años de implantación del programa. Se realizaron modelos de regresión logística, obteniendo odds ratio (OR) ajustadas por edad y sus intervalos de confianza del 95% (IC95%). Resultados: Un 91,9% indicó que se había realizado una mamografía alguna vez. Las mujeres que se habían realizado el último control mamográfico entre 1 y 2 años antes se asociaron a la clase social más alta (OR: 1,69;IC95%: 1,03-2,75). El motivo de realizar la última mamografía periódica por un programa poblacional se asoció a las mujeres cuya edad era de 60-69 años (OR: 1,51; IC95%: 1,04-2,19). Conclusión: Los resultados indican que existen desigualdades sociales en la realización de prácticas preventivas. Debemos identificar posibles grupos de riesgo con el fin de impulsar la implementación de acciones específicas

Trends in socioeconomic inequalities in cancer mortality in Barcelona: 1992-2003

Background: The objective of this study was to assess trends in cancer mortality by educational level in Barcelona from 1992 to 2003. Methods: The study population comprised Barcelona inhabitants aged 20 years or older. Data on cancer deaths were supplied by the system of information on mortality. Educational level was obtained from the municipal census. Age-standardized rates by educational level were calculated. We also fitted Poisson regression models to estimate the relative index of inequality (RII) and the Slope Index of Inequalities (SII). All were calculated for each sex and period (1992-1994, 1995-1997, 1998-2000, and 2001-2003). Results: Cancer mortality was higher in men and women with lower educational level throughout the study period. Less-schooled men had higher mortality by stomach, mouth and pharynx, oesophagus, larynx and lung cancer. In women, there were educational inequalities for cervix uteri, liver and colon cancer. Inequalities of overall and specific types of cancer mortality remained stable in Barcelona; although a slight reduction was observed for some cancers. Conclusion: This study has identified those cancer types presenting the greatest inequalities between men and women in recent years and shown that in Barcelona there is a stable trend in inequalities in the burden of cancer

Trends in socioeconomic inequalities in cancer mortality in Barcelona: 1992-2003

Background: The objective of this study was to assess trends in cancer mortality by educational level in Barcelona from 1992 to 2003. Methods: The study population comprised Barcelona inhabitants aged 20 years or older. Data on cancer deaths were supplied by the system of information on mortality. Educational level was obtained from the municipal census. Age-standardized rates by educational level were calculated. We also fitted Poisson regression models to estimate the relative index of inequality (RII) and the Slope Index of Inequalities (SII). All were calculated for each sex and period (1992-1994, 1995-1997, 1998-2000, and 2001-2003). Results: Cancer mortality was higher in men and women with lower educational level throughout the study period. Less-schooled men had higher mortality by stomach, mouth and pharynx, oesophagus, larynx and lung cancer. In women, there were educational inequalities for cervix uteri, liver and colon cancer. Inequalities of overall and specific types of cancer mortality remained stable in Barcelona; although a slight reduction was observed for some cancers. Conclusion: This study has identified those cancer types presenting the greatest inequalities between men and women in recent years and shown that in Barcelona there is a stable trend in inequalities in the burden of cancer

Trends in socioeconomic inequalities in cancer mortality in Barcelona: 1992–2003

Background: The objective of this study was to assess trends in cancer mortality by educational level in Barcelona from 1992 to 2003. Methods: The study population comprised Barcelona inhabitants aged 20 years or older. Data on cancer deaths were supplied by the system of information on mortality. Educational level was/nobtained from the municipal census. Age-standardized rates by educational level were calculated. We also fitted Poisson regression models to estimate the relative index of inequality (RII) and the/nSlope Index of Inequalities (SII). All were calculated for each sex and period (1992–1994, 1995–1997, 1998–2000, and 2001–2003). Results: Cancer mortality was higher in men and women with lower educational level throughout the study period. Less-schooled men had higher mortality by stomach, mouth and pharynx,/noesophagus, larynx and lung cancer. In women, there were educational inequalities for cervix uteri, liver and colon cancer. Inequalities of overall and specific types of cancer mortality remained stable/nin Barcelona; although a slight reduction was observed for some cancers. Conclusion: This study has identified those cancer types presenting the greatest inequalities/nbetween men and women in recent years and shown that in Barcelona there is a stable trend in inequalities in the burden of cancer.This project is partially financed by "Fondo de Investigaciones Sanitarias ( Grant nº 04/2013), CIBER de Epidemiologia y Salud Pública" (CIBERESP), and the Thematic Network of Cooperative Research on Cancer RD06/0020/0089. This paper forms part of the PhD dissertation of Rosa Puigpinós i Riera in the doctoral Programme in Public Health, University of Barcelona

Influence of social determinants, lifestyle, emotional well-being and the use of unconventional therapies in breast cancer progression in a cohort of women in Barcelona: protocol for the DAMA cohort

BACKGROUND: Breast cancer continues to be the most commonly diagnosed cancer in women. Breast cancer survivors face numerous problems, especially after completing the first year of intense treatment. We present the protocol for an ongoing study to analyze the impact of a series of factors on breast cancer survival related to lifestyle, emotional well-being, and use of complementary and alternative medicine (CAM). OBJECTIVE: We aim to analyze the influence of social determinants, lifestyle changes, emotional well-being, and use of CAM in the progression of breast cancer in women diagnosed with breast cancer between 2003 and 2013 in Barcelona, Spain. METHODS: We will perform a mixed cohort study (prospective and retrospective) of women diagnosed with breast cancer, created using a convenience sample in which we study the evolution of the disease (relapse, death, or remaining disease-free). Once identified, we sent the women information about the study and an informed consent form that they are required to sign in order to participate; a total of 2235 women were recruited. We obtained the following information from all participants: sociodemographic profile via a phone interview, and a self-administered survey of information about the study's objectives (lifestyles, emotional well-being, health care services, and the use of CAM). Lastly, we examined clinical records to obtain data on the tumor at the time of diagnosis, the treatment received, the occurrence of relapses (if any), and the tumor typology. We present data on the women's social profile based on descriptive data obtained from the telephone interview (welcome survey). RESULTS: Based on the welcome survey, which was completed by 2712 women, 14.42% (391/2712) of respondents were 65 years of age. A total of 43.69% (1185/2712) belonged to the highest social classes (I and II), 31.27% (848/2712) to the middle class (III), and 23.49% (637/2712) to the working classes (IV and V). Approximately 22.71% (616/2712) lived alone, 38.31% (1039/2712) lived with one person, and 38.97% (1057/2712) lived with two or more people. CONCLUSIONS: We obtained information from a large cohort of women, but this study has limitations related to the convenience sampling strategy, one of which is reduced representativeness. Conversely, being a self-administered survey, the study introduces biases, especially from respondents that answered on paper. However, the information that the study provides will serve as the basis for designing future interventions aimed at improving the knowledge gaps indicated for women with breast cancer