Ana Francisca Vaz

Quality of life and menopausal and sexual symptoms in gynecologic cancer survivors: a cohort study

Objectives:The aims of this study were to investigate the frequency of menopausal and sexual symptoms and the proportion of sexually active women and to assess and identify quality of life (QOL) predictors in gynecologic cancer survivors. Methods:A prospective case series following a cohort of women under radiation therapy was conducted, including 107 women (aged 21-75 y) with gynecologic cancer (cervical or endometrial cancer) who underwent pelvic radiotherapy in the Radiotherapy Division of the Womens Integral Healthcare Center at the Universidade Estadual de Campinas. Adverse effects of radiotherapy were evaluated using the Common Terminology Criteria Adverse Event Scale. QOL was measured using the abbreviated version of the World Health Organizations Quality of Life instrument before radiotherapy (T0) and at 4 months (T1), 1 year (T2), and 3 years (T3) after radiotherapy. QOL scores were assessed over time using the Wilcoxon signed-rank test. Multiple linear regression analysis was used to identify QOL predictors. Results:A decrease in the frequency of vaginal dryness (26.7% in T0 vs 8.3% in T3; P < 0.01) and an increase in the proportion of sexually active women (21.5% in T0 vs 44.2% in T3; P < 0.01) were observed. A significant increase in QOL scores was observed in the psychological domain and general health and overall QOL. Dyspareunia negatively affected the physical (P < 0.01), psychological (P < 0.01), and social relationship domains (P < 0.01); overall QOL (P = 0.01); and general health (P = 0.04). Family income was positively related to environment domain (P < 0.01), overall QOL (P = 0.04), and general health (P < 0.01). Conclusions:Data derived from this study indicated that gynecologic cancer survivors had a lower frequency of vaginal dryness and a higher proportion of these women were sexually active 3 years after completion of radiotherapy. Furthermore, QOL improved and dyspareunia negatively affected various QOL dimensions.

Implementação do processo de enfermagem em uma unidade de radioterapia: elaboração de instrumento para registro

E meta de nosso servico sistematizar a assistencia de enfermagem a clientes portadoras de câncer genital e mamario, submetidas a tratamento ambulatorial em radioterapia, atraves do processo de enfermagem, utilizando-se, na fase diagnostica, a taxionomia da North American Nursing Diagnosis Association (NANDA) e os problemas colaborativos. Foram elaboradas fichas que permitissem o registro de forma sucinta e completa dos dados mais relevantes para a assistencia de enfermagem, contendo: anamnese, orientacoes gerais a respeito do tratamento, principais diagnosticos de enfermagem e problemas colaborativos, intervencoes, resultados esperados e evolucao. Esses impressos foram testados no servico e avaliados pela equipe que os desenvolveu quanto ao conteudo e diagramacao, ate se obterem os modelos atuais que sao apresentados neste artigo.

Implementation of nursing process in a radiotherapy unit: creation of a record card

E meta de nosso servico sistematizar a assistencia de enfermagem a clientes portadoras de câncer genital e mamario, submetidas a tratamento ambulatorial em radioterapia, atraves do processo de enfermagem, utilizando-se, na fase diagnostica, a taxionomia da North American Nursing Diagnosis Association (NANDA) e os problemas colaborativos. Foram elaboradas fichas que permitissem o registro de forma sucinta e completa dos dados mais relevantes para a assistencia de enfermagem, contendo: anamnese, orientacoes gerais a respeito do tratamento, principais diagnosticos de enfermagem e problemas colaborativos, intervencoes, resultados esperados e evolucao. Esses impressos foram testados no servico e avaliados pela equipe que os desenvolveu quanto ao conteudo e diagramacao, ate se obterem os modelos atuais que sao apresentados neste artigo.

Reply to letter to the editor by J.-M. Kim et al. on "Sexual function and quality of life in women with cervical cancer before radiotherapy: a pilot study" by Grion et al.

We thank you for your letter and acknowledge all comments on our study about sexuality and quality of life in women with cervical cancer [1]. A healthy sexual life contributes to the individual sense of well-being, improves interpersonal relationships and is an important component of the overall quality of life [2]. This is also true in women diagnosed with gynecological cancer. In our study, we found that a significant proportion of women with cervical cancer is sexually active at the beginning of treatment, however, they have significant sexual dysfunction, due to increased stress after the diagnosis or adverse symptoms related to the tumor [1]. The PLISSIT model which consists in four levels of intervention—Permission, Limited Information, Specific Suggestions and Intensive Therapy— has been widely suggested as an intervention to treat sexual dysfunction after cancer [3]. Kim et al. notes that in Korea, programs based on the PLISSIT model have been successfully implemented in women with gynecological cancer [4, 5]. We praise this initiative, and understand that with the decrease in mortality associated with cervical cancer, not only the physical, but also psychological and sexual aspects have a growing importance. Programs like these could be extended to other countries around the world.

Implementación del proceso de enfermería en una unidad de radioterapia: elaboración de instrumento para el registro

E meta de nosso servico sistematizar a assistencia de enfermagem a clientes portadoras de câncer genital e mamario, submetidas a tratamento ambulatorial em radioterapia, atraves do processo de enfermagem, utilizando-se, na fase diagnostica, a taxionomia da North American Nursing Diagnosis Association (NANDA) e os problemas colaborativos. Foram elaboradas fichas que permitissem o registro de forma sucinta e completa dos dados mais relevantes para a assistencia de enfermagem, contendo: anamnese, orientacoes gerais a respeito do tratamento, principais diagnosticos de enfermagem e problemas colaborativos, intervencoes, resultados esperados e evolucao. Esses impressos foram testados no servico e avaliados pela equipe que os desenvolveu quanto ao conteudo e diagramacao, ate se obterem os modelos atuais que sao apresentados neste artigo.