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The rapid growth in the cancer survivor population in Chile and Latin America raises new challenges in addressing their care needs. This study assesses the health status and compares the quality of care and quality of life in cancer survivors at a primary care network and a private cancer centre in Santiago, Chile.
Retrospective cohort study.
Three primary care clinics and one cancer centre in Chile.
All breast and colorectal cancer patients identified from a primary care retrospective cohort of 61 174 were followed from 2018 to 2023 and compared with an equivalent sample of patients from a university cancer centre identified during the same period.
Quality of care was assessed based on American Cancer Society standards, while quality of life was measured using the EuroQol 5 Dimensions-5 Levels survey instrument.
A total of 420 cancer survivors participated in the study; 208 from primary care and 212 from the cancer centre. All participants received substandard care. Patients in primary care had lower educational levels and higher rates of comorbidity. They reported a lower quality of life score (72.22 vs 78.43, p
Cancer survivors face a significant disease burden and receive substandard care in Chile. As the primary source of care for this population, primary care is challenged to better integrate with speciality care to develop an effective shared care model for cancer survivors.
To analyse the impact of the COVID-19 pandemic on the sustainability of a breastfeeding (BF) clinical practice guideline (CPG) for women without COVID-19, throughout the 5 waves of the pandemic.
A mixed-methods design was utilised.
For the quantitative approach, an interrupted time series design was utilised, as well as the analysis of CPG sustainability reports as a qualitative approach. The study setting was in a health area in the Spanish health system from April 2019, until October 2021. The sample was composed of 2239 mother–infant dyads.
The exclusive-BF rate at hospital discharge obtained values between 90% and 94.8%, without statistically significant changes. A significant increase in the risk of not starting BF in the first feeding was observed (adjusted odds ratio = 9.36; 95% CI: 1.04–84.13), between the pre-pandemic period and the first wave. Skin-to-skin contact (SSC) decreased in the first wave to 82.20%, and the oscillations observed throughout the pandemic were not statistically significant. In general, the qualitative indicators were maintained. A decrease was observed in the spaces used for postpartum care due to the re-assigning to the intensive care unit. Also, the acquisition of materials and equipment decreased.
The measures implemented for the sustainability of the BF CPG during the 5 waves of the pandemic were positive. The programmes of implementation of BF guidelines were shown to resist the COVID-19 pandemic.
Our findings contribute to the understanding and evolution of the main indicators of the sustainability of a BF CPG on COVID-19 context, providing details on the magnitude of the effect and the process of change.
The Preferred Reporting Items for observational studies (STROBE) checklist was followed.
No Patient or Public Contribution.
Objetivo: Desarrollar una propuesta de análisis de narrativa de enfermería de un momento de cuidado a partir de los procesos Cáritas. Metodología: Propuesta metodológica, “Análisis Cáritas del momento de cuidado” desarrollada a través de la experiencia docente, a partir de la revisión de literatura y su desarrollo dentro de la práctica de una unidad de aprendizaje donde se aplicó la teoría de Jean Watson en torno a los procesos Cáritas. Resultados principales: Se propone metodología de seis fases: Fase 1. Escribir el momento de cuidado, creando la narrativa; Fase 2. Lectura de la narrativa inicial e incorporación dinámica; Fase 3. Selección de unidades textuales de cuidado significativas; Fase 4. Revisión de literatura; Fase 5. Reflexión convergente por proceso Cáritas; Fase 6. Reflexión integradora del momento de cuidado. Conclusión: Una vez analizada la propuesta metodológica diseñada puede ser utilizada tanto en la práctica asistencial, en la docencia y en la investigación cuando se deseen abordar elementos teóricos del cuidado humano y desarrollar conocimiento a través de las narrativas de situaciones de enfermería.
Objetivo principal: Describir el significado del cuidado humanizado de enfermeras hacia el adulto mayor en asilos. Metodología: Estudio cualitativo, descriptivo realizado con enfermeras de tres asilos de Guanajuato de agosto a octubre de 2021. Selección de participantes por disponibilidad y voluntariedad (n= 9), se realizaron entrevistas semiestructuradas telefónicas, análisis de datos con análisis de contenido temático, cuidando los principios éticos con consentimiento informado. Resultados principales: Emergieron cinco temas que construyen el cuidado humanizado: 1. Favorecer la plenitud física, emocional y espiritual, 2.Cuidar es recreación, 3.Acompañamiento en la soledad, 4.Brindar confianza, atención y disposición y 5.Cuidando en valores. Conclusión principal: El cuidado humanizado es hacer sentir al adulto mayor confianza, brindándole apoyo, respeto, atendiendo sus necesidades básicas, el cuidar de forma humanizada refleja un acto de acompañamiento en la última etapa de la vida donde se da el valor de ser humano.
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