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Objectives: The aim of the study was to know the witnessing of death from the perspective of the cancer patient in the hospital environment. Materials and Methods: This is a qualitative and descriptive study, which was carried out in a cancer hospital in southern Brazil, with 27 cancer patients, through semi-structured interview, after the institutional research ethics committee approval. For categorisation and data analysis, Iramuteq software and Creswell content analysis were used. Results: Six classes emerged from the Iramuteq software and four categories were formed: (1) The reflection of the other itself; (2) feelings and emotions aroused; (3) the witnessing of a peaceful death and (4) death as a habitual event. Conclusion: Patients felt sad and distressed, and some perceived death as something natural, often necessary for the relief of suffering. They put themselves in the place of the dying patient and their family members, imagining their loved ones and the suffering they would experience. Participants considered peaceful deaths to be good, unlike those in which patients had some kind of discomfort, described as horrible, distressing, sad and bad.

Objective: To trace the profile of patients with primary laryngeal neoplasia in hospitals of high oncological complexity in Pará in the time series 2000-2017. Method: Retrospective epidemiological study conducted with the secondary database from the Hospital Cancer Registry (RHC). Results: the profile of patients with malignant laryngeal neoplasia in services of high oncological complexity in the state of Pará are mostly: male, over 40, history of alcoholism and/or smoking, white or brown, incomplete elementary school, diagnosed in the most advanced stages advanced. Conclusion: Thus, it is clear that this neoplasm is strongly based on the interaction of environmental and endogenous factors. Above all, the health system is still tenuous to serve patients at risk or with laryngeal neoplasia, starting with the high levels of ignorance present in the secondary databases on health indicators, which implies the tendency of certain important variables for cancer prediction. Objetivo: rastrear el perfil de pacientes con neoplasia laríngea primaria en hospitales de alta complejidad oncológica en Pará en la serie temporal 2000-2017. Método: estudio epidemiológico retrospectivo realizado con la base de datos secundaria del Hospital Cancer Registry (RHC). Resultados: el perfil de los pacientes con neoplasia laríngea maligna en servicios de alta complejidad oncológica en el estado de Pará son principalmente: hombres, mayores de 40 años, antecedentes de alcoholismo y / o tabaquismo, escuela primaria incompleta blanca o marrón, diagnosticados en las etapas más avanzadas avanzado. Conclusión: Por lo tanto, está claro que esta neoplasia se basa fuertemente en la interacción de factores ambientales y endógenos. Sobre todo, el sistema de salud sigue siendo frágil para atender a pacientes en riesgo o con neoplasia laríngea, comenzando con los altos niveles de ignorancia presentes en las bases de datos secundarias sobre indicadores de salud, lo que implica la tendencia de ciertas variables importantes. para la predicción del cáncer. Objetivo: Traçar o perfil de pacientes com neoplasia primária de laringe em hospitais de alta complexidade oncológica no Pará na série temporal 2000-2017. Método: Estudo epidemiológico, retrospectivo realizado com a base de dados secundários provenientes do Registro Hospitalar de Câncer (RHC). Resultados: o perfil de pacientes com neoplasia maligna da laringe em serviços de alta complexidade oncológica no estado do Pará são em sua maioria: sexo masculino, maior de 40 anos, histórico de etilismo e/ou tabagismo, branco ou pardo, ensino fundamental incompleto, diagnosticados nos estágios mais avançados. Conclusão: Dessa forma, percebe-se que esta neoplasia está fortemente alicerçada na interação dos fatores ambientais e endógenos. Sobretudo, o sistema de saúde, ainda é tênue para atender aos pacientes em risco ou com a neoplasia de laringe, a começar pelos índices altos de desconhecimento presente nas bases de dados secundários sobre indicadores em saúde, o que implica na tendência de certas variáveis importantes para a predição do câncer.

Objective: Qualitatively evaluate the operation of a palliative care service in oncology. Methodology: Qualitative study conducted in a service in southern Brazil based on a fourth generation evaluation. Between September 2014 and June 2015, 460 hours of operation were observed, and 45 semi-structured interviews and five negotiation meetings were conducted; data were analyzed using the constant comparative method. Results: Potential services are: provision of outpatient palliative care, home and inpatient care provided by a multidisciplinary and support team, meeting the patient’s biological, psychological, social and spiritual needs. Study limitations: ineffective communication between clinical and surgical oncology and palliative care sectors, lack of specialized training for professionals and in interpersonal relationship issues among team members. Final Consideration: For palliative care progress in the service, some arrangements are required to enhance integrality of care. RESUMEN Objetivo: Evaluar cualitativamente el desempeño de un Servicio de Cuidados Paliativos oncológico. Método: Estudio de tipo cualitativo, realizado en un servicio en la región Sur de Brasil, adoptando como referencial metodológico la evaluación de cuarta generación. Entre septiembre de 2014 y junio de 2015 se realizaron 460 horas de observación, 45 entrevistas semiestructuradas y 5 encuentros de negociación, y se analizó los datos por el método comparativo constante. Resultados: Se caracteriza el servicio por: ofrecer cuidados paliativos de tipo ambulatorio, domiciliario y de hospitalización, realizado por un personal multidisciplinario y de apoyo, lo que permite asistir a las necesidades biológicas, psicológicas, sociales y espirituales del paciente-familia. Como limitaciones se presentan: la comunicación ineficaz entre los sectores de oncología clínica/quirúrgica y de cuidados paliativos; la falta de formación especializada de los profesionales; y la dificultad en las relaciones interpersonales entre los integrantes del personal. Consideraciones Finales: Para que avancen los cuidados paliativos en el servicio, son necesarios algunos ajustes que favorezca una atención integral. RESUMO Objetivo: Avaliar qualitativamente a atuação de um Serviço de Cuidados Paliativos oncológico. Método: Estudo de abordagem qualitativa realizado em um serviço no sul do Brasil, adotando como referencial metodológico a avaliação de quarta geração. Entre setembro de 2014 e junho de 2015 foram realizadas 460 horas de observação, 45 entrevistas semiestruturadas e cinco encontros de negociação e os dados analisados com o método comparativo constante. Resultados: Constituem potencialidades do serviço: oferta de cuidados paliativos na modalidade ambulatorial, domiciliar e internamento, prestada por equipe multidisciplinar e de apoio, o que permite atendimento às necessidades biológicas, psicológicas, sociais e espirituais do paciente-família. As limitações são: comunicação ineficaz entre setor de oncologia clínica/cirúrgica e de cuidados paliativos, falta de formação especializada dos profissionais e dificuldade nas relações interpessoais entre os integrantes da equipe. Considerações Finais: Para o avanço dos cuidados paliativos no serviço, fazem-se necessários alguns arranjos que potencializem a integralidade no atendimento.

Background In general, patients with a cancer suspicion visit the hospital multiple times before diagnosis is completed. Using various “operations management” techniques a few fast track diagnostic services were implemented in the Netherlands Cancer Institute (NKI) in 2006. Growing patient numbers and increasing process complexity, led to diminished service levels. To decrease the amount of patient visits and to extend these services beyond the (obvious) breast cancer services, fast track diagnostics is now implemented for all 18 cancer types that present with a frequency of minimally one per week. Methods The throughput time (first visit to diagnosis conversation) was measured before, and after implementation of fast track diagnostics. The process was redesigned closely involving the multidisciplinary teams. In an eclectic approach elements from lean management, theory of constraints and mathematical analysis were used to organize slots per tumor type for MRI, CT, PET and echography. A post measurement was performed after 3 and 6 months. Results In pre measurement access time was calculated to be 10 to 15 workdays, mean throughput time was 6.0 workdays. It proved possible to design the process of 18 tumors as a fast track, of which 7 as “one stop shop” (diagnosis completed in one visit). Involvement of clinical- and board leadership, massive communication efforts and commitment of physicians to reschedule their work proved decisive. After 3 and 6 months of implementation, the mean access time was 8.2 and 8.7 workdays respectively and mean throughput time was 3.4 and 3.3 workdays respectively. Conclusions Throughput- and access time were considerably shortened after implementation of fast track diagnostics for 18 cancer types. The involvement of physicians in reorganizing their work and rapid responding to their needs during the implementation phase were a crucial success factor.

Introduction: in Colombia, the mortality caused by the malignant melanoma has increased, being the clinical and histopathological characteristics little known. Objective: to describe clinical and anatomopathological performance of malignant melanoma in a series of patients from Cartagena de Indias, diagnosed from 2007 to 2012. Methodology: retrospective study carried out in two third level hospitals from Cartagena, Colombia. The variables analized were: age, gender, histological type and anatomic location of melanoma, Clark level and Breslow thickness. Descriptive analysis techniques were applied. Absolut, relative and accumulated frequencies for categorical variables were used. For categoric/dichotomic variables, 95% confidence intervals were used as measure of dispersion of data. Data analysis was made with Epidat 3.1. Results: 27 people were diagnosed and 59.3% were women. 63% of patients were from 40 to 70 years old. Age differences between men and women were not statistically significant (p=0.0661). The most frequent locations were lower limbs (51.8%) and upper limbs (18.5%). The most frequently histological types found were acral lentiginous (29.5%) and nodular (29.5%). 48.1% of patients had dermal infiltration between 0.75 mm – 1.5 mm, 7% were in-situ and 33% had infiltration through the reticular dermis reaching subcutaneous tissue. Conclusion: there were not statistically significant differences in the gender of patients with malignant melanoma. Six of each ten patients had acral lentiginous or nodular type of malignant melanoma. Rev.cienc.biomed. 2014;5(1):66-70 KEYWORDS Melanoma, Skin neoplasms, Oncology service hospital.

Introduction. Coping, regarded as the set of responses to stressful situations, executed to handle and neutralize them, is part of the psychological resources of human beings and it is a personal trait evidenced as intervening in terms of perceived quality of life.Objective. To determine the relationship between coping strategies and quality of life in cancer patients at different stages of their cancer condition at an oncology unit in the province of Nariño, Colombia.Materials and Methods. Cross-sectional study in a sample of 120 cancer patients attending in COEMSSANAR IPS, located in Pasto, Nariño.Results. It was observed that the most adopted type of coping was "positive attitude", followed by "positive guidance", while the least adopted ones were "anxious care" and "hopeless". As for quality of life, it is evidenced that is favorable for this population. The relationship between coping and quality of life is different for each stage of cancer. Patients with better coping are those with higher quality of life.Conclusion. A greater effort of the State and the institutions providing health services for the adoption of coping strategies in patients affected by cancer at all stages would significantly improve the quality of life of these people. Introducción. El afrontamiento, entendido como el conjunto de respuestas ejecutadas para mantener y neutralizar situaciones estresantes, es parte de los recursos psicológicos del individuo y es una de las variables personales evidenciadas como intervinientes en los niveles de calidad de vida percibida.Objetivo. Determinar la relación existente entre las estrategias de afrontamiento y la calidad de vida de pacientes oncológicos en diferentes estadios del cáncer en una unidad de oncológica de Nariño, Colombia.Materiales y métodos. Estudio descriptivo transversal realizado en una muestra de 120 pacientes oncológicos de Cooemssanar IPS en su sede de Pasto.Resultados. Se observó que el tipo de afrontamiento más adoptado fue "actitud positiva", seguido de "orientación positiva", y los menos adoptados fueron "preocupación ansiosa" y "sin esperanza". En cuanto a la calidad de vida, se evidencia que es favorable para la población estudiada, aunque la relación entre el afrontamiento y esta es diferente para cada estadio del cáncer. Los pacientes con mejor afrontamiento son los que tienen mayor calidad de vida.Conclusión. Un mayor esfuerzo del Estado y de las instituciones prestadoras de servicios de salud para la adopción de estrategias de afrontamiento en los pacientes afectados por el cáncer, en todos sus estadios, mejoraría notablemente la calidad de vida de estas personas.

Este es un estudio que tuvo como objetivo identificar el perfil de la enfermera que trabaja en las unidades hospitalarias de oncología. Se trata de una revisión integradora y la recolección de datos se llevó a cabo en cuatro bases de datos electrónicas en el período de marzo a mayo de 2013. Se seleccionaron 15 artículos publicados en el período 2004-2013. Los resultados se describen en dos categorías: 1. El perfil social y profesional de las enfermeras que trabajan en unidades hospitalarias de oncología y 2. Formación y preparación de la enfermera para actuar en unidades hospitalarias de oncología. Las enfermeras son mujeres, con edades comprendidas entre 23 y 57 años de experiencia en el campo, con la preparación académica suficiente para la graduación. Identifica la necesidad de un desarrollo científico y técnico profesional a través de la especialización, de postgrado, residencias, capacitación, cursos de actualización y la participación en conferencias. El estudio deberá aumentar la conciencia de las enfermeras y administradores de servicios de salud como el perfil y la preparación adecuada de los que trabajan en las unidades de oncología hospitalaria. Trata-se de um estudo que teve como objetivo identificar o perfil do enfermeiro que atua em unidades hospitalares oncológicas. É uma revisão integrativa e a coleta de dados foi realizada em quatro bases eletrônicas no período de março a maio de 2013. Foram selecionados 15 artigos, publicados no período de 2004 a 2013. Os resultados foram descritos em duas categorias: 1. O perfil social e profissional do enfermeiro que atua unidades hospitalares oncológicas e 2. Capacitação e preparo do Enfermeiro para atuar em unidades hospitalares oncológicas. Os enfermeiros são do sexo feminino, faixa etária entre 23 e 57 anos e experiência na área, com preparo acadêmico insuficiente durante a graduação. Identificam-se a necessidade de desenvolvimento profissional técnico-científico por meio de especializações, pós-graduação, residências, treinamentos, cursos de atualização e participação em congressos. O estudo deve provocar reflexão dos enfermeiros e gestores dos serviços de saúde quanto ao perfil e preparo adequado para a atuação em unidades hospitalares de oncologia. This is a study that aimed to identify the profile of the nurse working in oncology hospital units. It is an integrative review and data collection was conducted in four electronic databases in the period March-May 2013. 15 articles published in the period 2004-2013 were selected. The results were described in two categories: 1. The social and professional profile of nurses who work oncological hospitals and 2. Training and preparation of the nurse to act in oncological hospitals. The nurses are female, aged between 23 and 57 years, experience in the field, with insufficient academic preparation for graduation. Identifies the need for professional technical and scientific development through specialization, graduate, homes, training, refresher courses and participation in conferences. The study should increase awareness of nurses and managers of health services as the profile and adequate preparation of working in hospital oncology units.