Degree of complexity of nurse care: associations in clinical oncology in breast cancer

Silva, Lívia Gomes da; Moreira, Marléa Chagas

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Brasil

Revista Gaúcha de Enfermagem

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Sumário

Original Article • Rev. Gaúcha Enferm. 39 • 2018 • https://doi.org/10.1590/1983-1447.2018.20180015 copy

Degree of complexity of nurse care: associations in clinical oncology in breast cancer

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

OBJECTIVE

It was to evaluate the degree of complexity of nursing care required for breast cancer patients who are readmitted to hospital.

METHODS

Cross-sectional study whose 108 subjects were breast cancer patients in unplanned readmission into the oncological unit of hospital in Brazil. Used for documentary analysis and the data analyzed statistically.

RESULTS

The predominant degrees of complexity of complexity of nursing care were semi-intensive (36.1%) and intensive care (36.1%). In the multivariate analysis, only performance status (p<0.001) and arterial hypertension (p=0.024) remained associated with the degree of complexity.

CONCLUSIONS

The degree of complexity of patients readmitted was predominantly semi-intensive and intensive. This evaluation implies in the management of the care by means of the knowledge of the the profile breast cancer patients in hospital readmission and the detection of the characteristics associated to the degree of complexity.

Keywords:
Oncology nursing; Patient readmission; Needs assessment; Breast neoplasms

Variable	Minimal / intermediate care	Semi-intensive / intensive care	Total	P value
	n (%)	n (%)	n (%)
Age group
Less than or equal to 50 years old	9 (8.3)	29 (26.9)	38 (35.2)	0.484^a
Over 50 years old	21 (19.4)	49 (45.4)	70 (64.8)
Marital status
Has a partner	16 (15.1)	31 (29.2)	47 (44.3)	0.242^a
No partner	14 (13.2)	45 (42.5)	59 (55.7)
Schooling
Elementary and High School	23 (21.3)	67 (62)	90 (83.3)	0.102^b
Higher Education	5 (4.6)	11 (10.2)	16 (14.8)
Illiterate	2 (1.9)	0 (0)	2 (1.9)
Occupations - CNAE^¹
CNAE Occupations Groups	15 (13.9)	37 (34.3)	52 (48.1)
Housekeeper	14 (13.0)	35 (32.4)	49 (45.4)	0.889^b
Retired / pensioner	1 (0.9)	6 (5.6)	7 (6.5)
Income
< 1 minimum wage	8 (9.6)	15 (18.1)	23 (27.7)
1 to 2 minimum wages	11 (13.3)	33 (39.8)	44 (53.0)	0.639^b
3 to 5 minimum wages	2 (2.4)	9 (10.8)	11 (13.3)
< 5 minimum wages	2 (2.4)	3 (3.6)	5 (6.0)

	Degree of complexity
Variable	Minimal/ intermediate care	Semi-intensive / intensive care	Total	P value
	n (%)^*	n (%)^*	n (%)^*
Care level of the network where the diagnosis of breast cancer occurred
Primary	10 (15.6)	23 (35.9)	33 (51.6)	0.920^a
Secondary and Tertiary	4 (6.3)	27 (42.2)	31 (48.4)	0.920^a
Hospital readmission interval
Up to 10 days after discharge	16 (14.8)	33 (30.6)	49 (45.4)	0.303^a
Between 11 and 30 days after discharge	14 (13)	45 (41.7)	59 (54.6)
Staging
II	3 (2.9)	2 (1.9)	5 (4.8)	0.037^b
III	10 (9.5)	17 (16.2)	27 (25.7)
IV	15 (14.3)	58 (55.2)	73 (69.5)
Readmission performance status
P S¹ - 1 and 2	13 (12)	8 (7.4)	21 (19.4)	<0.001^a
P S¹ - 3 and 4	17 (15.7)	70 (64.8)	87 (80.6)
Comorbidities
Arterial hypertension	8 (7.4)	41 (38)	49 (45.4)	0.015^a
Diabetes	4 (3.7)	8 (7.4)	12 (11.1)	0.734^b
Hypothyroidism	1 (0.9)	6 (5.6)	7 (6.5)	0.671^b
Congestive heart insufficiency	1 (0.9)	4 (3.7)	5 (4.6)	1.000^b
Renal insufficiency	0 (0)	2 (1.9)	2 (1.9)	1.000^b
Asthma	1 (0.9)	1 (0.9)	2 (1.9)	0.480^b
No comorbidities	16 (14.8)	21 (19.4)	37 (34.3)	0.010^a
Other comorbidities²	1 (0.9)	3 (2.8)	4 (3.7)	1.000^b

Variable	p-value	*Exp B (odds)*	Confidence interval
Variable	p-value	*Exp B (odds)*	Inferior	Superior
Performance status	<0.001	0.122¹	0.048	0.424
Arterial hypertension	0.024	3.562²	1.245	10.658
No comorbidities	0.476	*	*	*
Staging	0.435	*	*	*
Schooling	0.844	*	*	*

Universidade Federal do Rio Grande do Sul. Escola de Enfermagem Rua São Manoel, 963 -Campus da Saúde , 90.620-110 - Porto Alegre - RS - Brasil, Fone: (55 51) 3308-5242 / Fax: (55 51) 3308-5436 - Porto Alegre - RS - Brazil
E-mail: revista@enf.ufrgs.br

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[1] Corresponding author:
Lívia Gomes da Silva. livia_nurse@yahoo.com.br