Introdução O câncer é uma doença crônica que ocupa posição de destaque. A adesão, as atitudes e o comportamento dos pacientes têm sido freqüentemente relatadas como um fator determinante para o sucesso da terapia com antineoplásicos orais. Objetivos Caracterizar o perfil de pacientes com terapia antineoplásica via oral, aspectos da doença, atitudes, crenças e percepções frente à doença e tratamento. População e Método Foram estudados 61 pacientes com diagnóstico de câncer sob terapia antineoplásica via oral em um ambulatório de hospital particular da cidade de São Paulo. Os instrumentos de avaliação usados foram Teste Morisky e Green, Escala de Lócus de Controle da Saúde e um questionário sobre fatores que podem interferir no tratamento medicamentoso. Valores de p<0,05 foram considerados estatisticamente significantes. Resultados Os pacientes estudados eram 64% mulheres, 54,8±15,6 anos, 95% brancos, 74% casados; 80% com ensino superior; 37% com renda entre 5 a 10 salários mínimos; 29% ocupavam atividades administrativas e comerciais; 34% tinham câncer gastrintestinal; 34% dos pacientes faziam uso do medicamento Capecitabina; tempo de doença de 37,1 ± 62,2 meses; tempo de tratamento 14,4 ± 25,1 meses; e tempo de tratamento com antineoplásico oral 8,6 ± 14,8 meses. O Teste Morisky e Green foi positivo em 28% dos pacientes e 25% afirmaram interrupção do tratamento. Na Escala de Lócus de Controle da Saúde os valores do lócus de controle interno (21,7±4,3) e externo-outros poderosos (22,5± 4,1) foram semelhantes e o menor valor foi no domínio externalidade-acaso (16,5±6,0), além de que os pacientes informaram poucas dificuldades que podem influenciar a adesão ao tratamento com antineoplásico oral. Houve as seguintes associações estatisticamente significantes (p<0,05): 1-Pacientes com teste de Morisky e Green positivo tinham maior tempo de tratamento e em relação ao medicamento oral, a positividade ocorreu com dois pacientes em uso de Mercaptopurina e cerca de um quarto em uso de Dexametasona, Talidomida e Hormonioterápicos. 2-Na Escala de Lócus de Controle de Saúde os pacientes que apresentaram maiores índices de internalidade eram do sexo masculino, que não realizaram cirurgia, não faziam massagem, com menor tempo de doença e de tratamento. Os pacientes com maiores índices no domínio de externalidade-outros poderosos interromperam o tratamento. Os pacientes que apresentaram maiores índices de externalidade-acaso faziam uso de antineoplásico oral continuamente e não praticavam rituais religiosos como outras formas de tratamento. 3-O questionário que avaliou aspectos frente ao tratamento mostrou que os pacientes que apresentaram mais dificuldade, tinham mais tempo de tratamento com antineoplásico via oral. Conclusões Os pacientes apresentaram atitudes positivas frente ao tratamento com medicamentos antineoplásicos orais e relataram poucas dificuldades no manejo da terapia / Introduction Cancer is a chronic disease ranked in an outstanding position. Patients’ compliance, attitudes and behavior have been frequently reported as a determining factor for the success of the therapy with oral antineoplastic drugs. Objectives Characterize oral antineoplastic therapy patients’ profiles; disease aspects and behavior, beliefs and perceptions with regard to the disease and the treatment. Population and Method Sixty-one patients diagnosed with cancer undergoing oral antineoplastic therapy in the out-patient unit of a private hospital in the city of São Paulo were studied. Assessment instruments applied were Morisky and Green Test, Health Locus of Control Scale and a questionnaire on factors that can interfere in drug treatment. P<0.05 values were considered statistically significant. Results Patients studied were 64% women, 54.8±15.6 years, 95% white, 74% married; 80% university graduated; 37% with monthly income between US$ 817.75 to US$ 1635.50; 29% worked on business and administrative activities, 34% had gastrointestinal cancer; 34% took Capecitabine; length of time of the disease was 37.1 ± 62.2 months; length of time of the treatment 14.4 ± 25.1 months; and length of time of oral antineoplastic therapy 8.6 ± 14.8 months. Morisky and Green Test was found to be positive in 28% of the patients and 25% stated having interrupted the treatment. In the Health Locus of Control (HLC) Scale, the scores of internal HLC (21.7±4.3) and powerful others externally HLC (22.5± 4.1) were similar. The lowest score was observed in the dimension of chance external HLC (16.5±6.0). Besides, patients reported few difficulties that can influence on their compliance with oral antineoplastic treatment. The following statistically significant (p<0.05) associations were observed: 1-Patients showing positive Morisky and Green test were longer under treatment in relation to the oral drug. Positive tests were observed in two patients using Mercaptopurine and in roughly one fourth, using Dexamethasona, Thalidomide and Hormonietherapics. 2-In Health Locus of Control Scale, men who did not undergo surgery, did not use to have a massage and with shorter time of disease and treatment were those who showed higher scores in Internal HLC. Patients with higher scores in the dimension of powerful others external HLC interrupted the treatment. Patients who showed higher scores in the dimension of Chance External HLC used oral antineoplastic drugs continuously and did not took part in religious rituals as other forms of treatment 3-The questionnaire that assessed aspects related to the treatment revealed that patients who showed more difficulties, were being treated with oral antineoplastic drugs for a longer time. Conclusions Patients showed positive attitudes regarding the treatment with oral antineoplastic drugs and reported few difficulties to lead with the therapy

Introdução O câncer é uma doença crônica que ocupa posição de destaque. A adesão, as atitudes e o comportamento dos pacientes têm sido freqüentemente relatadas como um fator determinante para o sucesso da terapia com antineoplásicos orais. Objetivos Caracterizar o perfil de pacientes com terapia antineoplásica via oral, aspectos da doença, atitudes, crenças e percepções frente à doença e tratamento. População e Método Foram estudados 61 pacientes com diagnóstico de câncer sob terapia antineoplásica via oral em um ambulatório de hospital particular da cidade de São Paulo. Os instrumentos de avaliação usados foram Teste Morisky e Green, Escala de Lócus de Controle da Saúde e um questionário sobre fatores que podem interferir no tratamento medicamentoso. Valores de p<0,05 foram considerados estatisticamente significantes. Resultados Os pacientes estudados eram 64% mulheres, 54,8±15,6 anos, 95% brancos, 74% casados; 80% com ensino superior; 37% com renda entre 5 a 10 salários mínimos; 29% ocupavam atividades administrativas e comerciais; 34% tinham câncer gastrintestinal; 34% dos pacientes faziam uso do medicamento Capecitabina; tempo de doença de 37,1 ± 62,2 meses; tempo de tratamento 14,4 ± 25,1 meses; e tempo de tratamento com antineoplásico oral 8,6 ± 14,8 meses. O Teste Morisky e Green foi positivo em 28% dos pacientes e 25% afirmaram interrupção do tratamento. Na Escala de Lócus de Controle da Saúde os valores do lócus de controle interno (21,7±4,3) e externo-outros poderosos (22,5± 4,1) foram semelhantes e o menor valor foi no domínio externalidade-acaso (16,5±6,0), além de que os pacientes informaram poucas dificuldades que podem influenciar a adesão ao tratamento com antineoplásico oral. Houve as seguintes associações estatisticamente significantes (p<0,05): 1-Pacientes com teste de Morisky e Green positivo tinham maior tempo de tratamento e em relação ao medicamento oral, a positividade ocorreu com dois pacientes em uso de Mercaptopurina e cerca de um quarto em uso de Dexametasona, Talidomida e Hormonioterápicos. 2-Na Escala de Lócus de Controle de Saúde os pacientes que apresentaram maiores índices de internalidade eram do sexo masculino, que não realizaram cirurgia, não faziam massagem, com menor tempo de doença e de tratamento. Os pacientes com maiores índices no domínio de externalidade-outros poderosos interromperam o tratamento. Os pacientes que apresentaram maiores índices de externalidade-acaso faziam uso de antineoplásico oral continuamente e não praticavam rituais religiosos como outras formas de tratamento. 3-O questionário que avaliou aspectos frente ao tratamento mostrou que os pacientes que apresentaram mais dificuldade, tinham mais tempo de tratamento com antineoplásico via oral. Conclusões Os pacientes apresentaram atitudes positivas frente ao tratamento com medicamentos antineoplásicos orais e relataram poucas dificuldades no manejo da terapia / Introduction Cancer is a chronic disease ranked in an outstanding position. Patients’ compliance, attitudes and behavior have been frequently reported as a determining factor for the success of the therapy with oral antineoplastic drugs. Objectives Characterize oral antineoplastic therapy patients’ profiles; disease aspects and behavior, beliefs and perceptions with regard to the disease and the treatment. Population and Method Sixty-one patients diagnosed with cancer undergoing oral antineoplastic therapy in the out-patient unit of a private hospital in the city of São Paulo were studied. Assessment instruments applied were Morisky and Green Test, Health Locus of Control Scale and a questionnaire on factors that can interfere in drug treatment. P<0.05 values were considered statistically significant. Results Patients studied were 64% women, 54.8±15.6 years, 95% white, 74% married; 80% university graduated; 37% with monthly income between US$ 817.75 to US$ 1635.50; 29% worked on business and administrative activities, 34% had gastrointestinal cancer; 34% took Capecitabine; length of time of the disease was 37.1 ± 62.2 months; length of time of the treatment 14.4 ± 25.1 months; and length of time of oral antineoplastic therapy 8.6 ± 14.8 months. Morisky and Green Test was found to be positive in 28% of the patients and 25% stated having interrupted the treatment. In the Health Locus of Control (HLC) Scale, the scores of internal HLC (21.7±4.3) and powerful others externally HLC (22.5± 4.1) were similar. The lowest score was observed in the dimension of chance external HLC (16.5±6.0). Besides, patients reported few difficulties that can influence on their compliance with oral antineoplastic treatment. The following statistically significant (p<0.05) associations were observed: 1-Patients showing positive Morisky and Green test were longer under treatment in relation to the oral drug. Positive tests were observed in two patients using Mercaptopurine and in roughly one fourth, using Dexamethasona, Thalidomide and Hormonietherapics. 2-In Health Locus of Control Scale, men who did not undergo surgery, did not use to have a massage and with shorter time of disease and treatment were those who showed higher scores in Internal HLC. Patients with higher scores in the dimension of powerful others external HLC interrupted the treatment. Patients who showed higher scores in the dimension of Chance External HLC used oral antineoplastic drugs continuously and did not took part in religious rituals as other forms of treatment 3-The questionnaire that assessed aspects related to the treatment revealed that patients who showed more difficulties, were being treated with oral antineoplastic drugs for a longer time. Conclusions Patients showed positive attitudes regarding the treatment with oral antineoplastic drugs and reported few difficulties to lead with the therapy

Exclusive breastfeeding and holistic maternity care are strategic to improving maternal and infant health outcomes in Nigeria. This thesis aimed at informing policies and interventions to promote breastfeeding and to improve Nigerian mother’s experiences in antenatal and intrapartum care. The study in this research focused upon psychological dynamics underlying societal culture around maternity and breastfeeding. Using quantitative method, attitudes toward breastfeeding and health orientation were surveyed in 400 Nigerian men and women using the Iowa Infant Feeding Attitude Scale (IIFAS) and the Multidimensional Health Locus of Control Scale (MHLoC). There were more positive attitudes toward breastfeeding in males, participants in the 20-29-year-old age category, and in those who identified as single. Higher internal HLoC was associated with more positive attitudes to breastfeeding and higher EHLoC scores were associated with more negative attitudes to formula feeding. The second study explored the experience of pregnancy and childbirth in Nigerian women. Qualitative interviews with 12 women implied that Nigerian women perceive pregnancy and childbirth as a multidimensional experience comprising physiological and psychological elements and also as risky. Control mechanisms that reflected internal HLoC included choosing multiple antenatal care sources to obtain holistic care, adopting new technology in bridging perceived communication gaps with health care providers and adopting physical and mental strategies in controlling the somatic and sensory changes that accompany pregnancy. Pregnancy and childbirth were viewed through an external HLoC lens as spiritual, and reflected in an entrenched belief in the intervention of deity to mitigate pain and risk associated with childbirth. These results have implications for practice, intervention and policy to promote breastfeeding at the societal level and improve maternity services for the current and next child-bearing generation.