No / Background: Lymphoedema secondary to cancer is a relatively neglected and under-researched condition. Few studies report people's experiences of care and treatment provision when living with the condition. Current practice focuses on the physical treatment yet psychosocial needs often remain unmet. A previous study examining the patient perspective identified the theme of being 'abandoned by medicine'. Perceived lack of support may result in a delayed adaptation and acceptance of this long-term condition and can significantly impact on psychological well-being. We explore this emerging theme alongside others in order to provide a guide to action for improvements for patient benefit. Aim: The central aim was to explore women's views of their care and treatment following a diagnosis with lymphoedema secondary to cancer. This forms part of a larger study aimed at assessing appropriate screening tools to measure psychosocial distress. Methods: A mixed-methods approach was used for the main study. Here we report the qualitative component, derived from in-depth semi-structured interviews conducted in the homes of the participants (n = 14) and focus group discussions (n = 15). In addition, qualitative comments from questionnaire data from a large-scale postal survey are included (n = 104). Findings: Participants identified considerable deficiencies in health care workers' knowledge and awareness of lymphoedema, which subsequently impacted on the patients' needs for information, support and understanding. Access to appropriate treatment was patchy and problems were identified with the process of obtaining compression garments, massage and other sources of help. Although lymphoedema is a long-term disfiguring condition, and much is known about how this impacts on patients' emotional well-being, little attention was paid by health professionals to potential psychosocial consequences. In essence women had to become experts of their own condition and cope as best as they could. We provide recommendations to improve service delivery and address these unmet needs.

Submitted by Maicon Juliano Schmidt (maicons) on 2015-06-10T19:25:30Z No. of bitstreams: 1 Andreza Chiomento Parise.pdf: 767027 bytes, checksum: 63443e89db7066f8682588f086c5bcdc (MD5) / Made available in DSpace on 2015-06-10T19:25:30Z (GMT). No. of bitstreams: 1 Andreza Chiomento Parise.pdf: 767027 bytes, checksum: 63443e89db7066f8682588f086c5bcdc (MD5) Previous issue date: 2015-03-19 / UNISINOS - Universidade do Vale do Rio dos Sinos / A preocupação com a saúde dos trabalhadores e como são as condições do ambiente no qual os mesmos estão inseridos, vem ganhando cada vez mais espaço nos debates sobre saúde e qualidade de vida no trabalho, em âmbito mundial. Objetivou-se mapear a situação de saúde dos trabalhadores de uma metalúrgica de implementos agrícolas do interior do Rio Grande do Sul, RS, considerando-se idade, sexo, escolaridade, acidentes de trabalho, imunizações, setor de trabalho, absenteísmo, situações de saúde e elaborar um programa de saúde para estes trabalhadores. Trata-se de um estudo descritivo com abordagem quantitativa. Participaram 167 trabalhadores, os quais responderam a um questionário. O sexo predominante foi o masculino. No que tange a escolaridade, a maioria possui ensino médio completo ou superior incompleto e idade entre 19 a 68 anos. Grande parte desempenha suas atividades laborais em setores de produção com jornada de trabalho de 8 horas e 48 minutos e a maioria não relatou terem sofrido acidentes de trabalho. O risco presente no ambiente de trabalho mais apontado foi o ruído, seguido por ergonômico, exposição a poeira, cortes, calor, queda, eletricidade, agentes biológicos e as radiações não ionizantes. A presença de Hipertensão Arterial Sistêmica foi relatada pela minoria e poucos com Diabete Mellitus. O IMC apontou presença de sobre peso ou algum grau de obesidade na maioria dos trabalhadores. O risco cardíaco obtido pela RCQ foi de alto a muito alto, também pela maioria dos trabalhadores. A avaliação MAN apontou poucos casos de desnutrição ou de risco para desnutrição. A maioria das mulheres adere ao autoexame de mama e ao Papanicolau. Em relação aos exames masculinos, os homens que responderam ao questionário não o fazem. A vacina mais frequente realizada foi a antitetânica, seguida por tríplice viral, febre amarela e hepatite B. O hábito de fumar está presente entre a minoria, mas o uso do álcool é comum a todos. Os resultados subsidiaram a elaboração de um Programa de Saúde para os trabalhadores, abordando avaliação nutricional e vacinal, tabagismo, ingesta de álcool, exames preventivos para mulheres e homens, doenças crônicas não transmissíveis, acidente de trabalho, absenteísmo e riscos ocupacionais. A realidade da saúde dos trabalhadores da metalúrgica mostrou a necessidade da elaboração do Programa de Saúde aos mesmos. A sua implantação no local de trabalho, de qualquer instituição é desafiadora e possível de ser realizada, mas é necessário que haja a concordância e o apoio da instituição. / The concerns regarding the health of workers and the environment conditions where they live is getting more and more attention in worldwide discussions on health and quality of life at work. The objective of this paper was to map the health conditions of workers from a metallurgic company located in the state of Rio Grande do Sul, Brazil, taking into account age, gender, education, work accidents, immunizations, job department, absenteeism, and health conditions, and to outline a health program for those workers. This is a description study with a quantitative approach. 167 workers were requested to respond a structured questionnaire. Male workers were predominant. Regarding education, most are graduated from high school or are currently attending college, and are between 19 and 68 years old. Most of them work in the production department, and their working hours are of 8 hours and 48 minutes a day. Most of them declared not having had labor accidents. The higher risk at the workplace mentioned was noise, followed by ergonomic problems, exposure to dust, cuts, heat, fall, electricity, biological agents and non-ionizing radiation. The existence of Systemic Hypertension was mentioned by the minority and a few declared suffering from Diabetes Mellitus. The BMI showed the presence of overweight or some degree of obesity in most of workers. The heart risk obtained by the waist-hip ratio was high to very high in most of workers as well. The method for nutritional assessment showed few cases of malnutrition or risk for malnutrition. Most women perform the breast self-examination and submit to the Papanicolaou’s test regularly. Regarding male exams, men who responded the questionnaire said they don’t do any kind of exams. The most frequently taken vaccine was the anti-tetanus vaccine, followed by the triple vaccine viral, yellow fever and hepatitis B. Smoking habit is present in a minority, but alcohol consumption is common to everybody. The results of the questionnaire supported the outline of a Health Program for workers comprising nutritional and vaccine assessment, smoking habit, alcohol intake, preventive exams for men and women, non-communicable chronic diseases, labor accidents, absenteeism and occupational risks. The status of the company workers’ health showed the need for a Health Program. The Program implementation at the workplace, like in any other institution, is challenging and feasible, but the institution must agree and support that undertaking.