Opportunistic screening actions for breast cancer performed by nurses working in primary health care

Moraes, Débora Cherchiglia de; Almeida, Ana Maria de; Figueiredo, Elisabeth Niglio de; Loyola, Edilaine Assunção Caetano de; Panobianco, Marislei Sanches

doi:10.1590/S0080-623420160000100002

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ORIGINAL ARTICLE • REEUSPRev. esc. enferm. USP 50 (1) • Feb 2016 • https://doi.org/10.1590/S0080-623420160000100002 copy

Opportunistic screening actions for breast cancer performed by nurses working in primary health care ^* * Extracted from the dissertation "Ações de rastreamento oportunístico do câncer de mama implementadas por enfermeiros da Atenção Básica de Saúde de Ribeirão Preto-SP", Programa de Pós-Graduação em Enfermagem em Saúde Pública, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, 2014.

Rastreo oportunista del cáncer de mama desarrollado por enfermeros de la atención primaria de salud

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

OBJECTIVE

To identify opportunistic screening actions for breast cancer performed by nurses working in primary health care units in Ribeirão Preto, São Paulo.

METHOD

Cross-sectional study with 60 nurses from 28 units, who had been working for at least one year in the public municipal health care network. Data were collected between December 2013 and March 2014, by means of a questionnaire, using descriptive analysis and the software IBM SPSS version 20 and Microsoft Excel 2010.

RESULTS

The results showed that 71.7% of the participants questioned their female patients as for risk factors for breast cancer, mainly during nursing consultation; 70.0% oriented users about the age to perform clinical breast exam, whereas 30.0% did not due to lack of knowledge and time; 60.0% explained about the age to perform mammogram; 73.3% did not refer patients with suspicious breast exam results to the referral department, citing scheduling as the main obstacle to referral. Educational activities were not performed by 78.3% of participants.

CONCLUSION

Investment is needed in professional training and management of breast cancer screening.

Descriptors
Breast Neoplasms; Primary Health Care; Nurse's Role

Variable	Absolute Frequency	%	95% CI
			Lower	Higher
Frequency indicated for first MMG
Annual	27.0	45.0	31.6	58.8
Biannual	8.0	13.3	5.4	23.1
There is no standard frequency	6.0	10.0	3.2	18.2
Other frequency	19.0	31.7	18.6	43.6
Recommended age for first mammogram
<35 years	2.0	3.3	0.0	8.8
35 \|- 40 years	7.0	11.7	3.9	19.4
40 \|- 50 years	30.0	50.0	37.0	63.0
>50 years	3.0	5.0	0.0	11.5
No age restriction	10.0	16.7	8.0	26.9
Does not remember	8.0	13.3	5.3	22.2
Orientation on age for first mammogram
No	24.0	40.0	27.9	53.1
Yes	36.0	60.0	46.9	72.1
Time delay between request for MMG and return of exam results
<1 month	7.0	11.7	3.8	20.8
1 to 3 months	33.0	55.0	42.1	68.1
3 to 6 months	7.0	11.7	3.6	20.7
Other - specify	1.0	1.6	0.0	5.7
Does not remember	12.0	20.0	10.6	30.6

Variable	Absolute Frequency	%	CI 95%
			Lower	Higher
Teaches patients how to self examine their breasts (n = 60)
No	18.0	30.0	17.9	41.8
Yes	42.0	70.0	58.2	82.1
Teaching time Pap collection (n = 42)
No	19.0	45.2^* * Note: each frequency was calculated by total responses.	30.2	60.5
Yes	23.0	54.8^* * Note: each frequency was calculated by total responses.	39.5	69.8
Nursing consultation (n = 42)
No	5.0	11.9^* * Note: each frequency was calculated by total responses.	2.9	22.7
Yes	37.0	88.1^* * Note: each frequency was calculated by total responses.	77.3	97.1
In case of specific complaint (n = 42)
No	1.0	2.4^* * Note: each frequency was calculated by total responses.	0.0	7.9
Yes	41.0	97.6^* * Note: each frequency was calculated by total responses.	92.1	100
Home visits (n = 42)
No	27.0	64.3^* * Note: each frequency was calculated by total responses.	50.0	78.4
Yes	15.0	35.7^* * Note: each frequency was calculated by total responses.	21.6	50.0
Age group to start BSE (n = 42)
Upon menstruation	22.0	52.3	36.8	66.7
<35 years	2.0	4.8	0.0	13.2
35 to 40 years	2.0	4.8	0.0	12.5
>40 years	2.0	4.8	0.0	11.1
No age restriction	14.0	33.3	20.0	47.8
Frequency with which a patient is advised to perform BSE (n = 42)
There is no standard frequency	8.0	19.0	7.5	31.2
Monthly	33.0	78.6	66.7	90.6
Bimonthly	1.0	2.4	0.0	8.3
Reason for not advising
Knowledge deficiency (n = 18)
No	17.0	94.4^* * Note: each frequency was calculated by total responses.	81.2	100
Yes	1.0	5.6^* * Note: each frequency was calculated by total responses.	0.0	18.8
Lack of appropriate location (n = 18)
No	13.0	72.2^* * Note: each frequency was calculated by total responses.	50.0	93.3
Yes	5.0	27.8^* * Note: each frequency was calculated by total responses.	6.7	50.0
Lack of time (n = 18)
No	14.0	77.8^* * Note: each frequency was calculated by total responses.	57.9	95.0
Yes	4.0	22.2^* * Note: each frequency was calculated by total responses.	5.0	42.1
Other reason (n = 18)
No	1.0	5.6^* * Note: each frequency was calculated by total responses.	0.0	17.6
Yes	17.0	94.4^* * Note: each frequency was calculated by total responses.	82.4	100.0

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Débora Cherchiglia de Moraes. Av. dos Bandeirantes, 3900- Monte Alegre, CEP 14040-902 - Ribeirão Preto, SP, Brazil. deboracherchiglia@hotmail.com