Preparation of a Booklet for the Prevention of Pathological Fractures in Patients with Bone Metastases

Authors

  • Juliana Miranda Dutra de Resende Instituto Nacional de Câncer (INCA), Hospital do Câncer IV (HCIV), Unidade de Cuidados Paliativos. Rio de Janeiro (RJ), Brasil. https://orcid.org/0000-0003-4232-4233
  • Livia Costa de Oliveira Instituto Nacional de Câncer (INCA), Hospital do Câncer IV (HCIV), Unidade de Cuidados Paliativos. Rio de Janeiro (RJ), Brasil. https://orcid.org/0000-0002-5052-1846
  • Suzana Sales de Aguiar Instituto Nacional de Câncer (INCA), Hospital do Câncer IV (HCIV), Unidade de Cuidados Paliativos. Rio de Janeiro (RJ), Brasil. https://orcid.org/0000-0003-1963-1294
  • Francine Peres da Silva Instituto Nacional de Câncer (INCA), Hospital do Câncer IV (HCIV), Unidade de Cuidados Paliativos. Rio de Janeiro (RJ), Brasil. https://orcid.org/0000-0002-4239-9705
  • Andrezza Helena Regadas Muniz Instituto Nacional de Câncer (INCA), Hospital do Câncer IV (HCIV), Unidade de Cuidados Paliativos. Rio de Janeiro (RJ), Brasil. https://orcid.org/0000-0002-1619-9486
  • Anke Bergmann Instituto Nacional de Câncer (INCA), Hospital do Câncer IV (HCIV), Unidade de Cuidados Paliativos. Rio de Janeiro (RJ), Brasil. https://orcid.org/0000-0002-1972-8777

DOI:

https://doi.org/10.32635/2176-9745.RBC.2025v71n4.5283

Keywords:

Bone Neoplasms, Neoplasm Metastasis, Fractures, Spontaneous/prevention & control, Caregivers, Health Education

Abstract

Introduction: Bone metastases are common in advanced cancer and, when associated with pathological fractures, can impact functionality, quality of life and prognosis. Education practices strengthen health care by incorporating family members and patients into the caring process. Until then, no guidelines for caregivers on care to prevent pathological fractures related to bone metastases were found in the literature. Objective: To develop and validate a booklet on care for caregivers of patients with bone metastases to prevent pathological fractures. Method: The process of preparing and validating the booklet was carried out in three stages: 1. elaboration of the material based on a literature review; 2. validation of content, appearance and language involving 20 healthcare professionals and ten patient caregivers. The Content Validity Index (CVI) was used to measure the proportion of agreement, with CVI ≥ 0.80 being considered acceptable; 3. experts panel to evaluate disagreements and suggestions arising from the previous stage. Results: An initial version of the booklet was prepared and submitted to content evaluation. All items of the material presented CVI > 0.90 in the first round of the evaluation. Additionally, suggestions from participants to improve the booklet through a questionnaire were evaluated, resulting in the acceptance of 65.2% of the suggestions. Conclusion: The booklet developed was validated and the suggestions incorporated allowed to reach the most appropriate final model, which will probably help to strengthen guidance to patient caregivers in the process of health care and education.

Downloads

Download data is not yet available.

References

Worldwide Hospice Palliative Care Alliance. Global Atlas of palliative care [Internet]. 2. ed. London: WHPCA; 2020. [acesso 2025 maio 20]. Disponível em: https://cdn.who.int/media/docs/default-source/integrated-health-services-(ihs)/csy/palliative-care/whpca_global_atlas_p5_digital_final.pdf?sfvrsn=1b54423a_3

Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-49. doi: https://doi.org/10.3322/caac.21660 DOI: https://doi.org/10.3322/caac.21660

Hong S, Youk T, Lee SJ, et al. Bone metastasis and skeletal related events in patients with solid cancer: a Korean nationwide health insurance database study. PLoS One. 2020;15(7):e0234927. doi: https://doi.org/10.1371/journal.pone.0234927 DOI: https://doi.org/10.1371/journal.pone.0234927

Migliorini F, Maffulli N, Trivellas A, et al. Bone metastases: a comprehensive review of the literature. Mol Biol Rep. 2020;47(8):6337-45. doi: https://doi.org/10.1007/s11033-020-05684-0 DOI: https://doi.org/10.1007/s11033-020-05684-0

Kuriakose J, Surendran S, Deodhar JK, et al. Prevalence and characteristics of pathological fractures in patients referred to specialist palliative care: a retrospective study from India. Am J Hosp Palliat Care. 2025;42(1):56-63. doi: https://doi.org/10.1177/10499091241240134 DOI: https://doi.org/10.1177/10499091241240134

Durante ALTC, Probstner D, Fontes EFPG, et al. Síndrome de compressão medular. In: Instituto Nacional de Câncer. Cuidados paliativos: vivências e aplicações práticas do Hospital do Câncer IV [Internet]. 2. ed. rev atual amp. Rio de Janeiro: INCA; 2024. 371-7. [Acesso 2025 jan 15]. Disponível em: https://ninho.inca.gov.br/jspui/bitstream/123456789/17003/4/Cuidado_%20Paliativos_2_ed.pdf

Rief H, Förster R, Rieken S, et al. The influence of orthopedic corsets on the incidence of pathological fractures in patients with spinal bone metastases after radiotherapy. BMC Cancer. 2015;15:745. doi: https://doi.org/10.1186/s12885-015-1797-5 DOI: https://doi.org/10.1186/s12885-015-1797-5

Yong C, Onukwugha E, Mullins CD. Clinical and economic burden of bone metastasis and skeletal related events in prostate cancer. Curr Opin Oncol. 2024;26(3):274-83. doi: https://doi.org/10.1097/cco.0000000000000071 DOI: https://doi.org/10.1097/CCO.0000000000000071

Tsukamoto S, Kido A, Tanaka Y, et al. Current overview of treatment for metastatic bone disease. Curr Oncol. 2021;28(5):3347-72. doi: https://doi.org/10.3390/curroncol28050290 DOI: https://doi.org/10.3390/curroncol28050290

Itokazu M, Higashimoto Y, Ueda M, et al. Effectiveness of rehabilitation for cancer patients with bone metastasis. Prog Rehabil Med. 2022;7:20220027. doi: https://doi.org/10.2490/prm.20220027 DOI: https://doi.org/10.2490/prm.20220027

Serranito L, Reis-Pina P. Physical rehabilitation in cancer patients with bone metastasis: added value or inconvenience? Acta Med Port. 2020;33(11):778-85. doi: https://doi.org/10.20344/amp.14396 DOI: https://doi.org/10.20344/amp.14396

Resende JMD, Silva FP, Chelles PA, et al. Avaliação do fisioterapeuta. In: Instituto Nacional de Câncer. A avaliação do paciente em cuidados paliativos. Rio de Janeiro: INCA; 2022. 379-86.

Resende JMD, Oliveira LC, Aguiar SS, et al. Prevalence and factors associated with the occurrence of pathological fractures and their impact on the overall survival of patients with bone metastases under palliative care. BMJ Support Palliat Care. 2023:spcare-2023-004582. doi: https://doi.org/10.1136/spcare-2023-004582 DOI: https://doi.org/10.1136/spcare-2023-004582

Resende JMD, Probstner D, Neves ACF, et al. Fratura patológica. In: Instituto Nacional de Câncer. Cuidados paliativos: vivências e aplicações práticas do Hospital do Câncer IV [Internet]. 2. ed. rev atual amp. Rio de Janeiro: INCA; 2024. 371-7. [Acesso 2025 jan 15]. Disponível em: https://ninho.inca.gov.br/jspui/bitstream/123456789/17003/4/Cuidado_%20Paliativos_2_ed.pdf

Falkenberg MB, Mendes TPL, Moraes EP, et al. Educação em saúde e educação na saúde: conceitos e implicações para a saúde coletiva. Ciênc Saúde Colet. 2024;19(3):847-52. doi: https://doi.org/10.1590/1413-81232014193.01572013%20%20 DOI: https://doi.org/10.1590/1413-81232014193.01572013

Echer IC. Elaboração de manuais de orientação para o cuidado em saúde. Rev. Lat.-Am. Enferm. 2005;13(5):754-7. doi: https://doi.org/10.1590/s0104-11692005000500022 DOI: https://doi.org/10.1590/S0104-11692005000500022

Giordani AT, Pires PABF. Normas editoriais orientação aos autores: cartilhas. Jacarezinho: UENP, 2020.

Conselho Nacional de Saúde (BR). Resolução n° 466, de 12 de dezembro de 2012. Aprova as diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos [Internet]. Diário Oficial da União, Brasília, DF. 2013 jun 13. [acesso 2025 fev 14]; Seção 1:59. Disponível em: https://bvsms.saude.gov.br/bvs/saudelegis/cns/2013/res0466_12_12_2012.html

SPSS®: Statistical Package for Social Science (SPSS) [Internet]. Versão 20.1. [Nova York]. International Business Machines Corporation. [acesso 2025 mar 9]. Disponível em: https://www.ibm.com/br-pt/spss?utm_content=SRCWW&p1=Search&p4=43700077515785492&p5=p&gclid=CjwKCAjwgZCoBhBnEiwAz35Rwiltb7s14pOSLocnooMOQh9qAL59IHVc9WP4ixhNTVMjenRp3-aEgxoCubsQAvD_BwE&gclsrc=aw.ds

Gonçalves RMV, Oliveira JLC, Kahl ERPY, et al. Elaboração de cartilha de orientação para uso de telemetria cardíaca. REAS. 2021;13(8):e8516. doi: https://doi.org/10.25248/reas.e8516.2021 DOI: https://doi.org/10.25248/reas.e8516.2021

Alexandre NMC, Coluci MZO. Validade de conteúdo nos processos de construção e adaptação de instrumentos de medidas. Ciênc. Saúde Colet. 2011;16(7):3061-8. doi: https://doi.org/10.1590/S1413-81232011000800006 DOI: https://doi.org/10.1590/S1413-81232011000800006

Instituto Nacional de Câncer. Como cuidar do paciente com metástase óssea: orientações para prevenção de fraturas [Internet]. Rio de Janeiro: INCA; 2024 [acesso 2025 abr 18]. Disponível em: https://ninho.inca.gov.br/jspui/bitstream/123456789/15755/1/Cartilha%20Como%20cuidar%20do%20paciente%20com%20met%C3%A1stase%20%C3%B3ssea.pdf

Cerqueira PMBC, Silva GMC, Lima TMSS, et al. Educação em saúde acerca das doenças crônicas e ao cuidado interdisciplinar. Rev JRG Estud Acad. 2024;7(15):e151305. doi: https://doi.org/10.55892/jrg.v7i15.1305 DOI: https://doi.org/10.55892/jrg.v7i15.1305

Pereira JL, Gonçalves RFM, Pinho DRS. Elaboração e avaliação de uma cartilha sobre os cuidados para realizar uma alimentação segura na clínica de cuidados paliativos oncológicos. Rev Bras Cancerol. 2023;69(2):e-123757. doi: https://doi.org/10.32635/2176-9745.RBC.2023v69n2.3757 DOI: https://doi.org/10.32635/2176-9745.RBC.2023v69n2.3757

Chelles PA, Oliveira LC, Couto LS, et al. Construção de um guia para avaliação e manejo fisioterapêutico da dor em pacientes com câncer. Rev Bras Cancerol. 2024;70(1):e-154522. doi: https://doi.org/10.32635/2176-9745.RBC.2024v70n1.4522 DOI: https://doi.org/10.32635/2176-9745.RBC.2024v70n1.4522

Aghaei MH, Vanaki Z, Mohammadi E. Inducing a sense of worthiness in patients: the basis of patient centered palliative care for cancer patients in Iran. BMC Palliat Care. 2021;20(1):38. doi: https://doi.org/10.1186/s12904-021-00732-3 DOI: https://doi.org/10.1186/s12904-021-00732-3

Silveira GC, Kasprczak I, Paim ED, et al. Validação de cartilha de orientações fonoaudiológicas para pacientes oncológicos disfágicos. Rev CEFAC. 2024;26(4):e0724. doi: https://doi.org/10.1590/1982-0216/20242640724s DOI: https://doi.org/10.1590/1982-0216/20242640724

Coleman RE, Croucher PI, Padhani AR, et al. Bone metastases. Nat Rev Dis Primers. 2020;6(1):83. doi: https://doi.org/10.1038/s41572-020-00216-3 DOI: https://doi.org/10.1038/s41572-020-00216-3

Published

2025-08-21

How to Cite

1.
Resende JMD de, Oliveira LC de, Aguiar SS de, Silva FP da, Muniz AHR, Bergmann A. Preparation of a Booklet for the Prevention of Pathological Fractures in Patients with Bone Metastases. Rev. Bras. Cancerol. [Internet]. 2025 Aug. 21 [cited 2026 Feb. 5];71(4):e-135283. Available from: https://rbc.inca.gov.br/index.php/revista/article/view/5283

Issue

Section

ORIGINAL ARTICLE

Most read articles by the same author(s)

1 2 3 4 5 6 > >>