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Vol. 29. Issue 1.
Pages 35-46 (January - June 2011)
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Vol. 29. Issue 1.
Pages 35-46 (January - June 2011)
DOI: 10.1016/S0870-9025(11)70006-2
Open Access
Impacto do cancro do osso e tecidos moles no ajustamento emocional e qualidade de vida
Impact of bone and soft tissue cancer on emotional adjustment and quality of life
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Tiago Paredesa,
Corresponding author
tiago_paredes@yahoo.com.br

Autor para correspondência.
, Maria Cristina Canavarrob, Mário Rodrigues Simõesc
a Instituto de Psicologia Cognitiva, Desenvolvimento Vocacional e Social, Faculdade de Psicologia e Ciências da Educação da Universidade de Coimbra, Coimbra, Portugal
b Faculdade de Psicologia e Ciências da Educação da Universidade de Coimbra, Coimbra, Portugal
c Faculdade de Psicologia e Ciências da Educação da Universidade de Coimbra, Coimbra, Portugal
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Resumo
Introdução

O presente estudo procurou comparar o ajustamento emocional e qualidade de vida (QdV) de doentes diagnosticados com cancro do osso e tecidos moles, que se encontravam em diferentes fases da trajectória da doença.

Material e métodos

Cinquenta e cinco doentes entre o diagnóstico e o inicio dos tratamentos, 55 a realizarem tratamento e 74 em consultas de seguimento ou follow-up foram avaliados com recurso a questionários de auto-resposta. Setenta indivíduos da população geral foram usados como grupo de controlo.

Resultados

Nas diferentes fases da doença, a maioria dos doentes com sarcoma revelou níveis normais ou ligeiros de ansiedade e depressão mas, uma minoria considerável exibiu níveis moderados a severos. De um modo geral, os doentes em cada fase da doença revelaram um distress emocional sem relevância clínica e comparável ao de indivíduos saudáveis. Apenas os doentes a realizarem tratamento exibiram níveis de depressão significativamente superiores aos manifestados pelos sobreviventes na fase de follow-up. Na fase de diagnóstico e tratamento observou-se uma pior percepção de QdV global e na dimensão física, quer comparativamente à fase de follow-up quer aos controlos saudáveis. O impacto na QdV, de um modo geral, parece ser mais evidente na fase de tratamento dados os piores níveis de funcionamento em diversas áreas da vida e a maior experiência de sintomas físicos, principalmente em relação à fase de follow-up. Os sobreviventes livres de doença apresentam uma QdV comparável à de indivíduos da população geral, nas suas diferentes dimensões.

Conclusões

O número de doentes que exibe um distress emocional significativo (entre 25% e 29,6% para a ansiedade e 8,3% e 23,6% para a depressão) e o impacto do cancro do osso e tecidos moles na QdV, principalmente na fase de diagnóstico e durante os tratamentos, apelam para a necessidade de implementar intervenções multidisciplinares em indivíduos diagnosticados com este tipo específico de patologia oncológica. Estas intervenções deverão incluir um componente psicossocial e ser adaptadas a cada fase da trajectória da doença.

Palavras-chave:
Sarcomas
Ajustamento emocional
Qualidade de vida
Trajectória da doença
Abstract
Introduction

The aim of the present study was the comparison of emotional adjustment and quality of life (QoL) of bone and soft tissue cancer patients that were in different phases of the disease trajectory.

Material and methods

Fifty five patients between diagnosis and treatment initiation, 55 under treatment and 74 in follow-up consultations were assessed using self-report questionnaires. Seventy persons from the general population were used as control group. In the different phases of the disease the majority of patients revealed normal or mild levels of anxiety and depression but, an important minority showed moderate to severe levels.

Results

In general, the emotional distress of patients in each phase of the disease was not clinically relevant and was comparable to that of healthy individuals. Only patients under treatment exhibited significant higher levels of depression compared to survivors in the follow-up phase. In diagnostic and treatment phase patients reported a poorer perception of overall and physical QoL compared to survivors and healthy controls. The impact on QoL, in general, seems more marked in the treatment phase given the worse levels of functioning in several domains of life, and the higher experience of physical symptoms, mainly compared with the follow-up phase. Free-disease survivors showed a QoL comparable to that of healthy individuals, in its different dimensions.

Conclusions

The number of patients with significant levels of emotional distress (between 25% and 29.6% for anxiety, and 8.3% and 23.6% for depression), and the impact of bone and soft tissue cancer on QoL, mainly in diagnostic phase and during treatments, call to the need of implementing multidisciplinary interventions in patients with this specific cancer diagnose. These interventions should include a psychosocial component and be adapted to each phase of the disease trajectory.

Keywords:
Sarcomas
Emotional adjustment
Quality of life
Disease trajectory
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Bibliografia
[1.]
A. Bowling.
What things are important in people's lives?: a survey of the public's judgements to inform scales of health related quality of life.
Soc Sci Med, 41 (1995), pp. 1447-1462
[2.]
I. Koinberg, A. Langius-Eklöf, L. Holmberg, B. Fridlund.
The usefulness of a multidisciplinary educational programme after breast cancer surgery: a prospective and comparative study.
Eur J Oncol Nurs, 10 (2006), pp. 273-282
[3.]
F.L. Pimentel.
Qualidade de vida e oncologia.
Edições Almedina, (2006),
[4.]
A. Bowden, J.A. Fox-Rushby.
A systematic and critical review of the process of translation and adaptation of generic health-related quality of life measures in Africa, Asia, Eastern Europe, the Middle East, South America.
Soc Sci Med, 57 (2003), pp. 1289-1306
[5.]
D. de Ridder, R. Geenen, R. Kuijer, H. van Middendorp.
Psychological adjustment to chronic disease.
[6.]
Fleck MPA. Problemas conceituais em qualidade de vida. Em: Fleck MPA, org; Souza J CRP, Barros NHS. A avaliação de qualidade de vida: guia para profissionais de saúde. Porto Alegre: Artmed; 2008. p. 19–28.
[7.]
D. Osoba.
Effect of cancer on quality of life.
CRC Press, (1991),
[8.]
J.L.P. Ribeiro.
A importância da qualidade de vida para a psicologia da saúde.
Análise Psicológica, 2 (1994), pp. 179-191
[9.]
J.L.P. Ribeiro.
Qualidade de vida e doença oncológica.
Territórios da psicologia oncológica, pp. 75-98
[10.]
B.J. Zebrack, J. Yi, L. Petersen, P.A. Ganz.
The impact of cancer and quality of life for long-term survivors.
Psychooncology, 17 (2008), pp. 891-900
[11.]
A. Bottomley.
The cancer patient and quality of life.
Oncologist, 7 (2002), pp. 120-125
[12.]
D.F. Cella.
Quality of life.
Psycho-oncology,
[13.]
B.R. Ferrell, K.H. Dow, M. Grant.
Measurment of the quality of life in cancer survivors.
Qual Life Res, 4 (1995), pp. 523-531
[14.]
R. Bergamasco, M. Angelo.
O sofrimento de descobrir-se com câncer de mama: como o diagnóstico é experienciado pela mulher.
Rev Bras Cancerol, 47 (2001), pp. 227-282
[15.]
L.E. Carlson, M. Speca, N. Hagen, P. Taenzer.
Computerized quality-of-life screening in a cancer pain clinic.
J Palliat Care, 17 (2001), pp. 46-52
[16.]
R.P. McQuellon, B.W. Loggie, A.B. Lehman, G.B. Russell, R.A. Fleming, P. Shen, et al.
Long-term survivorship and quality of life after cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy for peritoneal carcinomatosis.
Ann Surg Oncol, 10 (2003), pp. 155-162
[17.]
Behavioural medicine: psychological treatment of somatic disorders, pp. 231-246
[18.]
K. Han, P. Lee, S. Lee, E. Park.
Factors influencing quality of life in people with chronic illness in Korea.
J Nurs Scholarsh, 35 (2003), pp. 139-144
[19.]
O. Uzun, F.E. Aslan, D. Selimen, M. Koç.
Quality of life in women with breast cancer in Turkey.
J Nurs Scholarsh, 36 (2004), pp. 207-213
[20.]
J.L. Venâncio.
Importância da atuação do psicólogo no tratamento de mulheres com câncer de mama.
Rev Bras Cancerol, 50 (2004), pp. 55-63
[21.]
M. Michael, I.F. Tannock.
Measuring health-related quality of life in clinical trials that evaluate the role of chemotherapy in cancer treatment.
CMAJ, 158 (1998), pp. 1727-1734
[22.]
G. Tan, K. Waldman, R. Bostick.
Psychosocial issues, sexuality, and cancer.
Sex Disabil, 20 (2002), pp. 297-318
[23.]
I. Schou, Ø. Ekeberg, L. Sandvik, M.J. Hjermstad, C.M. Ruland.
Multiple predictors of health-related quality of life in early stage breast cancer: data from a year follow-up study compared with the general population.
Qual Life Res, 14 (2005), pp. 1813-1823
[24.]
U. Wedding, A. Koch, B. Röhrig, L. Pientka, H. Sauer, K. Höffken, et al.
Depression and functional impairment independently contribute to decreased quality of life in cancer patients prior to chemotherapy.
Acta Oncol, 47 (2008), pp. 56-62
[25.]
M.A. Andrykowski, J.S. Carpenter, R.K. Munn.
Psychosocial sequelae of cancer diagnosis and treatment.
Psychosocial treatment for medical conditions: principles and techniques, pp. 79-131
[26.]
L.R. Derogatis, G.R. Morrow, J. Fetting, D. Penman, S. Piasetsky, A.M. Schmale, et al.
The prevalence of psychiatric disorders among cancer patients.
JAMA, 249 (1983), pp. 751-757
[27.]
R. Allen, S.P. Newman, R.L. Souhami.
Anxiety and depression in adolescent cancer: findings in patients and parents at the time of diagnosis.
Eur J Cancer, 33 (1997), pp. 1250-1255
[28.]
I.J. Korfage, M.L. Essink-Bot, A.C. Janssens, F.H. Schröder, H.J. de Koning.
Anxiety and depression after prostate cancer diagnosis and treatment: 5-year follow-up.
Br J Cancer, 94 (2006), pp. 1093-1098
[29.]
B.E. Compas, M.F. Stoll, A.H. Thomsen, G. Oppedisano, J.E. Epping-Jordan, D.N. Krag.
Adjustment to breast cancer: age-related differences in coping and emotional distress.
Breast Cancer Res Treat, 54 (1999), pp. 195-203
[30.]
S.A. Alawadi, J.U. Ohaeri.
Health-related quality of life of Kuwaiti women with breast cancer: a comparative study using the EORTC Quality of Life Questionnaire.
BMC Cancer, 9 (2009), pp. 222
[31.]
M. Malone, A.L. Harris, D.K. Luscombe.
Assessment of the impact of cancer on work, recreation, home management and sleep using a general health status measure.
J R Soc Med, 87 (1994), pp. 386-389
[32.]
K. Weidner, F. Einsle, F. Siedentopf, Y. Stöbel-Richter, W. Distler, P. Joraschky.
Psychological and physical factors influencing the health-related quality of patients of a department of gynecology in a university hospital.
J Psychosom Obstet Gynaecol, 27 (2006), pp. 257-265
[33.]
C. Arving, B. Glimelius, Y. Brandberg.
Four weeks of daily assessments of anxiety, depression and activity compared to a point assessment with the Hospital Anxiety and Depression Scale.
Qual Life Res, 17 (2008), pp. 95-104
[34.]
G. Iconomou, A.V. Iconomou, A.A. Argyriou, A. Nikolopoulos, A.A. Ifanti, H.P. Kalofonos.
Emotional distress in cancer patients at the beginning of chemotherapy and its relation to quality of life.
J BUON, 13 (2008), pp. 217-222
[35.]
V. Strong, R. Waters, C. Hibberd, R. Rush, A. Cargill, D. Storey, et al.
Emotional distress in cancer patients: the Edinburgh Cancer Centre symptom study.
B J Cancer, 96 (2007), pp. 868-874
[36.]
I.C. Thuné-Boyle, L.B. Myers, S.P. Newman.
The role of illness beliefs, treatment beliefs, and perceived severity of symptoms in explaining distress in cancer patients during chemotherapy treatment.
Behav Med, 32 (2006), pp. 19-29
[37.]
M. Little, K. Paul, C.F. Jordens, E.J. Sayers.
Survivorship and discourses of identity.
Psychooncology, 11 (2002), pp. 170-178
[38.]
J.R. Bloom, S.H. Kang, D.M. Petersen, S.L. Stewart.
Quality of life in long-term cancer survivors.
Handbook of cancer survivorship, pp. 43-66
[39.]
J.R. Bloom, D.M. Petersen, S.H. Kang.
Multi-dimensional quality of life among long-term (5 + years) adult cancer survivors.
Psychooncology, 16 (2007), pp. 691-706
[40.]
C. Pinto, J.L.P. Ribeiro.
A qualidade de vida dos sobreviventes de cancro.
Rev Port Saúde Pública, 24 (2006), pp. 37-56
[41.]
C.C. Gotay, J.H. Farley, C.T. Kawamoto, A. Mearig.
Adaptation and quality of life among long-term cervical cancer survivors in the military health care system.
Mil Med, 173 (2008), pp. 1035-1041
[42.]
E.F. Morrill, N.T. Brewer, S.C. O’Neill, S.E. Lillie, E.C. Dees, L.A. Carey, et al.
The interaction of posttraumatic growth and posttraumatic stress symptoms in predicting depressive symptoms and quality of life.
Psychooncology, 17 (2008), pp. 948-953
[43.]
B.L. Andersen, B. Andersen, C. deProsse.
Controlled prospective longitudinal study of women with breast cancer.II.: psychological outcomes.
J Consult Clin Psychol, 57 (1989), pp. 692-697
[44.]
L.E. Carlson, M. Angen, J. Cullum, E. Goodey, J. Koopmans, L. Lamont, et al.
High levels of untreated distress and fatigue in cancer patients.
Br J Cancer, 90 (2004), pp. 2297-2304
[45.]
K. Millar, A.D. Purushotham, E. McLatchie, W.D. George, G.D. Murray.
A 1-year prospective study of individual variation in distress, and illness perceptions, after treatment for breast cancer.
J Psychosom Res, 58 (2005), pp. 335-342
[46.]
A.L. Stanton, P.R. Snider.
Coping with a breast cancer diagnosis: a prospective study.
Health Psychol, 12 (1993), pp. 16-23
[47.]
R. Felder-Puig, A.K. Formann, A. Mildner, W. Bretschneider, B. Bucher, R. Windhager, et al.
Quality of life and psychosocial adjustment of young patients after treatment of bone cancer.
Cancer, 83 (1998), pp. 69-75
[48.]
C.M. Custodio.
Barriers to rehabilitation of patients with extremity sarcomas.
J Surg Oncol, 95 (2007), pp. 393-399
[49.]
A.M. Davis, J.G. Wright, J.I. Williams, C. Bombardier, A. Griffin, R.S. Bell.
Development of a measure of physical function for patients with bone and soft tissue sarcoma.
Qual Life Res, 5 (1996), pp. 508-516
[50.]
J.P. Ginsberg, S.N. Rai, C.A. Carlson, A.T. Meadows, P.S. Hinds, E.M. Spearing, et al.
A comparative analysis of functional outcomes in adolescents and young adults with lower-extremity bone sarcoma.
Pediatr Blood Cancer, 49 (2007), pp. 964-969
[51.]
S. Mercadante.
Malignant bone pain: pathophysiology and treatment.
Pain, 69 (1997), pp. 1-18
[52.]
L.H. Aksnes, K.S. Hall, N. Jebsen, S.D. Fosså, A.A. Dahl.
Young survivors of malignant bone tumours in the extremities: a comparative study of quality of life, fatigue and mental distress.
Support Care Cancer, 15 (2007), pp. 1087-1096
[53.]
C. Eiser.
Assessment of health-related quality of life after bone cancer in young people: easier said than done.
Eur J Cancer, 45 (2009), pp. 1744-1747
[54.]
D. Schreiber, R.S. Bell, J.S. Wunder, B. O'Sullivan, R. Turcotte, B.A. Masri, et al.
Evaluating function and health related quality of life in patients treated for extremity soft tissue sarcoma.
Qual Life Res, 15 (2006), pp. 1439-1446
[55.]
A. Postma, A. Kingma, J.H. De Ruiter, H. Schraffordt Koops, R.P. Veth, L.N. Goëken, et al.
Quality of life in bone tumor patients comparing limb salvage and amputation of the lower extremity.
J Surg Oncol, 51 (1992), pp. 47-51
[56.]
L.H. Aksnes, Ø.S. Bruland.
Some musculo-skeletal sequelae in cancer survivors.
Acta Oncol, 46 (2007), pp. 490-496
[57.]
M.M. Hudson, A.C. Mertens, Y. Yasui, W. Hobbie, H. Chen, J.G. Gurney, et al.
Health status of adult long-term survivors of childhood cancer.
JAMA, 290 (2003), pp. 1583-1592
[58.]
J.A. Punyko, J.G. Gurney, K. Scott-Baker, R.J. Hayashi, M.M. Hudson, Y. Liu, et al.
Physical impairment and social adaptation in adult survivors of childhood and adolescent rhabdomyosarcoma: a report from the Childhood Cancer Survivors.
Psychooncology, 16 (2007), pp. 26-37
[59.]
K.M. Thijssens, J.E. Hoekstra-Weebers, R.J. van Ginkel, H.J. Hoekstra.
Quality of life after hyperthermic isolated limb perfusion for locally advanced extremity soft tissue sarcoma.
Ann Surg Oncol, 13 (2006), pp. 864-871
[60.]
C. Hoffmann, G. Gosheger, C. Gebert, H. Jürgens, W. Winkelmann.
Functional results and quality of life after treatment of pelvic sarcomas involving the acetabulum.
J Bone Joint Surg Am, 88 (2006), pp. 575-582
[61.]
P. Mansky, A. Arai, P. Stratton, D. Bernstein, L. Long, J. Reynolds, et al.
Treatment late effects in long-term survivors of pediatric sarcoma.
Pediatr Blood Cancer, 48 (2007), pp. 192-199
[62.]
L. Wiener, H. Battles, D. Bernstein, L. Long, J. Derdak, C.L. Mackall, et al.
Persistent psychological distress in long-term survivors of pediatric sarcoma: the experience at a single institution.
Psychooncology, 15 (2006), pp. 898-910
[63.]
A.S. Zigmond, R.P. Snaith.
The Hospital Anxiety and Depression Scale.
Acta Psychiatr Scand, 67 (1983), pp. 361-370
[64.]
R.P. Snaith.
The Hospital Anxiety and Depression Scale.
Health Qual Life Outcomes, 1 (2003), pp. 29
[65.]
J. Pais-Ribeiro, I. Silva, T. Ferreira, A. Martins, R. Meneses, M. Baltar.
Validation study of a Portuguese version of the Hospital Anxiety and Depression Scale.
Psychol Health Med, 12 (2006), pp. 225-237
[66.]
WHOQOL Group.
The World Health Organization Quality of Life Assessment (WHOQOL): development and general psychometric properties.
Soc Sci Med, 46 (1998), pp. 1569-1585
[67.]
M.C. Canavarro, A. Vaz-Serra, M. Pereira, M.R. Simões, L. Quintais, M.J. Quartilho, et al.
Desenvolvimento do instrumento de avaliação da Qualidade de Vida da Organização Mundial de Saúde (WHOQOL-100) para Português de Portugal.
Psiquiatria Clínica, 7 (2006), pp. 15-23
[68.]
N.K. Aaronson, S. Ahmedzai, B. Bergman, M. Bullinger, A. Cull, N.J. Duez, et al.
The European Organisation for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology.
J Natl Cancer Inst, 85 (1993), pp. 365-376
[69.]
J.L.P. Ribeiro, C. Pinto, C. Santos.
Validation study of the portuguese version of the QLQ-C30-V.3.
Psicologia, Saúde & Doenças, 9 (2008), pp. 89-102
[70.]
F. Faul, E. Erdfelder, A.G. Lang, A. Buchner.
G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences.
Behav Res Methods, 39 (2007), pp. 175-191
[71.]
G.D. Bishop.
Health psychology: integrating mind and body.
Allyn and Bacon, (1994),
[72.]
F.I. Fawzy, N.W. Fawzy.
A structured psychoeducational intervention for cancer patients.
Gen Hosp Psychiatry, 16 (1994), pp. 149-192
[73.]
J.C. Holland, D.B. Greenberg, M.K. Hughes.
Quick reference for oncology clinicians: the psychiatric and psychological dimensions of cancer symptom management.
IPOS Press, (2006),
[74.]
S. Moorey, S. Greer.
Cognitive behaviour therapy for people with cancer.
Oxford University Press, (2002),
[75.]
J. Odgen.
Psicologia da saúde.
Climepsi Editores, (1999),
[76.]
D. Spiegel, C. Classen.
Group therapy for cancer patients: a research-based handbook of psychosocial care.
Basic Books, (2000),
[77.]
C.A. White.
Cognitive behaviour therapy for chronic medical problems: a guide to assessment and treatment in practice.
John Wiley & Sons, (2001),
[78.]
D. Amiram, A.D. Vinokur, B.A. Threatt, R.D. Caplan, B.L. Zimmerman.
Physical and psychosocial functioning and adjustment to breast cancer: long-term follow-up of a screening population.
Cancer, 63 (1989), pp. 394-405
Copyright © 2011. Sociedade Portuguesa de Cardiologia
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