Buscar en
Revista Portuguesa de Saúde Pública
Toda la web
Inicio Revista Portuguesa de Saúde Pública Qualidade de vida de mulheres com cancro da mama nas diversas fases da doença: ...
Journal Information
Vol. 29. Issue 1.
Pages 64-76 (January - June 2011)
Share
Share
Download PDF
More article options
Vol. 29. Issue 1.
Pages 64-76 (January - June 2011)
Open Access
Qualidade de vida de mulheres com cancro da mama nas diversas fases da doença: o papel de variáveis sociodemográficas, clínicas e das estratégias de coping enquanto factores de risco/protecção
Quality of life of women with breast cancer at different phases of the disease: the role of sociodemographic, clinical variables and coping strategies as factors of risk/protection
Visits
5427
Sónia Silva
Corresponding author
soniaimsilva@gmail.com

Autor para correspondência.
, Danielle Bettencourt, Helena Moreira, Maria Cristina Canavarro
Faculdade de Psicologia e Ciências da Educação, Universidade de Coimbra, Coimbra, Portugal
This item has received

Under a Creative Commons license
Article information
Resumo
Introdução

Embora o cancro da mama possa comprometer significativamente a qualidade de vida (QdV) da mulher, sobretudo nas fases iniciais da doença, variáveis de ordem psicossocial podem intervir como factores de risco ou de protecção. Este estudo pretende analisar e comparar a QdV de mulheres com cancro da mama em diferentes fases da trajectória da doença e identificar o papel de variáveis sociodemográficas, clínicas e das estratégias de coping na QdV.

Material e métodos

A amostra é constituída por 55 mulheres recentemente diagnosticadas com cancro da mama, 63 a receber quimioterapia, 85 sobreviventes e 160 mulheres da população geral, que responderam ao WHOQOL-Bref e ao Brief COPE.

Resultados

Durante a fase de tratamento o cancro da mama compromete significativamente a QdV global e física da mulher. Um nível de escolaridade mais elevado, assim como o recurso a estratégias de coping Cognitivas Activas associam-se a uma melhor QdV global e Psicológica, após o diagnóstico e durante o tratamento. O recurso a um coping de Evitamento associa-se a uma pior QdV em todas as fases da doença.

Conclusões

Os resultados deste estudo ao contribuírem para um melhor conhecimento das implicações do cancro da mama na QdV em diferentes fases da trajectória da doença, bem como das variáveis que poderão intervir como factores de risco/protecção, revelam-se importantes para o desenvolvimento de intervenções psicológicas mais eficazes e ajustadas às necessidades da mulher.

Palavras-chave:
Cancro da mama
Qualidade de vida
Coping
Diagnóstico
Tratamento
Sobrevivência
Abstract
Introduction

Although breast cancer may significantly compromise women's quality of life (QoL), especially during the initial phases of the disease, psychosocial variables may act as factors of risk or protection. This study aims to analyse and compare the QoL of women in different phases of breast cancer and to identify the role of sociodemographic and clinical variables as well as coping strategies on QoL.

Method

The sample is composed of 55 women newly diagnosed with breast cancer, 63 women undergoing chemotherapy, 85 breast cancer survivors and 160 women from the general population. They all answered the WHOQOL-Bref and the Brief COPE.

Results

The results show that global and physical QoL is significantly impaired during treatment. Higher education and Active Cognitive Coping strategies are significantly associated with improved global and Psychological QoL, after diagnosis and during treatment. Avoidant coping relates to worse QoL in all phases of the disease.

Conclusions

The results of this study contribute to a better knowledge of the impact of breast cancer on QoL, in different phases of the disease trajectory, as well as give important information about the factors of risk/protection. Thus, they are helpful in developing more effective psychological interventions, tailored to the particular needs of women.

Keywords:
Breast cancer
Quality of life
Coping
Diagnosis
Treatment
Survival
Full text is only aviable in PDF
Bibliografia
[1.]
J. Ferlay, P. Autier, M. Boniol, M. Heanue, M. Colombet, P. Boyle.
Estimates of the cancer incidence and mortality in Europe in 2006.
Ann Oncol, 18 (2007), pp. 581-592
[2.]
M. Feuerstein.
Defining cancer survivorship.
J Cancer Surviv, 1 (2007), pp. 5-7
[3.]
M.J. Cordova, J. Giese-Davis, M. Golant, C. Kronenwetter, V. Chang, D. Spiegel.
Breast cancer as trauma: posttraumatic stress and posttraumatic growth.
J Clin Psychol Med Settings, 14 (2007), pp. 308-319
[4.]
D.W. Kissane, D.M. Clarke, J. Ikin, S. Bloch, G.C. Smith, L. Vitetta, et al.
Psychological morbidity and quality of life in Australian women with early-stage breast cancer: a cross-sectional survey.
Med J Aust, 169 (1998), pp. 192-196
[5.]
R. Schwarz, O. Krauss, M. Höckel, A. Meyer, M. Zenger, A. Hinz.
The course of anxiety and depression in patients with breast cancer and gynaecological cancer.
Breast Care (Basel), 3 (2008), pp. 417-422
[6.]
S. Silva, H.T.C. Moreira, M.C.C.S.P. Canavarro.
Ansiedade e depressão após o diagnóstico e sobrevivência para o cancro da mama: um estudo transversal sobre o papel das estratégias de coping.
Saúde Mental, XI (2009), pp. 28-42
[7.]
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
[8.]
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
[9.]
L.J. Fallowfield.
Assessment of quality of life in breast cancer.
Acta Oncol, 34 (1995), pp. 689-694
[10.]
B.R. Ferrell, M. Grant, B. Funk, N. Garcia, S. Otis-Green, M.L. Schaffner.
Quality of life in breast cancer.
Cancer Pract, 4 (1996), pp. 331-340
[11.]
E. Heim, L. Valach, L. Schaffner.
Coping and psychosocial adaptation: longitudinal effects over time and stages in breast cancer.
Psychosom Med, 59 (1997), pp. 408-418
[12.]
National Research Council. Meeting psychosocial needs of women with breast cancer,
[13.]
M.G. Pereira, C. Lopes.
O doente oncológico e a sua família.
Climepsi Editores, (2005),
[14.]
B.R. Ferrell, M.M. Grant, B. Funk, S. Otis-Green, N. Garcia.
Quality of life in breast cancer survivors as identified by focus groups.
[15.]
P.A. Ganz, A. Coscarelli, C. Fred, B. Kahn, M.L. Polinsky, L. Petersen.
Breast cancer survivors: pychosocial concerns and quality of life.
Breast Cancer Res Treat, 38 (1996), pp. 183-199
[16.]
The WHOQOL Group.
Development of the World Health Organization WHOQOL-BREF quality of life assessment: the WHOQOL Group.
Psychol Med, 28 (1998), pp. 551-558
[17.]
M.T. Knobf.
Psychosocial responses in breast cancer survivors.
Semin Oncol Nurs, 23 (2007), pp. 71-83
[18.]
J.H. Rowland, F. Baker.
Introduction: resilience of cancer survivors across the lifespan.
Cancer, 104 (2005), pp. 2543-2548
[19.]
M. Browall, K. Ahlberg, P. Karlsson, E. Danielson, L.O. Persson, F. Gaston-Johansson.
Health-related quality of life during adjuvant treatment for breast cancer among postmenopausal women.
Eur J Oncol Nurs, 12 (2008), pp. 180-189
[20.]
T.S. Lee, S.L. Kilbreath, K.M. Refshauge, S.C. Pendlebury, J.M. Beith, M.J. Lee.
Quality of life of women treated with radiotherapy for breast cancer.
Support Care Cancer, 16 (2008), pp. 399-405
[21.]
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
[22.]
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
[23.]
P.A. Ganz, J.H. Rowland, B.E. Meyerowitz, K.A. Desmond.
Impact of different adjuvant therapy strategies on quality of life in breast cancer survivors.
Recent Results Cancer Res, 152 (1998), pp. 396-411
[24.]
M. Neyt, J. Albrecht.
The long-term evolution of quality of life for disease-free breast cancer survivors: a comparative study in Belgium.
J Psychosoc Oncol, 24 (2006), pp. 89-123
[25.]
J.R. Bloom, S.L. Stewart, S. Chang, P.J. Banks.
Then and now: quality of life of young breast cancer survivors.
Psychooncology, 13 (2004), pp. 147-160
[26.]
M.T. King, P. Kenny, A. Shiell, J. Hall, J. Boyages.
Quality of life three months and one year after first treatment for early stage breast cancer: influence of treatment and patient characteristics.
Qual Life Res, 9 (2000), pp. 789-800
[27.]
M. Schroevers, A.V. Ranchor, R. Sanderman.
Adjustment to cancer in the 8 years following diagnosis: a longitudinal study comparing cancer survivors with healthy individuals.
Soc Sci & Med, 63 (2006), pp. 598-610
[28.]
W.A. Bardwell, J.M. Major, C.L. Rock, V.A. Newman, C.A. Thomson, J.A. Chilton.
Health-related quality of life in women previously treated for early-stage breast cancer.
Psychooncology, 13 (2004), pp. 595-604
[29.]
M. Dorval, E. Maunsell, L. Deschênes, J. Brisson, B. Mâsse.
Long-term quality of life after breast cancer: comparison of 8-year survivors with population controls.
J Clin Oncol, 16 (1998), pp. 487-494
[30.]
P.A. Ganz, J.H. Rowland, K. Desmond, B.E. Meyerowitz, G.E. Wyatt.
Life after breast cancer: understanding women's health-related quality of life and sexual functioning.
J Clin Oncol, 16 (1998), pp. 501-514
[31.]
V.S. Helgeson, P.L. Tomich.
Surviving cancer: a comparison of 5-year disease-free breast cancer survivors with healthy women.
Psychooncology, 14 (2005), pp. 307-317
[32.]
V. Peuckmann, O. Ekholm, N.K. Rasmussen, S. Møller, M. Groenvold, P. Christiansen, et al.
Health-related quality of life in long-term breast cancer survivors: nationwide survey in Denmark.
Breast Cancer Res Treat, 104 (2007), pp. 39-46
[33.]
A.F. van der Steeg, J. De Vries, J.A. Roukema.
The value of quality of life and health status measurements in the evaluation of the well-being of breast cancer survivors.
Eur J Surg Oncol, 34 (2008), pp. 1225-1230
[34.]
M.A. Andrykowski, S.L. Curran, J.L. Studts, L. Cunningham, J.S. Carpenter, P.C. McGrath, et al.
Psychosocial adjustment and quality of life in women with breast cancer and benign breast problems: a controlled comparison.
J Clin Epidemiol, 49 (1996), pp. 827-834
[35.]
F. Mols, A.J. Vingerhoets, J.W. Coebergh, L.V. van de Poll-Franse.
Quality of life among long-term breast cancer survivors: a systematic review.
Eur J Cancer, 41 (2005), pp. 2613-2619
[36.]
N.E. Avis, S. Crawford, J. Manuel.
Quality of life among younger women with breast cancer.
J Clin Oncol, 23 (2005), pp. 3322-3330
[37.]
V. Rebelo, L. Rolim, E. Carqueja, S. Ferreira.
Avaliação da qualidade de vida em mulheres com cancro da mama: um estudo exploratório com 60 mulheres portuguesas.
Psic, Saúde & Doenças, 8 (2007), pp. 13-32
[38.]
M. Dorval, E. Maunsell, L. Deschênes, J. Brisson.
Type of mastectomy and quality of life for long term breast carcinoma survivors.
Cancer, 83 (1998), pp. 2130-2138
[39.]
P.A. Ganz, A.C. Schag, J.J. Lee, M.L. Polinsky, S.J. Tan.
Breast conservation versus mastectomy: is there a difference in psychological adjustment or quality of life in the year after surgery?.
Cancer, 69 (1992), pp. 1729-1738
[40.]
B. Poulsen, H.P. Graversen, J. Beckmann, M. Blichert-Toft.
A comparative study of post-operative psychosocial function in women with primary operable breast cancer randomized to breast conservation therapy or mastectomy.
Eur J Surg Oncol, 23 (1997), pp. 327-334
[41.]
A. Moyer.
Psychosocial outcomes of breast-conserving surgery versus mastectomy: a meta-analytic review.
Health Psychol, 16 (1997), pp. 284-298
[42.]
S. Maes, H. Leventhal, D.T.D. Ridder.
Coping with chronic diseases.
Handbook of coping: theory, research, applications, pp. 221-245
[43.]
F.I. Fawzy, N.W. Fawzy.
A structured psychoeducational intervention for cancer patients.
Gen Hosp Psychiatry, 16 (1994), pp. 149-192
[44.]
S. Ransom, P.B. Jacobsen, J.E. Schmidt, M.A. Andrykowski.
Relationship of problem-focused coping strategies to changes in quality of life following treatment for early stage breast cancer.
J Pain Symptom Manage, 30 (2005), pp. 243-253
[45.]
A.L. Stanton, S. Danoff-Burg, M.E. Huggins.
The first year after breast cancer diagnosis: hope and coping strategies as predictors of adjustment.
Psychooncology, 11 (2002), pp. 93-102
[46.]
C.S. Carver, M.F. Scheier, J.K. Weintraub.
Assessing coping strategies: a theoretically based approach.
J Pers Soc Psychol, 56 (1989), pp. 267-283
[47.]
J. Harrison, P. Maguire.
Predictors of psychiatric morbidity in cancer patients.
Br J Psychiatry, 165 (1994), pp. 593-598
[48.]
M. Zeidner, D. Saklofske.
Adaptative and maladaptative coping.
Handbook of coping: theory, research, applications,
[49.]
A. Vaz-Serra, M.C. Canavarro, M.R. Simões, M. Pereira, S. Gameiro, M.J. Quartilho, et al.
Estudos psicométricos do instrumento de avaliação da Qualidade de Vida da Organização Mundial de Saúde (WHOQOL-Bref) para Português de Portugal.
Psiquiatria Clínica, 27 (2006), pp. 41-49
[50.]
C.S. Carver.
You want to measure coping but your protocol's too long: consider the brief COPE.
Int J Behav Med, 4 (1997), pp. 92-100
[51.]
J.L.P. Ribeiro, A.P. Rodrigues.
Questões acerca do coping: a propósito do estudo de adaptação do Brief COPE. Psic.
Saúde & Doenças, 5 (2004), pp. 3-15
[52.]
J.L. Austenfeld, A.L. Stanton.
Coping through emotional approach: a new look at emotion, coping, and health-related outcomes.
[53.]
J.P. Stevens.
Applied multivariate statistics for the social sciences.
Erlbaum, (1992),
[54.]
D. Bukovic, J. Fajdic, Z. Hrgovic, M. Kaufmann, I. Hojsak, T. Stanceric.
Sexual dysfunction in breast cancer survivors.
Onkologie, 28 (2005), pp. 29-34
[55.]
G.A. Greendale, L. Petersen, L. Zibecchi, P.A. Ganz.
Factors related to sexual function in postmenopausal women with a history of breast cancer.
Menopause, 8 (2001), pp. 111-119
[56.]
C.S. Carver, C. Pozo-Kaderman, A.A. Price, V. Noriega, S.D. Harris, R.P. Derhagopian, et al.
Concern about aspects of body image and adjustment to early stage breast cancer.
Psychos Med, 60 (1998), pp. 168-174
[57.]
C.S. Carver, C. Pozo, S.D. Harris, V. Noriega, M.F. Scheier, D.S. Robinson, et al.
How coping mediates the effect of optimism on distress: a study of women with early stage breast cancer.
J Pers Soc Psychol, 65 (1993), pp. 375-390
Copyright © 2011. Sociedade Portuguesa de Cardiologia
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos