Qualidade de vida de pacientes adultos com câncer de pulmão, submetidos a quimioterapia ambulatorial

Abstract

Este estudo descritivo, analítico, acerca da qualidade de vida de pacientes adultos com câncer de pulmão, submetidos à quimioterapia ambulatorial, pretende contribuir para a melhor compreensão do impacto desse tratamento na qualidade de vida desse paciente. A partir dessa compreensão, os profissionais de saúde que atuam no atendimento a esses pacientes poderão encontrar subsídios que fortaleçam o seu desempenho profissional. Estudos sobre qualidade de vida vêm despertando o interesse dos profissionais de saúde, motivados, sobretudo, pelo aumento da sobrevida desses pacientes proporcionada pelas terapias utilizadas atualmente. A incidência dos cânceres de pulmão tem aumentado progressivamente nos últimos anos e o diagnóstico precoce é dificultado pelo aparecimento tardio dos sintomas, o que quase sempre produz significativas repercussões na qualidade de vida dos pacientes. Foi traçado o perfil sócio-demográfico e clínico da amostra populacional do estudo, constituída de 72 pacientes, bem como avaliada a qualidade de vida dessa amostra de pacientes, correlacionando-se os escores de qualidade de vida obtidos antes e após serem submetidos ao primeiro ciclo de quimioterapia ambulatorial. Utilizou-se a abordagem multidimensional proposta pela Organização Mundial da Saúde (OMS), através de um instrumento genérico de avaliação nomeado WHOQOL– bref, proposto pelo WHOQOL GROUP. A investigação foi realizada em dois ambulatórios de quimioterapia, na Cidade de São Paulo, entre os anos de 2001 e 2002. Foi feita a análise descritiva de todas as variáveis do estudo e utilizado o teste de comparação entre duas proporções quando se fez necessário. O WHOQOL-bref e constituído de cinco domínios, a saber: 1 – Físico; 2 – Psicológico; 3 – Relações Sociais; 4 – Meio-ambiente; 5 – Geral. Comparados o antes e o após do primeiro ciclo da quimioterapia em todos os pacientes estudados, houve diferença estatisticamente significante para piora da qualidade de vida no domínio 2 (Psicológico). Fazendo-se uma comparação por sexo, somente o masculino apresentou diferença estatisticamente significante também para piora nos domínios 2 (Psicológico) e 5 (Geral). Em relação à faixa etária, houve uma diferença estatisticamente significante para a melhora nos domínios 1 (Físico) e 4 (Meio-ambiente), nos pacientes menores de 60 anos; ao contrário daqueles pacientes com idade igual ou superior a 60 anos, que nos domínios 2 (Psicológico), 4 (Meio-ambiente) e 5 (Geral) manifestaram insatisfação com a sua qualidade de vida.

This descriptive, analytic study about quality of life of adult patients having lung cancer, submitted to ambulatorial chemotherapy intends to contribute to better understand the impact caused by such a treatment in the quality of life of these patients. As one reaches such an understanding – and specially the health professional staff may find data to strengthen their performance while attending them. Studies about life quality have been done and awakes the attention of the professionals involved, specially motivated by the increase of survival of the patients as they are treated by the therapies used presently. The incidence of lung cancer has grown during the last years and the precocious diagnosis finds some problems due to the late appearance of symptoms, fact that produces disturbances in the quality of life of the patients. The clinical and demographical profile of the patients was made, a total of 72, and the quality of life was evaluated before and after the first cycle of chemotherapy. The multidimensional approach was utilized by means of a generic instrument of measurement, proposed by the World Health Organization, called WHOQOL – bref, created by the WHOQOL GROUP. The investigation was undertaken in two ambulatorial services in São Paulo City, between 2001 and 2002. The descriptive analysis of all variables of the study was done as well as the comparison test between two proportions when necessary. The WHOQOL – bref is constituted by five domains, namely, 1- Physical; 2- Psychological; 3- Social Relationships; 4- Environmental; and 5- General. By comparing the before and after the therapy there was a significant statistical difference to “worse” in the domain number 2 (Psychological). By making a comparison according to sex, the masculine ones presented a significant statistical difference to “worse” in domains 2 (Psychological) and 5 (General). According to age there was a significant statistical difference to “better” in domains 1 (Physical) and 4 (Environmental) for the patients below 60 years old; on the contrary, patients who were 60 or older presented dissatisfaction with their quality of life in domains 2 (Psychological), 4 (Environmental ) and 5 (General). This descriptive, analytic study about quality of life of adult patients having lung cancer, submitted to ambulatorial chemotherapy intends to contribute to better understand the impact caused by such a treatment in the quality of life of these patients. As one reaches such an understanding – and specially the health professional staff may find data to strengthen their performance while attending them. Studies about life quality have been done and awakes the attention of the professionals involved, specially motivated by the increase of survival of the patients as they are treated by the therapies used presently. The incidence of lung cancer has grown during the last years and the precocious diagnosis finds some problems due to the late appearance of symptoms, fact that produces disturbances in the quality of life of the patients. The clinical and demographical profile of the patients was made, a total of 72, and the quality of life was evaluated before and after the first cycle of chemotherapy. The multidimensional approach was utilized by means of a generic instrument of measurement, proposed by the World Health Organization, called WHOQOL – bref, created by the WHOQOL GROUP. The investigation was undertaken in two ambulatorial services in São Paulo City, between 2001 and 2002. The descriptive analysis of all variables of the study was done as well as the comparison test between two proportions when necessary. The WHOQOL – bref is constituted by five domains, namely, 1- Physical; 2- Psychological; 3- Social Relationships; 4- Environmental; and 5- General. By comparing the before and after the therapy there was a significant statistical difference to “worse” in the domain number 2 (Psychological). By making a comparison according to sex, the masculine ones presented a significant statistical difference to “worse” in domains 2 (Psychological) and 5 (General). xiii According to age there was a significant statistical difference to “better” in domains 1 (Physical) and 4 (Environmental) for the patients below 60 years old; on the contrary, patients who were 60 or older presented dissatisfaction with their quality of life in domains 2 (Psychological), 4 (Environmental ) and 5 (General).