Qualidade de vida de pacientes com câncer avançado na terapêutica paliativa e no cuidado paliativo

• Leonel dos Santos Silva ^[1] ; Bruna Eloise Lenhani ^[2] ; Dabna Hellen Tomim ^[1] ; Paulo Ricardo Bittencourt Guimarães ^[1] ; Luciana Puchalski Kalinke ^[1]
  1. [1] Universidade Federal do Paraná

     Universidade Federal do Paraná

     Brasil

     
  2. [2] Hospital Erasto Gaertner

     Hospital Erasto Gaertner

     Brasil

     
• Localización: Aquichan, ISSN-e 2027-5374, ISSN 1657-5997, Vol. 19, Nº. 3, 2019
• Idioma: portugués
• DOI: 10.5294/aqui.2019.19.3.7
• Títulos paralelos:
  • Quality of Life of Patients with Advanced Cancer in Palliative Therapy and in Palliative Care
  • Calidad de vida de pacientes con cáncer avanzado en tratamiento paliativo y cuidado paliativo
• Enlaces
  • Texto completo (pdf)
• Resumen
  • español

    Objetivo: evaluar la calidad de vida de pacientes con cáncer avanzado en tratamiento paliativo y cuidado paliativo. Material y método: estudio cuantitativo, observacional, transversal y analítico, desarrollado en un hospital de enseñanza en el departamento de Paraná, Brasil, de enero a junio del 2018, con 126 pacientes, siendo 107 en tratamiento paliativo y 19 en cuidado paliativo exclusivo. Los cuestionarios para recolectar datos fueron: Quality of Life Questionnaire-Core 15-Palliative, Functional Assessment of Chronic Ilness Therapy-Palliative Care 14 y Edmonton Symptom Assessment System. La prueba de coeficiente no paramétrico de Spearman se utilizó para el análisis. Resultados: la calidad de vida global en el tratamiento paliativo y el cuidado paliativo fue respectivamente 71,54/59,65; cuando correlacionados la puntuación total de calidad de vida del Quality of Life Questionnaire-Core 15-Palliative con el Functional Asses-sment of Chronic Illness Therapy-Palliative Care 14 (p=0,001) y la Edmonton Symptom Assessment System (p=0,001), se encontró diferencia significativa de mejor calidad de vida en el tratamiento paliativo. Conclusión: los pacientes en tratamiento paliativo poseen calidad de vida global buena, mientras que el grupo cuidado paliativo, regular. Los síntomas fueron más suaves en el tratamiento paliativo y más intensos y con más significancia en el cuidado paliativo; por lo tanto, conocer el comprometimiento de la calidad de vida auxiliará a los profesionales a que planeen intervenciones con enfoque transdisciplinario para el paciente y su familia.

  • English

    Objective: To assess the quality of life of patients with advanced cancer in palliative therapy and in palliative care. Materials and Methods: Quantitative, observational, cross-sectional, and analytic study conducted in a teaching hospital in Paraná, Brazil, from January to June 2018, with 126 patients: 107 in palliative therapy; 19 in exclusive palliative care. The questionnaires for data collec-tion were: Quality of Life Questionnaire-Core 15-Palliative, Functional Assessment of Chronic Illness Therapy-Palliative Care 14, and Edmonton Symptom Assessment System. The Spearman non-parametric coefficient test was used for the analysis. Results: The overall quality of life in palliative therapy and in palliative care was, respectively, 71.54/59.65; when correlating the total score of quality of life of the Quality of Life Questionnaire-Core 15-Palliative with the Functional Assessment of Chronic Illness Therapy-Palliative Care 14 (p = 0.001), and the Edmonton Symptom Assessment System (p = 0.001), significant difference of better quality of life was observed in the palliative therapy. Conclusion: Patients in palliative therapy have good overall quality of life, while the palliative care group reports regular quality of life. The symptoms were milder in the palliative therapy and more intense and with greater significance in palliative care; hence, knowing the compromise of quality of life will help professionals in planning interventions with transdisciplinary approach for patients and for their families.

  • português

    Objetivo: avaliar a qualidade de vida de pacientes com câncer avançado em terapêutica paliativa e em cuidado paliativo. Material e método: estudo quantitativo, observacional, transversal e analítico, desenvolvido num hospital de ensino no Paraná, Brasil, de janeiro a junho de 2018, com 126 pacientes, sendo 107 em terapêutica paliativa e 19 no cuidado paliativo exclusivo. Os questionários para a coleta de dados foram: Quality of Life Questionnaire-Core 15-Palliative, Functional Assessment of Chronic Ilness Therapy-Palliative Care 14 e Edmonton Symptom Assessment System. O teste de coeficiente não paramétrico de Spearman foi utilizado para a análise. Resultados: a qualidade de vida global na terapêutica paliativa e no cuidado paliativo foi respectivamente 71,54/59,65; quando correlacionados o escore total de qualidade de vida do Quality of Life Questionnaire-Core 15-Palliative com o Functional Assessment of Chronic Illness Therapy--Palliative Care 14 (p=0,001) e a EdmontonSymptom Assessment System (p=0,001), observou-se diferença significativa de melhor qualidade de vida na terapêutica paliativa. Conclusão: os pacientes em terapia paliativa possuem qualidade de vida global boa, enquanto o grupo cuidado paliativo, regular. Os sintomas foram mais leves na terapia paliativa e mais intensos e com maior significância no cuidado paliativo; portanto, conhecer o comprometimento da qualidade de vida auxiliará os profissionais no planejamento de intervenções com enfoque transdisciplinar para o paciente e para sua família.

• Referencias bibliográficas
  • Weinberg RA. The biology of cancer. 2nd ed. New York: Garland Science, 2014. 728 p.
  • Dong ST, Costa DSJ, Butow PN, Lovell MR, Agar M, Velikova G et al. Symptom clusters in advanced cancer patients: An empirical comparison of...
  • Cancer Research. Palliative treatment [Internet]. 2018 [cited 2018 sep 21]. Disponível em: https://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/palliative
  • World Health Organization (WHO). Global atlas of palliative care at the end of life [Internet]. 2014 [acesso em 21 set. 2018] 111 p. Disponível...
  • Knaul FM, Farmer PE, Krakauer EL, De Lima L, Bhadelia A, Jiang Kwete X et al. Alleviating the access abyss in palliative care and pain relief...
  • Ghandourh WA. Palliative care in cancer: managing patients’ expectations. J Med Radiat Sci. 2016; 63(4):242-57. DOI: https://doi.org/10.1002/jmrs.188
  • World Health Organization (WHO). WHOQOL: measuring quality of life. Psychol Med [Internet]. 1998 [citado em 12 nov. 2018]; 28(3):551-8. Disponível...
  • Romero M, Vivas-Consuelo D, Alvis-Guzman N. Is Health Related Quality of Life (HRQoL) a valid indicator for health systems evaluation? Springerplus....
  • Oken M, Creech R, Tormey D, Horton J, Davis T, McFadden E et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group....
  • Groenvold M, Petersen MA, Aaronson NK, Arraras JI, Blazeby JM, Bottomley A et al. The development of the EORTC QLQ-C15-PAL: A shortened questionnaire...
  • Zeng L, Bedard G, Cella D, Thavarajah N, Chen E, Zhang L et al. Preliminary results of the generation of a shortened quality-of-life assessment...
  • Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K. The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of...
  • McGee SF, Zhang T, Jonker H, Laurie SA, Goss G, Nicholas G et al. The Impact of Baseline Edmonton Symptom Assessment Scale Scores on Treatment...
  • McCaffrey N, Bradley S, Ratcliffe J, Currow DC. What Aspects of Quality of Life Are Important from Palliative Care Patients? Perspectives?...
  • West C, Paul SM, Dunn L, Dhruva A, Merriman J, Miaskowski C. Gender Differences in Predictors of Quality of Life at the Initiation of Radiation...
  • Trinquinato I, da Silva RM, Benavente SBT, Antonietti CC, Calache ALSC. Gender differences in the perception of quality of life of patients...
  • Instituto Nacional do Câncer (Brasil). Estimativa 2018 — Incidência de câncer no Brasil. 2018 [acesso em 12 nov. 2018. 130 p. Disponível em:...
  • Wu CC; Hsu TW, Chang CM, Lee CH, Huang CY, Lee CC. Palliative Chemotherapy Affects Aggressiveness of End-of-Life Care. The Oncologist. 2016;...
  • Matos TD de S, Meneguin S, Ferreira M de L da S, Miot HA. Qualidade de vida e coping religioso-espiritual em pacientes sob cuidados paliativos...
  • Han K, Kim SJ, Song H, Chun S, Ok C, Kim J et al. Associations between Quality of Life and Marital Status in Cancer Patients and Survivors....
  • Caires-Lima R, Cayres K, Protásio B, Caires I, Andrade J, Rocha L et al. Palliative chemotherapy outcomes in patients with ECOG-PS higher...
  • Zhang L, Wang N, Zhang J, Liu J, Luo Z, Sun W et al. Cross-cultural verification of the EORTC QLQ-C15-PAL questionnaire in mainland China....
  • LEE, Richard T. Meropol NJM. Rethinking the Value of Palliative Chemotherapy [Internet]. 2016 [citado 21 de set de 2017]; 9-12. Disponível...
  • Matos GDR, Pulschen AC. Qualidade de Vida de Pacientes Internados em uma Unidade de Cuidados Paliativos: um Estudo Transversal. Rev Bras Cancerol...
  • Ozcelik H, Guzel Y, Sonmez E, Aksoy F, Uslu R. Reliability and validity of the Turkish version of the EORTC QLQ-C15-PAL for patients with...
  • Freire MEM, Costa SF, Lima RAG, Sawada NO. Qualidade de vida relacionada à saúde de pacientes com câncer em cuidados paliativos. Texto Contexto...
  • Figueiredo JF, Souza VM, Coelho HV, Souza RS. Qualidade de vida de pacientes oncológicos em cuidados paliativos. Rev Enferm do Centro-Oeste...
  • Bedard G, Zeng L, Zhang L, Lauzon N, Holden L, Tsao M et al. Minimal important differences in the EORTC QLQ-C15-PAL to determine meaningful...
  • Nunes NAH. The quality of life of Brazilian patients in palliative care: Validation of the European Organization for Research and Treatment...
  • Bakitas MA, Dragnev KH, Bakitas MA, Tosteson TD, Li Z, Lyons KD et al. Early Versus Delayed Initiation of Concurrent Palliative Oncology Care:...
  • Frazer MS, Mobley P. A mixed methods analysis of quality of life among late-life patients diagnosed with chronic illnesses. Health Qual Life...
  • Bradley N, Lloyd-Williams M, Dowrick C. Effectiveness of palliative care interventions offering social support to people with life-limiting...
  • Smith H, Smith J, Smith A. An overview of nausea/vomiting in palliative medicine. Ann Palliat Med. 2012; 1(2):103-14. DOI: http://dx.doi.org/10.3978/j.issn.2224-5820.2012.07.06
  • Paiva CE, Manfredini LL, Paiva BSR, Hui D, Bruera E. The Brazilian version of the Edmonton Symptom Assessment System (ESAS) is a feasible,...
  • Yokomichi N, Morita T, Nitto A, Takahashi N, Miyamoto S, Nishie H et al. Validation of the Japanese Version of the Edmonton Symptom Assessment...
  • Hannon B, Dyck M, Pope A, Swami N, Banerjee S. Modified Edmonton Symptom Assessment System Including Constipation and Sleep: Validation in...
  • Limonero JT, Lacasta Reverte MA, Gómez-Romero MJ, Gil-Moncayo F. The role of emotions in palliative care. Palliat Med Hosp Care Open J. 2018;...
  • Bickel KE, McNiff K, Buss MK, Kamal A, Lupu D, Abernethy AP et al. Defining High-Quality Palliative Care in Oncology Practice: An American...