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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Avaliação da qualidade de vida de pacientes com câncer de cabeça e pescoço

Melo, Niebla Bezerra de 19 June 2017 (has links)
Submitted by Jean Medeiros (jeanletras@uepb.edu.br) on 2018-05-17T12:30:23Z No. of bitstreams: 1 PDF - Niebla Bezerra de Melo.pdf: 31979420 bytes, checksum: 2f73bd338c212e4141f4cf5ec9b57972 (MD5) / Approved for entry into archive by Secta BC (secta.csu.bc@uepb.edu.br) on 2018-05-23T16:38:16Z (GMT) No. of bitstreams: 1 PDF - Niebla Bezerra de Melo.pdf: 31979420 bytes, checksum: 2f73bd338c212e4141f4cf5ec9b57972 (MD5) / Made available in DSpace on 2018-05-23T16:38:16Z (GMT). No. of bitstreams: 1 PDF - Niebla Bezerra de Melo.pdf: 31979420 bytes, checksum: 2f73bd338c212e4141f4cf5ec9b57972 (MD5) Previous issue date: 2017-06-19 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Head and neck cancer is the sixth most common cancer in the world and is considered one of the most affected in the quality of life of the affected. The present study aimed to evaluate the health-related quality of life of patients diagnosed with head and neck cancer. The cross- sectional study was carried out at the Hospital of the Paraíba Care Foundation and at the Hospital Napoleão Laureano, both located in the state of Paraíba. The sample consisted of 130 patients diagnosed with malignant head and neck neoplasms, 102 (78.5%) receiving antineoplastic treatment and 28 (21.5%) before starting. For data collection, the Medical Outcomes Study 36 - Item - Short Form (SF36) and the Oral Health Impact Profile - short form (OHIP 14) were used. The analysis was done on an individual basis, considering only oral health, with all patients (n = 130) and in a unified form, considering oral health and general health in a single score, only with patients who were receiving antineoplastic treatment (N = 102). The statistical tests applied were the following: Mann-Whitney, Kruskal- Wallis, Kolmogorov-Smirnov, Levene, Canonical discriminant analysis, Wilks' F and Lambda tests, and Decision Tree Analysis using the Chi-squared Automatic Interaction Detector. The majority of patients were between 60 and 69 years of age (n = 36, 27.7%) and were male (n = 91, 70.0%). The most prevalent type of cancer was squamous cell carcinoma (66.2%) followed by metastatic carcinoma (14.3%) and non-Hodgkin's lymphoma (6.5%), with advanced lesions (72.1%). Located in the oral cavity (23.8%) or larynx (23.8%), followed by the pharynx. The OHIP-14 presented good internal consistency in the sample studied (Cronbach's Alpha = 0.861), with the mean total score being 19.52 ± 11.79. Hierarchically, the three most affected domains were: physical pain (3.70 ± 2.44), physical disability (3.26 ± 2.62) and functional limitation (3.24 ± 2.45). Non-white individuals (PR = 1.30, 95% CI = 1.07-1.58, p = 0.009), widows (PR = 1.36, 95% CI = 1.13-1.64, p = 0.001), Diagnosed with squamous cell carcinoma (RP = 1.28, 95% CI = 1.05-1.58, p = 0.017) and who reported pain in the TMJ (RP = 1.31, 95% CI = 1, 08-160, p = 0.007) were more likely to exhibit higher scores on OHIP-14. When assessing quality of life related to oral health and general health, a single score showed an association between the clinical staging of the lesion (p = 0.035), sex (p = 0.028) and treatment modality (p = 0.032). Self-reported, nonwhite, widowed individuals diagnosed with squamous cell carcinoma and who reported pain in TMJ were more likely to exhibit greater impact of oral health on quality of life. In addition, patients diagnosed with advanced lesions who were female, as well as those who underwent chemotherapy and / or radiotherapy, were more likely to exhibit worse overall and oral quality of life when assessed on a single score. It can be concluded that patients with head and neck cancer have an impact on the quality of life due to the impairment of their oral health and, consequently, general health. / O câncer de cabeça e pescoço ocupa a sexta colocação entre os tipos de câncer mais comuns a nível mundial e é considerado um dos que mais afeta a qualidade de vida. O presente estudo teve como objetivo avaliar a qualidade de vida relacionada à saúde de pacientes diagnosticados com câncer de cabeça e pescoço. Foi realizado um estudo do tipo transversal com uma amostra de 130 pacientes do Hospital da Fundação Assistencial da Paraíba (FAP) e do Hospital Napoleão Laureano, ambos localizados no estado da Paraíba. Destes 130 pacientes diagnosticados com neoplasias malignas de cabeça e pescoço, 102 (78,5%) encontravam-se em tratamento antineoplásico e 28 (21,5%) para iniciar o tratamento. Para a coleta de dados foram utilizados o Medical Outcomes Study 36 - Item – Short Form (SF36) e o Oral Health Impact Profile - short form (OHIP 14). A análise foi feita de forma individual, apenas considerando a saúde oral, com todos os pacientes (n=130) e de forma unificada, unindo a saúde oral e a saúde geral em um score único, apenas com os pacientes que estava m em tratamento antineoplásico (n=102). Os testes estatísticos aplicados foram os seguintes: Mann-Whitney,Kruskal-Wallis,Kolmogorov-Smirnov, Levene, Análise discriminante canônica, os testes F e Lambda de Wilks, além da Análise de Árvore de Decisão usando o Chi-squared Automatic Interaction Detector. A maioria dos pacientes tinha entre 60 e 69 anos de idade (n = 36; 27,7%) e era do sexo masculino (n = 91; 70,0%). O tipo de câncer mais prevalente foi o carcinoma de células escamosas (66,2%), seguido de carcinoma metastático (14,3%) e Linfoma não Hodgkin (6,5%), a maioria com lesões em estágio avançado (72,1%), localizados na cavidade oral (23,8%) ou laringe (23,8%), seguido pela faringe (16,2%). O OHIP-14 apresentou boa consistência interna na amostra estudada (Cronbach‟s Alpha = 0,861), sendo o escore total médio de 19,52±11,79. Hierarquicamente, os três domínios mais afetados foram: dor física (3,70±2,44), incapacidade física (3,26±2,62) e limitação funcional (3,24±2,45). Indivíduos não brancos (RP = 1,30; IC 95% = 1,07-1,58; p = 0,009), viúvos (RP = 1,36; IC 95% = 1,13-1,64; p = 0,001), diagnosticados com carcinoma de células escamosas (RP = 1,28; IC 95% = 1,05-1,58; p = 0,017) e que relataram dor na ATM (RP = 1,31; IC 95% = 1,08-1,60; p = 0,007) foram mais propensos a exibir escores mais elevados no OHIP-14. Quando avaliado a qualidade de vida relacionada à saúde oral e à saúde geral, em score único, observou-se associação entre ao estadiamento clínico da lesão (p = 0,035), sexo (p = 0,028) e modalidade de tratamento (p = 0,032). Indivíduos autodeclarados não brancos, viúvos, diagnosticados com carcinoma de células escamosas e que relataram dor na ATM foram mais propensos a exibir maior impacto da saúde oral na qualidade de vida. Além disso, pacientes diagnosticados com lesão em estágio avançado, que eram do sexo feminino, bem como que foram submetidos a quimioterapia e/ou radioterapia, demonstraram ser mais propensos a exibirem pior qualidade de vida geral e oral, quando avaliada em score único. Pode -se concluir que pacientes portadores de câncer de cabeça e pescoço sofrem impacto na qualidade de vida, devido ao comprometimento da sua saúde bucal e, consequentemente, saúde geral.

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