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The politics of memory: the role of the children of Holocaust survivorsLurie, Liane Natalie 01 1900 (has links)
The Holocaust represented humanities first confrontation with unparalleled destruction and evil unchecked. It continues to impact upon the lives of survivors, their children- the second generation- and generations thereafter. The study aimed to provide the second generation with a voice. Their roles within their respective family systems and the impact of the Holocaust upon them are explored.
The theoretical framework is social constructionism. One-on-one in-depth interviews were conducted with three adults whose parent/s are survivors. The manner of analysis was `Hermeneutic.'
The participants' narratives took the form of interview transcripts. These were analysed and themed by the researcher. Themes that repeated themselves were elaborated upon and later linked with the available literature.
The researcher hopes that the dissertation will contribute to existing research on the multigenerational effects of trauma in relation to familial and individual roles and memory. / Psychology / M. A. (Clinical Psychology)
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The effects of childhood sexual abuse on adult femalesRamasar, Anandra Devi 01 1900 (has links)
Text in English / This study examined the effects of childhood sexual abuse on the emotional functioning of adult female survivors and the impact on their relationships with their spouse I partner and child I children. Literature reveals that sexual abuse has negative long-term effects on adult survivors, including psychological impairments. To study this phenomenon, a psycho-educational perspective was utilised. A clinical, judgmental sample of sixteen adult female survivors who attributed their current difficulties and problems to their childhood sexual experience was selected and an in-depth qualitative study was undertaken. The
Emotions Profile Index Personality Test, a Questionnaire and an Interview were used to determine the present emotional functioning of the survivors and the impact on their relationships. The conclusions reached were that childhood sexual abuse had a detrimental effect on the emotional functioning of survivors and this impacted negatively on their relationships with their spouse I partner and child I children. / Psychology of Education / M. Ed. (Psychology of Education, with specialisation in Guidance and Counselling)
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A Content Analysis of the Counseling Sessions of Dyads with Breast and Prostate Cancer: Linguistic Predictors of Psychosocial Adjustment and Thematic Analysis of Key ConcernsDorros, Sybilla M. January 2010 (has links)
The purpose of this investigation was to explore how participants' language use during counseling (overall emotional expression, positive emotional expression, and communal coping, or "we-talk") was associated with superior adjustment, as measured by four psychosocial outcome variables (depression, positive affect, negative affect, and relationship satisfaction); as well as to identify the key concerns of dyads with cancer, how concerns differed by role and sex, and if they were associated with participants' well-being. The present study was a content analysis of the counseling sessions of 43 dyads (N = 86) with breast and prostate cancer. Using a multi-method approach, the audio recordings of 228 counseling sessions were transcribed and analyzed linguistically (quantitatively) and thematically (qualitatively).Results of the linguistic analyses revealed that participant's use of "we-talk" had the most consistent and beneficial effect on outcomes; specifically improved depression, negative affect, and relationship satisfaction. These findings suggest that it might not be as important how much a person expresses themselves emotionally, but rather, whether they have a close relational partner that they see as an instrumental part of their coping process and significantly intertwined in their life, which is reflected in their language use of communal coping.Results of the thematic analyses revealed that survivors' concerns were more focused on cancer and treatment related issues, whereas partners' concerns centered on the well-being of their spouse/partner with cancer, and what they were doing to help their loved one cope with his/her illness. The overarching key concern that was intertwined in participants' discourse was frequent discussion of relationship maintenance, negotiation, and communication issues. In addition, discussion of these concerns showed greatest benefits for women with breast cancer.The findings of this study has implications for counselors and clinicians in that language use and topics discussed during counseling have the potential to increase psychosocial adjustment for dyads coping with cancer. The general discourse of survivors mirrored that of their partners, which indicates that helping to modify or change how one person speaks, has the potential to influence how their partner talks as well; which has implications for the well-being of both dyad members.
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Kvinnors sexuella hälsa efter diagnostisering av cervixcancer : En litteraturöversikt / Women's sexual health after diagnosis of cervical cancer : A literature reviewAhlund, Angelica, Frank, Lovisa January 2017 (has links)
Bakgrund: Sexualitet och sexuell hälsa är två begrepp som hör samman. Sexualitet innebär närhet och kontakt medan sexuell hälsa innebär att det ska vara tryggt och säkert att utföra sexuella aktiviteter. Cervix tillhör kvinnans inre reproduktionsorgan. Globalt sett är cervixcancer en av den vanligaste cancerformen bland kvinnor. Mortaliteten är högre i utvecklingsländer än industriländer. Humant papillomvirus, HPV, är en av de bidragande faktorer till cervixcancer där kirurgi, cytostatika och strålbehandling är olika typer av behandling. Ett cancerbesked kan ge upphov till reaktioner som påverkar både den fysiska och psykiska hälsan. Syfte: Syftet var att belysa kvinnors sexuella hälsa efter diagnostisering av cervixcancer. Metod: Denna litteraturöversikt sammanställdes genom insamling av material från tidigare forskning inom ett vårdvetenskapligt kunskapsområde. Tio stycken vetenskapliga artiklar som berör cervixcancer och sexualitet ligger till grund för resultatet. Materialet granskades och analyserades enligt Fribergs metod för att slutligen sammanfattas i huvudteman och underteman i en litteraturöversikt. Resultat: Resultatet presenteras i tre huvudteman; Fysiska aspekter, Psykiska aspekter och Sociala aspekter. Resultatet visade att kvinnans sexualitet och sexuella hälsa påverkas i samband med cervixcancer. Positiva upplevelser som uttrycktes var att kvinnor uppskattade sexuella aktiviteter mer efter sjukdomen och negativa upplevelser som rapporterades var att kvinnor inte vågade utföra sexuella aktiviteter där samlagssmärta var en orsak. Sexuella hinder påverkade den sexuella funktionen och skapade oro hos kvinnorna. Behandlingen av cervixcancer påverkade kvinnan genom olika kroppsliga förändringar och obehag vid samlag. Diskussion: De fysiska aspekterna påverkar kvinnans sexualitet och identitet. Ett behov av kunskap kring cervixcancer relaterat till sexualitet kan urskiljas hos kvinnorna, där sjuksköterskans ansvar är att tillhandahålla kvinnorna med denna information. Sjuksköterskan kan ta hjälp av Virginia Hendersons behovsteori och Cancercentrums Vårdprogram. / Background: Sexuality and sexual health are two concepts that belong together. Sexuality means proximity and contact while sexual health means that it is safe and secure to perform sexual activities. Cervix is a part of women's inner reproductive organs. Cervical cancer is globally seen as one of the most common forms of cancer amongst women where pain is a late symptom of cervical cancer. Mortality is higher in developing countries than industrialized countries. Human papillomavirus, HPV is the most common cause of cervical cancer, where surgery, cytostatic and radiation therapy are different types of treatment. Cytological changes do not always mean cancer. Getting a cancer message can induce emotional reactions such as anxiety, anger and concern. At different coping strategies; Active and passive, the woman can adapt to the new life situation. A cancer diagnosis can develop reactions that affect both the physical and the mental health. Aim: The purpose was to highlight women’s sexual health after diagnosis of cervical cancer. Method: This literature review was compiled by collecting material from previous research within a healthcare knowledge area. Ten scientific articles related to cervical cancer and sexuality are the basis for the outcome. The material was reviewed and analyzed according to Fribergs method and finally summarized into mainthemes and subthemes in a literature review. Results: The result is presented in three main themes; Physical aspects, Mental aspects, and Social aspects. The results showed that cervical cancer affected women’s sexuality and sexual health. Positive experiences expressed by the women were an increased estimation on sexual activity after the disease. While negative experiences that were reported was a fear of performing sexual activities where dyspareunia was a cause. Sexual barriers affected the sexual function and created a concern among the women. The treatment of cervical cancer affected the woman through various bodily changes and discomfort during sexual intercourse. Discussion: The physical changes that the woman experience is affecting her sexuality and identity. A need for knowledge about cervical cancer related to sexuality was noted in the women, where the nurse's responsibility is to provide women with this information. Virginia Henderson's behavior theory and the Cancer center care program may be a support for the nurse.
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A Comparative Study of the Retirement and Survivors Benefits under the Proposed Social Security Amendment, as Amended in House Bill 6000, and under the Texas Teacher Retirement SystemPeters, Malta Douglas 08 1900 (has links)
The problem of this study is to compare the retirement benefits under the federal Social Security System, as proposed in House Bill 6000, the retirement benefits under the Texas Teachers Retirement System, and the retirement annuities of private insurance companies. Further, the study will compare the survivors benefits under the proposed Social Security amendment and under the Texas Teacher Retirement System. Last, the study will compare the general nature and principles of the proposed Social Security amendment with those of the Texas Teacher Retirement System.
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Stress management for cancer survivors using a technologically adapted psychosocial intervention: A randomized trial determining the effect of expressive writing on psychoneuroimmunology based outcomesSubnis, Utkarsh B 01 January 2014 (has links)
Patients with cancer transitioning from completing their final cancer treatments to survivorship are particularly at risk for experiencing psychosocial stress, and the Institute of Medicine (IOM) has referred to these cancer patients as “lost in transition.” In this study, patients with cancer in their transition phase after completing their final radiation treatment were defined as cancer survivors (CS). CS must deal with chronic stressors such as the fear of cancer recurrence as well as the resumption of their roles in their family and work lives. Chronic stress impacts the nervous system and increases secretion of stress hormones (e.g. cortisol) from the endocrine system, which in turn influences immune function. These systems are particularly relevant for CS since research has shown associations between abnormal cortisol patterns and increased mortality in breast CS and immune dysfunction in CS can increase susceptibility to infections. The theoretical framework of psychoneuroimmunology (PNI), which describes the interactions between the psychosocial, neuroendocrine and immune systems, guided the choice of outcomes for this study. The IOM has identified a lack of theory-driven interventions for managing psychosocial stress in CS. We reviewed the literature and identified two major types of PNI-based psychosocial interventions for cancer patients, namely cognitive-behavioral and complementary medical. One promising brief and inexpensive psychosocial intervention was expressive writing, which involved participants disclosing their deepest thoughts and feelings regarding their cancer in four 20-30 minute writing sessions over four consecutive days. We conducted a two-arm randomized controlled trial to determine the efficacy of an online expressive writing (EW) intervention delivered to CS who were 2-12 months post-radiation treatment completion. The results of this study revealed that EW was effective in regulating stress in our sample of CS over a period of six weeks as measured by lowered salivary cortisol levels and lowered self-reported fear of cancer recurrence. Online EW is a low-cost and convenient approach for delivering stress-management interventions for CS during survivorship. However, coordinated efforts are needed from health researchers, professionals and policy makers to define standardized approaches for testing psychosocial interventions and using PNI biomarkers to help develop evidence-based psychosocial cancer-care for CS during survivorship.
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Reflexe genocidy českých židů od roku 1945 do současnosti (Analýza národních příběhů hostitelských zemí obětí holokaustu a vliv na jejich individuální válečné svědectví) / Reflection of the Genocide of Czech Jews from 1945 until Present Times (The Analysis of the National Stories of Holocaust Survivors Host Countries and Influence on Their Individual War Testimonies)Roubínek, Jan January 2015 (has links)
(in English): My goal is to demonstrate that witnesses of certain historical events can describe their experiences in a variety of ways without distorting actual facts. The subject of my research is a reflection of the Czech Jewry Genocide through the eyes of a generation born during the so-called first Czechoslovak Republic. On the day of their liberation, Czech Jews who had survived Shoah were mainly unified in the fundamental aspects of the perception of their past in Nazi Concentration and Extermination Camps, regardless of whether their native tongue was Czech or German. What's more, any ideological differences that could have possibly existed between them in pre-war years, ceased being important under the influence of a common fate. It is fair to say then, that from the viewpoint of Czech Shoah Survivors in 1945, they constituted a relatively unified group but not for much longer. After the end of WWII, these people returned to the newly established Czechoslovak Republic and the point of view within the groups gradually began to vary. For some, the new regime had fulfilled their expectations. The majority of Czech Jews however, chose to emigrate after the Communist Coup d'etat and in time began to share their war experiences. The Jews in the Czech Republic began telling their stories as well....
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Associação entre experiências precoces adversas e comportamentos relacionados ao suicídio na vida adulta / Association between adverse childhood experiences and suicidal behaviors in adulthoodCoêlho, Bruno Mendonça 04 December 2017 (has links)
INTRODUÇÃO: As adversidade precoces (APs) são um grupo de experiências negativas vivenciadas durante o desenvolvimento e associadas a diversos desfechos clínicos e psiquiátricos. A literatura sobre os transtornos mentais (TMs) e cognições e comportamentos suicidas (CCS) destaca que a exposição a APs durante a infância se relaciona com essas condições na vida adulta. Contudo, o tamanho e a qualidade do efeito das APs nas CCS varia entre os estudos. Como os TMs também determinam CCS, é preciso avaliar a contribuição concomitante de APs e TMs nos CCS. OBJETIVOS: Investigar a relação associativa entre APs e CCS na vida adulta e os fatores determinantes dessa relação. MÉTODOS: Este estudo é uma investigação transversal, multiestratificada e probabilística da população geral da Região Metropolitana de São Paulo. O instrumento Composite International Diagnostic Interview versão 3.0 foi aplicado em 5037 indivíduos adultos. Os fatores sociodemográficos, 12 APs, 20 TMs ao longo da vida e CCS ao longo da vida foram coletados por meio de entrevistas no domicílio do respondente. Foram calculadas as prevalências das APs e estimados os modelos fatoriais, modelos de resposta ao item e modelos de redes para descrever as APs, para amostra total e por sexo. Correlações entre APs e subsequentes TMs ou CCS foram testadas e análises de trajetória avaliaram a mediação da associação entre APs e CCS pelos TMs. RESULTADOS: As APs atingiram 53,6% da amostra e 48,4% apresentaram duas ou mais APs na vida, sendo as mulheres significativamente mais expostas que os homens (59,0% vs 47,66%). Nas análises fatoriais confirmatórias, a solução com três fatores (\"Violência Familiar e Desajuste Parental\"; \"Uso indevido de Substâncias, Criminalidade e Abuso Sexual\"; e \"Adversidade Econômica e Perda Parental\") foi mais ajustada para os homens e a de dois fatores (\"Violência Familiar e Desajuste Parental\" e \"Abuso Sexual e Perda Parental\") mais ajustada para as mulheres. Nas análises de rede, apesar de similaridades na estrutura global, homens e mulheres tem diferenças em APs específicas. O \'TM parental\' (Odds ratio [OR] = 1,99 a 2,27) e a \'violência familiar\' (OR = 1,55 a 1,99) foram as APs mais consistentemente associadas à TM em todas as faixas etárias. Os \'TM parentais\' e as \'adversidades econômicas\' foram associados as quatro classes de TMs examinados (transtornos de humor, ansiedade, controle do impulso e do uso de substâncias). Quando a associação entre APs e CCS foi controlada por TMs, somente o \'abuso físico\' foi associado a tentativas de suicídio em todos os estágios de vida subsequentes (OR = 2,1). Nas análises estruturais, o efeito dos TMs como mediadores da associação entre APs e CCS foi confirmado, sendo essa mediação mais importante nas mulheres. CONCLUSÕES: As APs são um grupo heterogêneo e interrelacionado de fatores de risco. Sua exposição é diferente em meninos e meninas. As APs foram consistentemente associadas a TMs e embora algumas APs tenham sido associadas a CCS, os papéis desempenhados pelos diferentes tipos de APs na infância variam em magnitude, levando a resultados diversos e diferentes níveis de gravidade / BACKGROUND: Adverse childhood experiences (ACEs) are a group of negative events experienced during development that has been associated with various clinical and psychiatric outcomes. The literature on mental disorders (MDs) and on suicidality highlights the association of these conditions during adulthood with the previous exposure to ACEs. However, the size and quality of the effect of ACEs on suicidality varies between studies. Since MDs also predict suicidality, it is necessary to evaluate the concomitant contribution of ACEs and MDs on suicidality. OBJECTIVES: The aims of this study were to investigate the association between ACEs and suicidality in adulthood and the determinants of this relationship. METHODS: This is a cross-sectional, multistratified and probabilistic study of the general population of São Paulo Metropolitan Area. The Composite International Diagnostic Interview version 3.0 was applied in 5037 adult subjects. Sociodemographic data, 12 ACEs, 20 lifetime MDs, and lifetime suicidality were collected in household interviews. The prevalence of suicidality was estimated and factor models, item response theory models and network analysis models were calculated to describe ACEs for total sample and by sex. Correlations between ACEs and subsequent MDs or suicidality were tested. Path analyzes assessed the mediation of the association between APs and suicidality by MDs. RESULTS: ACEs were reported by 53.6% of the sample and 48.4% presented two or more ACEs early in life and women were significantly more exposed than men (59.0% vs 47.66%). In confirmatory factor analyzes, the three-factor solution (\"Family Violence and Parental Maltreatment\", \"Substance Misuse, Criminality and Sexual Abuse\", and \"Economic Adversity and Parental Loss\") was more adjusted for men and the two-factors solution (\"Family Violence and Parental Maltreatment\", and \"Sexual Abuse and Parental Loss\") was more adjusted for women. In network analyzes, despite similarities in overall network structure, men and women have differences in specific ACEs. The \'parental MD\' (Odds Ratio [OR] = 1.99 to 2.27) and \'family violence\' (OR = 1.55 to 1.99) were the most consistently disorders associated with ACEs across all age groups. \'Parental MD\' and \'economic adversity\' were associated with the four classes of MDs examined (mood, anxiety, impulse control and substance use disorders). When the association between ACEs and suicidality was controlled by MDs, only \'physical abuse\' was associated with suicide attempts in all subsequent stages of life (OR = 2.1). In the path analyzes, the effect of the MDs as mediators of the association between ACEs and suicidality was confirmed, being this mediation effect more important in women than in men. CONCLUSIONS: ACEs are a heterogeneous and interrelated group of risk factors. Their exposure profile is different in boys and girls. ACEs were consistently associated with MDs and although some ACEs were associated with suicidality, the roles played by different types of ACEs vary in magnitude, leading to varying results and different levels of severity
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Aspectos conceituais teóricos e subjetivos da sobrevivência ao câncer: contribuições para a enfermagem oncológica / Theoretical conceptual and subjective aspects of cancer survivorship: contributions to cancer nursingOliveira, Rafaela Azevedo Abrantes de 22 September 2017 (has links)
O progresso no diagnóstico precoce do câncer e terapias, bem como longevidade e o crescimento populacional, remete no aumento do número de indivíduos sobreviventes do câncer em todos os países, e com ele surge uma nova nomenclatura, a da sobrevivência ao câncer (SC). Este estudo teve como objetivo geral, analisar o conceito da SC na literatura de saúde e entre adoecidos adultos e/ou idosos diagnosticados com a doença. Para alcançar este propósito elaboramos mais quatro objetivos específicos que nos fez organizar a tese em três grandes etapas. A primeira etapa tem como objetivo analisar o conceito da SC apresentado na literatura de saúde, segundo o modelo evolucionário de análise conceitual de Rodgers. Este modelo está disposto em seis etapas, preconizando a análise dos estudos levantados pela análise temática indutiva e interpretados segundo o referencial teórico do conceito de cultura. Como resultado obtivemos os componentes do conceito, que nos auxilia na compreensão do mesmo, são eles: antecedente - ser diagnosticado com câncer; consequente - qualidade de vida dos sobreviventes do câncer (StC) e crescimento pessoal; atributos - processo de liminaridade e cuidado culturalmente congruente; termos substitutos - StC, sobrevivência em longo prazo e aquele que está vivendo após o diagnóstico do câncer, e por último os termos relacionados - sobrevida e reabilitação do câncer. Para a segunda etapa dessa pesquisa o propósito foi apreender os sentidos atribuídos a ser StC entre adoecidos, assim como, descrever os sentidos atribuídos ao conceito da SC entre adoecidos adultos e idosos por meio de sínteses narrativas. Desse modo, construímos um estudo qualitativo, com método narrativo e com referencial da antropologia médica. Realizamos entrevistas semi-estruturadas com 14 participantes diagnosticados com os diferentes tipos de câncer urológico de ambos os sexos, adultos e idosos, com no mínimo três meses pós-tratamento. Após transcrição dos dados, os mesmos foram analisados segundo a análise temática indutiva e duas sínteses narrativas foram elaboradas, a primeira delas é as dualidades da vida após o tratamento: da perda do autocontrole, da incerteza da recorrência da doença ao otimismo e esperança. Nessa síntese, discutimos acerca da experiência do sobrevivente com a doença, a perda de controle que a doença desencadeia e o consequente crescimento pessoal e aquisição do otimismo apesar das circunstâncias vividas. A segunda síntese é intitulada, o que eu sou? Sou um sobrevivente do câncer? Autorreflexão da identidade após o tratamento primário do câncer. Nela apreendemos a reflexão dos participantes sobre como se enxergam e veem a si mesmo e atribuem sentidos a ser ou estar doente, curado, vítima e principalmente StC. Com essas duas sínteses narrativas conseguimos descrever e nos aproximar dos sentidos atribuídos a SC. A terceira etapa foi desenvolvida em três tópicos, o primeiro consiste na comparação dos resultados da etapa um com a etapa dois, complementando com a importância da enfermagem oncológica no cuidado aos StC e uma reflexão sobre as políticas de saúde públicas atuais. Essa tese atualiza o conceito da SC e traz novas perspectivas sobre ele, contribuindo para a enfermagem oncológica / The progress in the early diagnosis of cancer and therapies, as well as the longevity and population growth remit to an increased number of cancer survivors around the world, giving rise to a new term, that of cancer survivorship (CS). The general objective in this study was to analyze the concept of CS in the health literature and among adult and/or elderly patients diagnosed with the disease. To achieve this objective, we elaborated four specific objectives, which made us organize the dissertation in three main phases. The objective of the first phase is to analyze the concept of CS presented in the health literature, according to Rodgers\' evolutionary model of concept analysis. This model is arranged in six steps, recommending the analysis of the studies surveyed by means of inductive thematic analysis and their interpretation according to the theoretical framework of the culture concept. As a result, we obtained the components of the concept, which help us understand it. These are: antecedent - being diagnosed with cancer; consequent - quality of life of cancer survivors (StC) and personal growth; attributes - liminality process and culturally congruent care; substitute terms - StC, long-term survival and individuals living after the cancer diagnosis, and finally the related terms - cancer survival and rehabilitation. For the second phase, the purpose was to apprehend the meanings attributed to being StC among the patients, as well as to describe the meanings adult and elderly patients attribute to the CS concept through narrative syntheses. Thus, we built a qualitative study, using the narrative method and the reference framework of medical anthropology. We held semistructured interviews with 14 participants diagnosed with different types of urological cancer, male and female, adult and elderly, with at least three months post-treatment. After transcribing the data, they were analyzed according to inductive thematic analysis and two narrative syntheses were elaborated, the first being the dualities of life after the treatment; from loss of self-control, the uncertainty of the disease relapse to optimism and hope. In this synthesis, we discuss the survivor\'s experience with the disease, the loss of control the disease triggers and the consequent personal growth and gaining of optimism despite the circumstances experienced. The second synthesis is entitled: Who am I? Am I a cancer survivor? Self-reflection on the identity after the primary cancer treatment. In this synthesis, we apprehend the participants\' reflection on how they see themselves and attribute meanings to being ill, cured, victim and mainly StC. These two narrative syntheses allowed us to describe and get closer to the meanings attributed to CS. The third phase was developed in three topics, the first being the comparison between the results of phase one and phase two, complemented with the importance of oncology nursing in care for StC and a reflection on the current public health policies. This dissertation updates the concept of CS and offers new perspectives, contributing to oncology nursing
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Avaliação da qualidade de vida de sobreviventes de câncer na infância: uma proposta alternativa de coleta de dados / Evaluation of quality of life of survivors of childhood cancer: an alternative proposal for data collectionSouza, Clelia Marta Casellato de 10 October 2014 (has links)
O acometimento do câncer na infância é relativamente raro, com taxas relevantes de incidência de alguns tumores, como a leucemia linfoblástica aguda (LLA) e o tumor de Wilms (TW). Embora o câncer seja uma das dez primeiras causas de óbito de crianças e adolescentes e a primeira por doença a partir dos cinco anos, nas últimas décadas o progresso da terapêutica tem possibilitado um declínio nas taxas de mortalidade e expansão dos prazos de sobrevida. Desta forma, o acompanhamento efetivo no enfrentamento da doença passou a buscar análises mais amplas dos efeitos orgânicos tardios da doença e da terapêutica, incluindo as condições psicossociais do sobrevivente, como nas avaliações da qualidade de vida relacionada à saúde (QVRS). No sentido de ampliar o conhecimento e alternativas para o acompanhamento ambulatorial e periódico da condição de sobrevivência, este estudo buscou comparar o impacto na QVRS do sobrevivente adulto, dada a diferença na terapêutica de escolha para a remissão da LLA (quimioterapia) e do TW (cirurgia e quimioterapia), utilizando uma avaliação a distância da QVRS (SF-36, via telefone).Objetivos: Analisar e comparar a QVRS de sobreviventes adultos de LLA e TW, entre si e em relação a participantes sadios, acompanhados no Ambulatório Fora de Terapia do ITACI-HC-FMUSP, através da aplicação alternativa (via telefone) do SF-36.Casuística e Método: 90 participantes, acima de 18 anos. Grupo controle(CTRL) (30 sujeitos, fisicamente saudáveis, com ausência de diagnóstico prévio de câncer, recém-ingressos em curso superior) e Grupos experimentais (60 sobreviventes - Ambulatório Fora de Terapia - ITACI - HCFMUSP): grupo LLA (GLLA) - 30 sobreviventes LLA e grupo TW (GTW) 30 sobreviventes TW. A avaliação foi realizada através da aplicação, via telefone, do SF- 36. Após compilação dos domínios do SF-36, os resultados foram analisados através do teste de qui-quadrado, teste t-independente e teste de ANOVA. Resultados: Os participantes não apresentaram diferença significativa quanto a idade, a maioria eram solteiros, sem filhos e provenientes de São Paulo. O nível mais elevado de escolaridade do CTRL decorreu do critério de inclusão, mas com relevante proporção de sobreviventes no nível superior. Nos sobreviventes não houve diferença significativa de idade de diagnóstico e tempo de fora de terapia. Quanto a QVRS, houve melhores resultados dos sobreviventes masculinos em relação às sobreviventes e participantes CTRL. Especificamente, GLLA e GTW para Vitalidade e GLLA para Aspectos sociais, Saúde mental e Aspectos emocionais, no último aspecto detectada diferença também para as sobreviventes GTW. Nos sobreviventes com diagnóstico tardio (acima 53 meses) o GLLA apresentou melhores resultados na Capacidade funcional. Na percepção da própria saúde, houve diferença para todos os domínios, exceto nos Aspectos sociais e emocionais, estando as diferenças circunscritas a percepções positivas (boa, muito boa e excelente) da própria saúde pelos sobreviventes e controles. Conclusão: Particularmente no período do estudo, para a amostra selecionada e os aspectos analisados pelo SF-36 pode-se inferir que, apesar de algumas diferenças encontradas, os sobreviventes não apresentaram evidências de comprometimento de QVRS. O SF-36 (via telefone) pode ser um recurso de acesso e avaliação de QVRS de sobreviventes sob acompanhamento ambulatorial / The involvement of childhood cancer is relatively rare, with relevant incidence rates of some cancers such as Acute Lymphoblastic Leukemia (ALL) and Wilms Tumor (WT). Although cancer is one of the top ten causes of death in children and adolescents and the first disease from the age of five, in recent decades the therapeutic progress has made possible a decline in mortality rates and expansion of the survival periods. In this way, the effective monitoring in the confrontation of the disease passed to seek broader analyses of later organic effects from disease and therapy, including the psychosocial conditions of survivor, as in evaluations of healthrelated quality of life (HRQoL). In order to increase knowledge and alternatives for monitoring outpatient and periodic survival condition, this study sought to compare the impact on HRQoL of adult survivor, given the difference in the choice therapy for the remission of ALL (chemotherapy) and WT (surgery) using a remote assessment of HRQoL (SF -36 via telephone call). Objectives: Analyze and compare the HRQoL of adult survivors of ALL and WT between themselves and in relation to healthy participants, followed at the Ambulatory outside ITACI - HC - USP therapy , by alternative application ( by phone calls) of the SF - 36 . Methods: 90 participants , above 18 years. Control group (CTRL): (30 subjects, physically healthy, no history of oncological diagnosis, newly joined in higher education) and experimental groups (60 survivors - Outpatient Therapy - ITACI - HCFMUSP ): ALL group ( GALL ) - 30 ALL survivors and WT group ( GWT ) 30 WT survivors. The evaluation was performed by applying SF-36, via telephone calls. After compilation of the SF -36 domains, the results were analyzed through chi - square test, independent t test and ANOVA test. Results: Participants showed no significant difference regarding age, most were single, childless and from Sao Paulo. CTRL highest level of schooling resulted from inclusion criterion but with relevant proportion of survivors at the top level. In survivors there was no significant difference in age of diagnosis and time outside therapy. As for HRQoL there have been better results of male survivors in relation to female survivors and CTRL participants. Specifically GALL and GWT for vitality domain and GALL for social aspects, mental health and emotional aspects. In the last domain, it was detected also difference female survivors GWT. In survivors with late diagnosis (above 53 months) the GALL presented better results in functional capacity. In the perception of their own health, there were differences for all domains except in social and emotional aspects, with differences confined to positive perceptions (good, very good and excellent ) of own health by survivors and controls. Conclusion: Particularly during the study period, for the selected sample and the analyzed aspects by SF -36 can be inferred that, despite some differences, survivors did not show evidence of impairment of HRQoL . The SF -36 (via telephone calls) can be a resource of access HRQoL evaluation of survivors under ambulatory followup
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