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Avalia??o psicol?gica pr? e p?s-cir?rgica em pacientes mastectomizadas submetidas a procedimento reconstrutivo de mama

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Previous issue date: 2012-11-30 / Introduction : Breast cancer is a disease that by its high incidence deserves more attention of public health organizations. It represents one of the highest death reasons among women. Researches substantiate that diagnosed women experience some degree of emotional perturbation like: sadness, anxiety, guilt anger and fear. But the most common psychiatric perturbations are depression and anxiety. These feelings assail both women and their families. Objective : To rate the feelings awaken in women who have undergone mastectomy procedures submitted to mammary reconstruction, as for the presence of depressive symptoms, anxiety, hopelessness and self-esteem. Method : longitudinal, observational and descriptive study, with patient follow-up. Evaluation of psychological characteristics of 30 women who have undergone mastectomy procedures submitted to mammary reconstruction attended in university hospitals. Patients depressive symptoms, anxiety, hopelessness and self-esteem were evaluated through the application of the following instruments: BDI; BAI; BHS and Rosenberg Self-esteem Scale UNIFESP EPM, respectively. Result : It has been certified that depression, anxiety and hopelessness levels decreased after mammary reconstruction procedures. Wilcoxon signaled posts test for results comparisons between the first and second evaluations indicated that 80% of the sample decreased depression scores and 20% increased their scores, being the value of p = 0.000 with the significant difference at the level of 1%. As for anxiety, 83.3% of women decreased their scores on anxiety; 13.3% increased their levels and 3.3% kept the same score on both evaluations, being the value of p = 0.001, significant difference at the level of 1%. BHS showed that 64.3% of the sample decreased the scores of hopelessness: 17.9% decreased it and 17.9% kept the same score on both evaluations, being the value of p = 0.008 (significant difference at the level of 1%). It was observed that 73.3% of women increased their levels of self-esteem; 16.7% had self-esteem lower and 10% didn t suffer change. Student t test, for paired samples for score average comparison on both evaluations indicate an average = 10.60 and a DP=5.18 in the first evaluation and an average = 8.20 and a DP=4.35 in the second evaluation, therefore, the value of p=0.000 substantiating significant difference between the averages at the level of 1%. Conclusion : Breast cancer brings psychological repercussions for patients and their families, being depression and anxiety the most prevalent disturbances. According to results a reduction is noticed on depressive symptoms, anxiety, hopelessness and a higher self-esteem after mammary reconstruction. Mammary reconstruction surgery has a positive impact in the life quality of patients who have undergone mastectomy surgeries. / Introdu??o : O c?ncer de mama ? uma doen?a que merece aten??o dos ?rg?os de sa?de p?blica pela alta incid?ncia, representando uma das maiores causas de morte entre as mulheres. As pesquisas tem evidenciado que as mulheres diagnosticadas experimentam algum grau de perturba??o emocional, como: tristeza, ansiedade, culpa, raiva e medo. Mas os transtornos psiqui?tricos mais frequentes s?o a depress?o e a ansiedade. Esses sentimentos acometem tanto as mulheres quanto suas fam?lias. Objetivo : avaliar os sentimentos despertados em mulheres mastectomizadas submetidas ? reconstru??o mam?ria, quanto a presen?a de sintomas depressivos, ansiedade, desesperan?a e autoestima. M?todo : estudo longitudinal, observacional e descritivo, com seguimento de pacientes. Avalia??o das caracter?sticas psicol?gicas de 30 mulheres mastectomizadas submetidas a procedimento cir?rgico de reconstru??o mam?ria, atendidas em um hospital universit?rio. Foram avaliados os sintomas depressivos, ansiedade, desesperan?a e autoestima das pacientes atrav?s da aplica??o dos seguintes instrumentos: BDI; BAI; BHS e Escala de Autoestima de Rosenberg UNIFESP EPM, respectivamente. Resultado : constatou-se que o n?vel de depress?o, ansiedade e desesperan?a diminu?ram ap?s o procedimento de reconstru??o mam?ria. O Teste dos Postos com sinal de Wilcoxon para compara??o dos resultados entre a 1? e 2? avalia??es, indicou que 80% da amostra diminuiu os escores de depress?o e 20% aumentaram os escores, sendo o valor de p = 0,000 com diferen?a significativa ao n?vel de 1%. Quanto a ansiedade,83,3% das mulheres diminu?ram os escores de ansiedade; 13,3% aumentaram seus n?veis e 3,3% permaneceu com o mesmo escore nas duas avalia??es, sendo o valor de p = 0,001, diferen?a significativa ao n?vel de 1%. O BHS mostrou que 64,3% da amostra diminuiu os escores de desesperan?a; 17,9% aumentaram e 17,9% permaneceu com o mesmo escore nas duas avalia??es, sendo o valor de p = 0,008 ( diferen?a significativa ao n?vel de 1%). Observou-se que 73,3% das mulheres elevaram seus n?veis de autoestima; 16,7% estavam com a autoestima menos elevada e 10% n?o tiveram mudan?as na autoestima. O teste t de Student, para amostras pareadas para compara??o das m?dias dos escores nas duas avalia??es, indicou uma m?dia = 10,60 e um DP=5,18na primeira avalia??o e uma m?dia =8,20 e um DP=4,35 na segunda avalia??o, logo, o valor de p=0,000 evidenciando diferen?a significativa entre as m?dias ao n?vel de 1%. Conclus?o : O C?ncer de Mama traz repercuss?es psicol?gicas para a paciente e sua fam?lia, sendo a depress?o e a ansiedade os transtornos mais prevalentes. De acordo com os resultados observa-se uma diminui??o dos sintomas depressivos, da ansiedade, desesperan?a e uma autoestima mais elevada ap?s a reconstru??o mam?ria. A cirurgia de reconstru??o mam?ria tem um impacto positivo na qualidade de vida das pacientes mastectomizadas.

Identiferoai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/2688
Date30 November 2012
CreatorsLufiego, Claudia Adriana Facco
ContributorsFrasson, Antonio Luiz
PublisherPontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Gerontologia Biom?dica, PUCRS, BR, Instituto de Geriatria e Gerontologia
Source SetsIBICT Brazilian ETDs
LanguagePortuguese
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis
Formatapplication/pdf
Sourcereponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS
Rightsinfo:eu-repo/semantics/openAccess
Relation4438661476953179033, 500, 600, 2296420844541114010

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