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Previous issue date: 2017-09-29 / A leucemia linfoide aguda (LLA) ? o tipo de c?ncer mais comum entre crian?as e
adolescentes. A sofistica??o dos processos diagn?sticos e terap?uticos promoveu a
eleva??o da sobrevida e a redu??o das reca?das da doen?a. A inclus?o do tratamento
profil?tico direcionado ao SNC, realizado atrav?s de quimioterapia e/ou radioterapia, tem
sido apontada como essencial para o sucesso terap?utico, todavia parece relacionar-se ?
emerg?ncia de efeitos neuropsicol?gicos tardios em cerca de 30% dos sobreviventes.
Estudos sugerem que altera??es sobre dom?nios cognitivos espec?ficos contribuem para
o decl?nio do funcionamento intelectual e dificuldades acad?micas. O objetivo geral da
presente pesquisa foi investigar aspectos neuropsicol?gicos e acad?micos de crian?as e
adolescentes sobreviventes de LLA. A pesquisa foi dividida em quatro estudos: 1)
Funcionamento intelectual de crian?as e adolescentes diagnosticados com LLA; 2)
Aten??o e fun??es executivas em pacientes pedi?tricos sobreviventes de LLA; 3)
Tradu??o e adapta??o do Question?rio Comportamental Deasy-Spinetta (DSBQ); 4)
Investiga??o de aspectos acad?micos em crian?as e adolescentes diagnosticados com
LLA. Participaram desse estudo 26 crian?as e adolescentes sobreviventes de LLA
submetidas exclusivamente ? quimioterapia (grupo cl?nico) e 26 crian?as e adolescentes
saud?veis (grupo controle), al?m de 26 pais e 46 professores. O protocolo de avalia??o
neuropsicol?gica contemplou os seguintes dom?nios: funcionamento intelectual, aten??o,
mem?ria, fun??es executivas, habilidades acad?micas e aspectos comportamentais. Os
resultados foram analisados por ferramentas estat?sticas descritivas e inferenciais. No
estudo 1 o grupo cl?nico apresentou desempenho significativamente inferior ao grupo
controle. A baixa escolaridade materna foi associada a menor desempenho nos dom?nios
verbal, n?o-verbal e funcionamento intelectual global. A menor idade ao diagn?stico foi
correlacionada com baixos desempenhos no dom?nio verbal, capacidade intelectual global e mem?ria operacional, estando esta ?ltima tamb?m associada ao maior tempo de
conclus?o do tratamento. O estudo 2 evidenciou desempenho significativamente inferior
do grupo cl?nico em aten??o e fun??es executivas, especialmente no subgrupo de crian?as
diagnosticadas antes dos cinco anos de idade. Os resultados do estudo 3 sugeriram que o
DSBQ apresenta validade aparente ou de face, sendo um instrumento de f?cil utiliza??o.
No estudo 4 o grupo cl?nico apresentou resultados inferiores em aritm?tica, compreens?o
de textos e nos processos de armazenamento, evolu??o da aprendizagem e recupera??o
de informa??es. Dificuldades espec?ficas do funcionamento escolar associaram-se
predominantemente com a menor idade da crian?a ao diagn?stico. Espera-se que o
conhecimento produzido por esse estudo possa contribuir com o desenvolvimento de
programas voltados para a reinser??o escolar e a elabora??o de pol?ticas p?blicas para
essa popula??o cl?nica, bem como a realiza??o de estudos futuros em neuropsicologia do
desenvolvimento e da aprendizagem. / Acute lymphoblastic leukemia (ALL) is the most common type of cancer among children
and adolescents. The sophistication of the diagnostic and therapeutic processes has
promoted an increase in survival and reduction of relapse of the disease. The inclusion of
prophylactic CNS therapy, performed through chemotherapy and/or radiotherapy, has
been identified as essential for therapeutic success, but it seems to be related to the
emergence of late neuropsychological effects in about 30% of survivors. Studies suggest
that changes in specific cognitive domains contribute to the decline of intellectual
functioning and academic difficulties presented by this clinical population. The main
objective of the present study was to investigate the neuropsychological and academic
aspects of children and adolescents who survived ALL. The research was divided into
four studies: 1) The intellectual functioning of children and adolescents diagnosed with
ALL; 2) Attention and executive functions in pediatric survivors of ALL; 3) Translation
and adaptation of the Deasy-Spinetta Behavioral Questionnaire (DSBQ); 4) Investigation
of academic aspects in children and adolescents diagnosed with ALL. 26 children and
adolescents surviving ALL who underwent chemotherapy (clinical group), 26 healthy
children and adolescents (control group), 26 parents and 46 teachers took part in this
study. The neuropsychological evaluation protocol included the following domains:
intellectual functioning, attention, memory, executive functions, academic abilities and
behavioral aspects. The results were analyzed by descriptive and inferential statistical
tools. In study 1, the clinical group performed significantly lower than the control group.
Maternal low schooling was associated with lower performance in verbal, nonverbal and
global intellectual functioning. The younger age at diagnosis was correlated with low
verbal domain, global intellectual capacity and working memory, and the latter was also
associated with longer treatment completion time. Study 2 evidenced significantly lower performance of the clinical group in attention and executive functions, especially in the
subgroup of children diagnosed before the age of five. The results of study 3 suggested
that the DSBQ has an apparent or face validity, being a readily usable instrument. In study
4 the clinical group presented lower results in arithmetic, text comprehension and storage
processes, learning evolution and information retrieval. Specific difficulties of school
functioning were associated predominantly with the child's lower age at diagnosis. It is
hoped that the knowledge produced by this study may contribute to the development of
programs aimed at the reinsertion of the school and the elaboration of public policies for
this clinical population, as well as the accomplishment of future studies in
neuropsychology of development and learning.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/24491 |
| Date | 29 September 2017 |
| Creators | Gomes, Ediana Rosselly de Oliveira |
| Contributors | 71223010449, Azoni, Cintia Alves Salgado, 03610236698, Silva, Neuciane Gomes da, 71418393720, Seabra, Alessandra Gotuzo, 16869600856, Almeida, Rosa Maria Martins de, 91903580749, Pires, Izabel Augusta Hazin |
| Publisher | PROGRAMA DE P?S-GRADUA??O EM PSICOLOGIA, UFRN, Brasil |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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