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Ajustamento psicossocial ao cancro da mama em função do tipo de cirurgia
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Advisor(s)
Abstract(s)
Resumo: Este estudo compara o ajustamento psicossocial a doença em mulheres com cancro da mama submetidas a cirurgia de conservação e mastectomia, prevendo diferenças entre os dois grupos. Procura ainda avaliar se há diferenças no ajustamento ao longo de quatro momentos de avaliação. A amostra foi constituída por 74 mulheres no estádio I-III da doença submetidas a cirurgia. Todas as mulheres responderam a questionários de baseline, antes da cirurgia, e foram seguidas longitudinalmente até ao final dos tratamentos. As dimensões do ajustamento psicossocial avaliadas foram o estado emocional, as representações da doença e a funcionalidade, não se tendo verificado diferenças no ajustamento, para a grande maioria das variáveis psicossociais estudadas, em função do tipo de cirurgia. Contudo, encontramos diferenças significativas para as representações de doença (compreensão da doença) e para a funcionalidade (categoria lazer, sono e dimensão psicossocial), tendo os resultados sido mais favoráveis para as mulheres que realizaram uma mastectomia. Estes resultados são inesperados uma vez que a cirurgia de conservação pretende proporcionar um resultado cosmético mais satisfatório e com taxas de sobrevivência equivalentes as da mastectomia, fazendo supor que se conseguiria obter um melhor ajustamento psicossocial. Os dados encontrados sugerem que o tipo de cirurgia não parece predizer o ajustamento psicossocial. No entanto, considera-se que implicar as doentes na escolha do tipo de cirurgia, sempre que isso seja possível, pode beneficiar uma compreensão mais ajustada acerca da doença e do tratamento, com repercussões mais favoráveis ao nível emocional e da funcionalidade.
Abstract: The aim of this study was to examine psychosocial adjustment differences between breast cancer women who underwent a lumpectomy or mastectomy, predicting differences between the two groups. The participants were 74 Portuguese recently diagnosed breast cancer patients, recruited in the main Oncology Hospital of the North of Portugal. The study design is longitudinal with four-time points: before surgery (baseline); two weeks after surgery, during adjuvant treatments; and at the end of adjuvant treatment. The evaluated dimensions were emotional state, illness perception and illness functional limitations. We didn’t find differences for most of the variables, between the two groups. However, we find significant differences for comprehension (illness perception) and for leisure, sleep and psychosocial dimension (perceived functioning), with better adjustment for women who underwent mastectomy. These results are unexpected since conservation surgery aims to provide a more satisfying cosmetic outcome and survival rates equivalent to those of mastectomy, assuming a better psychosocial adjustment. The data suggest that the type of surgery doesn’t seem to predict the psychosocial adjustment. However, involving patients in choosing surgery type, whenever it is possible, can benefits a better understanding about the disease and the treatment, with more favourable repercussions on the emotional level and functionality.
Abstract: The aim of this study was to examine psychosocial adjustment differences between breast cancer women who underwent a lumpectomy or mastectomy, predicting differences between the two groups. The participants were 74 Portuguese recently diagnosed breast cancer patients, recruited in the main Oncology Hospital of the North of Portugal. The study design is longitudinal with four-time points: before surgery (baseline); two weeks after surgery, during adjuvant treatments; and at the end of adjuvant treatment. The evaluated dimensions were emotional state, illness perception and illness functional limitations. We didn’t find differences for most of the variables, between the two groups. However, we find significant differences for comprehension (illness perception) and for leisure, sleep and psychosocial dimension (perceived functioning), with better adjustment for women who underwent mastectomy. These results are unexpected since conservation surgery aims to provide a more satisfying cosmetic outcome and survival rates equivalent to those of mastectomy, assuming a better psychosocial adjustment. The data suggest that the type of surgery doesn’t seem to predict the psychosocial adjustment. However, involving patients in choosing surgery type, whenever it is possible, can benefits a better understanding about the disease and the treatment, with more favourable repercussions on the emotional level and functionality.
Description
Keywords
Cancro da mama Ajustamento psicossocial Tipo de cirurgia Mastectomia Cirurgia Breast cancer Psychosocial adjustment Type of surgery Mastectomy Conservation
Citation
Fernandes, S., McIntyre, T., & Leite, Â. (2018). Ajustamento psicossocial ao cancro da mama em função do tipo de cirurgia. Análise Psicológica, 36(2), 199-217. https://doi.org/10.14417/ap.1205
Publisher
Edições ISPA