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Tamoxifeno e cancro da mama: um contributo para o estudo de cronotipos e de perceção da efetividade terapêutica
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Em 1976, James A. Horne e Olov Ostberg apresentaram um questionário construído com o intuito de estudar diferenças individuais em atitudes circadianas. Este questionário foi chamado de Morningness–Eveningness Questionnaire (MEQ), e com este a cada respondente seria atribuído uma de cinco categorias (chamadas de cronotipos): “Definitivamente Noturno”, “Moderadamente Noturno”, “Nem Um Nem Outro”, “Moderadamente Matinal”, e “Definitivamente Matinal”. Ao longo dos anos seguintes, este questionário foi traduzido para várias outras línguas, sendo a versão portuguesa publicada por Loureiro & Garcia-Marques, em 2015. A perceção é um conceito difícil de definir, mas que tende a estar associado aos órgãos sensoriais que coletam as informações a partir das quais construímos nossa perceção. No entanto, as nossas perceções são influenciadas por muitos factores, entre estes factores ambientais e individuais. É por causa destes que podemos ter pessoas de origens e estilos de vida semelhantes a dar uma avaliação geral diferente das suas vidas. A satisfação de vida é um tema intimamente relacionado à saúde e um seu importante preditor. Na tentativa de relacionar esses dois temas, cronotipo e perceção, especificamente perceção da eficácia terapêutica, foi elaborado um novo questionário em português, que inclui a versão reduzida do MEQ e foca na perceção da eficácia terapêutica e fatores relacionados que podem ser alterados para melhorar a perceção da efetividade terapêutica de um medicamento. Deste resultaram 98 inquéritos preenchidos, a partir dos quais se comprovou uma relação entre a ocorrência de efeitos secundários e a avaliação dada ao tamoxifeno, tendo-se também comprovado um agravamento desta avaliação quando se encontrava ganho de peso entre os efeitos secundários declarados. No objetivo de inferir da associação entre a duração do tratamento com a perceção do seu benefício, não foi estabelecida uma relação, no entanto, no objetivo final de “Relacionar o cronotipo pessoal com o horário de toma de Tamoxifeno” foi observado um viés na escolha da hora de toma do tamoxifeno para a hora de jantar e com alguma expressão, para a hora do pequeno-almoço, independentemente do cronotipo da mulher.
In 1976 James A. Horne e Olov Ostberg presented a self-assessment questionnaire designed to study individual differences in circadian attitudes. They called it Morningness–eveningness questionnaire (MEQ) and with this tool each respondent would be given one of five categories (called chronotypes): definitely Evening type, moderately Evening type, neither type, moderately Morning type, and definitely Morning type. Throughout the following years this questionnaire was translated into several other languages, having the Portuguese version been published by Loureiro & Garcia-Marques in 2015. Perception is a concept difficult to define but one that tends to be associated to the sensory organs that collect the information from which we build our perception. However, our perceptions are influenced by many factors, including environment and individual factors. Due to these we can have people from similar backgrounds and lifestyles give different general assessment of their lives. Life satisfaction is a subjected closely related with health and an important predictor of it. In an attempt to relate these two topics, chronotype and perception, specifically perception of therapeutic effectiveness, a new questionnaire was designed in Portuguese which includes the shorten version of the MEQ and focuses on the perception of therapeutically effectiveness and related factores that can be changed to improved said the perception of a medicine’s therapeutic effectiveness. For the application of this questionnaire 98 women were interviewed, and from their answers a relationship between side-effects and the self-appreciation of tamoxifen, having been also observed a worsening of this appreciation when weight gain was included among the reported side-effects. For the objective of inferring from the association between the duration of treatment and the perception of its benefit, a relationship was not established, however, for the last objective, “To link personal chronotype to Tamoxifen intake schedule”, a bias was observed in the choice of the schedule for tamoxifen intake for dinner time and with some expression for a small lunch time using the woman's schedule.
In 1976 James A. Horne e Olov Ostberg presented a self-assessment questionnaire designed to study individual differences in circadian attitudes. They called it Morningness–eveningness questionnaire (MEQ) and with this tool each respondent would be given one of five categories (called chronotypes): definitely Evening type, moderately Evening type, neither type, moderately Morning type, and definitely Morning type. Throughout the following years this questionnaire was translated into several other languages, having the Portuguese version been published by Loureiro & Garcia-Marques in 2015. Perception is a concept difficult to define but one that tends to be associated to the sensory organs that collect the information from which we build our perception. However, our perceptions are influenced by many factors, including environment and individual factors. Due to these we can have people from similar backgrounds and lifestyles give different general assessment of their lives. Life satisfaction is a subjected closely related with health and an important predictor of it. In an attempt to relate these two topics, chronotype and perception, specifically perception of therapeutic effectiveness, a new questionnaire was designed in Portuguese which includes the shorten version of the MEQ and focuses on the perception of therapeutically effectiveness and related factores that can be changed to improved said the perception of a medicine’s therapeutic effectiveness. For the application of this questionnaire 98 women were interviewed, and from their answers a relationship between side-effects and the self-appreciation of tamoxifen, having been also observed a worsening of this appreciation when weight gain was included among the reported side-effects. For the objective of inferring from the association between the duration of treatment and the perception of its benefit, a relationship was not established, however, for the last objective, “To link personal chronotype to Tamoxifen intake schedule”, a bias was observed in the choice of the schedule for tamoxifen intake for dinner time and with some expression for a small lunch time using the woman's schedule.
Descrição
Tese de Mestrado, Regulação e Avaliação do Medicamento e Produtos de Saúde, Universidade de Lisboa, Faculdade de Farmácia, 2019
Palavras-chave
Cronotipo Tamoxifeno Inquérito Cancro da mama Percepção Efectividade terapêutica Teses de mestrado - 2019