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Prevalência e repercussão da obstipação no doente oncológico
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Resumo(s)
A obstipação está presente em mais de 50% dos pacientes com cancro e é considerado como um dos mais aflitivos sintomas causando tanto desconforto físico como emocional. A necessidade de tratar a obstipação no doente oncológico é geralmente devido a uma falha na própria prevenção. Existe pouca literatura nesta área e a investigação é praticamente inexistente. Poder-se-á argumentar que os profissionais de saúde muitas vezes priorizam a monitorização dos efeitos diretos do tratamento e frequentemente descuram os efeitos secundários. Tendo em conta que a obstipação intestinal é em grande parte evitável, existe a necessidade de destacar a importância da prevenção, além de estabelecer diretrizes que permitam uma melhoria na qualidade de vida do doente oncológico. O objetivo deste estudo foi: Determinar a prevalência de obstipação e o impacto em doentes oncológicos, tendo sido formulada a seguinte questão orientadora: “Constitui a obstipação um sintoma importante, frequentemente identificado, como causa de sofrimento e desconforto no doente oncológico?“. O estudo baseou-se numa metodologia quantitativa, observacional, descritiva e prospetiva, envolvendo doentes oncológicos em fases avançadas, seguidos em consulta de Doenças Oncológicas e que receberam algum tipo de seguimento no Hospital de Dia do Hospital do Litoral Alentejano, em Santiago do Cacém no período de Janeiro de 2013 a Dezembro de 2013. Para a obtenção dos dados foram utilizadas entrevistas semiestruturadas, realizadas a sessenta e cinco participantes do estudo, adultos, selecionados de acordo com critérios de intencionalidade previamente definidos. As entrevistas foram posteriormente transcritas e analisadas. Para a análise dos resultados quantitativos utilizou-se a análise estatística descritiva.
Os resultados obtidos mais relevantes foram: A prevalência de obstipação nos doentes estudados foi de 58%. 71% Dos doentes, no momento do estudo, já recebiam benefícios e acompanhamento pela equipa intra-hospitalar de Cuidados Paliativos da Unidade Local de Saúde do Litoral Alentejano, 35% dos doentes tinham diagnosticado tumores do colon, 14% tumores de pulmão, seguidos em ordem de frequência pelo tumor da mama. 68% Fazia tratamento com algum tipo de opióides, 49% dos doentes objeto de estudo tinham sinais de obstipação habitual e 84% dos participantes faziam tratamento com algum tipo de laxante. Para avaliar o impacto da obstipação no doente oncológico em estadio avançado, foi utilizada uma escala numérica verbal, onde o doente localizou espacialmente a intensidade da repercussão negativa da obstipação.
The constipation is present in more than 50% of patients with cancer and is considered as one of the most distressing symptoms causing both physical and emotional discomfort. The need to treat the constipation oncologic patients is usually due to a failure in their own prevention.There is very little literature in the area and the research is almost non-existent. It could be argued that health professionals often prioritize monitoring the direct effects of treatment and often disregard the secondary effects. Considering that the intestinal obstipation is in large part avoidable, there is a need to highlight the importance of prevention, as well as establish guidelines which will allow an improvement in the quality of life in cancer patients.The objective of this study is: to Determine the prevalence of constipation and the impact on cancer patients, having been formulated the following guiding question: "is obstipation an important symptom, often identified as the cause of suffering and discomfort in oncologic patient?". The study was based on a quantitative, observational, descriptive and perspective methodology, involving cancer patients in advanced stages, followed in Oncologic Diseases Consultation and who received some type of follow-up in Hospital de Dia of Hospital do Litoral Alentejano, in Santiago do Cacém in the period from January 2013 to December 2013. For the retrieval of data were used semi-structured interviews, carried out to sixty and five study participants, adults, selected according to previously defined criteria of intentionality. The interviews were transcribed and analyzed. For the analysis of the quantitative results descriptive statistical analysis were used. The small sample size does not allow, however, relate in a decisive way the results demographic, socio-economic or stage of life cycle, with the prevalence of constipation in patient oncology. The most relevant results obtained were: The prevalence of constipation in patients studied was 58 %. 71% Of the patients, at the time of the study, already receiving benefits and monitoring by intra-hospital team of Palliative Care of the Unidade Local de Saúde do Litoral Alentejano, 35% of patients were diagnosed colon tumors, 14% lung tumors, followed in order of frequency by breast tumor. 68% Had some type of treatment with opioids, 49% had signs of regular obstipation and 84% of participants took treatment with some type of laxative. To assess the impact of constipation in oncologic patient in advanced stage, a verbal numeric scale was used, where the patient located spatially the intensity of the negative repercussions of constipation.
The constipation is present in more than 50% of patients with cancer and is considered as one of the most distressing symptoms causing both physical and emotional discomfort. The need to treat the constipation oncologic patients is usually due to a failure in their own prevention.There is very little literature in the area and the research is almost non-existent. It could be argued that health professionals often prioritize monitoring the direct effects of treatment and often disregard the secondary effects. Considering that the intestinal obstipation is in large part avoidable, there is a need to highlight the importance of prevention, as well as establish guidelines which will allow an improvement in the quality of life in cancer patients.The objective of this study is: to Determine the prevalence of constipation and the impact on cancer patients, having been formulated the following guiding question: "is obstipation an important symptom, often identified as the cause of suffering and discomfort in oncologic patient?". The study was based on a quantitative, observational, descriptive and perspective methodology, involving cancer patients in advanced stages, followed in Oncologic Diseases Consultation and who received some type of follow-up in Hospital de Dia of Hospital do Litoral Alentejano, in Santiago do Cacém in the period from January 2013 to December 2013. For the retrieval of data were used semi-structured interviews, carried out to sixty and five study participants, adults, selected according to previously defined criteria of intentionality. The interviews were transcribed and analyzed. For the analysis of the quantitative results descriptive statistical analysis were used. The small sample size does not allow, however, relate in a decisive way the results demographic, socio-economic or stage of life cycle, with the prevalence of constipation in patient oncology. The most relevant results obtained were: The prevalence of constipation in patients studied was 58 %. 71% Of the patients, at the time of the study, already receiving benefits and monitoring by intra-hospital team of Palliative Care of the Unidade Local de Saúde do Litoral Alentejano, 35% of patients were diagnosed colon tumors, 14% lung tumors, followed in order of frequency by breast tumor. 68% Had some type of treatment with opioids, 49% had signs of regular obstipation and 84% of participants took treatment with some type of laxative. To assess the impact of constipation in oncologic patient in advanced stage, a verbal numeric scale was used, where the patient located spatially the intensity of the negative repercussions of constipation.
Descrição
Tese de mestrado, Cuidados Paliativos, Faculdade de Medicina, Universidade de Lisboa, 2015
Palavras-chave
Obstipação Oncologia Desconforto Cuidados paliativos Teses de mestrado - 2015