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Impacto psicossocial da experiência de cancro em adolescentes sobreviventes
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Introdução: A taxa de sobrevivência de cancro pediátrico tem crescido nas últimas décadas, levando consequentemente ao aumento de efeitos secundários tardios, nomeadamente físicos (cardiotoxicidade, lesões de órgão alvo, osteoporose), psiquiátricos (depressão, ansiedade, stress pós-traumático) e cognitivos. A adolescência é uma fase de transição com dificuldades psicossociais específicas, podendo estas ser agravadas pelos desafios que a experiência de cancro apresenta, como tal é importante compreendê-la melhor.
Objetivos: Perceber qual o impacto psicossocial da experiência de cancro em adolescentes (10 a 19 anos) que tiveram a doença. Identificar as necessidades dos adolescentes no processo de sobrevivência e as medidas que melhorem o acompanhamento dos mesmos.
Métodos: Foi realizada uma revisão sistemática da literatura, através da pesquisa de palavras-chave que incluem ‘childhood cancer’, ‘adolescent survivors of cancer’, ‘psychological outcomes’ e ‘social outcomes’ nas bases de dados MEDLINE (PubMed), PMC (PubMed Central) e ScienceDirect (Elsevier).
Resultados: Identificou-se um comprometimento no domínio cognitivo, com alteração principalmente da velocidade de processamento, e ao nível das capacidades sociais.
No domínio psicossocial a literatura não é consensual, existindo estudos em que os sobreviventes apresentam mais sintomas de sofrimento psicológico do que a população em geral. Por outro lado, outros não identificam diferenças significativas entre os dois grupos e alguns referem ainda um melhor bem-estar psicológico. Os sobreviventes apresentavam uma taxa significativa de comportamentos de risco, sendo semelhante ou ligeiramente inferior à população em geral.
Conclusões: Apesar da maioria dos sobreviventes não apresentarem problemas de saúde mental, existe um pequeno grupo com maior vulnerabilidade ao sofrimento psicológico. A sua identificação precoce permite um acompanhamento adequado e uma minimização das consequências negativas da experiência de cancro
Introduction: Paediatric cancer survival rates have increased in the last decades, leading to an increase of late side effects, such as physical (cardiotoxicity, target organ damage, osteoporosis), psychiatric (depression, anxiety, post-traumatic stress) and cognitive. Adolescence is a transitional phase with specific psychosocial difficulties, which can be exacerbated by the challenges presented by the experience of cancer, therefore it is important to have a better understanding of it. Objectives: To understand the psychosocial impact of cancer experience in adolescents (10-19 years old) who had the disease. To identify the needs of adolescents in the process of survival and measures to improve their follow-up. Methods: A systematic literature review was conducted by searching the databases MEDLINE (PubMed), PMC (PubMed Central) and ScienceDirect (Elsevier) for keywords including 'childhood cancer', 'adolescent survivors of cancer', 'psychological outcomes' and 'social outcomes'. Results: Survivors presented consequences in the cognitive domain, mainly in the processing speed, and in social skills. In the psychosocial domain, literature is not consensual, survivors may show more symptoms of psychological distress than the general population, no significant differences between the two groups or even exhibit better psychological well-being. Survivors had a significant rate of risky behaviours, it being similar or slightly lower than the general population’s. Conclusion: Even though most survivors don’t present mental health problems, there is a small group with greater vulnerability to psychological distress. It’s early identification allows an adequate follow-up and a mitigation of cancer experience’s negative consequences.
Introduction: Paediatric cancer survival rates have increased in the last decades, leading to an increase of late side effects, such as physical (cardiotoxicity, target organ damage, osteoporosis), psychiatric (depression, anxiety, post-traumatic stress) and cognitive. Adolescence is a transitional phase with specific psychosocial difficulties, which can be exacerbated by the challenges presented by the experience of cancer, therefore it is important to have a better understanding of it. Objectives: To understand the psychosocial impact of cancer experience in adolescents (10-19 years old) who had the disease. To identify the needs of adolescents in the process of survival and measures to improve their follow-up. Methods: A systematic literature review was conducted by searching the databases MEDLINE (PubMed), PMC (PubMed Central) and ScienceDirect (Elsevier) for keywords including 'childhood cancer', 'adolescent survivors of cancer', 'psychological outcomes' and 'social outcomes'. Results: Survivors presented consequences in the cognitive domain, mainly in the processing speed, and in social skills. In the psychosocial domain, literature is not consensual, survivors may show more symptoms of psychological distress than the general population, no significant differences between the two groups or even exhibit better psychological well-being. Survivors had a significant rate of risky behaviours, it being similar or slightly lower than the general population’s. Conclusion: Even though most survivors don’t present mental health problems, there is a small group with greater vulnerability to psychological distress. It’s early identification allows an adequate follow-up and a mitigation of cancer experience’s negative consequences.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2022
Palavras-chave
Adolescentes sobreviventes de cancro Comportamentos em saúde Impacto psicossocial Impacto cognitivo Psiquiatria