Sintomas psicoemocionais e qualidade de vida de pacientes com câncer em quimioterapia: estudo longitudinal

Abstract

Introduction: Cancer diagnosis and treatment have a negative impact on patients' physical, psychological, and social aspects, and may reduce their health-related quality of life and cause psychoemotional symptoms such as depression, anxiety, and stress. Objective: To evaluate the presence of psychoemotional symptoms and health-related quality of life in cancer patients during chemotherapy treatment. Method: This is a prospective, quantitative, descriptive, and longitudinal study developed in a chemotherapy center of a public hospital. Data were collected in two moments: the first occurred in the first session of the first, second, or third cycle of chemotherapy, and the second moment was 21 days after the first. Patients aged 18 years or older, of both sexes, diagnosed with cancer in initial treatment were included. The instruments used were: Sociodemographic and Clinical-Therapeutic Questionnaire; Depression, Anxiety, and Stress Scale; and Quality of Life Questionnaire-Core30. For data analysis, the normality test was used, followed by the paired t-test, the t-test for independent groups, and the Pearson test. In case of violation of the normality test, the nonparametric Wilcoxon test was performed. The level of statistical significance was set at 5%. Data were analyzed using the Statistical Package for the Social Sciences version 21.0. The study was approved by the Research Ethics Committee. Results: Thirty-five patients participated, with a mean age of 61.97 years. Most were white, married, Catholic, retired women with low income and low education. The most frequent cancers were: colorectal, breast, and lung, without metastasis. Stress presented the highest means (4.4 and 3.25), with a decrease between collection times, unlike anxiety (means: 2.62 and 2.85) and depression (means: 1.65 and 2.71), which increased. In the evaluation of the Quality of Life Questionnaire-Core30 instrument, the global health scale obtained an adequate score (means: 68.09 and 70.94) and the cognitive (means: 84.76 and 87.14) and social (means: 79.99 and 82.85) functions had the best means. In the symptom scale, insomnia (mean: 41.90) and pain (mean: 34.76) were prevalent in the first collection, while loss of appetite (mean: 50.47) and fatigue (mean: 42.53) were prevalent in the second collection. The variables loss of appetite and diarrhea were statistically significant in the comparison of means. Depression was the variable that showed the highest correlation with quality of life at both collection times. Age and sex showed the highest number of associations with quality of life. Conclusion: During chemotherapy treatment, patients showed reduced stress but reported increased anxiety and depression, the latter correlated with physical function, fatigue, nausea and vomiting, and insomnia. Quality of life was considered satisfactory, with elderly patients having higher means for emotional function (T1), nausea (T1), pain (T1), and diarrhea (T1) when compared with adult patients; while women had higher means for loss of appetite (T1), diarrhea (T1 and T2), cognitive function (T2), nausea and vomiting (T2) compared with men.