Distúrbios no padrão do sono e fadiga em pacientes submetidos à cirurgia oncológica gastrointestinal

Abstract

Cancer patients may experience sleep disturbances and fatigue, caused both by disease and by treatment, that have a negative impact on quality of life. Gastrointestinal cancer, which is prevalent in Brazil and the world, has surgery as the treatment of choice. This study aimed to evaluate sleep pattern and fatigue in cancer patients undergoing gastrointestinal oncologic surgery, and relate them to quality of life dimensions. This is a cross-sectional study with a quantitative approach, involving 114 patients. Data were collected at the oncology outpatient of Dr. Hélio Angotti hospital, and sociodemographic and clinical instruments, Pittsburgh Sleep Quality Index ( PSQI ), Piper Fatigue Scale and EORTC- QLQ - C30 were used . Data were analysed with the Statistical Package for Social Sciences (SPSS version 20 ), and the value of 0.05 was considered statistically significant . Of the 114 patients interviewed, 74 ( 64.9 % ) were male , 35 ( 30.7 % ) had age between 60 and 70, and 36 ( 31.6 % ) between 50 and 60. Among the types of gastrointestinal cancer , colorectal predominated ( 52.6 %). Regarding the pattern of sleep, 43 patients (37.7%) required 16-30 minutes to fall asleep and 84 (73.3%) reported daytime naps; the sleep disturbance component (1.75) was the one which most negatively influenced the quality of sleep. Mild fatigue predominated (62.3%) among respondents, and the affective dimension had the highest score (4.25). The emotional function (52,48) was the most affected domain of the EORTC- QLC - C30 . In multiple linear regression analysis, duration of surgery (p = 0.000) and the time of diagnosis (p = 0.013) were predictive for sleep disorders; pain presented p = 0.068. Sleep disorders (p = 0.019) and pain (p = 0.000) were predictive of fatigue . It is concluded that quality is required by the multidisciplinary health care team in the care provided to cancer survivors, and knowledge of physical and biological processes of disease, as well as of symptoms generated by treatment are important factors.