Sekundarni limfedem ruke, percepcija bolesti, samoefikasnost i depresija kao determinante kvaliteta života obolelih od karcinoma dojke
Sažetak
Uvod/Cilj. Sekundarni limfedem ruke je jedan od mogućih neželjenih efekata i komplikacija karcinoma dojke kao i lečenja karcinoma dojke, koji može doprineti i dovesti do većeg broja novih psiholoških problema. Cilj ove studije bio je da se ispita postojanje razlika u kvalitetu života bolesnica sa karcinomom dojke koje imaju sekundarni limfedem ruke u odnosu na one koje ga nemaju i da se utvrdi značaj percepcije bolesti, depresivnih simptoma i samoefikasnosti za ukupni kvalitet života. Metode. Sprovedeno istraživanje je dizajnirano kao studija preseka, sa odgovarajućim kliničkim uzorkom kojeg su činile 64 bolesnice, od kojih 34 sa limfedemom ruke i 30 bez limfedema. Za procenu kvaliteta života primenjen je upitnik FACT-B+4, za percepciju bolesti BIPQ; depresivnost je merena skalom DASS-21, dok je samoefikasnost ispitana skalom SGSE. Za obradu podataka korišćeni su t-test, Mann Whitney U Test, χ2 test i hijerarhijska regresiona analiza. Rezultati. Nije utvrđena značajna razlika između grupa kako u ukupnom skoru kvaliteta života (t = 0.469, p > 0.05), tako ni u pojedinačnim domenima: fizičko blagostanje (t = 0,535, p > 0,05), socijalno/porodično blagostanje (t = 1.43, p > 0,05), emocionalno blagostanje (t =1.35, p > 0,05), funkcionalno blagostanje (z = -0.243, p > 0.05), simptomi izazvani karcinomom dojke (t = -0.839, p > 0.05), te tegobama ruke (t = -0.514, p > 0.05), dok su se percepcija bolesti (β = -0.603, t = -5.958, p < 0.001) i depresivnost (β = -0.411, t = -4.101, p < 0.001) pokazali kao značajni prediktori kvaliteta života i objašnjavaju 50,2% varijanse ukupnog kvaliteta života. Zaključak. Rezultati naše studije ukazuju na značaj sveobuhvatnog programa rehabilitacije, usmerenog kako na funkcionalne tako i na psihosocijalne aspekte.
Reference
References
Revicki DA. Health-related quality of life in the evaluation of medical therapy for chronic illness. J Fam Pract 1989; 29(4): 377–92.
Bomar L, Humphrey K. Lymphedema. Rehab Oncol 1999; 17(2): 25–8.
Chan DN, Lui LY, So WK. Effectiveness of exercise pro¬grams on shoulder mobility and lymphedema after axillary lymph node dissection for breast cancer: Systematic re¬view. J Adv Nurs 2010; 66(9): 1902–14.
Chan DN, So WK. Developing an evidence-based exercise guideline on improving shoulder motion and lessening the se-verity of lymphedema for breast cancer patients after axillary lymph-node dissection. Clin Oncol Cancer Res 2010; 7(3): 169–74.
Popović-Petrović S. Risk factors for development of the sec-ondary lymphedema of the arm in malignant breast tu¬mors [dissertation]. Novi Sad: Faculty of Medicine; 2008. (Serbian)
Popović-Petrović S, Tomić S, Popović M. Rehabilitation in on¬cology. HealthMED 2010; 4(4): 815–8.
Popović-Petrović S, Nedeljković M, Popović L, Petrović V. Sec¬ondary lymphedema of the arm in breast carcinoma at the Oncology institute of Vojvodina: 2001-2006. Health¬MED 2011; 5(6): 1719–24.
Popović-Petrović S, Vasović M, Nedeljković M. Prevention and treatment of secondary lymphedema of arm in breast cancer. Arch Oncol 2002; 10(2): 77–8.
Popović-Petrović S, Tomić S, Nedeljković M, Popović L, Ma¬tovina G. Early rehabilitation in patients operated for breast carcinoma. Vojnosanit Pregl 2013; 70(4): 407–10.
Passik SD, McDonald MV. Psychosocial aspects of upper ex-tremity lymphedema in women treated for breast carci¬noma. Cancer 1998; 83(12 Suppl American): 2817–20.
Tobin MB, Lacey HJ, Meyer L, Mortimer PS. The psychologi¬cal morbidity of breast cancer-related arm swelling. Psy¬chological morbidity of lymphoedema. Cancer 1993; 72(11): 3248–52.
Velanovich V, Szymanski W. Quality of life of breast can¬cer pa-tients with lymphedema. Am J Surg 1999; 177(3): 184–7; dis-cussion 188.
Beaulac SM, Mcnair LA, Scott TE, la Morte WW, Kavanah MT. Lymphedema and quality of life in survivors of early-stage breast cancer. Arch Surg 2002; 137(11): 1253–7.
Hormes JM, Bryan C, Lytle LA, Gross CR, Ahmed RL, Troxel AB, et al. Impact of lymphedema and arm symp¬toms on quali-ty of life in breast cancer survivors. Lym¬phology 2010; 43(1): 1–13.
Morgan PA, Franks PJ, Moffatt CJ. Health-related quality of life with lymphoedema: A review of the literature. Int Wound J 2005; 2(1): 47–62.
Bugarski V, Biro M, Novović Z. Relations between the qual¬ity of life and depressive characteristics in patients on haemodialysis. Appl Psychol 2009; 2(1): 5–24.
Leventhal H, Diefenbach M, Leventhal EA. Illness cognition: Us-ing common sense to understand treatment adherence and af-fect cognition interactions. Cogn Ther Res 1992; 16(2): 143–63.
Bandura A, Adams NE, Hardy AB, Howells GN. Tests of the generality of self-efficacy theory. Cogn Ther Res 1980; 4(1): 39–66.
Smith HM, Betz NE. An examination of efficacy and esteem pathways to depression in young adulthood. J Couns Psy¬chol 2002; 49(4): 438–48.
Kohler CL, Fish L, Greene PG. The relationship of per¬ceived self-efficacy to quality of life in chronic obstructive pulmo-nary disease. Health Psychol 2002; 21(6): 610–14.
Giese-Davis J, Koopman C, Butler LD, Classen C, Morrow GR, Spiegel D. Self-efficacy with emotions predicts higher quality of life in primary breast cancer patients. In: Brady M (Chair), Self efficacy and cancer: Theory, assessment, and treatment. Symposium conducted at the meetin of the Society of Behav-ioral Medicine, San Diego, CA: American Psychological Asso-ciation; 1999.
Merluzzi TV, Nairn MA. An exploration of self-efficacy and longevity in persons with cancer. 20th annual meeting of the Society of Behavioral Medicine; 1999; San Diego, Cali¬fornia: American Psychological Association; 1999.
Ganz PA, Guadagnoli E, Landrum MB, Lash TL, Rakowski W, Silliman RA. Breast Cancer in Older Women: Quality of Life and Psychosocial Adjustment in the 15 Months Af¬ter Diagno-sis. J Clin Oncol 2003; 21(21): 4027–33.
Mols F, Vingerhoets AJ, Coebergh JW, van de Poll-Franse LV. Quality of life among long-term breast cancer survivors: A sys-tematic review. Eur J Cancer 2005; 41(17): 2613–9.
Brady MJ, Cella DF, Mo F, Bonomi AE, Tulsky DS, Lloyd SR, et al. Reliability and validity of the Functional Assessment of Cancer Therapy-Breast quality-of-life instrument. J Clin On-col 1997; 15(3): 974–86.
Broadbent E, Petrie K, Main J, Weinman J. The brief illness per-ception questionnaire. J Psychosom Res 2006; 60(6): 631–7.
Broadbent E, Wilkesa C, Koschwaneza H, Weinmanb J, Nor¬ton S, Petrie KJ. A systematic review and meta-analysis of the Brief Illness Perception Questionnaire. Psychol Health 2015; 30(11): 1361–85.
Lovibond PF, Lovibond SH. The structure of negative emo¬tional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety In¬ventories. Behav Res Ther 1995; 33(3): 335–43.
Jovanović V, Gavrilović-Jerković V, Žuljević D, Brdarić D. Psycho-metric evaluation of the depression anxiety stress Scales -21 (DASS-21) in a Serbian student sample. Psi¬hologija 2014; 47(1): 93–112. (Serbian)
Schwarzer R, Jerusalem M. Generalized Self-Efficacy scale. In: Weinman J, Wright S, Johnston M, editors. Measures in health psychology: A user's portfolio. Causal and control beliefs. Windsor, U. K.: NFER-NELSON; 1995. p. 35–7
Scholz U, Gutiérrez-Doña B, Sud S, Schwarzer R. Is general self-efficacy a universal construct?, Psychometric findings from 25 countries. Eur J Psychol Assess 2002; 18(3): 242–51.
Chachaj A, Małyszczak K, Pyszel K, Lukas J, Tarkowski R, Pu-dełko M, et al. Physical and psychological impairments of women with upper limb lymphedema following breast cancer treatment. Psychooncology 2010; 19(3): 299–305.
Pain SJ, Vowler S, Purushotham AD. Is physical function a more appropriate measure than volume excess in the as¬sessment of breast cancer-related lymphoedema (BCRL)?. Eur J Cancer 2003; 39(15): 2168–72.
Pereira de Godoy JM, Braile DM, de Fatima Godoy M, Longo O Jr. Quality of life and peripheral lymphedema. Lym¬phology 2002; 35(2): 72–5.
Kim SJ, Yi CH, Kwon OY. Effect of complex decongestive therapy on edema and the quality of life in breast cancer pa-tients with unilateral leymphedema. Lymphology 2007; 40(3): 143–51.
Kim SJ. The long term effects of complex decongestive physi-cal therapy on lower extremity secondary lymphoe¬dema and quality of life. J Phys Ther Sci 2011; 23(1): 155–9.
Buragadda S, Alhusaini A, Melam GR, Arrora N. Effect of complete decongestive therapy and home program on health- related quality of life in post mastectomy lymphe¬dema pa-tients. J Phys Ther Sci 2015; 27(9): 2743–8.
Ashley L, Marti J, Jones H, Velikova G, Wright E. Illness per-ceptions within 6 months of cancer diagnosis are an inde-pendent prospective predictor of future health-related quality of life 15 months post-diagnosis. Psychooncology 2015; 24(11): 1463–70.
Reich M, Lesur A, Perdrizet-Chevallier C. Depression, qual¬ity of life and breast cancer: A review of the literature. Breast Can-cer Res Treat 2008; 110(1): 9–17.
Mosher CE, Duhamel KN, Egert J, Smith MY. Self-efficacy for coping with cancer in a multiethnic sample of breast cancer patients: Associations with barriers to pain man¬agement and distress. Clin J Pain 2010; 26(3): 227–34.
Yeung NC, Lu Q. Affect as a mediator between self-efficacy and quality of life among Chinese cancer survivors in China. Eur J Cancer Care (Engl) 2014; 23(1): 149–55.