Šta najviše doprinosi kvalitetu života pacijentkinja tokom terapije karcinoma dojke – klinički faktori, funkcionalni i emocionalni status ili socijalna podrška?
Sažetak
Uvod/Cilj. Pošto je tokom decenija došlo do značajnog napretka u lečenju raka, ključna pitanja u onkologiji danas se ne odnose samo na lečenje bolesti, već i na kvalitet života pacijentkinja. Zbog toga je cilj ovog istraživanja bio da se ispita koji skup determinanti (klinički faktori, funkcionalno stanje, afektivni status ili socijalna podrška) u najvećoj meri doprinosi predviđanju kvaliteta života kod žena koje žive sa dijagnozom raka dojke. Metode. U istraživanju su učestvovale 64 žene (prosečne životne dobi od 58,36 ± 11,30 godine) tokom zračne terapije na Institutu za onkologiju Vojvodine. Upitnik Quality of Life Instrument – Breast Cancer Patient Version (QOL-BC) primenjen je za procenu fizičkog, psihičkog, socijalnog, duhovnog i opšteg kvaliteta života, Upper Extremity Functional Index (UEFI) je upotrebljen za procenu funkcije gornjih ekstremiteta, Depression, Anxiety, and Stress Scale-21 Items (DASS-21) korišćen je za procenu simptoma depresije, anksioznosti i stresa, Medical Outcomes Survey, Social Support Survey (MOS-SSS) služio je za procenu
socijalne podrške, a prikupljeni su i demografski i klinički podaci pacijentkinja. Rezultati. Primenom testa analize varijanse (ANOVA) sa ponovljenim merenjima [F(2,03, 127,80) = 20,24, p < 0,001] nađeno je da je fizički kvalitet života pacijentkinja bio značajno bolji u odnosu na ostale domene, dok je socijalni kvalitet života bio značajno lošiji u odnosu na fizički i psihološki aspekt. Hijerarhijska regresiona analiza [F(8, 55) = 7,16, p < 0.001, R2 = 0,5] pokazala je da su ispitanice koje su primile adjuvantnu hemioterapiju, i iskusile povišen nivo distresa i lošiju socijalnu podršku, imale smanjen generalni kvalitet života. Uvođenje varijabli povezanih sa afektivnim stanjem [ΔR2 = 0.16, p(ΔF) < 0.01] i socijalnom podrškom [ΔR2 = 0.05, p(ΔF) < 0.05] dovelo je do značajnog porasta u proporciji objašnjene varijanse, povrh kliničkih i funkcionalnih faktora. Zaključak. Naši rezultati ukazuju na to da psihološki i socijalni resursi imaju važniju ulogu u predviđanju kvaliteta života u poređenju sa kliničkim i funkcionalnim faktorima. Istovremeno, socijalno, psihološko i duhovno blagostanje pacijentkinja bilo je značajno lošije u poređenju sa fizičkim kvalitetom života, što znači da još mnogo toga treba da bude preduzeto u cilju napretka od dominantno somatskog, ka holističkom pristupu u lečenju karcinoma dojke.
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