RESUMEN
The main purpose of this study was to analyze the effect of risk-reducing salpingo-oophorectomy (RRSO) on the quality of life (QoL) and psychosocial functioning of patients with the BRCA1/BRCA2 mutations. This survey-based study was conducted using the Blatt-Kupperman Index, the Women's Health Questionnaire, the Perceived Stress Scale, the State-Trait Anxiety Inventory, the Beck Depression Inventory-II, and the authors' questionnaire. All calculations were done using Statistica 13.3. The QoL after RRSO was statistically significantly lower in most domains compared with the state before surgery. The greatest decline in the QoL was observed in the vasomotor symptoms domain (d = 0.953) and the smallest in the memory/concentration domain (d = 0.167). We observed a statistically significant decrease in the level of anxiety as a state (d = 0.381), as well as a statistically significant increase in the severity of climacteric symptoms (d = 0.315) and depressive symptoms (d = 0.125). Prophylactic surgeries of the reproductive organs have a negative effect on the QoL and psychosocial functioning of women with the BRCA1/2 mutations, as they increase the severity of depressive and climacteric symptoms. At the same time, these surgeries reduce anxiety as a state, which may be associated with the elimination of cancerophobia.
Asunto(s)
Genes BRCA1 , Genes BRCA2 , Neoplasias Ováricas/genética , Neoplasias Ováricas/psicología , Neoplasias Ováricas/cirugía , Calidad de Vida/psicología , Salpingooforectomía/psicología , Adulto , Proteína BRCA1/genética , Proteína BRCA2/genética , Depresión/etiología , Femenino , Humanos , Persona de Mediana Edad , Mutación , Polonia , Factores de Riesgo , Conducta de Reducción del Riesgo , Salpingooforectomía/métodos , Encuestas y CuestionariosRESUMEN
Introduction: Breastfeeding is the optimal method of feeding children during the first period of their life. The correct management of lactation is essential for proper breastfeeding initiation which would be continued long enough. Many factors have a huge impact on lactation, among others mode of delivery, parturition, hospital procedures and practices, such as suctioning the airway, 'skin to skin' contact, feeding the baby, and the competent support of the staff. The aim of the study was to analyze the impact of selected procedures related to childbirth and post-natal care, as well as hospital practices on lactation. Materials and methods: The study involved 145 women who gave birth in the Department of Foetal Medicine and Gynaecology Pomeranian Medical University in Szczecin located in Police, West Pomeranian Province in Poland. The research was carried out by a diagnostic survey with a self-authorship questionnaire. Conclusions: 1. Some hospital practices, such as suctioning the airway, short 'skin to skin' contact after cesarean delivery, and complementary feeding of a newborn baby with a bottle had negative impact on maintaining lactation. 2. Complementary feeding of an infant with a bottle was a frequent hospital practice. As the procedure has an adverse impact on lactation, breastfeeding should be replaced by complementary feeding in an alternative way only in justified cases. 3. Most of the patients who obtained support during lactation were breastfeeding exclusively. Competent assistance in initiating and maintaining lactation is the responsibility of the medical personnel, thus there is a necessity for their permanent development, and a constant need to modify hospital practices to ones that affect lactation favourably.