Impact of oral health problems on the quality of life of women with breast cancer / Impacto dos problemas bucais na qualidade de vida em mulheres com câncer de mama

ABSTRACT Objective To evaluate the impact of oral health on quality of life and to examine the association with sociodemographic, clinical staging and dental variables in women diagnosed with breast cancer. Methods This is an observational cross-sectional study with sample composed of 89 women treated at a Reference Hospital in Vitória, Espírito Santo, Brazil, between January and December 2012. Two scripts in the form of interviews were used, one to record participants' information; and the Oral Health Impact Profile (OHIP-14), to evaluate the impacts produced by the oral condition on quality of life. Descriptive analysis of data was performed. The comparison of the percentage of the impact dimensions with independent variables was tested by the chi-square test or the Fisher exact test, when appropriate. To assess the strength of association between exposure and event, odds ratio was calculated. Significance level of 5% was adopted. Results The impact was 28.1%, there was a statistically significant association with variables income (p = 0.039) and reason for the visit to the oral health professional (p = 0.012). Conclusion Studies on quality of life of cancer patients are of fundamental importance for understanding the impact of oral health problems on quality of life.

RESUMO Objetivo Avaliar o impacto produzido por problemas bucais na qualidade de vida; e examinar a associação com as variáveis sociodemográficas, odontológicas e de estadiamento clínico em mulheres com diagnóstico de câncer de mama. Métodos Estudo observacional transversal. Amostra composta por 89 mulheres atendidas em um hospital de referência em Vitória, Espírito Santo, Brasil, entre janeiro e dezembro de 2012. Utilizaram-se dois roteiros na forma de entrevista, um para registro das informações das participantes; e o Oral Health Impact Profile (OHIP-14), para avaliar os impactos produzidos pela condição bucal sobre a qualidade de vida. Realizou-se análise descritiva dos dados. A comparação dos percentuais das dimensões do impacto com as variáveis independentes foi verificada pelo teste qui-quadrado ou pelo teste exato de Fisher, quando apropriado. Para avaliar a força da associação entre evento e exposição, calculou-se o odds ratio. Adotou-se o nível de significância de 5%. Resultados O impacto foi de 28,1%, houve associação estatisticamente significante com as variáveis renda (p=0,039) e motivo da visita ao profissional de saúde bucal (p=0,012). Conclusão Estudos sobre qualidade de vida em pacientes oncológicos são de fundamental importância na compreensão do impacto dos problemas bucais em sua vida.

Associação das Manifestações Bucais com Variáveis Sociodemográficas e Clínicas em Mulheres com Câncer de Mama / Association of Oral Diseases With Sociodemographic and Clinical Variables in Women With Breast Cancer

Objetivos: Avaliar prevalência de doenças bucais e sua associação com variáveis sociodemográficas e clínicas em mulheres com diagnóstico de câncer de mama e em tratamento. Material e Métodos: Trata-se de um estudo analítico, transversal, composto por 89 participantes. Foi realizado exame clínico ­ cárie, xerostomia, gengivite e afta; entrevista utilizando um roteiro semiestruturado para coleta de dados. Realizou-se análise descritiva dos dados. Os testes exato de Fisher e qui-quadrado foram utilizados para verificar possíveis associações, considerou-se nível de significância de 5%. Resultados: Mulheres acima de 50 anos de idade representaram 25,8% da população estudada, ensino fundamental incompleto (36%), raça/cor branca (64%), condição socioeconômica C (57,3%) e renda de até dois salários mínimos (38,2%). Houve predomínio da necessidade de uso de prótese (60,7%) devido ao grande número de dentes perdidos (média de 17,9). As pacientes com maior faixa etária apresentaram maior prevalência de xerostomia e maior número de dentes extraídos. Conclusão: Houve alterações bucais de associação aos tratamentos do câncer, como a necessidade de próteses dentárias, xerostomia, gengivites e aftas. Com o aumento da faixa etária, aumentouse também a extração dos dentes, a prevalência da xerostomia e da gengivite. Xerostomia esteve associada a raça/cor branca e uso de anti-hipertensivos. (AU)

Objective: To evaluate the prevalence of oral diseases and their association with sociodemographic and clinical variables in women diagnosed with breast cancer undergoing treatment. Material and Methods: This is an analytical, crosssectional study, composed of 89 participants. Clinical examination was performed to check for dental caries, xerostomia, gingivitis and cold sore. Participants were interviewed using a semistructured script and the data were analyzed descriptively. Fisher's exact and chi-square tests were used to verify possible associations, with a 5%significance level. Results: Women aged over 50 years accounted for 25.8% of the study population, with a predominance of incomplete elementary school (36%), White race (64%), socioeconomic condition "C class" (57.3%) and income up to two minimum wages (38.2%). There was a predominance of the use of dentures(60.7%) due to the large number of missing teeth (mean of 17.9). Older patients had a higher prevalence of xerostomia and a higher number of extracted teeth. Conclusion: There were oral alterations associated with cancer treatment, such as the need for dentures, xerostomia, gingivitis and canker sores. As the age range increased, tooth extraction, xerostomia prevalence and gingivitis were also increased. Xerostomia was associated with white race and use of anti hyper tensives. (AU)

Calidad de vida de mujeres con cáncer de mama en pre y postoperatorio / Qualidade de Vida de Mulheres com Câncer de Mama no Pré e Pós-Operatório / Quality of Life of Women with Pre-and Post-Operative Breast Cancer

Objective. The objective of this study was to evaluate the Quality of Life (QOL) at the pre and postoperative time of women with breast cancer submitted to surgery and to associate it with the socioeconomic class. Methods. This is a longitudinal study, performed at Santa Rita de Cássia Hospital (HSRC), Vitória - ES, Brazil. The EORTC QLQ instrument C-30 and the EORTC BR-23 were used to measure the QOL of the interviewees before and after breast surgery. Results. A population composed of 87 women, 42.5% were 60 years old or more. The socioeconomic condition C was identified as predominant among the interviewees, covering 62% of the sample (n=54). Women´s QOL in the preoperative period was better in the Physical Function dimensions for class C and D; and the Emotional was better for class B. There was improvement in QOL after surgery for Body Image in class C, and for Social Function in B. Evaluating all social classes, only the dimensions Cognitive Function and Future Perspectives improved in the postoperative period. Conclusion. The quality of life of women after breast surgery worsened in most of the studied dimensions, evidencing the need for an interdisciplinary work dedicated to the recovery and rehabilitation of these patients. (AU)

Objetivo. Evaluar la calidad de vida en los momentos antes y después de la cirugía en mujeres con cáncer de mama sometidas a tratamiento quirúrgico y su asociación con la clase socioeconómica. Métodos. Estudio longitudinal, realizado en el Hospital Santa Rita de Casia (HSRC), Vitória - ES, Brasil. Se utilizó el instrumento EORTC QLQ C-30 y la EORTC BR-23 para medir la calidad de vida de las participantes antes y después de la cirugía de mama. El criterio de clasificación económica establece la división: A1, A2, B1, B2, C1, C2, D y E, siendo, A1 la mayor renta. Resultados. El estudio incluyó 87 mujeres, el 42.5% mayores de 60 años. Se identificó como predominante en las participantes la condición socioeconómica C (62% ). La calidad de vida de las mujeres en el preoperatorio fue mejor en la dimensión de Funcionamiento Físico en las clases C y D, y en la Emocional en la clase B. Hubo mejoría en la calidad de vida después de la cirugía de la Imagen Corporal en la clase C, del Funcionamiento Social en B, y del Funcionamiento Cognitivo y de las Perspectivas de Futuro en todas las clases sociales. Conclusión. La calidad de vida de las mujeres empeora después de la cirugía de mama en una parte de las dimensiones estudiadas, lo que evidencia la necesidad de un trabajo interdisciplinario dedicado a la recuperación y rehabilitación de estas pacientes. (AU)

Objetivo. Avaliar a Qualidade de Vida no momento pré e pós-operatório de mulheres com câncer de mama submetidas à cirurgia e associar à classe socioeconômica. Métodos. Estudo longitudinal, realizado no Hospital Santa Rita de Cássia (HSRC), Vitória ­ ES, Brasil. Utilizou-se o instrumento EORTC QLQ C-30 e o EORTC BR-23 para mensurar a QV das entrevistadas antes e após cirurgia da mama. O critério de Classificação Econômica estabelece a seguinte divisão: A1, A2, B1, B2, C1, C2, D e E, sendo, A1 a maior renda. Resultados. O estudo incluiu 87 mulheres, 42.5% apresentaram 60 anos ou mais. Identificou-se a condição socioeconômica C como predominante entre as participantes (62%). A QV das mulheres no pré-operatório foi melhor nas dimensões Funcionamento Físico para a classe C e D; Emocional para a classe B. Houve melhora da QV após a cirurgia para Imagem Corporal na classe C, e para Funcionamento Social na B. Avaliando todas as classes sociais, somente as dimensões Funcionamento Cognitivo e Perspectivas Futuras melhoraram no pós-operatório. Conclusão. A qualidade de vida das mulheres após a cirurgia da mama piorou uma parte das dimensões estudadas, evidenciando necessidade de um trabalho interdisciplinar dedicado à recuperação e reabilitação dessas pacientes. (AU)

Impact of Oral Problems on the Quality Of Life of Women Subjected To Chemotherapy for Breast Cancer: A Longitudinal Study

Objective: To evaluate the impact of oral problems on the quality of life of women before and during chemotherapy for breast cancer. Material and Methods: A longitudinal study was conducted on women with breast cancer at a Hospital reference, Espírito Santo, Brazil from January 2012 to January 2013. Assessment was performed at three time-points, the first before the onset of therapeutic intervention, the second after the first chemotherapy session, and the third after the second chemotherapy session. The volunteers were assessed using interviews that included the application of the subjective indicator Oral Health Impact Profile (OHIP-14). The data were subjected to descriptive analysis based on tables of absolute and percentage frequencies relative to the OHIP-14 dimensions. McNemar's test assessed the direction of discordance, and the Kappa test measured the levels of concordance among the three assessments. The significance level was established at 5%. Results: The percent frequency of the impact of oral problems on the quality of life increased from the first (27%) to the second (49%) time-point, and functional limitation (p=0.001), physical pain (p=0.039), and physical disability (p=0.039) were statistically significant. Conclusion: Oral problems exerted a substantial impact on the volunteers' quality of life before the onset of chemotherapy, and quality of life became poorer after the onset of treatment. Patients with breast cancer require specific oral care and should be monitored before, during, and after anticancer treatment to minimize the deleterious effects of chemotherapy and improve their quality of life.