A representação da doença e o coping na pessoa com tumor do aparelho locomotor

Abstract

As part of the evidence of practice, in the context of providing nursing care to individuals with bone and soft tissue tumors, we found that malignant disease causes drastic changes in lifestyle of individuals for which they are unprepared, lacking adequate strategies to adapt to the new life situation. This process is sudden and unexpected, and is influenced by the image that individuals have of their illness. The aim of this study is to better understand the disease representation and coping strategies of individuals with soft and bone tissue tumors. The deepening of knowledge about the representation of disease in individuals with locomotor system tumors, will allow to identify nursing focus of intervention in the adaptation area in order to help individuals with bone and soft tissue tumors in its transition process. In the attempt to understand this phenomenon, we conducted a descriptive, correlational study, through wich we tried to identify the representation of the disease, and determine the existence of a relationship with coping strategies and sociodemographic and clinical data. The sample study comprises 64 patients with bone and soft tissue tumors, a week after starting chemotherapy treatment, in the period from January to June 2009, admitted in Orthopaedics B - Soft and Bone Tissue Tumors Unit, of Hospitais da Universidade de Coimbra (HUC). Thus, we used a non-probability accidental sample consisting of individuals between 40-49 years, divided between the two genders (34 males and 30 females), with the tertiary level education (40.60%). Regarding the professional categorization, the sample individuals are mainly semi-skilled workers, small businessmen and landowners, of which 67.20% are active. As clinical variables we have the time elapsed since the diagnosis of bone and soft tissue tumor and the experience of previous forms of chronic disease. The most frequent symptoms refered were vomiting/nausea and fatigue corresponding to 82.80% of the sample, followed by hair loss that corresponds to 62.50% of the sample. To obtain a reliable representation of the variables under study, we used three data collection tools: a socio-demographic questionnaire, the Illness Perception Questionnaire Revised (IPQ-R) and Problem-Solving Inventory (IRP). We found that the surveyed individuals have a strong disease representation that explains, through a linear regression model, 79.90% coping strategies used. In this sense, individuals who perceive to be living a chronic illness ("Length acute/chronic”),who have the perception to be living a recurrent disease ("Length cyclical") and that individuals attach emotional meanings to illness (“Emotional Representation”), use more coping strategies in general. The coping strategies more often used by individuals in the sample, are "Active confrontation and resolution of problems", "Strategies for emotions control " and "Aggressiveness internalized / externalized”. The illness representation varies with the time of tumor diagnosis, whereas the factor "Consistency of disease” increases with the time elapsed after the tumor diagnosis, and the factor “Emotional representation" decreases as the time elapsed after tumor diagnosis increases. We also found that the illness representation is negatively correlated with age in the factors "Duration (acute/cyclic)" and "Personal control", ie as age increases, the representation of the disease reduces the factors "Length (acute/ cycle) "and "Personal control ".

Date of Award	2010
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Paulo Joaquim Pina Queirós (Supervisor)