Grupos de síntomas en pacientes con cáncer gástrico gastrectomizados y su impacto sobre el estado de desempeño

Gloria Mabel Carrillo

Gloria Mabel Carrillo Facultad de Enfermería, Departamento de Enfermería. Universidad Nacional de Colombia. Sede Bogotá, Colombia

Palabras clave: Gastrectomía, Neoplasia del estómago, Análisis del clúster, Medición de síntomas

Key-words: Stomach neoplasms, Gastrectomy, Symptom assessment, Cluster analysis

Resumen

Objetivo: identificar los síntomas y el estado de desempeño en pacientes cáncer gástrico sometidos a gastrectomía. Método: estudio descriptivo que contó con 240 pacientes con cáncer gástrico sometidos a gastrectomía en dos hospitales de oncología en Bogotá (Colombia). Se utilizó un instrumento que mide síntomas y la escala de Karnofsky. Resultados: se identificaron 5 clúster de síntomas, así molestias físicas asociadas con el tratamiento del cáncer gástrico; sufrimiento emocional en relación consigo mismo; molestias físicas-independencia y energía; sufrimiento emocional en relación con los demás; molestias físicas que afectan de manera especial la identidad e intercambio. Dos de los cinco clúster influyen el estado de desempeño del paciente. Conclusiones: se requieren generar intervenciones en la transición y egreso hospitalario de adultos con cáncer gástrico posgastrectomizados que incluyan como eje central la valoración e intervención sobre los síntomas emocionales y físicos, lo que redundará en mejoramiento de su desempeño.

Abstract

Objective: to identify the symptoms and the performance status in patients with gastric cancer, who have undergone a gastrectomy and the influence of the symptom groups on their performance status. Methods: 240 patients with gastric cancer where included, who had been practiced gastrectomy with some time longer than 30 days after the oncologic surgery, and even 48 months in two centers in Bogotá, Colombia. A structured instrument, which measures symptoms and Karnofsky’s scale were used. Results: 5 clusters of symptoms were identified: Physical complaints associated with treatment of gastric cancer; emotional suffering in relation to self; physical complaints-independence and energy; emotional suffering in relation to others; physical complaints that particularly affect the identity. Two of the five clusters have influenced the performance status. Conclusion: this study contributes to the need of creating assistance in hospital staying and leaving in adult patients with gastric cancer, who have gone gastrectomy, which includes as the central focus the assessment and intervention of emotional and physical symptoms.

Bibliografía

1. Ang TL, Fock TL. Clinical epidemiology of gastric cancer. Singapur Med J. 2014; 40:250-60.
2. Agency for Research on Cancer (IARC). 2014. Estadísticas de cáncer en el mundo. Disponible en http://globocan.iarc.fr/Pages/fact_sheets_population.aspx?country=900 [acceso: 15/05/2017].
3. Blanco O, Cantillo A, Rivera J. Enfoque actual del cáncer gástrico. Medicas UIS. 2013; 26(2):59-70.
4. Van Cutsem E, Van de Velde C, Roth A, Lordick F, Köhne CH, Cascinu S, Aapro M. Expert opinion on management of gastric and gastro-oesophageal junction adenocarcinoma on behalf of the European Organisation for Research and Treatment of Cancer (EORTC)-gastrointestinal cancer group. European Journal of Cancer. 2008; 44(2); 182–94.
5. Csendes A, Figuero M. Situación del cáncer gástrico en el mundo y en Chile. Revista Chilena de Cirugía 2017; 69(6): 502-507.
6. Nakamura M, Kido Y, Egawa T. Development of a 32-item scale to assess postoperative dysfunction after upper gastrointestinal cancer resection. Journal of Clinical Nursing 2008; 17(11): 1440–9.
7. Javier M, Loarte A, Pilco P. Nutritional evaluation in patients with total and partial gastrectomy for gastric adenocarcinoma. Rev Gastroenterol Peru. 2008; 28(3):239-43.
8. Conroy T, Marchal F, Blazeby JM. Quality of life in patients with oesophageal and gastric cancer: an overview. Oncology 2006; 70(6):391–402.
9. Parameswaran R, McNair A, Avery KN, Berris-ford RG, Wajed SA, Sprangers MA, et al. The role of health-related quality of life outcomes in clinical decision making in surgery for esophageal cancer: a systematic review. Ann Surg Oncol. 2008; 15 (9):2372–9.
10. Dorcaratto D, Grande L, Ramon J, Pera L. Quality of life of patients with cancer of the oeso-phagus and stomach. Cirugia Española 2011; 89(10):635-44.
11. Avery K, Hughes R, McNair A, Alderson D, Barham P, Blazeby J. Health-related quality of life and survival in the 2 years after surgery for gastric cancer. Eur J Surg Oncol. 2010; 36(2):148–54.
12. Kobayashi D, Kodera Y, Fujiwara M, Koike M, Nakayama G, Nakao A. Assessment of quality of life after gastrectomy using EORTC QLQ-C30 and STO22. World J Surg. 2011; 35(2):357–64.
13. Lee S, Chung H, Kwon OK, Yu W. Quality of life in cancer survivors 5 years or more after total gastrectomy: A case-control study. Int J Surg. 2014; 12(7):700-705.
14. Tyrvainen T, Sand H, Sintonen H, Nordback I. Quality of life in the long-term survivors after total gastrectomy for gastric carcinoma. J Surg Oncol. 2008; 97(2): 121-124.
15. Nakamura M, Nakamori M, Ojima T, Katsuda M, Takeshi L, Hayata K, et al. Reconstruction after proximal gastrectomy for early gastric cancer in the upper third of the stomach: An analysis of our 13-year experience. Surgery 2014; 156(1): 57-63.
16. Jericó C, Bretón I, García A, Oliveira A, Rubio MA, Tinahones F, Vidal J, Vilarrasa N. Diagnosis and treatment of iron deficiency, with or without anemia, before and after bariatric surgery. Endocrinología y Nutrición 2016; 63(1): 32–42.
17. Bolton JC, Conway C. Postgastrectomy Syn-dromes. Surg Clin North Am. 2011; 91(5): 1105–22.
18. Karanicolas PJ, Graham D, Gonen M, Strong V, Brennan MF, Coit DG. Quality of life after gastrectomy for adenocarcinoma: a prospective cohort study, Ann. Surg. 2013; 257(6):1039-1046.
19. Sánchez B, Carrillo G, Cárdenas D, Alarcón A. Design, facial and content validation of the instru-ment “Burden of chronic illness for the patient - GCPC-UN”. Rev. Med. Risaralda. 2017; 23 (1):17 – 21.
20. Humphreys J, Janson S, Donesky D, Dracup K, Lee K, Puntillo K, et al. Theory of symptom management. In Smith M and Liehr P (Eds.). Middle Range Theory for Nursing (Third edi). Nw York: Springer Publishing Company, 2014.
21. Puiggro C, Lecha M, Rodríguez T, Perez-Portabella C, Planas M. Karnosfsky index as a mortality predicting factor in patients on home-based enteral nutrition. Nutr Hosp. 2009; 24(2): 156-160.
22. Otero W. Cáncer gástrico en Colombia: un diagnóstico tardío que amerita el compromiso del estado. Rev Col Gastroenterol. 2008; 23(4):302-4.
23. Adrada J, Calambás F, Díaz J, Delgado D, Sierra C. The socio-demographic and clinical cha-racteristics in gastric cancer population in the De-partment of Cauca, Colombia. Rev Col Gastroente-rol. 2008; 23 (4): 309-313.
24. Lee MS, Ahn SH, Lee JH, Park DJ, Lee HJ, Kim HH, Yang HK, Kim N, Lee WW. What is the best reconstruction method after distal gastrectomy for gastric cancer? Surg. Endosc. 2012; 26(6): 1539-1546.
25. Smolskas E, Lunevicius R, Samalavicius N. Quality of life after subtotal gastrectomy for gastric cancer: Does restoration method matter?-A retros-pective cohort study. Ann Med Surg (Lond). 2015; 4(4): 371-375.
26. Cano A. Control emocional, estilo represivo de afrontamiento y cáncer. Psicooncología 2005; 2(1): 71-80.
27. Bae JM, Kim S, Kim YW, Ryu KW, Lee JH, Noh JH, et al. Health-related quality of life among disease-free stomach cancer survivors in Korea. Qual Life Res. 2006; 15 (10):1587–96.
28. Dodd M J, Cho MH, Cooper B, Miaskowski C. The effect of symptom clusters on functional status and quality of life in women with breast cancer. European Journal of Oncology Nursing. Eur J Oncol Nurs. 2010; 14(2): 101–10.
29. Sánchez L, Rihuete MI. Influencia de las distor-siones sensoriales sobre el estado nutricional del paciente oncológico. Index de Enfermería 2016; 25(4): 233-237.
30. Beck SL, Dudley WN, Barsevick A. Pain, sleep disturbance, and fatigue in patients with cancer : Using a Mediation Model to Test a Symptom Cluster. Oncol Nurs Forum. 2005; 32(3): 542.
31. Ferreira KA, Kimura M, Teixeira MJ, Mendoza TR, da Nóbrega JC,Graziani SR, Takagaki TY. Impact of cancer-related symptom synergisms on health-related quality of life and performance status. Journal of Pain and Symptom Management. 2008; 35(6): 604–16.

Grupos de síntomas en pacientes con cáncer gástrico gastrectomizados y su impacto sobre el estado de desempeño

Symptom cluster in patients with gastric cancer who have undergone a postgastrectomy and its impact on the performance status

Resumen

Abstract

Bibliografía