Metástase de câncer de mama: eficácia adaptativa e funcionamento global

Abstract

Breast cancer is the second most frequent type of cancer in the world, and the most common among women, representing around 22% of new cases each year. Considering that most cases of breast cancer are still diagnosed in advanced stages of the illness, there is a great possibility of compromising regional lymph nodes and developing metastasis in the distance, that is, the spread of the illness to other organs and tissues. Thus, this study aims to check and correlate the adaptive efficacy and the global functioning of women with breast cancer metastasis. Six women with breast cancer metastasis, attended at Malignant Mastology Sector, at Clinics Hospital of Federal University of Uberlândia (HC/UFU), took part in this study. The following procedures were followed: Preventive Clinical Interview, the Operational Adaptive Diagnostic Scale (EDAO), in its two evaluation proposals, EDAO and EDAO/R, as well as the Global Assessment of Functioning Scale (GAF). Concerning the classification of this study´s participants´ adaptive efficacy, the results, show that Gerbera, Tulip and Gardenia presented non effective moderate adaptation, without crisis, Group III; and Rose, Amaryllis and Violet presented non effective severe adaptation, without crisis, Group V, according to the EDAO. According to the EDAO/R, Gardenia presented ineffective light adaptation, without crisis, Group 2; Gerbera, Tulip and Violet presented ineffective moderate adaptation, without crisis, Group 3; and Rose and Amaryllis presented ineffective severe adaptation, without crisis, Group 4. Concerning the classification of participants´ global functioning, the results show that Gerbera and Gardenia belong in the 61 to 70 range, indicating some light symptoms or some difficulty in occupational and social functioning; Tulip belongs in the 51 to 60 range, showing moderate symptoms or difficulty in occupational and social functioning; Amaryllis and Rose fit the 41 to 50 range, presenting serious symptoms or loss in the social or occupational functioning; Violet, though, couldn´t be classified, due to the fact that, in part, fits the 71 to 80 range, indicating if present, temporary symptoms, consisting of predictable reactions to psychosocial stressors; and, in part, in the 21 to 30 range, indicating incapacity of functioning in the occupational area. The results also show statistically significant differences between: the adaptive efficacy degree and respective variations, according to the two evaluation proposals of EDAO, which is EDAO > EDAO/R; positive correlations between adaptation values, according to the EDAO and EDAO/R; positive correlation between the sum values of affective-relational (A-R) and productivity (Pr) sectors adequacy, by the EDAO and of these sectors by the redefinition, EDAO/R, that is, by adaptation of EDAO/R; sector Pr and EDAO adequacy; and social-cultural (SC) and EDAO sector adequacy; negative correlation, statistically significant, between the adaptive efficacy values and SC sector negative factors; positive correlations, statistically significant between the GAF scale score and the A-R, Pr and SC sectors adequacy sum, according to EDAO; between the GAF scale score and the adaptation, by the EDAO, and between the GAF scale score and the EDAO/R. We conclude that the first EDAO evaluation proposal was more sensitive than the EDAO/R and GAF to evaluate the adaptive efficacy and global functioning of women with breast cancer metastasis, once it is more extensive and considers the personality functioning in a whole.