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Abstract(s)
Introdução: O distress psicológico é um fenómeno de extrema relevância em doentes oncológicos devido à sua alta prevalência, sobretudo quando os diagnósticos de cancro são cada vez mais frequentes. Estima-se que apenas um terço dos doentes com níveis de distress clinicamente significativos são direcionados para serviços de saúde mental. Reforça-se ainda que a maioria dos centros clínicos carecem de recursos para rastreios do distress. Assim sendo, o distress é uma condição psicológica debilitante que afeta o sujeito a nível físico, psicológico, social, espiritual e ocupacional, sendo entendido por um continuum que varia em grau de gravidade. Objetivos: Este estudo propõe reunir de forma sistemática informação relevante à operacionalização do distress, bem como aos instrumentos utilizados para avaliação deste processo. Para além desta componente de estado da arte, o trabalho propõe-se a incluir uma componente de revisão crítica, pretendendo contribuir para uma proposta futura de melhoria tanto para a operacionalização do distress como a avaliação do mesmo. Método: Os dados incluídos nesta revisão sistemática foram recolhidos através da seguinte meta base de dados: EBSCO, e as seguintes bases de dados: PsycArticles, PubMED e SCOPUS. Apenas foram selecionados artigos publicados depois de 2014 tendo em consideração critérios de inclusão e exclusão previamente definidos. Resultados: Importaram-se 1028 referências e foram excluídos 54 artigos duplicados. Entre as 974 referências, 934 foram excluídas por possuírem título, palavras-chave ou resumo incompatíveis com os objetivos traçados ao longo da investigação. Finalmente, com os 40 artigos obtidos, 3 foram excluídos pelo estudo de sobreviventes oncológicos de longa duração, 1 por ter uma população não oncológica e 9 não expressaram um foco sobre o distress, resultando em 27 artigos incluídos nesta revisão sistemática. Discussão: A maioria dos estudos obtidos não discrimina os participantes em função do diagnóstico ou protocolo de tratamento. Tal observação induz alguma preocupação, visto que o nível de distress varia consoante as variáveis previamente mencionadas. Assim, existe um risco em agrupar doentes oncológicos com níveis de distress dispersos que, por consequência, podem influenciar os resultados obtidos, a discussão e a conclusão consequentes. A definição do distress pelo NCCN é uma das mais utilizadas e completas no que concerne a captação da experiência que se revela tendencialmente negativa, de um doente oncológico. A avaliação do distress é tendencialmente marcada pelo recurso a Emotion Thermometers (ET), nomeadamente o Distress Thermometer (DT) e a Problem List (PL), como complemento e contexto aos resultados obtidos. A literatura analisada revela que a operacionalização do distress e a sua respetiva avaliação são frequentemente expostas a visões reducionistas, possivelmente insuficientes na compreensão total da vivência de um doente oncológico. Conclusão: A psico-oncologia precisa de melhorar a compreensão e avaliação do distress em pacientes oncológicos. A falta de uma visão holística e homogénea, bem como a utilização de instrumentos reducionistas, são problemas comuns. Apela-se a uma compreensão mais completa do distress como necessária para avaliar e comunicar de forma eficaz com outros profissionais de saúde e os respetivos doentes.
Introduction: Psychological distress is an extremely relevant phenomenon in cancer patients due to its high prevalence, especially when cancer diagnoses are increasingly frequent. It is estimated that only a third of patients with clinically significant levels of distress are referred to mental health services. To reinforce this point, most health centers lack the resources to screen for distress. Distress is a debilitating psychological condition that affects the subject on a physical, psychological, social, spiritual, and occupational level and is understood as a continuum that varies in its degree of severity. Objectives: To add relevant information to the operationalization of distress, as well as the instruments used. In addition to this compilatory component, the current work contains a critical thinking component in relation to them, making a future proposal for improvement in both the operationalization of distress and its assessment. Method: The compiled data for this systematic review was collected through the following metadatabase: EBSCO and the following databases: PsycArticles, PubMED, and SCOPUS. Only those published after 2014 were selected, considering previously defined inclusion and exclusion criteria. Results: A total of 1028 references were imported, and 54 duplicate articles were excluded. Of the 974 references, 934 were excluded because they had titles, keywords, or abstracts that were incompatible with the research objectives. Finally, of the 40 articles obtained, 3 were excluded for having cancer survivors, 1 for having a non-oncology population, and 9 did not express a focus on distress, resulting in 27 articles included in this systematic review. Discussion: Most of the studies obtained do not discriminate between participants according to diagnosis or treatment protocol. This observation causes some concern, since the level of distress varies according to the variables mentioned above. Thus, there is a risk in grouping together cancer patients with dispersed levels of distress which, consequently, could influence the results obtained and the resulting discussion and conclusion. The NCCN's definition of distress is one of the most widely used and complete when it comes to capturing an oncology patient's experience, which tends to be negative. The assessment of distress tends to be marked by the use of Emotion Thermometers (ET), namely the Distress Thermometer (DT) and the Problem List (PL), as a complement and context to the results obtained. The literature analyzed reveals that the operationalization of distress and its assessment are often exposed to reductionist views, which are possibly insufficient to fully understand the experience of a cancer patient. Conclusion: Psycho-oncology needs to improve the understanding and assessment of distress in cancer patients. The lack of a holistic and homogeneous vision, as well as the use of reductionist instruments are common problems. A more complete understanding of distress is called for as necessary to assess and communicate effectively with other health professionals and their patients.
Introduction: Psychological distress is an extremely relevant phenomenon in cancer patients due to its high prevalence, especially when cancer diagnoses are increasingly frequent. It is estimated that only a third of patients with clinically significant levels of distress are referred to mental health services. To reinforce this point, most health centers lack the resources to screen for distress. Distress is a debilitating psychological condition that affects the subject on a physical, psychological, social, spiritual, and occupational level and is understood as a continuum that varies in its degree of severity. Objectives: To add relevant information to the operationalization of distress, as well as the instruments used. In addition to this compilatory component, the current work contains a critical thinking component in relation to them, making a future proposal for improvement in both the operationalization of distress and its assessment. Method: The compiled data for this systematic review was collected through the following metadatabase: EBSCO and the following databases: PsycArticles, PubMED, and SCOPUS. Only those published after 2014 were selected, considering previously defined inclusion and exclusion criteria. Results: A total of 1028 references were imported, and 54 duplicate articles were excluded. Of the 974 references, 934 were excluded because they had titles, keywords, or abstracts that were incompatible with the research objectives. Finally, of the 40 articles obtained, 3 were excluded for having cancer survivors, 1 for having a non-oncology population, and 9 did not express a focus on distress, resulting in 27 articles included in this systematic review. Discussion: Most of the studies obtained do not discriminate between participants according to diagnosis or treatment protocol. This observation causes some concern, since the level of distress varies according to the variables mentioned above. Thus, there is a risk in grouping together cancer patients with dispersed levels of distress which, consequently, could influence the results obtained and the resulting discussion and conclusion. The NCCN's definition of distress is one of the most widely used and complete when it comes to capturing an oncology patient's experience, which tends to be negative. The assessment of distress tends to be marked by the use of Emotion Thermometers (ET), namely the Distress Thermometer (DT) and the Problem List (PL), as a complement and context to the results obtained. The literature analyzed reveals that the operationalization of distress and its assessment are often exposed to reductionist views, which are possibly insufficient to fully understand the experience of a cancer patient. Conclusion: Psycho-oncology needs to improve the understanding and assessment of distress in cancer patients. The lack of a holistic and homogeneous vision, as well as the use of reductionist instruments are common problems. A more complete understanding of distress is called for as necessary to assess and communicate effectively with other health professionals and their patients.
Description
Keywords
Distress Psicológico Doentes Oncológicos Instrumentos de Avaliação do Distress Psico-Oncologia Revisão Sistemática Saúde Mental