Predictors and quality of life in patients with radiodermatitis: a longitudinal study

Rocha, Daniel de Macêdo; Pedrosa, Aliny de Oliveira; Oliveira, Aline Costa de; Benício, Claudia Daniella Avelino Vasconcelos; Santos, Ana Maria Ribeiro dos; Nogueira, Lídya Tolstenko

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Original Article • Acta Paul Enferm. 34 • 2021 • https://doi.org/10.37689/acta-ape/2021AO01063 copy

Predictors and quality of life in patients with radiodermatitis: a longitudinal study

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To analyze sociodemographic, clinical and therapeutic predictors and quality of life in patients with radiodermatitis.

Methods:

This longitudinal study was conducted with 196 participants who developed skin reactions as an adverse event to radiotherapy treatment. A form was used for clinical characterization and evaluation, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core30 instrument was used for measuring the quality of life in two stages. Data analysis consisted of the Wilcoxon, Mann-Whitney and Kruskal-Wallis tests, considering a statistically significant difference for p<0.05.

Results:

The comparison between scores of the quality of life showed that radiodermatitis contributed to the worsening of overall health status and quality of life, deterioration of functional capacity, financial difficulty and intensification of emotional reactions and physical symptoms such as anxiety, depression, pain, fatigue, insomnia and appetite loss. Factors such as sex, income, educational level, concomitant chemotherapy, anatomical location of the injury and degre of tissue destruction were determinant for the greater impairment of global scores. Thus, the need for nursing interventions that favor the identification of predictors and care optimization based on clinical guidelines and recommendations.

Conclusion:

Radiodermatitis negatively influenced the quality of life of patients, had a high impact associated with a greater degree of tissue destruction and the main predictors were clinical and therapeutic aspects. Studies of this nature are essential for the formulation of effective, integrated, sustainable and evidence-based public policies aimed at preventing, controlling and treating the injury.

Keywords
Neoplasms; Radiotherapy; Radiodermatitis; Quality of life

Scales and domains		First evaluation	Second evaluation	p-value
Scales and domains		A ± SD	A ± SD	p-value
Overall health and QoL		76.5 ± 15.7	35.5 ± 18.5	<0.001 ^* * Significant difference for p < 0.05
Functioning
	Physical	84.8 ± 20.4	65.8 ± 25.3	<0.001 ^* * Significant difference for p < 0.05
	Role functioning	77.9 ± 24.7	48.9 ± 31.0	<0.001 ^* * Significant difference for p < 0.05
	Emotional	77.8 ± 21.4	41.8 ± 29.56	<0.001 ^* * Significant difference for p < 0.05
	Cognitive	89.2 ± 16.0	82.6 ± 23.5	<0.001 ^* * Significant difference for p < 0.05
	Social	85.9 ± 18.2	58.4 ± 28.3	<0.001 ^* * Significant difference for p < 0.05
Symptoms
	Fatigue	19.1 ± 16.7	50.9 ± 22.9	<0.001 ^* * Significant difference for p < 0.05
	Nausea and vomiting	10.5 ± 18.0	18.0 ± 27.8	<0.001 ^* * Significant difference for p < 0.05
	Pain	5.1 ± 11.3	40.1 ± 25.1	<0.001 ^* * Significant difference for p < 0.05
	Dyspnea	3.4 ± 11.6	4.5 ± 12.8	0.108
	Insomnia	21.9 ± 27.7	54.1 ± 35.3	<0.001 ^* * Significant difference for p < 0.05
	Appetite loss	16.2 ± 24.3	40.8 ± 38.6	<0.001 ^* * Significant difference for p < 0.05
	Constipation	11.0 ± 22.9	9.6 ± 18.7	0.401
	Diarrhea	8.8 ± 21.3	7.2 ± 14.5	0.257
	Financial difficulty	51.8 ± 37.6	80.6 ± 30.5	<0.001 ^* * Significant difference for p < 0.05

Scales and domains / Variables		Sex	Marital Status	Educational level	Income	Cancer location	Nr. of sessions	Chemotherapy
Scales and domains / Variables		p-value	p-value	p-value	p-value	p-value	p-value	p-value
Overall health and QoL		0.095	0.793	0.489	0.522	0.106	0.652	0.002 ^* * Significant difference for p <0.05
Functioning
	Physical	0.878	0.706	0.964	0.412	0.015 ^* * Significant difference for p <0.05	0.036 ^* * Significant difference for p <0.05	0.026 ^* * Significant difference for p <0.05
	Role functioning	0.008 ^* * Significant difference for p <0.05	0.046 ^* * Significant difference for p <0.05	0.732	0.152	0.074	0.440	0.003 ^* * Significant difference for p <0.05
	Emotional	0.010 ^* * Significant difference for p <0.05	0.951	0.061	0.421	0.07	0.307	0.133
	Cognitive	0.906	0.157	0.018 ^* * Significant difference for p <0.05	0.151	0.549	0.129	0.678
	Social	0.584	0.023 ^* * Significant difference for p <0.05	0.620	0.331	0.437	0.291	0.118
Symptoms
	Fatigue	0.018 ^* * Significant difference for p <0.05	0.607	0.526	0.008 ^* * Significant difference for p <0.05	0.026 ^* * Significant difference for p <0.05	0.356	0.001 ^* * Significant difference for p <0.05
	Nausea and vomiting	0.191	0.506	0.420	0.586	0.01 ^* * Significant difference for p <0.05	0.763	0.001 ^* * Significant difference for p <0.05
	Pain	0.609	0.664	0.299	0.401	0.488	0.494	0.001 ^* * Significant difference for p <0.05
	Dyspnea	0.127	0.212	0.995	0.967	0.195	0.005 ^* * Significant difference for p <0.05	0.016 ^* * Significant difference for p <0.05
	Insomnia	0.018 ^* * Significant difference for p <0.05	0.563	0.648	0.517	0.210	0.182	0.138
	Apetite loss	0.146	0.172	0.854	0.392	0.025 ^* * Significant difference for p <0.05	0.198	0.001 ^* * Significant difference for p <0.05
	Constipation	0.677	0.001 ^* * Significant difference for p <0.05	0.568	0.701	0.014 ^* * Significant difference for p <0.05	0.128	0.285
	Diarrhea	0.083	0.119	0.873	0.774	0.001 ^* * Significant difference for p <0.05	0.18	0.19
	Financial difficulty	0.133	0.716	0.033 ^* * Significant difference for p <0.05	0.001 ^* * Significant difference for p <0.05	0.669	0.229	0.645

Scales and domains/ location and clinical characteristics		Head and neck	Breast	Vaginal	Inguinal	Grade	Type of tissue	Quantity of exsudate
Scales and domains/ location and clinical characteristics		p-value	p-value	p-value	p-value	p-value	p-value	p-value
Overall health and QoL		0.035 ^* * Significant difference for p <0.05	0.180	0.134	0.045 ^* * Significant difference for p <0.05	<0.001 ^* * Significant difference for p <0.05	<0.001 ^* * Significant difference for p <0.05	<0.001 ^* * Significant difference for p <0.05
Functioning
	Physical	0.957	0.017 ^* * Significant difference for p <0.05	0.831	0.018 ^* * Significant difference for p <0.05	<0.001 ^* * Significant difference for p <0.05	<0.001 ^* * Significant difference for p <0.05	0.007 ^* * Significant difference for p <0.05
	Role functioning	0.144	0.188	0.886	0.003 ^* * Significant difference for p <0.05	<0.001 ^* * Significant difference for p <0.05	<0.001 ^* * Significant difference for p <0.05	0.002 ^* * Significant difference for p <0.05
	Emotional	0.366	0.199	0.805	0.807	0.759	0.892	0.508
	Cognitive	0.111	0.825	0.903	0.340	0.002 ^* * Significant difference for p <0.05	0.046 ^* * Significant difference for p <0.05	<0.001 ^* * Significant difference for p <0.05
	Social	0.020 ^* * Significant difference for p <0.05	0.504	0.942	0.003 ^* * Significant difference for p <0.05	<0.001 ^* * Significant difference for p <0.05	<0.001 ^* * Significant difference for p <0.05	<0.001 ^* * Significant difference for p <0.05
Symptoms
	Fatigue	0.065	0.191	0.063	0.726	0.020 ^* * Significant difference for p <0.05	0.020 ^* * Significant difference for p <0.05	0.259
	Nausea and vomiting	0.03 ^* * Significant difference for p <0.05	0.947	0.105	0.671	<0.001 ^* * Significant difference for p <0.05	<0.001 ^* * Significant difference for p <0.05	<0.001 ^* * Significant difference for p <0.05
	Pain	0.538	0.412	0.793	0.173	0.381	0.550	0.391
	Dyspnea	0.392	0.225	0.817	0.141	0.022 ^* * Significant difference for p <0.05	0.013 ^* * Significant difference for p <0.05	0.016 ^* * Significant difference for p <0.05
	Insomnia	0.108	0.602	0.039 ^* * Significant difference for p <0.05	0.032 ^* * Significant difference for p <0.05	0.001 ^* * Significant difference for p <0.05	<0.001 ^* * Significant difference for p <0.05	0.070
	Apetite loss	0.518	0.251	0.361	0.996	0.039 ^* * Significant difference for p <0.05	0.183	0.350
	Constipation	0.066	0.584	0.454	0.938	0.553	0.871	0.116
	Diarrhea	0.036 ^* * Significant difference for p <0.05	0.754	0.006 ^* * Significant difference for p <0.05	0.116	<0.001 ^* * Significant difference for p <0.05	<0.001 ^* * Significant difference for p <0.05	<0.001 ^* * Significant difference for p <0.05
	Financial difficulty	0.997	0.083	0.799	0.182	0.001 ^* * Significant difference for p <0.05	<0.001 ^* * Significant difference for p <0.05	0.002 ^* * Significant difference for p <0.05

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
E-mail: actapaulista@unifesp.br

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[1] Corresponding Author Daniel de Macêdo Rocha, E-mail: daniel_m.rocha@outlook.com.br