Quality of life in dysphagia and functional performance of cancer patients in palliative care

TL;DR

This study explores how swallowing difficulties affect the quality of life and functional abilities of cancer patients in palliative care.

Contribution

It identifies a moderate correlation between dysphagia severity and functional performance in palliative care cancer patients.

Findings

Outpatients showed a moderate correlation between MDADI scores and PPS functionality.

Common cancer sites were pancreas and stomach, with patients showing reduced ambulation but maintained self-care.

Dysphagia was found to significantly impact quality of life in palliative care settings.

Abstract

To correlate the functional performance and impact of dysphagia on the quality of life of cancer patients in palliative care.

This cross-sectional, quantitative study was conducted at the outpatient clinic and oncology ward of a university hospital. Inclusion criteria required patients to respond positively to the question: “Do you have difficulty or problems swallowing?”. Patients were excluded if they had been diagnosed with head and neck cancer, were unable to answer questionnaires due to actively dying status, were in a state of drowsiness, experienced extreme pain and systemic instability, or if data collection instruments were incomplete. Two instruments were used in their Brazilian Portuguese versions: the Palliative Performance Scale (PPS) and the M. D. Anderson Dysphagia Inventory (MDADI). The variables were analyzed using descriptive and inferential statistics, with Pearson's correlation used at a 5% significance level.

The sample consisted of 39 participants, with an average age of 65.3 years, of whom 24 (61.5%) were women. The most frequent neoplasm sites were the pancreas and stomach. The results of the PPS indicated that the average patient had reduced ambulation and inability to work, but maintained independence in self-care, with a complete level of swallowing and consciousness. The MDADI showed an average degree of limitation. Outpatients exhibited a moderate correlation between the MDADI result and the level of functionality according to the PPS.

Cancer patients at the palliative care outpatient clinic demonstrated a correlation between functional performance and the impact of dysphagia on quality of life.

Correlacionar a performance funcional e impacto da disfagia na qualidade de vida de pacientes oncológicos em cuidados paliativos.

Estudo transversal e quantitativo realizado no ambulatório e enfermaria de oncologia de um hospital universitário. Os critérios de inclusão exigiram que os pacientes respondessem positivamente à pergunta: “você tem dificuldade ou problema para engolir?”. Foram excluídos os pacientes que tivessem diagnóstico de câncer de cabeça e pescoço, incapacidade de responder questionários devido a estarem em processo ativo de morte, estado de sonolência, dor extrema e instabilidade sistêmica, bem como os instrumentos de coleta que não foram concluídos. Foram aplicados dois instrumentos em suas versões para o português brasileiro: a Palliative Performance Scale (PPS) e M. D. Anderson Dysphagia Inventory (MDADI). A análise das variáveis foi realizada com base na estatística descritiva e inferencial, por meio da correlação de Pearson, em nível de significância de 5%.

A amostra foi composta por 39 participantes, com média de 65,3 anos, dos quais 24 (61,5%) eram mulheres. As localizações mais frequentes de neoplasia foram: pâncreas e estômago. O resultado da PPS indicou que a média dos pacientes apresentou deambulação reduzida, incapacidade para trabalhar, porém com independência no autocuidado, nível de ingesta e consciência completos e o MDADI obteve grau médio de limitação. Pacientes ambulatoriais apresentaram correlação moderada entre o resultado do MDADI e nível de funcionalidade pela PPS.

Pacientes oncológicos do ambulatório de cuidados paliativos apresentaram correlação entre performance funcional e o impacto da disfagia na qualidade de vida.