Impacto da reabilitação bucomaxilofacial sobre o estado nutricional, sintomas depressivos, autoimagem, autoestima e qualidade de vida em adultos e idosos

Abstract

The high number about new cases of cancer on the head and neck registered every year, with emphasis on the elderly, draws the attention of professionals, managers and health researchers. This study is semiexperimental Coorte, and was conducted to evaluate the impact of maxillofacial rehabilitation on nutritional status, depression, self-image, self-esteem and quality of life in adults and elderly patients with deformities of the face and oral cavity. The sample consisted of 41 patients treated at the Maxillofacial Rehabilitation of the Lauro Wanderley University Hospital of the Federal University of Paraíba, in João Pessoa -PB, from January 2011 to December 2013. The clinical record was applied to define the sociodemographic characteristics and the history of the deseases. To assess nutritional status, it was used the Mini - Nutritional Assesement MNA ®, the assessment of depressive symptoms was measured by Yesavage scale, and to assess quality of life, the instruments WHOQOL-Bref and WHOQOL-Old were applied. The statistical calculations were made using SPSS (Statistical Package for Social Sciences), the error rate used was 5.0%. The absolute and relative frequencies and standard deviations were obtained. The possible differences in the results of different time points were tested by analysis of variance (ANOVA), while the ratio of the frequencies with the stages of follow-up was tested by Chisquare. To compare the scores of the scales during follow-up, and in the presence of a significant ANOVA, post hoc Bonferroni test was applied. The results revealed a prevalence of 56.1% males; 58.5% elderly, and 53.7% were married. The highest percentage was among the browns and whites, with 87.8%, 73.1% were between the iliterate and high school or less, and 82.9% of them were retired and received minimum wage. The most frequent injuries were intra - oral area with 41.4% in the nasal with 31.7%, followed by 16.9% for the orbitofacial. After six months of rehabilitation, the percent of malnourished participants was significantly reduced from 13.2% to 5.3%, while those at risk of malnutrition decreased 40% from baseline. Distribution of the sample according to the assessment of geriatric depression scale of Yesavage, it was found improvement in depressive symptoms of patients during follow-up (p < 0.001). The percentage of the symptoms of major depression decreased 83% from baseline and lower depression decreased 59%. The values in the WHOQOL-Bref table showed a significant improvement in the psychological domain, with 55%. The significant improvement in scores for quality of life WHOQOL-Old in the domains of Sensory Skills, Autonomy, Social Participation and Total Score occurred. The team multiprofissional was effective for maxillofacial rehabilitation of patients who carries deformities, for improving of their nutritional, psychological status and quality of life