Adesão ao tratamento oncológico : fatores de personalidade, lócus de controle e histórico de câncer familiar

Abstract

Introduction: The prevalence of anxiety and depression symptoms in cancer patients is high, indicating that these variables, the locus of control (LOC) and the level of knowledge about disease may interfere with the treatment adherence process. Personality factors are also associated with health behaviors and outcomes. All these variables seem to influence the levels of treatment adherence. Objectives: The main objective of this thesis was to verify if sociodemographic and clinical variables, knowledge about disease, symptoms of anxiety and depression, personality factors and LOC are predictive of treatment adherence in a sample of cancer patients. The specific objectives were: to characterize the personality profile of the sample; to verify the prevalence of LOC orientation and the level of knowledge about disease; to analyze if the education level is predictive of knowledge about disease and if the orientation of LOC is predictive of education level and level of knowledge about disease; to verify the presence of depressive and anxiety symptomatology, and to analyze if sociodemographic variables and personality factors are predictors of symptoms of depression and anxiety in this population. Method: Four empirical studies were developed to answer the objectives, and the instruments used in the data collection were: a questionnaire to identify sociodemographic and clinical data; Neo-FFI Personality Inventory Revised (NEO-FFI-R); Multidimensional Health Locus of Control (MHLC) Scale, Hospital Anxiety and Depression Scale (HADS) and Adherence Determinants Questionnaire. The data are described by means of absolute (n) and relative (%) frequencies for qualitative variables, and by mean and standard deviation for quantitative variables. To verify the association or correlation between variables, the Chi-square test and Spearman correlations were used, based on the Kolmogorov-Smirnov test result. To verify the predictive power of the variables, Multiple Linear Regression and Logistic Regression Analysis and a network analysis were performed. Results: The evaluated sample had high levels of agreeableness (44%) and conscientiousness (64.1%) personality factors, as well as low levels of neuroticism (31.4%) and openness to experience (49.6%). We found a prevalence of powerful others external LOC (60.9%) and moderate knowledge about disease (41.4%). Education level was a predictor of knowledge about the disease, and external LOC (powerful others and chance) a predictor of education level. In addition, 21.4% of the patients presented symptoms of depression and 35% symptoms of anxiety. Previous psychiatric history and the personality factors neuroticism and extroversion were shown as predictors of depressive symptoms. Only neuroticism was a predictor of anxiety symptoms. The powerful others external LOC and the personality factors conscientiousness and agreeableness, were presented as predictors of greater adherence to treatment. Family cancer history, in turn, was a predictor of lower adherence levels. Conclusion: It was concluded that the variables identified as predictors of treatment adherence may also have interfered in the development of cancer in this sample. In addition, it is believed that the sample studied, regarding its beliefs and personality characteristics, it is showing high treatment compliance instead of high adherence. Thus, there is a high probability of this population keep the same health habits and behaviors, presenting a higher risk of recurrence, the development of other diseases or the appearance of new cases of cancer in their closest relatives. Thus, the evaluation of these predictor variables and the planning of specific interventions may contribute, in long term, to a possible prevention of the disease within families and communities or at least to the early detection of the disease, which would be useful to the individual, family, community and health systems as a whole.