Utjecaj depresivnih simptoma na adherenciju kod bolesnica s uznapredovalim karcinomom dojke

master's thesis

• Title (english): Influence of depressive symptoms on adherence in patients with advanced breast cancer
• Author: Magdalena Krajinović
• Mentor: Maja Ortner Hadžiabdić (mentor)
• Mentor: Miranda Sertić (mentor)
• Committee member: Maja Ortner Hadžiabdić (predsjednik povjerenstva)
• Committee member: Miranda Sertić (član povjerenstva)
• Committee member: Lidija Bach-Rojecky (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Centre for applied pharmacy); Zagreb
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Department of pharmaceutical analysis); Zagreb
• Defense date and country: 2022-11-25, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Svaka osma žena u svijetu oboljet će od raka dojke. Kao dostupna terapija sve su češći oralni antitumorski lijekovi koji pospješuju kvalitetu
života pacijentica na adjuvantnoj terapiji. Navedena terapija zahtijeva od pacijenata preuzimanje odgovornosti za uzimanje lijekova i
aktivno sudjelovanje u procesu liječenja. Upravo je zato u ovom kontekstu postao važan pojam adherencije. Literaturni podatci ukazuju
da je adherencija na oralne antitumorske lijekove često suboptimalna. Cilj ovog istraživanja bio je utvrditi stopu adherencije kod pacijentica
s uznapredovalim rakom dojke. Ispitivana je i učestalost depresivnih simptoma te utjecaj depresivnih simptoma na adherenciju kod takvih
pacijentica. Obzirom da smanjena adherencija može dovesti do recidiva bolesti i povećanja smrtnosti, bilo je važno utvrditi čimbenike koji
utječu na nju te potencijalnu prevenciju istih. Provedeno je opažajno, presječno ispitivanje. U istraživanje su bile uključene žene starije od
18 godina koje boluju od uznapredovalog raka dojke (stadij IV), a primaju oralnu terapiju. Adherencija je mjerena validiranim MARS-5
upitnikom, a prisutnost depresivnih simptoma Beckovim inventarom depresije – drugo izdanje. Adherencija pacijentica s uznapredovalim
rakom dojke u ovom istraživanju pokazala se visokom, a iznosila je 24,04 (±1,653) od maksimalno mogućih 25 bodova. Kod pacijentica
s rakom dojke, osobito onih s metastatskim rakom dojke prevalencija depresivnih simptoma je viša nego u općoj populaciji. Smatra se da
depresivni simptomi mogu utjecati na smanjenje adherencije i tako prouzrokovati lošije terapijske ishode. Iako je gotovo 45% pacijentica
imalo neki oblik depresivnih simptoma, statistički značajna povezanost depresivnih simptoma i smanjene adherencije nije nađena
(p=0,455). Na pacijentice s depresivnim simptomima svejedno treba obratiti pažnju jer kronični odgovor na stres koji može doprinijeti
razvoju depresije kod oboljelih od raka, može također pridonijeti povećanju invazivnosti raka.

Abstract (english)

Every eighth woman in the world will be diagnosed with breast cancer. Available oral antitumor drugs are becoming more
common and can improve quality of life in patients that are receiving adjuvant therapy. Previously mentioned therapy requires
patients to take responsibility for taking the medication and to actively participate in the treatment process. That is why term
adherence has become important in this context. Body of literature shows that adherence to oral antitumor drugs is often
suboptimal. The purpose of this research was to determine the rate of adherence in patients with advanced breast cancer. The
prevalence of depressive symptoms and influence of depressive symptoms on adherence was also questioned. Because lower
adherence can lead to disease recurrence and higher mortality rates, it was important to determine the factors that can influence
adherence and how to prevent them. Conducted research was observational and cross-sectional. Women over 18 years with
advanced breast cancer (stage IV) that are on oral therapy were included in the study. Adherence was measured with validated
MARS-5 questioner and the presence of depressive symptoms was measured with Beck’s depression inventory – second edition.
Patients with advanced breast cancer included in the research had a high adherence rate, specifically their score was 24,04
(±1,653) out of maximal possible 25. The prevalence of depressive symptoms in patients with breast cancer, especially those
with metastatic breast cancer is higher than in the general population. It is considered that depressive symptoms can lead to
lower adherence and therefore cause worse therapeutic outcomes. Although almost 45% of patients had some form of depressive
symptoms, the statistically important relationship between depressive symptoms and lower adherence was not found (p=0,455).
Still, it is important to pay attention to patients with depressive symptoms because the chronic stress response which can
contribute to depression in patients with cancer, can also lead to increased cancer invasiveness.

• Keywords: adherencija; rak dojke; depresivni simptomi
• Keywords (english): adherence; breast cancer; depressive symptoms
• Language: croatian
• URN:NBN: urn:nbn:hr:163:247124
• Study programme: Title: Pharmacy; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: magistar/magistra farmacije (magistar/magistra farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Embargoed access; Embargo expiration date: 2024-11-25
• Created on: 2022-11-29 12:07:45