Avaliação da qualidade da assistência em saúde bucal para prevenção e tratamento da mucosite oral em pacientes submetidos ao transplante de células-tronco hematopoiéticas
Introduction: Oral mucositis (OM) is an inflammation of the oral mucosa, quite prevalent in patients undergoing Hematopoietic Stem Cell Transplantation (HSCT), contributing to the interruption of antineoplastic treatment. Photobiomodulation therapy (PBM) has been proposed due to its preventive an...
Na minha lista:
| Autor principal: | |
|---|---|
| Outros Autores: | |
| Formato: | Dissertação |
| Idioma: | pt_BR |
| Publicado em: |
Universidade Federal do Rio Grande do Norte
|
| Assuntos: | |
| Endereço do item: | https://repositorio.ufrn.br/handle/123456789/30968 |
| Tags: |
Adicionar Tag
Sem tags, seja o primeiro a adicionar uma tag!
|
| Resumo: | Introduction: Oral mucositis (OM) is an inflammation of the oral mucosa, quite prevalent in
patients undergoing Hematopoietic Stem Cell Transplantation (HSCT), contributing to the
interruption of antineoplastic treatment. Photobiomodulation therapy (PBM) has been proposed
due to its preventive and therapeutic action for OM. Objective: To evaluate the quality of oral
health care through the process and result in the prevention and treatment of OM in patients
undergoing HSCT. Materials and methods: Observational, descriptive, prospective and health
quality assessment study, appropriate according to Squire 2.0. The sample consisted of thirty-six
patients who received previous dental treatment and PBM as a preventive protocol for oral
mucositis. When diagnosed with mucositis, patients received therapeutic PBM. The patients were
followed up and evaluated during the conditioning regime (T0), one day after HSCT (T1), with 5
days after HSCT (T2) and with 10 days after HSCT (T3). The following indicators were used to
evaluate the process: Evidence-based therapy, Assessment and recording of symptoms at all
visits, Preventive care with PBM during hospitalization and Therapeutic plan for the outbreak of
symptoms and worsening. The result indicators were expressed in percentages, being the
Percentage of individuals who developed: OM; OM according to gravity; Ache; Severe, mild and
/ or moderate pain; Oral changes; OM according to sex; OM in leukopenic individuals. Plus
percentage of individuals who used painkillers during therapy; Pain reduction; Presence of
another associated treatment; Individuals with comorbidities who developed OM and Individuals
with autologous and allogeneic transplants who developed OM. Descriptive and statistical
analysis of the indicators was performed using the non-parametric Wilcoxon test and the Chisquare test with a significance level of 5%. Results: For the process, it was observed that in all
indicators, 100% of the sample obtained assistance within the desirable standard. Result indicators
showed that 66.6% of patients had Oral Mucositis in at least one follow-up period, with a
statistically significant increase between times T1 and T2, as well as between times T1 and T3 (p
<0.05), with a predominance grade I (p = 0.014). Four patients (16.7%) reported pain, both at T2
and T3, with a statistically significant increase between T1 and T2 (p <0.05), with moderate pain
being the most observed, with no reports of severe pain. In the evaluation of the leukocyte count,
it can be observed that in the period in which the patients had a greater number of oral mucositis
(T2 and T3), they exhibited leukopenia, but without statistically significant differences (p> 0.05).
OM had no statistically significant association with pain, associated treatment, leukopenia,
comorbidities and the type of transplant, presenting for females (p = 0.015). There was no
statistically significant association for pain reduction. Conclusion: The results presented showed
excellent process indicators used to assess the quality of health service provision. The results of
the photobiomodulation protocols demonstrated that although there is still the development of
OM in these patients, there was a predominance of grade I, with less severity of OM as well as
associated pain. |
|---|