Mucosa oral prejudicada em pacientes sob quimioterapia: estudo de revisão de literatura e validação clínica

Abstract

Because the non-specificity of cancer chemotherapy to cancer cells, toxic effects may arise, including those affecting the oral mucosa. Oral complications can interfere with the patients quality of life, lead to higher costs and even interruption of the cancer treatment. The NANDA International establishes a nursing diagnosis of damaged oral mucosa which lacks validation. The objectives of the study were: analyze the oral mucosa problem impaired in patients undergoing cancer chemotherapy in the chemotherapy outpatient clinic of a public hospital in BeloHorizonte, identify defining characteristics and related diagnostic factors, translate and conceptually validate a range of oral assessment, to estimate the prevalence of diagnosis of oral mucosa nursing impaired in patients undergoing cancer chemotherapy, build predictive model for oral mucosa impaired in the population studied and validate the diagnosis in adult cancer patients undergoing chemotherapy. This is a study conducted in four stages: an integrative literature review; translation and validation from content of the Oral Assessment Guide instrument; training and interrater agreement and clinical validation through crosssectionalstudy to establish the prevalence and predictive model for diagnosis. Theanalysis of cross-sectional study of data was carried out in four stages: descriptive analysis, the prevalence calculation, bivariate and multivariate analysis through the bivariate regression and multivariate model of Poisson. In the integrative review of literature, eight articles were selected, most of them studies of prospective cohort (Lo E III). They identified 22 related factors and 19 defining characteristics that made upthe instrument used in the cross-sectional study. The content validation of the Oral Assessment Guide instrument was carried out by a committee of six nurses and the Content Validation Index was 0.94 (94%). After the evaluators training, the interrater agreement obtained between researchers and the gold standard was considered almost perfect (Kappa=1). In the prevalence of transversal study were included 110patients between April and July 2015. The prevalence of the studied diagnosis was 79.1%. The prediction model obtained for the development of impaired mucosa included the variables intolerance to flavor, taste alteration, dry mouth, gums and tongue dorsum. The results revealed high prevalence of the nursing diagnosis of oral mucosa impaired in cancer patients during cancer chemotherapy.