Ivone Patrão^* & Isabel Leal

Instituto Superior de Psicologia Aplicada, Lisboa

RESUMO: Este artigo tem como objectivo realizar uma abordagem ao tema do impacto psicossocial no adoecer da mama. Os factores psicossociais considerados são: Acontecimentos de Vida; Suporte Social Percebido; Qualidade de Vida; Stress; Coping; Controle Emocional e Necessidade de Harmonia; e a Personalidade. Realiza-se uma breve introdução justificando a pertinência do tema e de seguida uma apresentação de cada factor psicossocial e sua relação com o adoecer da mama.

Palavras chave: Cancro da Mama, Factores Psicossociais.

Psychosocial Impact of the Breast Cancer

ABSTRACT: This article aims to address the psychosocial impact of the breast cancer disease. The psychosocial factors considered are: Life Events; Perceived Social Support; Quality of Life; Coping; Emotional Control and Necessity of Harmony; and Personality. The article starts with a brief introduction to explain the relevance of this issue, followed by a presentation of each psychosocial factor and its relation to the breast cancer disease.

Texto completo disponível apenas em PDF.

Full text only available in PDF format.

REFERÊNCIAS

Alferi, S., Carver, C., Antoni, M., Weiss, S., & Dúran, R. (2001). An exploratory study of social support, distress, and life disruption among low-income hispanic women under treatment for early stage breast cancer. Health Psychology, 20(1), 41-46.         [ Links ]

Al-Ghazal, S., Fallowfield, L., & Blamey, R. (2000). Comparison of psychological aspects and patient satisfaction following breast conserving surgery, simple mastectomy and breast reconstruction. European Journal of Cancer, 36, 1938-1943.

Alter, C., Pelcovitz, D., Axelrod, A., Goldenberg, B., Harris, H., Meyers, B., Grobois, B., Mandel, F., Septimus, A., & Kaplan, S. (1996). Identification of PTSD in Cancer Survivors. Psychosomatics, 37, 137-143.

Amelang, M., Sclmidt-Rathjens, C., & Matthews, G. (1996). Personality, cancer and coronary heart disease: Futher evidence on a controversial issue. British Journal of Health Psychology, 1, 191-205.

Andreu, Y. (2001). Personalidad TIPO C. Historia y validez del concepto. In E. Durá & M. Rosario (Coords), Territorios da Psicología Oncológica (pp. 399-426). Lisboa: Climepsi

Andrykowski, M., & Cordova, M. (1998). Factors associated with PTSD symptoms following treatment for breast cancer: Test of Andersen Model. Journal of Traumatic Stress, 11(2), 189-203.

Andrykowski, M., Cordova, M., McGrath, P., Sloan, D., & Kennady, D. (2000). Stability and change in posttraumatic stress disorder following breast cancer treatment: A 1 year follow-up. Psycho-oncology, 9(1), 69-78.

Butler, L., Koopman, Ch., Classen, C., & Spiegel, D. (1999). Traumatic stress, life events, and emotional support in women with metastatic breast cancer: Cancer-related traumatic stress symptoms associated with past and current stressors. Health Psychology, 18(6), 555-560.

Bleiker, E., Ploeg, V., Hendriks, J., Leer, J.W., & Kleijn, W. (1993). Rationality, emotional expression and control: Psychometric characteristics of a questionnaire for research in Psycho-oncology. Journal of Psychosomatic Research, 37(8), 861-872.

Bloom, J., Stewart, S., Johnston, M., & Banks, P. (1998). Intrusiveness of illness and quality of life in young women with breast cancer. Psycho-Oncology, 7, 89-100.

Bloom, J. (2000). The role of Family Support in cancer control. In L. Baider, C. Cooper, &

A. De-Nour (Eds.), Cancer and the family (2nd ed., pp. 55-71). New York: John Wiley & Sons. Bloom, J., Stewart, S., Johnston, M., Banks, P., & Fobair, P. (2001). Sources of support and the physical and mental well-being of young women with breast cancer. Social Science & Medicine, 53, 1513-1524.

Bolger, N., Vinokur, A., Foster, M., & Ng, R. (1996). Close relationship and adjustment to a life crisis: The case of breast cancer. Journal of Personality and Social Psychology, 70(2), 283-294.

Butow, P., Hiller, J., Price, M., Thackway,S., Kricker, A., & Tennant, C.(2000). Epidemiological evidence for relationship between life events, coping style, and personality factors in the development of breast cancer. Journal of Psychosomatic Research, 49, 169-181.

Carlsson, M., & Hamrin, E. (1994). Psychological and psychosocial aspects of breast cancer and breast cancer treatment. Cancer Nursing, 17(5), 418-428.

Carver, C., Harris, S., Pozo-Kaderman, C., Price, A., Noriega, V., Derhagopian, R., Robison, D., & Moffatt, F. (1998). Concern about aspects of body image and adjustment to early stage breast cancer. Psychosomatic Medicine, 60, 168-174. Cella, D. (1998). Quality of Life. In J. Holland (Ed.), Handbook of Psychooncology (pp. 1135-1146).

New York: Oxford University Press. Classen, C., Koopman, C., Angell, K., & Spiegel, D. (1996). Coping styles associated with psychological adjustment to advenced breast cancer. Health Psychology, 15(6), 434-437.

Cohen, L., Hack, T., Moor, C., Katz, J., & Goss, P. (2000). The effects of type of surgery and time on psychological adjustment in women after breast cancer treatment. Annals of Surgical Oncology, 7(6), 427-434.

Compas, B., Stoll, M., Thomsen, A., Oppedisano, G., Epping-Jordan, J., & Krag, D. (1999). Adjustment to breast cancer: Age-related differences in coping and emotional distress. Breast Cancer Research and Treatment,54, 195-203.

Cordova, M., Cunningham, C., Carlson, C., & Andrykowaki, M. (2001). Posttraumatic growth following breast câncer: A controlled comparion study. Health Psychology, 20(3), 176-185.

Degoratis, L. (1982). Self-report mesasures of stress. In L. Goldberger & S. Breznitz (Eds.), Handbook of Stress: Theoretical and clinical aspects (pp. 270-290).

New York: Free Press. Endler, N., & Edwards, J. (1982). Stress and Personality. In L. Goldberger & S. Breznitz (Eds.), Handbook of Stress: Theoretical and clinical aspects (pp. 36-48).

Fernandez -Ballesteros, R., & Garde, R. (1998). Emotional expression in healthy women and those with breast cancer. British Journal of Health Psychology, 3, 41-50.

Green, B., Krupnick, J., Rowland, J., Epstein, S., Stockton, P., Spertus, & Stern, N. (2000). Trauma history as a predictor of psychologic symptoms in women with breast cancer. Journal of Clinical Oncololy, 18(5), 1084-93.

Hack, T. E Degner, L. (1999). Coping with breast cancer: A cluster analityc approach. Breast Cancer Research and Treatment, 54, 185-194.

Hamptom, M., & Frombach, I. (2000). Women experience of traumatic stress in cancer treatment. Health Care for Woman International, 21, 67-76.

Haan, N. (1982). The assessment of coping, defense, and stress. In L. Goldberger & S. Breznitz (Eds.), Handbook of Stress: Theoretical and clinical aspects (pp. 254-269).

New York: Free Press. Helgeson, V., Cohen, S., & Fritz, H. (1998). Social Ties and Cancer. In J. Holland (Ed.), Psycho-oncology (pp. 99-109).

New York: Oxford University Press. Hilakivi-Clarke, L., Rowland, J., Clarke, R., & Lippman, M. (1993). Psychosocial factors in the development/progression of breast cancer. Breast Cancer Research and Treatment, 29, 141-160.

Holroyd, K., & Lazarus, R. (1982). Stress, coping, and somatic adaptation. In L. Goldberger & S. Breznitz (Eds.), Handbook of Stress: Theoretical and clinical aspects (pp. 21-35).

New York: Free Press. Hopwood, P., Lee, A., Shenton, A., Baildam, A., Brain, A., Lalloo, F., Evans, G., & Howell, A. (2000). Clinical follow-up after bilateral risk reducing ('prophylactic') mastectomy: Mental health and body image outcomes. Psycho-oncology, 9, 462-472.

Iwamitsu, Y.M, Shimoda, K., Abe, H., Tani, T., Kodama, M., & Okawa, M. (2003). Differences in emotional distress between breast tumor patients with emotional inhibition and those with emotional expression. Psychiatry and Clinical Neuroscience, 57, 289-294.

Jacobs, J., & Bovasso, G. (2000). Early and chronic stress and their relation to breast cancer. Psychological Medicine, 30, 669-678.

Komproe, I., Rijken, M., Ros, W., Winnubst, J., & Hart, H. (1997). Available support and received support: Different effects under stressful circumstances. Journal of Social and Personal Relationships, 14(1), 59-77.

Kornblith, A., Herndon, J., Zuckerman, E., Viscoli, C., Horwitz, R., Cooper, M., Harris, L., Tkaczuk, K., Perry, M., Budman, D., Norton, L., & Holland, J. (2001). Social support as a buffer to the psychological impact of stressful life events in women with breast cancer. Cancer, 91(2), 443-454.

Kreitler, S., Kreitler, H., Chaitchik, S., Shaked, S., & Shaked, T. (1997). Psychological and Medical Predictors of disease course in breast cancer: A prospective study. European Journal of Personality, 11(5), 383-400.

Lima, M. (1997). NEO-PI-R: Contextos Teóricos e Psicometricos: "Ocean ou Iceberg"? Dissertação Doutoramento. Faculdade Psicologia Ciências Educação da Universidade de Coimbra.

Lieberman, M. (1982). The effects of social supports on response to stress. In L. Goldberger & S. Breznitz (Eds.), Handbook of Stress: Theoretical and clinical aspects (pp. 764-783). New York: Free Press.

Lindop, E., & Cannon, S. (2001). Evaluating the self-assessed support needs of women with breast cancer. Journal of Advanced Nursing, 34(6), 760-771.

Massie, M., & Popkin, M. (1998). Depressive disorders. In J. Holland (Ed.), Psycho-oncology (pp. 518-540). New York: Oxford University Press.

Mckenna, M., Zevon, M,, Corn, B. & Round, J. (1999). Psychosocial factors and the development of breast cancer: A meta-analysis. Health Psychology, 18(5), 520-531.

McLean, B. (1995). Social support, support groups, and breast cancer: A literature review. Canadian Journal, 14(2), 207-227.

Michael, Y., Berkman, L., Colditz, G., Holmes, M. & Kawachi, I. (2002). Social Networks and health-related quality of life in breast cancer survivors: A prospective study. Journal of Psychosomatic Research, 52, 285-293.

Miranda, A. (1994). Rastreio do cancro. Revista Portuguesa de Saúde Pública, 12(3), 57-60.

Moos, R., & Billings, A. (1982). Conceptualizing and measuring coping resources and processes. In L. Goldberger & S. Breznitz (Eds.), Handbook of Stress: Theoretical and clinical aspects (pp. 212-230).

New York: Free Press. Moyer, A. (1997). Psychosocial outcomes of breast-conseving surgery versus mastectomy: A meta-analytic review. Health Psychology,16(3), 284-298.

Nelles, W., McCaffrey, R., Blanchard, C., & Ruckdeschel, J. (1991). Social supports and breast cancer: A review. Journal of Psychosocial Oncology, 9(2), 21-34.

Ogden, J. (1999).Psicologia da Saúde. Lisboa: Climepsi

Osowiecki, D., & Compas, B. (1999). A prospective study of coping, perceived control, and psychological adaptation to breast cancer. Cognitive Therapy and Research, 23(2), 169-180.

Perkins, D. (1982). The assessment of stress using life events scales. In L. Goldberger & S. Breznitz (Eds.), Handbook of Stress: Theoretical and clinical aspects (pp. 320-331).

New York: Free Press. Petticrew, M., Fraser, J., & Regan, M. (1999). Adeverse life events and risk of breast cancer: A meta-analysis. British Journal of Health Psychology, 4, 1-17.

Ribeiro, J. (2001). Qualidade de Vida e doença oncológica. In E. Durá & M. Rosário (Eds.), Territorios da Psicología Oncológica (pp. 75-98). Lisboa: Climepsi.

Primo, K., Compas, B., Oppedisano, G., Howell, D., Epping-Jordan, D., & Krag, D. (2000). Intrusive thougts and avoidance in breast cancer: Individual differences and association with psychological distress. Psychology and Health, 14, 1141-1153.

Rietman, J., Dijkstra, P., Hoekstra, H., Eisma, W., Szabo, B., Groothoff, J., & Geertzen, H. (2003). Late morbidity after treatment of breast cancer in relation to daily activities and quality of life: A systematic review. European Journal of Surgical Oncology, 29, 229-238.

Rowland, J., Desmond, K., Meyerowitz, B., Belin, T., Wyatt, G., & Ganz, P. (2000). Role of breast reconstructive surgery in physical and emotional outcomes among breast cancer survivors. Journal of the National Cancer Institute, 92(17), 1422-1429.

Ruíz, M., Bermudez, M., & Garde, A. (1999). Factores psicosociales en el cáncer de mama: Un estudio cuasi-prospectivo. Boletín de Psicología, 64, 57-80.

Russell, J., Craig, H., & Massie, M. (1998). Anxiety disorders. In J. Holland (Ed.), Psycho-oncology (pp. 548-563). New York: Oxford University Press.

Schag, C., Ganz, P., Polinsky, M., Fred, C., Hirji, K., & Petersen, L. (1993). Characteristics of women at risk for psychosocial distress in the year after breast cancer. Journal of Clinical Oncology, 11(4), 783-793.

Sosa, C., Capafóns, J., & Carbalheira, M. (1999). Afrontamiento, ajuste psicológico y cáncer de mama. Ansiedade y Estrés, 5(1), 47-60.

Spencer, S., Lehman, J., Wynings, C., Arena, P., Carver, C., Antoni, M., Derhagopian, R., & Iroson, G. (1999). Concerns about breast cancer and relations to psychosocial well-being in a multiethnic sample of early-stage patients. Health Psychology, 18(2), 159-168.

Stanton, A., Danofferon, C., Bishop, M., Collins, C. Kirk, S., Sworowski, L., & Twillman, R. (2000). Emotionally expressive coping predicts psychological and physical adjustment to breast cancer. Journal of Consulting and Clinical Psychology, 68(5), 875-882.

Swan, G., Carmelli, D., Dame, A., Rosenman, R., & Spielberger, C. (1991). The rationality/ /emotional defensiveness scale - I. Internal structure and stability. Journal of Psychosomatic Research, 35(4/5), 545-554.

Swan, G., Carmelli, D., Dame, A., Rosenman, R., & Spielberger, C. (1992). The rationality/ /emotional defensiveness scale - II. Convergent and discriminant correlational analysis in males and females with and without cancer. Journal of Psychosomatic Research, 36(4), 349-359.

Widows, M., Jacobsen, P., & Fields, K. (2000). Relation of psychological vulnerability factors to posttraumatic stress disorder symptomatology in bone marrow transplant recipients. Psychosomatic Medicine, 62, 873-882.

Winnubst, J., Couzjin, A., & Ros, W. (1990). Social support and cancer: Main themes and problems. In L. Schmidt, P. Schwenkmezger, J. Weiman, & S. Maes (Eds.), Theoretical and Applied Aspects of Health Psychology (pp. 203-212). New York: Harwood Academic Publishers.

Woodword, V., & Webb, C. (2001). Women's anxieties surrounding breast disorders: A systematic review of the literature. Journal of Advanced Nursing, 33(1), 29-41.

Zakowski, S., Valdimarsdottir, H., Bovbjerg, D., Borgen, P., Holland, J., Kash, K., Miller, D., Mitnick, J., Osborne, M., & Van Zee, K. (1997). Predictors of intrusive thougts and avoidance in women with family histories of breast cancer. Annals of Behavioral Medicine, 19(4), 362-369.

*Contactar para E-mail: iamp@sapo.pt

Investigação realizada com apoio da Bolsa Doutoramento da FCT (BD/10047/02).