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Pioneering study of the impact on quality of life in diabetic patients submitted to bone marrow transplantation.

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Author(s):
Amanda Ferraz Salomé Silva
Total Authors: 1
Document type: Master's Dissertation
Press: Ribeirão Preto.
Institution: Universidade de São Paulo (USP). Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto (PCARP/BC)
Defense date:
Examining board members:
Manoel Antonio dos Santos; Francisco Hashimoto; Maria Lucia Zanetti
Advisor: Manoel Antonio dos Santos
Abstract

The diabetes mellitus (DM) is a multiple etiology\'s syndrome caused by lack of insulin and/or inability of insulin perform adequately its effects. There are two diabetes types: type 1 and type 2 diabetes mellitus. The consequences of DM in long term include dysfunction and failure of various organs, especially kidneys, eyes, nerves, heart and blood vessels. Bone Marrow Transplantation (BMT), in autologous modality, is a procedure used to treat autoimmune diseases such as type 1 diabetes mellitus, experimental alternative to conventional treatment (insulin therapy). This procedure, however, consists in potential stressful phases for patient. This study aimed to assess the quality of life and Psychological adjustment of diabetes patients who decided to undergo BMT. The assessments were made at two distinct times: patient\'s admission and outpatient return one hundred days after the transplantation. The sample consisted of 14 patients, 10 men and four women, aged betweem 14 and 31 years. All of them were hospitalized at the nursing ward of the Bone Marrow Transplantation Unit (UTMO) at the University of São Paulo at Ribeirão Preto Hospital das Clínicas between October 2005 and December 2006. The instrument used for data collection was semi-structured interview, Post-BMT Recovery Interview, ISSL, HAD, SF-36 and Functional Assessment Cancer Therapy - Bone Marrow Transplantation (FACT-BMT). The instruments were applied individually in the nursing ward (pre-BMT) and ambulatory of UTMO (post-BMT). The application was divided into two or more sessions, as needed. The interviews were audio recorded and transcribed completely and literally. The instruments were scored according to the recommendations established by the specific literature for each technique and a qualitative approach was used for analysis of interviews, i.e. content analysis. The obtained results demonstrated that the quality of life escores post-TMO were higher than before, with significant differences for Physical Aspects, Vitality and Mental Health,which were committed in the pre-transplant evaluations and preserved in subsequent evaluation. Following the trend of improvement in clinical condition of patients, the psychological adjustment was preserved, with emphasis on reduction of clinical conditions installed of stress. There was significant improvement of patients undergoing transplant one hundred days after the transplantation, in quality of life domains and adaptation model. These results are relevant to confirm BMT as a promising proposal in relation to traditional therapy for treating type 1 diabetes, contributing to the improvement of psychosocial indicators. (AU)