Quality of life in colorectal cancer patients: integrative review of literature

Abstract

Introduction: Colorectal Cancer (CRC) is defined as a malignant tumor that affects the colon and rectum, more common in advanced ages. It is one of the most frequent neoplasms in the adult population worldwide, presenting increasing incidence and mortality in several countries, with a strong impact on patient’s quality of life. Objective: To identify interventions and factors associated with oncological treatment that impact the quality of life of adult and elderly patients with CRC, available in the literature, aiming at the improvement of nursing care. Methods: This is an integrative review carried out using the PubMed, LILACS and SciELO databases, where 38 articles published in the period 2007 to 2017 were selected, excluding those that were not related to the study problem. Results: The selected studies evaluated the quality of life (QoL) of patients with CRC as satisfactory. It was observed that
the most used instrument was the QLQ-C30 and the most affected areas were Psychological / Emotional and Physical, while the Social domain was preserved. It was also verified that the practice of physical exercise, good nutrition, psychosocial support, family support and the adoption of complementary therapies that encompass, from individual prayer and aspects related to spirituality to Glutamine supplementation and the use of other bioactive substances, may improve the QoL of these patients. On the other hand, the side effects of antineoplastic chemotherapy and /or radiotherapy (pain, especially), as well as the consequences of surgery
(for example, stomatostomy and altered bowel habits) are the main factors that worsen QoL. The main complaints of patients undergoing chemotherapy were related to the gastrointestinal tract and the most frequent symptoms were fatigue, pain and insomnia, in addition to irritation and depression. There was disagreement in the evaluation of QoL of ostomized patients, understanding that ostomy may not influence or worsen QoL depending on the coping strategies adopted. Men had higher QoL scores compared to women, mainly in the preservation of emotional and cognitive functions and in the financial evaluation, no difficulties were demonstrated due to the disease. Considerations: Therefore, the importance of nurse’s performance in symptom control and quality care planning should be emphasized, based on an individualized, humanized and systematic evaluation that takes into account all aspects and peculiarities that involve the process of health and disease in which the CRC patient is inserted.
Therefore, the limitations of some studies could provide an overview of the evidence in the literature related to the quality of life of these patients, highlighting the factors that have a positive or negative influence on their perception.