RBM - Volume 20, Número 1, Jan-Mar 2010 - Sociedade Brasileira ...

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Quality of life and self-esteem outcomes following augmentation mammaplasty23Evaluating health perception from the patient’s point ofview could enhance assessment of surgical outcomes and helpplastic surgeons to improve their technical procedures 2 . Inaddition, positive changes in patient’s quality of life may helpto assure the importance of esthetic surgical procedures andtheir relevance 2 .Some instruments to assess individual health status havebeen developed, appraising health in its various domains. Physicaland psychological improvement following esthetic andreconstructive surgery has been researched, and the literatureshows positive results for most of the surgical procedures studied2-4 .The benefits resulting from subpectoral and submammaryaugmentation mammaplasty have not been measured yet inan objective and standardized way. The aim of this study wasto evaluate the quality of life and self-esteem of patients whowere submitted to subpectoral and submammary augmentationmammaplasty, providing data about the health needs ofesthetic surgery and the benefits and differences obtained fromeach treatment.MethodsThis study was conducted at the Plastic and ReconstructiveDivision, Department of Surgery of Universidade Federal deSão Paulo (UNIFESP), São Paulo, Brazil, from January 2002to March 2003.Forty pacientes with hypomastia were consecutively selectedfrom a waiting list at São Paulo Hospital (UNIFESP). Patientsunderwent clinical examination and were invited to takepart as volunteers in this prospective study.The patients included were female, Caucasian, aged 18to 50 years, and presenting hypomastia. All patients sufferingfrom acute or chronic diseases, taking daily medication,smokers, those who are sensitive to lidocaine or bupivacaine,and those who had already undergone mammary surgery wereexcluded.Social and demographic data were also collected in the preoperativephase.To assess the quality of life of these patients, the MedicalOutcomes Study 36-Item Short-Form Health Survey (SF-36)was applied. This is the most widely used method for measuringchanges in quality of life following medical treatment. 5SF-36 is made up of 11 questions divided into 36 items thatassess quality of life in 8 subscales, as shown in Table 1.To evaluate self-esteem, the Rosenberg Self-Esteem Scale(RSS) was applied. The RSS questionnaire comprises ten questions,and scoring ranges from zero to 30, with zero representingthe best state of self-esteem and 30, the worst.Patients were asked to answer both questionnaires in thepreoperative period and in the second and fourth postoperativemonths during consultation with the attending plastic surgeon.Statistical methodsSF-36 and RSS scores were analyzed through descriptive statistics(mean and standard deviation). Analysis of variance forblock desing 6 was performed to investigate significant statisticaldifferences among the three evaluation periods for each ofthe SF-36 subscales and for RSS. Post hoc comparision by Bonferroimethod was used. The p- values equal to or below 0.05were considered the required level for statistical significance.ResultsThe evaluation period started with the preoperative assessmentin January 2002, ending on March 2003, after all patients hadcompleted the four-month follow-up. Forty patients were con-Table 1. SF-36 Subscales and Respective Aspects AssessedSF-36 SubscalesPainPhysical functionRole limitations due to physical problemsHealth perceptionEnergySocial functionRole limitations due to emotional problemsMental healthHow much pain did the patient experience during the studied period, and whatlimitations did it cause in patient’s daily activities (at work and home)Daily activities such as dressing, bathing, walking, climbing stairs, lifting objects, andsports practice, among othersHow does physical health interfere in working activities?Individual perception of own state of health (individualy and compared to otherpeople) and about own health in the futureQuestions about tranquility, energy, and temper for daily tasksHow long has the patient been away from normal social relationships (in general andhome circles) due to emotional and physical state?How do emotional problems (anxiety and depression) interfere in daily working anddomestic activities?How much time does the patient feel anxious and depressed or happy and peaceful?Each subscale is evaluated independently. Scoring is out of 100, zero being the worst state of health and 100, the best. This questionnaire evaluates a period of4 weeks before the application.Rev Bras Mastologia. 2010;20(1):22-26
24Abla LEF, Sabino Neto M , Garcia EB, Ferreira LMTable 2. SF-36 and RSS scores compared at preoperative period, 60 th and 120 th postoperative daysVariablesPreoperative 60 d Postoperative 120 d Postoperative p-valuesMean (SD)Mean (SD)Mean (SD)Pain 89.53 (13.89) 84.13 (20.83) 88.55 (13.09) 0.336+Physical function 95.5 (7.99) 93.13 (8.37) 95.88 (6.39) 0.063 (a) ö>0.999 (b) ö0.020 * (c) öRole limitations due to physical problems 94.38 (13.26) 86.25 (29.93) 98.13 (8.75) 0.059+Health perception 85.15 (14.30) 91.35 (9.14) 93.00 (8.93) 0.038 * (a) ö0.002 * (b) ö0.138 (c) öEnergy 73.38 (14.87) 78.63 (16.91) 85.90 (10.42) 0.009 * (a) ö0.999 (a) ö0.002 * (b) ö0.002 * (c) öRole limitations due to emotional problems 82.48 (31.13) 81.64 (28.22) 95.83 (15.46) >0.999 (a) ö>0.019 * (b) ö0.002 * (c) öMental health 73.90 (14.72) 80.00 (16.63) 85.40 (10.78) 0.052 (a) ö
Page 1 and 2: ISSN 0104-8058Órgão Oficial da So
Page 3 and 4: Ex-presidentesAlberto L. M. Coutinh
Page 5 and 6: Sua paciente merece todocarinho na
Page 7 and 8: cípios, em especial das grandes e
Page 9 and 10: 4 Steinmacher DI, Kemp C, Nazário
Page 15: ARTIGO ORIGINALEstudo do biomarcado
Page 19 and 20: 14Melitto AS, Mattar A, Cintra KA,
Page 21 and 22: 16Jardim DLF, Calabrich AFC, Katz A
Page 27: ARTIGO ORIGINALQuality of life and
Page 31 and 32: 26Abla LEF, Sabino Neto M , Garcia
Page 33 and 34: 28Tarricone Junior V , Tarricone SP
Page 39 and 40: 34Manoel WJ, Paula CI, Paula ÉC, P
Page 41 and 42: 36Manoel WJ, Paula CI, Paula ÉC, P
Page 43 and 44: Carcinoma ductal em mama supranumé
Page 45 and 46: 40Oliveira HR, Zucoloto FJ, Madurei
Page 47 and 48: ARTIGO DE REVISÃOAvaliação da qu
Page 49 and 50: 44Torres AF, Figueira Filho ASSlinf
Page 51 and 52: 46Torres AF, Figueira Filho ASSa do
Page 53 and 54: ARTIGO DE ATUALIZAÇÃOGenética e
Page 55 and 56: 50Barros ACSD, Barros ACSDpara a ge
Page 57 and 58: 52Barros ACSD, Barros ACSDverme (Ca
Page 59 and 60: 54Barros ACSD, Barros ACSDser class
Page 61 and 62: por todos os doentes. E o que se en
Page 63: INSTRUÇÕES AOS AUTORESas implica

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