Nonostante i progressi della medicina e della chirurgia, i traumi da ustione a tutt’oggi rappresentano una causa significativa di menomazione e disabilità, comportano una significativa riduzione della qualità della vita e sono associati a diversi esiti psicopatologici, inclusi la depressione e il disturbo da stress post-traumatico. Questa revisione narrativa non sistematica della letteratura si propone di presentare le evidenze più significative relative alla qualità della vita, ai sintomi psicopatologici, ai relativi fattori protettivi e di rischio, agli strumenti di valutazione e agli interventi psicologici rivolti ai pazienti ustionati. I risultati mostrano che la storia naturale delle lesioni da ustione è un processo complesso che coinvolge una varietà di fattori, tra cui l’insoddisfazione per l’immagine del corpo, le strategie di coping e il supporto sociale. Appare evidente che la valutazione del trauma da ustione debba tenere conto non solo degli effetti funzionali ed estetici del trauma, ma anche di quelli psicologici e sociali. Inoltre, è fondamentale che, in aggiunta ai trattamenti medici, chirurgici e riabilitativi, interventi psicologici siano resi disponibili a questi pazienti e ai loro familiar
This paper presents a multi-professional integrated approach toward the recognition and management of the nutritional and psychological needs of cancer patients. In particular, the patients undertook a multi-professional, multistep process that included the collection of both personal and clinical data, the evaluation of anthropometric measures, nutritional status and psychometric indices, and an ensuing personalized nutritional prescription and psychological support, ultimately leading to combined nutritional and psychological interventions to control their adherence to a nutritional program and to consolidate motivation to change. Overall, 120 patients were recruited for the study. The majority (84.2%) were female. Breast cancer was by far the most frequent malignancy (52.5%), followed by colorectal (17.5%), pancreatic (9.2%), ovarian (9.2%) and lung (5.0%) cancers. The results of the nutritional and psychological screening at baseline indicated that only 35% of patients had a normal BMI, whilst a relatively high proportion (nearly 32%) was overweight or obese (25%). The INRAN and MEDI-LITE questionnaires, which were used to assess the eating habits and adherence to a Mediterranean diet, respectively, revealed a mixed prevalence of cereals/cereal-based, fresh/processed meat, and fish or fishery food, with a medium–low adherence to the Mediterranean diet in nearly 38% of patients. The BUT, HADS and SF-36 tests, which were used to assess psychological disturbances, showed that 37.5% of patients had disorders regarding body image, 29.2% had abnormal anxiety and 20.0% had a depressive state, while no significant association was observed between the SF-36 PCS and MCS and the patients′ characteristics. The results of the potential impact of this novel approach on the QoL of patients after completion of the course are awaited with expectation.
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