Assistência interprofissional na pré-habilitação e reabilitação cirúrgica de pacientes com câncer no período perioperatório: revisão integrativa
DOI:
https://doi.org/10.11606/issn.2176-7262.rmrp.2024.226056Palavras-chave:
Cuidados perioperatórios, Reabilitação, Exercício pré-operatório, Recuperação aprimorada após cirurgia, Oncologia cirúrgicaResumo
Objetivo: Analisar evidências científicas sobre o papel da equipe interprofissional na pré habilitação e reabilitação cirúrgica de pacientes oncológicos adultos e idosos durante o período
perioperatório. Método: Trata-se de uma Revisão Integrativa da Literatura (RIL), desenvolvida
em seis etapas, conduzida de acordo com a estratégia de pesquisa PICo e baseada nas recomendações do Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-
-ScR). O aplicativo Rayyan foi utilizado como ferramenta de automação e filtragem dos estudos.
As buscas foram realizadas nas bases de dados LILACS, CINAHL, Scopus, Web of Science e
PUBMED, utilizando critérios de inclusão e exclusão, com recorte temporal de 2012 a 2024. Os
dados da amostra foram analisados para identificar os estudos, características metodológicas, avaliação do rigor metodológico e síntese dos resultados. Um terceiro revisor foi envolvido para resolver desacordos por meio de reuniões de consenso. O instrumento de coleta de dados incluiu informações de identificação, conforme o Formulário de Extração de Dados de Métodos Mistos, seguindo a ferramenta de Abordagem Integrada Convergente do Instituto Joanna Briggs. O estudo foi registrado na plataforma Figshare sob o DOI https://doi.org/10.6084/m9.figshare.
21980156.v1. Resultados: Foram considerados elegíveis 29 artigos para esta RIL. Quanto
ao nível de evidência, a maioria dos estudos foi classificada como nível IV (n=11; 37,9%). Em
relação à localização do tumor primário, observou-se predominância de malignidade retal (CID
10 - C20) (n=10; 26,3%). Além disso, os artigos foram categorizados em três fases: (1) “pré-
-habilitação cirúrgica”; (2) “perioperatório cirúrgico”, subdividido em abordagens de cuidados e educativas; e (3) “pós-operatório cirúrgico”, com a telereabilitação como continuação do período perioperatório. A maioria dos estudos concentrou-se na fase de “pré-habilitação cirúrgica” (n=21; 72,4%). Conclusão: Esta revisão integrativa da literatura forneceu evidências que reforçam a importância da assistência da equipe interprofissional no contexto cirúrgico perioperatório para a reabilitação de pacientes oncológicos adultos e idosos. Tal assistência promoveu melhorias na deambulação, alimentação oral, aptidão cardiopulmonar, taxas de saturação de oxigênio, redução do tempo de internação e bem-estar emocional.
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Referências
Reeves S, Xyrichis A, Zwarenstein M. Teamwork, collaboration, coordination, and networking: Why we need to distinguish between different types of interprofessional practice. J Interprof Care [Internet]. 2018 [cited 2024 Apr 17];1(3):1-3. DOI https://doi.org/10.1080/13561820.2017.1400150
World Health Organization. Framework for action on interprofessional education and collaborative practice. [Internet]. 2010 [cited 2024 Apr 17]. Available from: https://www.who.int/publications/i/item/framework-for-action-on-interprofessional-education-collaborative-practice
Reeves S, Pelone F, Harrison R, Goldman J, Zwarenstein M. Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database Syst. Rev [Internet]. 2017 [cited 2024 Apr 17];6(6). DOI https://doi.org/10.1002/14651858.CD000072.pub3
Araujo S, Leal A, Centrone A, Teich V, Malheiro D, Cypriano A et al. Impact of COVID-19 pandemic on care of oncological patients: experience of a cancer center in a Latin American pandemic epicenter. Einstein (São Paulo) [Internet]. 2021 [cited 2024 Apr 17];1(19). DOI http://dx.doi.org/10.31744/einstein_journal/2021AO6282
Teixeira T, de Moura V, dos Santos G, Carneiro I, de Domenico E. Covid-19 pandemic and specialized oncology care: experience report. Rev Cuid [Internet]. 2021 [cited 2024 Apr 17];12(2). DOI https://doi.org/10.15649/cuidarte.1377
Bardoscia L, Triggiani L, Sandri M, Francavilla S, Borghetti P, Dalla-Volta A et al. Non-metastatic ductal adenocarcinoma of the prostate: pattern of care from an uro-oncology multidisciplinary group. World J Urol [Internet]. 2021 [cited 2024 Apr 17];39:1161-1170. DOI https://doi.org/10.1007/s00345-020-03315-8
Trombetta A, Ramos F, Vargas M, Marques A. Singularities work of a rehabilitation center under the perspective of the healthcare team. Esc. Anna Nery [Internet]. 2015 [cited 2024 Apr 17];19(3). DOI https://doi.org/10.5935/1414-8145.20150059
Horlait M, de Regge M, Baes S, Eeckloo K, Leys M. Exploring non-physician care professionals’ roles in cancer multidisciplinary team meetings: A qualitative study. Plos One [Internet]. 2022 [cited 2024 Apr 17];17(2). DOI https://doi.org/10.1371/journal.pone.0263611
Verhoeven D, Chollette V, Lazzara E, Shuffler E, Osarogiagbon R, Weaver S. The Anatomy and Physiology of Teaming in Cancer Care Delivery: A Conceptual Framework. J Natl Cancer Inst [Internet]. 2021 [cited 2024 Apr 17];113(4):360-370. DOI https://doi.org/10.1093/jnci/djaa166
McSharry V, Glennom K, Mullee A, Brennan D. The impact of body composition on treatment in ovarian cancer: a current insight. Expert Rev Clin Pharmacol [Internet]. 2021 [cited 2024 Apr 17];14(9). DOI https://doi.org/10.1080/17512433.2021.1937125
Waterland J, Chahal R, Ismail H, Sinton C, Riedel B, Francis J. Implementing a telehealth prehabilitation education session for patients preparing for major cancer surgery. BMC Health Serv Res [Internet]. 2021 [cited 2024 Apr 17];443. DOI https://doi.org/10.1186/s12913-021-06437-w
Chmelo J, Chmelová I, Phillips A. Prehabilitation, improving postoperative outcomes. Rozhl Chir [Internet]. 2021 [cited 2024 Apr 17]; 100(9). DOI https://doi.org/10.33699/PIS.2021.100.9.421-428
Mendes K, Silveira R, Galvão C. Integrative literature review: a research method to incorporate evidence in health care and nursing. Texto Contexto Enferm [Internet]. 2008 [cited 2024 Apr 17];17(4): DOI https://doi.org/10.1590/S0104-07072008000400018
Prates P, Júnior A, Paraizo-Horvath C, Teles A, Sonobe H. Figshare [Internet]. Interprofessional team for surgical rehabilitation of cancer patients: integrative review protocol; 30 Jan 2023 [cited 2024 Apr 17]. DOI https://doi.org/10.6084/m9.figshare.21980156.v1
Whittemore R, Knafl K. The integrative review: updated methodology. J Adv Nurs [Internet]. 2005 [cited 2024 Apr 17];52(5). DOI https://doi.org/10.1111/j.1365-2648.2005.03621.x
Page M, McKenzie J, Bossuyt P, Boutron I, Hoffmann T, Mulrow C et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Res Methods Amp Report [Internet]. 2021 [cited 2024 Apr 17];372(71). DOI https://doi.org/10.1136/bmj.n71
Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan — a web and mobile app for systematic reviews. Syst Rev [Internet]. 2016 [cited 2024 Apr 17];5:210. DOI https://doi.org/10.1186/s13643-016-0384-4
Aromataris E, Munn Z. JBI Manual for Evidence Synthesis. [Internet]. 2021 [cited 2024 Apr 17]. DOI https://doi.org/10.46658/JBIMES-20-01
Oxford Centre for Evidence-based Medicine: levels of evidence. [Internet]. 2009 [cited 2024 Apr 17]. Available From: http://www.cebm.net/oxford-centre-evidence-based-medicine-levels-evidence-march-2009
Melnyk B, Fineout-Overholt E. Evidence-based practice in nursing & healthcare. 4th ed. Philadelphia: Wolters Kluwer Health. 2019.
Valencia-Contrera M. Scale for evaluating articles with heterogeneous methodologies for integrative reviews. Rev Cuid [Internet]. 2022 [cited 2024 Apr 17];13(2): DOI https://doi.org/10.15649/cuidarte.2744
Ministério da Saúde. SUS Hospital Morbidity - ICD-10 - Tabulation List for Morbidity – DATASUS. [Internet]. 2024 [cited 2024 Apr 17]. Available From: http://tabnet.datasus.gov.br/cgi/sih/mxcid10lm.htm
Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Res Psychol [Internet]. 2006 [cited 2024 Apr 17];3(2):77-101. DOI https://doi.org/10.1191/1478088706qp063oa
Allen S, Brown V, White D, King D, Hunt J, Wainwright J et al. Multimodal Prehabilitation During Neoadjuvant Therapy Prior to Esophagogastric Cancer Resection: Effect on Cardiopulmonary Exercise Test Performance, Muscle Mass and Quality of Life-A Pilot Randomized Clinical Trial. Ann Surg Oncol [Internet]. 2022 [cited 2024 Apr 17];29:1839-1850. DOI https://doi.org/10.1245/s10434-021-11002-0
Akiyama Y, Iwaya T, Endo F, Shioi Y, Kumagai M, Takahara T et al. Effectiveness of intervention with a perioperative multidisciplinary support team for radical esophagectomy. Support Care Cancer [Internet]. 2017 [cited 2024 Apr 17];25:3733–3739. DOI https://doi.org/10.1007/s00520-017-3801-x
Aldhaam N, Elsayed A, Hussein A, Siam A, Osei J, Jing Z et al. Impact of Perioperative Multidisciplinary Rehabilitation Pathway on Early Outcomes after Robot-assisted Radical Cystectomy: A Matched Analysis. Urology [Internet]. 2021 [cited 2024 Apr 17];147:155-161. DOI https://doi.org/10.1016/j.urology.2020.05.113
Boukili I, Flaris A, Mercier F, Cotte E, Kepenekian V, Vaudoyer D et al. Prehabilitation before major abdominal surgery: Evaluation of the impact of a perioperative clinical pathway, a pilot study. Scand J Urol [Internet]. 2022 [cited 2024 Apr 17];111(2). DOI https://doi.org/10.1177/14574969221083394
Brahmbhatt P, Sabiston C, Lopez C, Chang E, Goodman J, Jonas J et al. Feasibility of Prehabilitation Prior to Breast Cancer Surgery: A Mixed-Methods Study. Frontiers Oncol [Internet]. 2020 [cited 2024 Apr 17];10. DOI https://doi.org/10.3389/fonc.2020.571091
Carminucci A, Ausiello J, Page-Wilson G, Lee M, Good L, Bruce J et al. Outcome Of Implementation Of A Multidisciplinary Team Approach To The Care Of Patients After Transsphenoidal Surgery. Endocr Pract [Internet]. 2016 [cited 2024 Apr 17];22(1):36-44. DOI https://doi.org/10.4158/EP15894.OR
Eades M, Murphy J, Carney S, Amdouni S, Lemoignan J, Jelowicki M et al. Effect of an interdisciplinary rehabilitation program on quality of life in patients with head and neck cancer: review of clinical experience. Head and Neck [Internet]. 2013 [cited 2024 Apr 17];35(3). DOI https://doi.org/10.1002/hed.22972
Fujita T, Iida Y, Tanaka C, Nakamura K, Ueno J, Iino Y et al. Development and evaluation of an "Interdisciplinary Postoperative Support Program" in outpatient clinics after thoracic esophagectomy. IJS [Internet]. 2017 [cited 2024 Apr 17]; 43:58-66. DOI https://doi.org/10.1016/j.ijsu.2017.05.036
Heil T, Verdaasdonk E, Maas H, Munster B, Rikkert M, de Wilt J et al. Improved Postoperative Outcomes after Prehabilitation for Colorectal Cancer Surgery in Older Patients: An Emulated Target Trial. Ann Surg Oncol [Internet]. 2023 [cited 2024 Apr 17];30(1):244-254. DOI https://doi.org/10.1245%2Fs10434-022-12623-9
Hulst H, Bastiaannet E, Portielje J, Bol J, Dekker J. Can physical prehabilitation prevent complications after colorectal cancer surgery in frail older patients? Eur J Surg Oncol [Internet]. 2021 [cited 2024 Apr 17];41(11). DOI https://doi.org/10.1016/j.ejso.2021.05.044
Illini O, Valipour A, Gattinger D, Petrovic M, Fabikan H, Hochmair M et al. Effectiveness of Outpatient Pulmonary Rehabilitation in Patients with Surgically Resected Lung Cancer: A Retrospective Real-World Analysis. Cancers [Internet]. 2022 [cited 2024 Apr 17];14(14). DOI https://doi.org/10.3390/cancers14143479
Jain R, Gibson L, Corboun N. Prehabilitation for surgical oncology patients: empowering patient volition. Support Care Cancer [Internet]. 2018 [cited 2024 Apr 17]; 26:3665–3667. DOI https://doi.org/10.1007/s00520-018-4300-4
Klerk M, Van-Dalen D, Venrooij L, Meijerink W, Verdaasdonk E. A multimodal prehabilitation program in high-risk patients undergoing elective resection for colorectal cancer: A retrospective cohort study. Eur J Surg Oncol [Internet]. 2021 [cited 2024 Apr 17];47(11):2849-2856. DOI: https://doi.org/10.1016/j.ejso.2021.05.033
Loughney L, Cahill R, O‘Malley K, McCaffrey N, Furlong B. Compliance, adherence and effectiveness of a community-based pre-operative exercise programme: a pilot study. Periop Med [Internet]. 2019 [cited 2024 Apr 17]. DOI https://doi.org/10.1186/s13741-019-0126-y
Machado P, Pimenta S, Garcia A, Nogueira T, Silva S, Oliveiros B et al. Home-Based Preoperative Exercise Training for Lung Cancer Patients Undergoing Surgery: A Feasibility Trial. J. Clin. Med. [Internet]. 2023 [cited 2024 Apr 17];12(8). DOI https://doi.org/10.3390/jcm12082971
Mina D, Sellers D, Au D, Alibhai S, Clarke H, Cuthbertson B et al. A Pragmatic Non-Randomized Trial of Prehabilitation Prior to Cancer Surgery: Study Protocol and COVID-19-Related Adaptations. Frontiers Oncol [Internet]. 2021 [cited 2024 Apr 17];11. DOI https://doi.org/10.3389/fonc.2021.629207
Mina D, Hilton W, Matthew A, Awasthi R, Bousquet-Dion G, Alibhai S et al. Prehabilitation for radical prostatectomy: A multicentre randomized controlled trial. Surg. Oncol [Internet]. 2018 [cited 2024 Apr 17];27(2):289-298. DOI https://doi.org/10.1016/j.suronc.2018.05.010
Miralpeix E, Sole-Sedeno J, Rodriguez-Cosmen C, Taus A, Muns M, Fabregó B et al. Impact of prehabilitation during neoadjuvant chemotherapy and interval cytoreductive surgery on ovarian cancer patients: a pilot study. World J Surg Oncol [Internet]. 2022 [cited 2024 Apr 17];20(46). DOI https://doi.org/10.1186/s12957-022-02517-1
Moore J, Scoggins C, Philips P, Egger M, Tennant P, Little J et al. Implementation of Prehabilitation for Major Abdominal Surgery and Head and Neck Surgery: a Simplified Seven-Day Protocol. J Gastrointest Surg [Internet]. 2021 [cited 2024 Apr 17]; 25:2076-2082. DOI https://doi.org/10.1007/s11605-020-04740-1
Nakajima H, Yokoyama Y, Inoue T, Nagaya M, Mizuno Y, Kadono I et al. Clinical Benefit of Preoperative Exercise and Nutritional Therapy for Patients Undergoing Hepato-Pancreato-Biliary Surgeries for Malignancy. Ann Surg Oncol [Internet]. 2019 [cited 2024 Apr 17];26(1). DOI https://doi.org/10.1245/s10434-018-6943-2
Rooijen S, Carli F, Dalton S, Thomas G, Bojesen R, Le G et al. Multimodal prehabilitation in colorectal cancer patients to improve functional capacity and reduce postoperative complications: the first international randomized controlled trial for multimodal prehabilitation. BMC Cancer [Internet]. 2019 [cited 2024 Apr 17];19(1). DOI https://doi.org/10.1186/s12885-018-5232-6
Rooijen S, Molenaar C, Schep G, Lieshout R, Beijer S, Dubbers R et al. Making Patients Fit for Surgery: Introducing a Four Pillar Multimodal Prehabilitation Program in Colorectal Cancer. Am J Phys Med Rehabil [Internet]. 2019 [cited 2024 Apr 17];98(10):888-896. DOI https://doi.org/10.1097/phm.0000000000001221
Schmidt H, Boese S, Lampe K, Jordan K, Fiedler E, Muller-Werdan U et al. Trans sectoral care of geriatric cancer patients based on comprehensive geriatric assessment and patient-reported quality of life - Results of a multicenter study to develop and pilot test a patient-centered interdisciplinary care concept for geriatric oncology patients (PIVOG).
J Geriatr Oncol [Internet]. 2017 [cited 2024 Apr 17];8(4):262-270. DOI https://doi.org/10.1016/j.jgo.2017.04.002
Souwer E, Bastiaannet E, Bruijin S, Breugom A, Bos F, Portielje J et al. Comprehensive multidisciplinary care program for elderly colorectal cancer patients: “From prehabilitation to independence”. Eur J Surg Oncol [Internet]. 2018 [cited 2024 Apr 17];44(12):1864-1900. DOI https://doi.org/10.1016/j.ejso.2018.08.028
Sorg M, Trone J, Méry B, Guichard J, Rivoirard R, Pecaut C et al. Re-entrainment to physical activity in the global management of breast cancer: pilot study in a mono-institutional experience. Bull Cancer [Internet]. 2014 [cited 2024 Apr 17];101(7-8):698-702. DOI https://doi.org/10.1684/bdc.2014.2009
Wooten S, Fleming R, Wolf Jr J, Stray-Gundersen S, Bartholomew J, Mendoza D et al. Prehabilitation program composed of blood flow restriction training and sports nutrition improves physical functions in abdominal cancer patients awaiting surgery. Eur J Surg Oncol [Internet]. 2021 [cited 2024 Apr 17];47(11). DOI https://doi.org/10.1016/j.ejso.2021.05.038.
Wu F, Rotimi O, Laza-Cagigas R, Rampal T. The Feasibility and Effects of a Telehealth-Delivered Home-Based Prehabilitation Program for Cancer Patients during the Pandemic. Curr. Oncol. [Internet]. 2021 [cited 2024 Apr 17];28(3). DOI https://doi.org/10.3390/curroncol28030207
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Copyright (c) 2024 Pedro Emílio Gomes Prates, Antonio Jorge Silva Correa-Júnior, Tatiana Mara da Silva Russo, Camila Maria Silva Paraizo-Horvath, André Aparecido da Sila Teles, Helena Megumi Sonobe nobe; Tatiana Mara da Silva Russo
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
