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Published in: Journal of Genetic Counseling 5/2016

01-10-2016 | Original Research

Quality of Life in Adults with Neurofibromatosis 1 in Brazil

Authors: Natália Parenti Bicudo, Balduíno Ferreira de Menezes Neto, Lucimar Retto da Silva de Avó, Carla Maria Ramos Germano, Débora Gusmão Melo

Published in: Journal of Genetic Counseling | Issue 5/2016

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Abstract

Neurofibromatosis type 1 (NF1) is a neurocutaneous genetic disorder that can be associated with severe complications, and it may shorten patients’ lifespan and affect their quality of life negatively. This study aimed to examine quality of life constructs among adults with NF1 in Brazil. It is an exploratory, descriptive and cross-sectional study consisting of two stages, involving thirteen adult patients with NF1. The first stage was developed using a quantitative methodology, namely the WHOQOL-100 questionnaire; responses for the 13 patients were compared to a matched control group. The second stage comprised clinical-qualitative research whereby participants took part in a semi-structured interview; these data were analyzed using the categorical thematic analysis technique. There were no statistically significant differences in the questionnaire domains between the NF1 patients and the control subjects. Eighteen main themes were extracted from the interviews, showing interference of the NF1 visibility principally in psychological aspects and social relationships. Patients mentioned curiosity about NF1 and confusion about the distinctions between NF1 and contagious diseases, which lead to prejudice. They were concerned about the future and how the disease would develop in themselves and their offspring, and emphasized difficulties acquiring proper healthcare. These findings may help in planning healthcare for Brazilian NF1 patients and improving their quality of life.
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Literature
go back to reference Ablon, J. (1996). Gender response to neurofibromatosis 1. Social Science & Medicine, 42(1), 99–109.CrossRef Ablon, J. (1996). Gender response to neurofibromatosis 1. Social Science & Medicine, 42(1), 99–109.CrossRef
go back to reference Bardin, L. (2011). Análise de conteúdo (Vol. 70, p. 279). São Paulo: Edições. Bardin, L. (2011). Análise de conteúdo (Vol. 70, p. 279). São Paulo: Edições.
go back to reference Benjamin, C. M., Colley, A., Donnai, D., Kingston, H., Harris, R., & Kerzin-Storrar, L. (1993). Neurofibromatosis type 1 (NF1): knowledge, experience, and reproductive decisions of affected patients and families. Journal of Medical Genetics, 30(7), 567–74. doi:10.1136/jmg.30.7.567.CrossRefPubMedPubMedCentral Benjamin, C. M., Colley, A., Donnai, D., Kingston, H., Harris, R., & Kerzin-Storrar, L. (1993). Neurofibromatosis type 1 (NF1): knowledge, experience, and reproductive decisions of affected patients and families. Journal of Medical Genetics, 30(7), 567–74. doi:10.​1136/​jmg.​30.​7.​567.CrossRefPubMedPubMedCentral
go back to reference Cerello, A. C., Gianordoli-Nascimento, I. F., Moreira, A. H., Rocha, V. S., L.de Ribeiro, M., & de Rezende, N. A. (2013). Social representations of patients and relatives regarding Type 1 Neurofibromatosis. Ciência & Saúde Coletiva, 18(8), 2359–2368. doi:10.1590/S1413-81232013000800020.CrossRef Cerello, A. C., Gianordoli-Nascimento, I. F., Moreira, A. H., Rocha, V. S., L.de Ribeiro, M., & de Rezende, N. A. (2013). Social representations of patients and relatives regarding Type 1 Neurofibromatosis. Ciência & Saúde Coletiva, 18(8), 2359–2368. doi:10.​1590/​S1413-8123201300080002​0.CrossRef
go back to reference Cohen, J. S., Levy, H. P., Sloan, J., Dariotis, J., & Biesecker, B. B. (2015). Depression among adults with neurofibromatosis type 1: prevalence and impact on quality of life. Clinical Genetics, 88(5), 425–430. doi:10.1111/cge.12551.CrossRefPubMed Cohen, J. S., Levy, H. P., Sloan, J., Dariotis, J., & Biesecker, B. B. (2015). Depression among adults with neurofibromatosis type 1: prevalence and impact on quality of life. Clinical Genetics, 88(5), 425–430. doi:10.​1111/​cge.​12551.CrossRefPubMed
go back to reference Crawford, H. A., Barton, B., Wilson, M. J., Berman, Y., McKelvey-Martin, V. J., Morrison, P. J., et al. (2015). The impact of neurofibromatosis type 1 on the health and wellbeing of Australian adults. Journal of Genetic Counseling. doi:10.1007/s10897-015-9829-5.PubMed Crawford, H. A., Barton, B., Wilson, M. J., Berman, Y., McKelvey-Martin, V. J., Morrison, P. J., et al. (2015). The impact of neurofibromatosis type 1 on the health and wellbeing of Australian adults. Journal of Genetic Counseling. doi:10.​1007/​s10897-015-9829-5.PubMed
go back to reference Fleck, M. P., Louzada, S., Xavier, M., Chachamovich, E., Vieira, G., Santos, L., et al. (1999). Application of the Portuguese version of the instrument for the assessment of quality of life of the World Health Organization (WHOQOL-100). Revista de Saúde Pública, 33(2), 198–205.CrossRefPubMed Fleck, M. P., Louzada, S., Xavier, M., Chachamovich, E., Vieira, G., Santos, L., et al. (1999). Application of the Portuguese version of the instrument for the assessment of quality of life of the World Health Organization (WHOQOL-100). Revista de Saúde Pública, 33(2), 198–205.CrossRefPubMed
go back to reference Fombuena, M., Galiana, L., Barreto, P., Oliver, A., Pascual, A., & Soto-Rubio, A. (2015). Spirituality in patients with advanced illness: the role of symptom control, resilience and social network. Journal of Health Psychology. doi:10.1177/1359105315586213.PubMed Fombuena, M., Galiana, L., Barreto, P., Oliver, A., Pascual, A., & Soto-Rubio, A. (2015). Spirituality in patients with advanced illness: the role of symptom control, resilience and social network. Journal of Health Psychology. doi:10.​1177/​1359105315586213​.PubMed
go back to reference Fontanella, B. J., Campos, C. J., & Turato, E. R. (2006). Data collection in clinical-qualitative research: use of non-directed interviews with open-ended questions by health professionals. Revista Latino-Americana de Enfermagem, 14(5), 812–820. doi:10.1590/S0104-11692006000500025.CrossRefPubMed Fontanella, B. J., Campos, C. J., & Turato, E. R. (2006). Data collection in clinical-qualitative research: use of non-directed interviews with open-ended questions by health professionals. Revista Latino-Americana de Enfermagem, 14(5), 812–820. doi:10.​1590/​S0104-1169200600050002​5.CrossRefPubMed
go back to reference Fontanella, B. J., Luchesi, B. M., Saidel, M. G., Ricas, J., Turato, E. R., & Melo, D. G. (2011). Sampling in qualitative research: a proposal for procedures to detect theoretical saturation. Cadernos de Saúde Pública, 27(2), 388–394. doi:10.1590/S0102-311X2011000200020.PubMed Fontanella, B. J., Luchesi, B. M., Saidel, M. G., Ricas, J., Turato, E. R., & Melo, D. G. (2011). Sampling in qualitative research: a proposal for procedures to detect theoretical saturation. Cadernos de Saúde Pública, 27(2), 388–394. doi:10.​1590/​S0102-311X201100020002​0.PubMed
go back to reference Granström, S., Langenbruch, A., Augustin, M., & Mautner, V. F. (2012). Psychological burden in adult neurofibromatosis type 1 patients: impact of disease visibility on body image. Dermatology, 224(2), 160–167. doi:10.1159/000337548.CrossRefPubMed Granström, S., Langenbruch, A., Augustin, M., & Mautner, V. F. (2012). Psychological burden in adult neurofibromatosis type 1 patients: impact of disease visibility on body image. Dermatology, 224(2), 160–167. doi:10.​1159/​000337548.CrossRefPubMed
go back to reference Ironson, G., & Kremer, H. (2009). Spiritual transformation, psychological well-being, health, and survival in people with HIV. International Journal of Psychiatry in Medicine, 39(3), 263–281. doi:10.2190/PM.39.3.d.CrossRefPubMed Ironson, G., & Kremer, H. (2009). Spiritual transformation, psychological well-being, health, and survival in people with HIV. International Journal of Psychiatry in Medicine, 39(3), 263–281. doi:10.​2190/​PM.​39.​3.​d.CrossRefPubMed
go back to reference Jim, H. S., Pustejovsky, J. E., Park, C. L., Danhauer, S. C., Sherman, A. C., Fitchett, G., et al. (2015). Religion, spirituality, and physical health in cancer patients: a meta-analysis. Cancer, 121(21), 3760–3768. doi:10.1002/cncr.29353.CrossRefPubMed Jim, H. S., Pustejovsky, J. E., Park, C. L., Danhauer, S. C., Sherman, A. C., Fitchett, G., et al. (2015). Religion, spirituality, and physical health in cancer patients: a meta-analysis. Cancer, 121(21), 3760–3768. doi:10.​1002/​cncr.​29353.CrossRefPubMed
go back to reference Kodra, Y., Giustini, S., Divona, L., Porciello, R., Calvieri, S., Wolkenstein, P., et al. (2009). Health-related quality of life in patients with neurofibromatosis type 1. A survey of 129 Italian patients. Dermatology, 218(3), 215–220. doi:10.1159/000187594.CrossRefPubMed Kodra, Y., Giustini, S., Divona, L., Porciello, R., Calvieri, S., Wolkenstein, P., et al. (2009). Health-related quality of life in patients with neurofibromatosis type 1. A survey of 129 Italian patients. Dermatology, 218(3), 215–220. doi:10.​1159/​000187594.CrossRefPubMed
go back to reference Krab, L. C., Oostenbrink, R., de Goede-Bolder, A., Aarsen, F. K., Elgersma, Y., & Moll, H. A. (2009). Health-related quality of life in children with neurofibromatosis type 1: contribution of demographic factors, disease-related factors, and behavior. Journal of Pediatrics, 154(3), 420–425. doi:10.1016/j.jpeds.2008.08.045.CrossRefPubMed Krab, L. C., Oostenbrink, R., de Goede-Bolder, A., Aarsen, F. K., Elgersma, Y., & Moll, H. A. (2009). Health-related quality of life in children with neurofibromatosis type 1: contribution of demographic factors, disease-related factors, and behavior. Journal of Pediatrics, 154(3), 420–425. doi:10.​1016/​j.​jpeds.​2008.​08.​045.CrossRefPubMed
go back to reference Levin, J. S., & Chatters, L. M. (1998). Religion, health, and psychological well-being in older adults: findings from three national surveys. Journal of Aging and Health, 10(4), 504–531.CrossRefPubMed Levin, J. S., & Chatters, L. M. (1998). Religion, health, and psychological well-being in older adults: findings from three national surveys. Journal of Aging and Health, 10(4), 504–531.CrossRefPubMed
go back to reference Melo, D. G., de Paula, P. K., de Araujo Rodrigues, S., da Silva de Avó, L. R., Germano, C. M., & Demarzo, M. M. (2015). Genetics in primary health care and the national policy on comprehensive care for people with rare diseases in Brazil: opportunities and challenges for professional education. Journal of Community Genetics, 6(3), 231–240. doi:10.1007/s12687-015-0224-6.CrossRefPubMedPubMedCentral Melo, D. G., de Paula, P. K., de Araujo Rodrigues, S., da Silva de Avó, L. R., Germano, C. M., & Demarzo, M. M. (2015). Genetics in primary health care and the national policy on comprehensive care for people with rare diseases in Brazil: opportunities and challenges for professional education. Journal of Community Genetics, 6(3), 231–240. doi:10.​1007/​s12687-015-0224-6.CrossRefPubMedPubMedCentral
go back to reference Merker, V. L., Bredella, M. A., Cai, W., Kassarjian, A., Harris, G. J., Muzikansky, A., et al. (2014). Relationship between whole-body tumor burden, clinical phenotype, and quality of life in patients with neurofibromatosis. American Journal of Medical Genetics Part A, 164A(6), 1431–1437. doi:10.1002/ajmg.a.36466.CrossRefPubMed Merker, V. L., Bredella, M. A., Cai, W., Kassarjian, A., Harris, G. J., Muzikansky, A., et al. (2014). Relationship between whole-body tumor burden, clinical phenotype, and quality of life in patients with neurofibromatosis. American Journal of Medical Genetics Part A, 164A(6), 1431–1437. doi:10.​1002/​ajmg.​a.​36466.CrossRefPubMed
go back to reference NIH. (1988). National Institutes of Health Consensus Development Conference Statement: neurofibromatosis. Bethesda, Md, USA, July 13–15, 1987. Neurofibromatosis, 1(3), 172–178. NIH. (1988). National Institutes of Health Consensus Development Conference Statement: neurofibromatosis. Bethesda, Md, USA, July 13–15, 1987. Neurofibromatosis, 1(3), 172–178.
go back to reference Oates, E. C., Payne, J. M., Foster, S. L., Clarke, N. F., & North, K. N. (2013). Young Australian adults with NF1 have poor access to health care, high complication rates, and limited disease knowledge. American Journal of Medical Genetics Part A, 161A(4), 659–666. doi:10.1002/ajmg.a.35840.CrossRefPubMed Oates, E. C., Payne, J. M., Foster, S. L., Clarke, N. F., & North, K. N. (2013). Young Australian adults with NF1 have poor access to health care, high complication rates, and limited disease knowledge. American Journal of Medical Genetics Part A, 161A(4), 659–666. doi:10.​1002/​ajmg.​a.​35840.CrossRefPubMed
go back to reference Page, P. Z., Page, G. P., Ecosse, E., Korf, B. R., Leplege, A., & Wolkenstein, P. (2006). Impact of neurofibromatosis 1 on quality of life: a cross-sectional study of 176 American cases. American Journal of Medical Genetics Part A, 140(18), 1893–1998. doi:10.1002/ajmg.a.31422.CrossRefPubMed Page, P. Z., Page, G. P., Ecosse, E., Korf, B. R., Leplege, A., & Wolkenstein, P. (2006). Impact of neurofibromatosis 1 on quality of life: a cross-sectional study of 176 American cases. American Journal of Medical Genetics Part A, 140(18), 1893–1998. doi:10.​1002/​ajmg.​a.​31422.CrossRefPubMed
go back to reference Rafferty, K. A., Billig, A. K., & Mosack, K. E. (2015). Spirituality, religion, and health: the role of communication, appraisals, and coping for individuals living with chronic illness. Journal of Religion and Health, 54(5), 1870–1885. doi:10.1007/s10943-014-9965-5.CrossRefPubMed Rafferty, K. A., Billig, A. K., & Mosack, K. E. (2015). Spirituality, religion, and health: the role of communication, appraisals, and coping for individuals living with chronic illness. Journal of Religion and Health, 54(5), 1870–1885. doi:10.​1007/​s10943-014-9965-5.CrossRefPubMed
go back to reference Riccardi, V. M., & Kleiner, B. (1977). Neurofibromatosis: a neoplastic birth defect with two age peaks of severe problems. Birth Defects Original Article Series, 13(3C), 131–138.PubMed Riccardi, V. M., & Kleiner, B. (1977). Neurofibromatosis: a neoplastic birth defect with two age peaks of severe problems. Birth Defects Original Article Series, 13(3C), 131–138.PubMed
go back to reference Samuelsson, B., & Riccardi, V. M. (1989). Neurofibromatosis in Gothenburg, Sweden. III. Psychiatric and social aspects. Neurofibromatosis, 2(2), 84–106.PubMed Samuelsson, B., & Riccardi, V. M. (1989). Neurofibromatosis in Gothenburg, Sweden. III. Psychiatric and social aspects. Neurofibromatosis, 2(2), 84–106.PubMed
go back to reference Sharif, S., Moran, A., Huson, S. M., Iddenden, R., Shenton, A., Howard, E., et al. (2007). Women with neurofibromatosis 1 are at a moderately increased risk of developing breast cancer and should be considered for early screening. Journal of Medical Genetics, 44(8), 481–484. doi:10.1136/jmg.2007.049346.CrossRefPubMedPubMedCentral Sharif, S., Moran, A., Huson, S. M., Iddenden, R., Shenton, A., Howard, E., et al. (2007). Women with neurofibromatosis 1 are at a moderately increased risk of developing breast cancer and should be considered for early screening. Journal of Medical Genetics, 44(8), 481–484. doi:10.​1136/​jmg.​2007.​049346.CrossRefPubMedPubMedCentral
go back to reference Tedrus, G. M., Fonseca, L. C., De Pietro Magri, F., & Mendes, P. H. (2013). Spiritual/religious coping in patients with epilepsy: relationship with sociodemographic and clinical aspects and quality of life. Epilepsy & Behavior, 28(3), 386–390. doi:10.1016/j.yebeh.2013.05.011.CrossRef Tedrus, G. M., Fonseca, L. C., De Pietro Magri, F., & Mendes, P. H. (2013). Spiritual/religious coping in patients with epilepsy: relationship with sociodemographic and clinical aspects and quality of life. Epilepsy & Behavior, 28(3), 386–390. doi:10.​1016/​j.​yebeh.​2013.​05.​011.CrossRef
go back to reference Vranceanu, A. M., Merker, V. L., Park, E., & Plotkin, S. R. (2013). Quality of life among adult patients with neurofibromatosis 1, neurofibromatosis 2 and schwannomatosis: a systematic review of the literature. Journal of Neuro-Oncology, 114(3), 257–262. doi:10.1007/s11060-013-1195-2.CrossRefPubMed Vranceanu, A. M., Merker, V. L., Park, E., & Plotkin, S. R. (2013). Quality of life among adult patients with neurofibromatosis 1, neurofibromatosis 2 and schwannomatosis: a systematic review of the literature. Journal of Neuro-Oncology, 114(3), 257–262. doi:10.​1007/​s11060-013-1195-2.CrossRefPubMed
go back to reference Vranceanu, A. M., Merker, V. L., Plotkin, S. R., & Park, E. R. (2014). The relaxation response resiliency program (3RP) in patients with neurofibromatosis 1, neurofibromatosis 2, and schwannomatosis: results from a pilot study. Journal of Neuro-Oncology, 120(1), 103–109. doi:10.1007/s11060-014-1522-2.CrossRefPubMed Vranceanu, A. M., Merker, V. L., Plotkin, S. R., & Park, E. R. (2014). The relaxation response resiliency program (3RP) in patients with neurofibromatosis 1, neurofibromatosis 2, and schwannomatosis: results from a pilot study. Journal of Neuro-Oncology, 120(1), 103–109. doi:10.​1007/​s11060-014-1522-2.CrossRefPubMed
go back to reference Vranceanu, A. M., Merker, V. L., Park, E. R., & Plotkin, S. R. (2015). Quality of life among children and adolescents with neurofibromatosis 1: a systematic review of the literature. Journal of Neuro-Oncology, 122(2), 219–228. doi:10.1007/s11060-015-1725-1.CrossRefPubMed Vranceanu, A. M., Merker, V. L., Park, E. R., & Plotkin, S. R. (2015). Quality of life among children and adolescents with neurofibromatosis 1: a systematic review of the literature. Journal of Neuro-Oncology, 122(2), 219–228. doi:10.​1007/​s11060-015-1725-1.CrossRefPubMed
go back to reference Wolters, P. L., Burns, K. M., Martin, S., Baldwin, A., Dombi, E., Toledo-Tamula, M. A., et al. (2015). Pain interference in youth with neurofibromatosis type 1 and plexiform neurofibromas and relation to disease severity, social-emotional functioning, and quality of life. American Journal of Medical Genetics Part A, 167(9), 2103–2113. doi:10.1002/ajmg.a.37123.CrossRef Wolters, P. L., Burns, K. M., Martin, S., Baldwin, A., Dombi, E., Toledo-Tamula, M. A., et al. (2015). Pain interference in youth with neurofibromatosis type 1 and plexiform neurofibromas and relation to disease severity, social-emotional functioning, and quality of life. American Journal of Medical Genetics Part A, 167(9), 2103–2113. doi:10.​1002/​ajmg.​a.​37123.CrossRef
Metadata
Title
Quality of Life in Adults with Neurofibromatosis 1 in Brazil
Authors
Natália Parenti Bicudo
Balduíno Ferreira de Menezes Neto
Lucimar Retto da Silva de Avó
Carla Maria Ramos Germano
Débora Gusmão Melo
Publication date
01-10-2016
Publisher
Springer US
Published in
Journal of Genetic Counseling / Issue 5/2016
Print ISSN: 1059-7700
Electronic ISSN: 1573-3599
DOI
https://doi.org/10.1007/s10897-016-9939-8

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