Shakespeare V, Postle K
Laing Laboratory for Plastic Surgery and Burn Research, Salisbury District Hospital, UK.
Br J Plast Surg. 1999 Apr;52(3):198-204. doi: 10.1054/bjps.1999.3106.
The objectives of this study were to discover the views of patients about the effects of breast-reduction surgery carried out 2 years previously, to detect any change from perceptions at 3-6 months after surgery, and to determine whether the benefits of this operation are maintained long term. Qualitative research methods were employed, comprising: (a) an open-format survey of opinions; (b) semi-structured telephone interviews with a smaller number of patients; and (c) assessment of self-concept using a well-known scalar measure (the Rosenberg Self-esteem Scale). The subjects were 93 patients treated at the regional Plastic Surgery Service in Salisbury, who had previously participated in a quantitative study at 3-6 months after surgery. Sixty patients responded to the 2-year follow-up. Benefits of breast reduction most valued by patients did not change significantly with time and were: relief of pain and discomfort, which led to increased physical activity and better general health; greatly increased choice and fit of attractive clothes and underwear; improved personal and social life, leading to enhanced relationships with partner or friends; and greatly improved self-confidence in all areas of life. The interaction of all these factors led to improved self-image and improved quality of life. The main disadvantage of the operation for a small number of patients was the persistence of painful, disfiguring scarring which in two cases had a detrimental effect on social and personal relationships and led to a deterioration in quality of life. Improvement in self-esteem after surgery was maintained in 55 out of the 60 2-year responders. The results indicate that breast reduction confers significant health gains which are maintained in the long term.
本研究的目的是了解患者对两年前进行的乳房缩小手术效果的看法，检测与术后3至6个月时的认知相比是否有任何变化，并确定该手术的益处是否能长期维持。采用了定性研究方法，包括：（a）开放式意见调查；（b）对少数患者进行半结构化电话访谈；以及（c）使用一种知名的标量测量工具（罗森伯格自尊量表）评估自我概念。研究对象是在索尔兹伯里地区整形手术服务中心接受治疗的93名患者，他们之前在术后3至6个月时参与了一项定量研究。60名患者对2年随访做出了回应。患者最看重的乳房缩小手术的益处并未随时间显著变化，这些益处包括：疼痛和不适减轻，这使得身体活动增加且总体健康状况改善；美观衣物和内衣的选择和合身程度大大增加；个人和社交生活改善，从而增进了与伴侣或朋友的关系；以及生活各方面的自信心大大增强。所有这些因素的相互作用导致了自我形象的改善和生活质量的提高。对少数患者而言，该手术的主要缺点是疼痛、毁容性疤痕持续存在，在两例病例中，这对社交和个人关系产生了不利影响，并导致生活质量下降。在60名对2年随访做出回应的患者中，有55名患者术后自尊水平的改善得以维持。结果表明，乳房缩小手术带来了显著的健康益处，且这些益处在长期内得以维持。
