Kuzu Mehmet Ayhan, Topçu Omer, Uçar Keriman, Ulukent Suat, Unal Ekrem, Erverdi Nezih, Elhan Atilla, Demirci Salim
Department of Surgery, University of Ankara, Ankara, Turkey.
Dis Colon Rectum. 2002 Oct;45(10):1359-66. doi: 10.1007/s10350-004-6425-4.
Living with a permanent colostomy significantly diminishes a patient's quality of life. However, little is known about its influence on worship patterns in Muslims. Therefore, the aim of this study was to assess the quality of life in Muslim patients after surgery for rectal carcinoma, especially with respect to religious worship.
We studied 178 patients who had undergone curative surgery for colorectal carcinoma. The patients fell into three groups based on the type of surgery they underwent: abdominoperineal resection (n = 75), sphincter-saving resection (n = 51), and anterior resection including sigmoid colectomy (n = 52). Quality of life was measured with the Medical Outcomes Study Short Form 36 Health Survey and a questionnaire that asked participants about their work responsibilities, sexual life, and religious worship.
The scores for all eight subscales of the Short Form 36 in the abdominoperineal resection group were significantly poorer than those in the sphincter-saving resection and anterior resection groups ( P< 0.001). In addition, social life and work responsibilities were significantly more affected in the abdominoperineal resection group than in the other two groups ( P< 0.001). A significantly ( P< 0.001) greater number of patients in the abdominoperineal resection group stopped praying daily (either alone or in a mosque) and fasting during Ramadan.
Two aspects of religious worship (praying and fasting) were significantly impaired in the Muslim patients who had a stoma as a result of sphincter-sacrificing surgery. To improve quality of life in these patients, religious issues as they relate to the presence of a stoma should be discussed during preoperative counseling, the informed consent process, and counseling with local religious authorities.
永久性结肠造口术会显著降低患者的生活质量。然而，关于其对穆斯林宗教礼拜模式的影响却知之甚少。因此，本研究的目的是评估直肠癌手术后穆斯林患者的生活质量，尤其是在宗教礼拜方面。
我们研究了178例接受结直肠癌根治性手术的患者。根据所接受的手术类型，患者分为三组：腹会阴联合切除术（n = 75）、保肛手术（n = 51）和包括乙状结肠切除术的前切除术（n = 52）。生活质量通过医学结局研究简表36健康调查以及一份询问参与者工作职责、性生活和宗教礼拜情况的问卷进行测量。
腹会阴联合切除术组简表36所有八个子量表的得分均显著低于保肛手术组和前切除术组（P < 0.001）。此外，腹会阴联合切除术组的社交生活和工作职责受到的影响明显大于其他两组（P < 0.001）。腹会阴联合切除术组中停止每日祈祷（无论是独自祈祷还是在清真寺祈祷）以及在斋月期间禁食的患者数量显著更多（P < 0.001）。
因保肛手术而有造口的穆斯林患者在宗教礼拜的两个方面（祈祷和禁食）受到了显著损害。为了提高这些患者的生活质量，应在术前咨询、知情同意过程以及与当地宗教当局的咨询中讨论与造口存在相关的宗教问题。
