Moolenburgh Sanne E, Mureau Marc A M, Versnel Sarah L, Duivenvoorden Hugo J, Hofer Stefan O P
Department of Plastic and Reconstructive Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
Psychooncology. 2009 Jul;18(7):747-52. doi: 10.1002/pon.1459.
Total or partial nasal amputation following tumour resection is one of the more severe facial disfigurements. Successful nasal reconstruction can therefore be regarded as restoring a patient's psychosocial health. The objective of this study, therefore, was to evaluate different determinants of patient's psychosocial functioning and their effect on patient satisfaction after nasal reconstruction.
A cross-sectional study with a case-control study design was conducted. Level of satisfaction with nasal appearance and psychosocial functioning were assessed with validated questionnaires.
A total of 30 consecutive patients were recruited. They were treated between November 2001 and May 2005 for (sub)total nasal defects following radical tumour resection. For the control group 99 consented to participate. Social anxiety and avoidance were scored significantly higher within the patient group (p=0.01). Patients cope significantly more passive than controls (p=0.04). Self-esteem levels did not differ significantly between patients and controls (p=0.22). Determinants of satisfaction with nasal reconstruction were self-esteem (p=0.0001), active coping strategy (p=0.001), and passive coping strategy (p=0.0001).
Nasal reconstruction has an impact on psychosocial functioning of nasal reconstruction patients. In addition, self-esteem and coping strategy are important determinants of satisfaction with nasal reconstruction, and should be held in mind when treating a patient.
肿瘤切除术后全鼻或部分鼻切除是较为严重的面部毁容之一。因此,成功的鼻再造可被视为恢复患者的心理社会健康。所以,本研究的目的是评估患者心理社会功能的不同决定因素及其对鼻再造术后患者满意度的影响。
采用病例对照研究设计进行横断面研究。使用经过验证的问卷评估对鼻外观的满意度和心理社会功能。
共招募了30例连续患者。他们于2001年11月至2005年5月期间接受了根治性肿瘤切除术后(部分或全部)鼻缺损的治疗。对照组有99人同意参与。患者组的社交焦虑和回避得分显著更高(p=0.01)。患者应对方式比对照组明显更消极(p=0.04)。患者和对照组的自尊水平无显著差异(p=0.22)。鼻再造满意度的决定因素是自尊(p=0.0001)、积极应对策略(p=0.001)和消极应对策略(p=0.0001)。
鼻再造对鼻再造患者的心理社会功能有影响。此外,自尊和应对策略是鼻再造满意度的重要决定因素,在治疗患者时应予以考虑。