[向患者提供的腮腺切除术信息的解读与记忆]

Laccourreye L, Werner A, Cauchois R, Laccourreye O

Service d'otorhinolaryngologie et de chirurgie cervicofaciale, université d'Angers, CHU d'Angers, Angers, France.

Ann Otolaryngol Chir Cervicofac. 2009 Apr;126(2):53-60. doi: 10.1016/j.aorl.2009.02.003. Epub 2009 Apr 5.

OBJECTIVE

A prospective analysis of patient memorization and perception of the preoperative information provided on the surgical risks related to parotidectomy for benign tumor.

PATIENTS AND METHODS

A prospective study conducted in an academic tertiary care referral center. An inception cohort of 51 patients with a benign tumor of the parotid gland consecutively informed by the same surgeon over the period from 2003 to 2006. Analysis of the consequences of the preoperative information on the surgery-related risks, in terms of patient perception of the information and the degree of memorization.

RESULTS

After being informed on the risks related to surgery, 15.6% of patients declined surgery and 9.1% elected to wait 6 months on average before undergoing surgery. Among the patients who had a parotidectomy performed, 83.3% had a positive opinion and 33.3% had a negative opinion regarding the preoperative information delivered regarding the surgical related risks; 26.8% of patients simultaneously expressed a positive and a negative opinion. None of the patients remembered more than four out of the five main surgical risks; 64.3% of the patients remembered only one or two surgery-related risks, and 7.1% of the patients did not remember a single surgery-related risk. In addition, 83.3% of patients remembered the risk of facial nerve paralysis, 40.4% the risk of death, and 23.8% the risk of Frey's syndrome, while 14.2 and 2.3% of patients remembered the common risks related to surgery and the risk of neuroma, respectively. In univariate analysis, no significant statistical relation was noted between the variables under analysis and either patient memorization or perception of the various surgery-related risks related to parotidectomy.

CONCLUSION

Patient information regarding the surgical risks resulted in substantial stress for the patient and modified the patient-surgeon relation. This information caused a certain number of patients to decide not to follow the surgeon's advice.

目的

对患者记忆及对腮腺良性肿瘤切除术相关手术风险术前信息的认知进行前瞻性分析。

患者与方法

在一家学术性三级医疗转诊中心进行的前瞻性研究。2003年至2006年期间，由同一位外科医生连续告知51例腮腺良性肿瘤患者。分析术前信息对手术相关风险的影响，包括患者对信息的认知及记忆程度。

结果

在被告知手术相关风险后，15.6%的患者拒绝手术，9.1%的患者选择平均等待6个月后再接受手术。在接受腮腺切除术的患者中，83.3%对所提供的关于手术相关风险的术前信息持积极态度，33.3%持消极态度；26.8%的患者同时表达了积极和消极的看法。没有患者能记住五项主要手术风险中的四项以上；64.3%的患者仅记住一两项手术相关风险，7.1%的患者一项手术相关风险都没记住。此外，83.3%的患者记住了面神经麻痹风险，40.4%记住了死亡风险，23.8%记住了Frey综合征风险，而分别有14.2%和2.3%的患者记住了与手术相关的常见风险和神经瘤风险。在单因素分析中，所分析的变量与患者对腮腺切除术各种手术相关风险的记忆或认知之间未发现显著的统计学关系。