Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Colorectal Dis. 2010 Dec;12(12):1198-207. doi: 10.1111/j.1463-1318.2009.02008.x.
The study assessed compliance of patients with familial adenomatous polyposis (FAP) with endoscopic surveillance.
In this nationwide, cross-sectional study, individuals from FAP families registered with the Netherlands Foundation for the Detection of Hereditary Tumours were invited to complete a questionnaire on endoscopic screening experiences.
A total of 328 individuals were eligible for the study of whom 85 were at risk for FAP, 108 had an intact rectum after a colectomy with ileorectal anastomosis (IRA), and 135 had had a pouch following a proctocolectomy with ileoanal anastomosis (IPAA). Based on medical record data, 20% of the at-risk group and 26% of the IRA-group were found to be undercompliant with surveillance advice which was associated significantly with perceived self-efficacy, use of sedatives during surveillance, pain after surveillance and low perceived benefits of surveillance (P < 0.05).
One in five individuals at risk for FAP and one in four with a retained rectum are undercompliant with screening advice. We recommend that sedatives should be patient-tailored for FAP individuals undergoing surveillance and that adequate pain medication be provided after endoscopy.
本研究评估了家族性腺瘤性息肉病（FAP）患者对内镜监测的依从性。
在这项全国性的横断面研究中，邀请荷兰遗传性肿瘤检测基金会注册的 FAP 家族成员填写一份内镜筛查体验问卷。
共有 328 人符合研究条件，其中 85 人有 FAP 风险，108 人在接受结肠直肠切除术和回肠直肠吻合术（IRA）后直肠完整，135 人在接受直肠结肠切除术和回肠肛管吻合术（IPAA）后有袋。根据病历数据，风险组中有 20%和 IRA 组中有 26%的人不遵守监测建议，这与自我效能感、监测时使用镇静剂、监测后疼痛和对监测益处的低感知显著相关（P<0.05）。
五分之一有 FAP 风险的人和四分之一保留直肠的人不遵守筛查建议。我们建议在对接受监测的 FAP 个体使用镇静剂时应根据患者情况进行调整，并在内镜检查后提供足够的止痛药物。
