Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Ontario, Canada.
J Neurosurg. 2010 May;112(5):1056-60. doi: 10.3171/2009.6.JNS09716.
Routine and nonselective use of awake and outpatient craniotomy for supratentorial tumors has been shown to be safe and effective from a medical standpoint. In this study the authors aim was to explore patients' perceptions about awake and outpatient craniotomy.
Qualitative research methodology was used. Two semistructured, open-ended interviews were conducted with 27 participants, who were ambulatory adult patients who underwent craniotomy for brain tumor excision between October 2008 and April 2009. The participants were each assigned to one of the following categories: 1) awake outpatient; 2) awake inpatient; 3) outpatient under general anesthesia; and 4) inpatient under general anesthesia. Interviews were audiotaped and transcribed, and the data were subjected to thematic analysis.
The following 6 overarching themes emerged from the data: 1) patients had a positive experience with awake craniotomy; 2) patient satisfaction with outpatient surgery was high; 3) patients understood the rationale behind awake surgery; 4) patients were surprised that brain surgery can be done on an outpatient basis; 5) trust in one's surgeon was important; and 6) patients were more concerned about the disease than the procedure.
The results reflected positively on the patients' awake and outpatient surgery experience, but there were some areas that require improvement, specifically perioperative pain control and postoperative care. These insights on patients' perspectives can lead to better delivery of care, and ultimately, improved health outcomes.
从医学角度来看，常规和非选择性使用清醒和门诊开颅术治疗幕上肿瘤是安全有效的。在这项研究中，作者旨在探讨患者对清醒和门诊开颅术的看法。
采用定性研究方法。对 27 名接受开颅术切除脑肿瘤的活动成年人患者进行了两次半结构化、开放式访谈，这些患者在 2008 年 10 月至 2009 年 4 月期间进行了手术。每位患者被分配到以下类别之一：1）清醒门诊；2）清醒住院；3）全身麻醉下门诊；4）全身麻醉下住院。访谈进行了录音和转录，并对数据进行了主题分析。
从数据中得出以下 6 个总体主题：1）患者对清醒开颅术有积极的体验；2）患者对门诊手术的满意度很高；3）患者理解清醒手术的基本原理；4）患者对脑外科手术可以在门诊进行感到惊讶；5）信任自己的外科医生很重要；6）患者更关心疾病而不是手术过程。
研究结果反映了患者对清醒和门诊手术的积极体验，但在一些方面仍需要改进，特别是围手术期疼痛控制和术后护理。这些患者观点的见解可以改善护理的提供，并最终改善健康结果。
