Hong Kyung Sook, Oh Bo-Young, Kim Eui-Jung, Chung Soon Sup, Kim Kwang Ho, Lee Ryung-Ah
Department of Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.
Department of Psychiatry, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.
Ann Surg Treat Res. 2014 Mar;86(3):152-60. doi: 10.4174/astr.2014.86.3.152. Epub 2014 Feb 24.
In recent years, many psychological problems in patients with stomas have been addressed in a number of studies. But there are only a few studies that use objective measures to take into account self-appraisal by patients with permanent or temporary stomas. The aim of this study is to compare the psychological attitude of patients with permanent and temporary stomas and to determine the most appropriate psychological supportive care.
Sixty-five patients, who received a stoma between January 2009 and March 2012, were classified into two groups with either permanent or temporary stomas and were observed prospectively. We developed a questionnaire with the aid of a psychiatrist to analyze the grade of psychological attitude of self-appraisal of patients. The questionnaire was categorized into three parts; body image scale, self-esteem scale, and depression scale. Patients responded to the questionnaire 4 weeks after the operation and the answers of each group were compared.
Out of 65 patients, 42 received temporary stomas and 23 received permanent stomas. There was no significant mean difference between permanent and temporary stoma patients in the body image scale, the self-esteem scale, and the depression scale. However, patients with a permanent stoma tended to have a worse body image and lower self-esteem on some specific items within the questionnaires.
Patients with stomas have negative attitudes toward themselves and some meaningful differences were found between different types of stoma applied. Surgeons should be concerned about postoperative psychological support for patients with stomas.
近年来,多项研究探讨了造口患者的诸多心理问题。但仅有少数研究采用客观测量方法来考量永久性或临时性造口患者的自我评估。本研究旨在比较永久性和临时性造口患者的心理态度,并确定最适宜的心理支持护理。
将2009年1月至2012年3月期间接受造口手术的65例患者分为永久性造口组和临时性造口组,并进行前瞻性观察。我们在精神科医生的协助下编制了一份问卷,以分析患者自我评估的心理态度等级。问卷分为三个部分:身体意象量表、自尊量表和抑郁量表。患者在术后4周对问卷进行作答,并比较两组的答案。
65例患者中,42例接受临时性造口,23例接受永久性造口。永久性造口患者和临时性造口患者在身体意象量表、自尊量表和抑郁量表上的平均差异无统计学意义。然而,永久性造口患者在问卷中的某些特定项目上往往身体意象较差且自尊较低。
造口患者对自身持消极态度,不同类型造口之间存在一些有意义的差异。外科医生应关注造口患者术后的心理支持。