Jakobsson Jenny, Idvall Ewa, Wann-Hansson Christine
Department of Care Science, Malmö University, Sweden.
Department of Surgery, Skane University Hospital, Malmö, Sweden.
J Adv Nurs. 2016 Feb;72(2):328-38. doi: 10.1111/jan.12841. Epub 2015 Nov 9.
To describe and compare general health and state anxiety before surgery and up to 6 months after surgery in patients with colorectal cancer undergoing elective rectal resection, abdominoperineal resection or colonic resection in an enhanced recovery context.
Little is known about patient-reported health and anxiety after colorectal cancer surgery in an enhanced recovery context.
A prospective cohort study.
Data were collected from October 2011-February 2013. The questionnaires - EuroQol 5-Dimensions 3-Levels and State-Trait Anxiety Inventory - were answered before surgery, at discharge and 1 and 6 months after surgery. Data were analysed using inferential statistics to describe differences between groups of patients (Kruskal-Wallis test) and between assessments within groups (Friedman's anova).
Patients (N = 105), divided into three groups based on surgical procedure, showed a high health index and a low state anxiety in all assessments without differences between the groups. Patients considered for abdominoperineal resection rated their pre-operative health as significantly higher than patients after rectal and colonic resections did. Within groups, patients recovering from abdominoperineal resection and rectal resection deteriorated significantly in health index 1 month after surgery. However, after 6 months they had improved again. After colonic resection, patients improved significantly in self-rated health and anxiety 1 month after surgery with no further discernible improvement after 6 months.
The study showed that patients generally had a high level of health and a low level of anxiety throughout the study period. Only a few differences occurred between assessments within groups.
描述并比较在强化康复背景下接受择期直肠切除术、腹会阴联合切除术或结肠切除术的结直肠癌患者术前及术后长达6个月的总体健康状况和状态焦虑。
在强化康复背景下，关于结直肠癌手术后患者报告的健康状况和焦虑情况知之甚少。
一项前瞻性队列研究。
数据收集于2011年10月至2013年2月。使用欧洲五维健康量表3级版和状态-特质焦虑问卷在术前、出院时以及术后1个月和6个月进行调查。采用推断统计学分析数据，以描述患者组间差异（Kruskal-Wallis检验）和组内评估间差异（Friedman方差分析）。
患者（N = 105）根据手术方式分为三组，在所有评估中均显示出较高的健康指数和较低的状态焦虑，组间无差异。考虑接受腹会阴联合切除术的患者对其术前健康状况的评分显著高于直肠和结肠切除术后的患者。在组内，接受腹会阴联合切除术和直肠切除术的患者在术后1个月健康指数显著恶化。然而，6个月后他们又有所改善。结肠切除术后，患者在术后1个月自我评估的健康状况和焦虑水平显著改善，6个月后无进一步明显改善。
该研究表明，在整个研究期间患者总体健康水平较高，焦虑水平较低。组内评估之间仅出现了一些差异。
