Kossintseva Irèn, Zloty David
*Both authors are affiliated with the Department of Dermatology & Skin Science, University of British Columbia, Vancouver, British Columbia, Canada.
Dermatol Surg. 2017 Aug;43(8):1029-1035. doi: 10.1097/DSS.0000000000001152.
Patients undergoing Mohs micrographic surgery (MMS) exhibit anxiety relating to cancer cure or the expected cosmetic outcome.
To obtain quantitative measurements of perioperative cancer and cosmetic anxiety levels in first-time MMS patients. Parameters influencing anxiety and its natural course were assessed.
Prospective, single-blinded, questionnaire study of 173 patients undergoing MMS of the face. Anxiety levels were assessed using a visual analog scale preoperatively and postoperatively over 6 months.
Mohs patients demonstrate a trend to greater or equal anxiety about cancer over cosmesis at all measured time points, but differences only reached statistical significance beginning 1 week postoperatively. Clinically relevant lowering of cancer anxiety levels is delayed until 3 months postoperatively. Cosmetic anxiety reaches a clinically relevant improvement by 1 week. The intuitive predictors of cosmetic anxiety, namely female gender and younger age, were quantitatively reinforced in this study. The predictor of cancer anxiety was the use of preoperative lorazepam.
To maximize patient care, Mohs surgeons must be aware of covert patient anxieties and the parameters, which influence these anxieties. Identifying and anticipating the course of cancer- and cosmetic-related anxieties will reduce patient fears, improving their satisfaction with the MMS experience.
接受莫氏显微外科手术（MMS）的患者表现出与癌症治愈或预期美容效果相关的焦虑。
获取首次接受MMS患者围手术期癌症及美容焦虑水平的定量测量结果。评估影响焦虑及其自然病程的参数。
对173例接受面部MMS手术的患者进行前瞻性、单盲问卷调查研究。术前及术后6个月使用视觉模拟量表评估焦虑水平。
在所有测量时间点，莫氏手术患者对癌症的焦虑趋势大于或等于对美容的焦虑，但差异仅在术后1周开始具有统计学意义。癌症焦虑水平在临床上显著降低延迟至术后3个月。美容焦虑在术后1周达到临床上显著改善。本研究定量强化了美容焦虑的直观预测因素，即女性和较年轻的年龄。癌症焦虑的预测因素是术前使用劳拉西泮。
为了最大限度地提高患者护理质量，莫氏外科医生必须了解患者潜在的焦虑情绪以及影响这些焦虑的参数。识别并预测与癌症和美容相关的焦虑病程将减轻患者恐惧，提高他们对MMS手术体验的满意度。
