Royal Alexandra Hospital, Paisley, UK.
School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.
Colorectal Dis. 2018 Nov;20(11):970-980. doi: 10.1111/codi.14293. Epub 2018 Jul 5.
Colorectal surgeons regularly make the decision to anastomose, defunction or form an end colostomy when performing rectal surgery. This study aimed to define personality traits of colorectal surgeons and explore any influence of such traits on the decision to perform a rectal anastomosis.
Fifty attendees of The Association of Coloproctology of Great Britain and Ireland 2016 Conference participated. After written consent, all underwent personality testing: alexithymia (inability to understand emotions), type of thinking process (intuitive versus rational) and personality traits (extraversion, agreeableness, openness, emotional stability, conscientiousness). Questions were answered regarding anastomotic decisions in various clinical scenarios and results analysed to reveal any influence of the surgeon's personality on anastomotic decision.
Participants were: male (86%), consultants (84%) and based in England (68%). Alexithymia was low (4%) with 81% displaying intuitive thinking (reflex, fast). Participants scored higher in emotional stability (ability to remain calm) and conscientiousness (organized, methodical) compared with population norms. Personality traits influenced the next anastomotic decision if: surgeons had recently received criticism at a departmental audit meeting; were operating with an anaesthetist that was not their regular one; or there had been no anastomotic leaks in their patients for over 1 year.
Colorectal surgeons have speciality relevant personalities that potentially influence the important decision to anastomose and could explain the variation in surgical practice across the UK. Future work should explore these findings in other countries and any link of personality traits to patient-related outcomes.
直肠手术中,结直肠外科医生通常需要决定是否进行吻合、功能障碍或形成末端结肠造口术。本研究旨在确定结直肠外科医生的人格特征,并探讨这些特征对行直肠吻合术决策的影响。
共有 50 名参加 2016 年英国和爱尔兰结直肠外科学会会议的与会者参与了本研究。在书面同意后,所有参与者均接受了人格测试:述情障碍(无法理解情绪)、思维过程类型(直觉与理性)和人格特质(外向性、宜人性、开放性、情绪稳定性、尽责性)。回答了各种临床情况下的吻合决策问题,并对结果进行分析,以揭示外科医生的人格对吻合决策的影响。
参与者为:男性(86%)、顾问(84%)和英格兰(68%)。述情障碍较低(4%),81%表现出直觉思维(反射性、快速)。与人群平均值相比,参与者在情绪稳定性(保持冷静的能力)和尽责性(有组织、有条理)方面的得分较高。如果外科医生最近在部门审计会议上受到批评、与非常规麻醉师一起手术,或其患者在 1 年以上时间内没有吻合口漏,则人格特质会影响下一次吻合决策。
结直肠外科医生具有特定的专业相关人格特征,这可能会影响到吻合这一重要决策,并解释了英国各地手术实践的差异。未来的研究应在其他国家探索这些发现,并探讨人格特征与患者相关结局之间的联系。