Department of Surgery, Hamilton Health Sciences and McMaster University, Hamilton, ON, Canada.
Department of Surgery, London Regional Cancer Program, Western University, London, ON, Canada.
Ann Surg Oncol. 2019 Apr;26(4):1063-1070. doi: 10.1245/s10434-018-07120-x. Epub 2019 Jan 2.
The cytoreduction and hyperthermic intraperitoneal chemotherapy (CS/HIPEC) procedure is complex, involving lengthy preparation and recovery in a heterogeneous patient group. Understanding the patient experience is essential to improving interactions with health professionals that is critical to recovery.
This study sought to characterize the early recovery and return to quality of life (at 3 and 6-12 months post-surgery, respectively) in patients having undergone CS/HIPEC, through structured interviews.
Two sets of interviews were conducted among 20 CS/HIPEC patients. Interviews were uploaded into QSR NVivo 10 qualitative software (QSR International, Australia) and coded by two study personnel. Interview 1 focused on initial treatment decision making and postoperative hospitalization, while interview 2 focused on recovery, supports, and return to quality of life.
Among the participants, 60% were female and the mean age was 57 years (range 31-71). Diagnoses included disseminated peritoneal adenomucinosis (n = 6), appendiceal adenocarcinoma (n = 4), colorectal adenocarcinoma (n = 6), goblet cell (n = 2), and mesothelioma (n = 2). The first interview identified common themes of perioperative psychosocial isolation, lack of direction, and the importance of an established support system. Patients requested printed and audiovisual materials focused on addressing expectations. The main findings from the second interview captured patient experiences with longer-term complications, as well as surveillance.
Focused interviews with patients recently having undergone CS/HIPEC identified key issues that may be addressed in programs to improve the patient experience. These issues were distinctly different in relation to phase of recovery, and patient-centered programs designed with these factors in mind have the potential to enhance the recovery process.
细胞减灭术和腹腔热灌注化疗（CS/HIPEC）过程复杂，涉及到在异质患者群体中进行长时间的准备和恢复。了解患者体验对于改善与健康专业人员的互动至关重要，这对于康复至关重要。
本研究通过结构访谈，旨在描述接受 CS/HIPEC 的患者的早期恢复和生活质量（分别在手术后 3 个月和 6-12 个月时）。
对 20 名 CS/HIPEC 患者进行了两组访谈。访谈被上传到 QSR NVivo 10 定性软件（QSR International，澳大利亚），并由两名研究人员进行编码。访谈 1 重点关注初始治疗决策和术后住院治疗，而访谈 2 重点关注恢复、支持和生活质量的恢复。
在参与者中，60%是女性，平均年龄为 57 岁（范围 31-71）。诊断包括弥漫性腹膜腺粘液瘤（n=6）、阑尾腺癌（n=4）、结直肠癌（n=6）、杯状细胞（n=2）和间皮瘤（n=2）。第一次访谈确定了围手术期社会心理隔离、缺乏方向和建立支持系统的重要性等常见主题。患者要求提供针对期望的印刷和视听材料。第二次访谈的主要发现是患者对长期并发症以及监测的体验。
对最近接受 CS/HIPEC 的患者进行的重点访谈确定了可能在改善患者体验的项目中解决的关键问题。这些问题与恢复阶段明显不同，考虑到这些因素设计的以患者为中心的计划有可能增强恢复过程。
