Baur Karen M, Chamberlain Jill, Wendler M Cecilia, Harwood Paula, Colle Joni, Yeaman Deb
Memorial Medical Center, Springfield, IL, USA.
J Patient Exp. 2019 Dec;6(4):278-286. doi: 10.1177/2374373518803618. Epub 2018 Oct 2.
Lung volume reduction surgery (LVRS), a reduction in damaged lung tissue in end-stage chronic obstructive pulmonary disease, is a breakthrough surgical procedure requiring months of rigorous screening, testing, and conditioning. Engaging in this process is prolonged and challenging with no research found exploring patients and loved ones' experiences through this demanding process.
The purpose was to examine the experience of LVRS for patients and loved ones as they encounter the complex preparation required prior to, during, and throughout the extended convalescence following surgery.
A mixed-methods approach was used, combining health outcomes with interview data. Participants and loved ones were purposefully selected, invited, and consented during the perioperative phase of LVRS. Quantitative data were obtained via chart review, while qualitative data were gathered through a 2-stage interview process, preoperatively and postoperatively. Qualitative data were analyzed using naturalistic inquiry approaches.
Patients and loved ones described difficulties of living with illness during the preoperative phase, and expressed relief and joy for an improved quality of life afterward. The overarching theme uncovered was hope. Preoperatively, hope was coupled with anxiety about the upcoming surgery and potential outcomes, whereas the hope expressed after surgery focused on the future, in particular, a shared future. Statistically significant differences were found in the quality of life measures.
For both patients and loved ones, LVRS is filled with hope for a more expansive future. Although that future is unclear prior to surgery, clarification and a new normal signals hope for a shared future following LVRS.
肺减容手术(LVRS)是一种针对终末期慢性阻塞性肺疾病减少受损肺组织的手术,是一种突破性的外科手术,需要数月的严格筛查、测试和调理。参与这个过程漫长且具有挑战性,目前尚未发现有研究探讨患者及其亲人在这个苛刻过程中的经历。
目的是研究肺减容手术患者及其亲人在手术前、手术期间以及术后漫长康复过程中经历复杂准备时的体验。
采用混合方法,将健康结果与访谈数据相结合。在肺减容手术围手术期有目的地选择、邀请参与者及其亲人并获得他们的同意。通过病历审查获得定量数据,而定性数据则通过术前和术后两阶段访谈过程收集。使用自然主义探究方法分析定性数据。
患者及其亲人描述了术前与疾病共存的困难,并对术后生活质量的改善表示欣慰和喜悦。发现的总体主题是希望。术前,希望与对即将进行的手术和潜在结果的焦虑相伴,而术后表达的希望则侧重于未来,特别是共同的未来。在生活质量测量方面发现了统计学上的显著差异。
对于患者及其亲人来说,肺减容手术都充满了对更广阔未来的希望。虽然手术前未来尚不明朗,但明确和新的常态预示着肺减容手术后共同未来的希望。