Department of Colorectal Surgery, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
Colorectal Dis. 2020 Sep;22(9):1139-1146. doi: 10.1111/codi.15036. Epub 2020 Apr 11.
Our aim was to identify whether personality traits and decision-making styles affect quality of life (QoL) outcomes and levels of psychological distress following pelvic exenteration (PE).
Patients undergoing PE between 2008 and 2015 were identified from a prospectively maintained database at a single quaternary referral centre. Patients were invited to complete two validated questionnaires, with the Big Five inventory being used to assess personality traits and the Melbourne Decision Making Questionnaire to determine decision-making style. Data on QoL outcomes and distress from the prospectively established database were utilized. QoL with respect to both physical and mental health components was measured using Short Form 36 version 2 (SF-36v2) and the Functional Assessment of Cancer Therapy - Colorectal (FACT-C). Distress was measured using the Distress Thermometer. Postoperative pain scores were also measured using SF-36v2.
Of the 93 patients eligible for participation, 42 returned the study questionnaire. On multivariate analysis, neuroticism was the most significant predictor of poorer QoL and increased levels of distress, consistent across all of the measures utilized and at the different time points used. Other personality traits showed an isolated statistically significant impact upon QoL. There were no significant findings with respect to decision-making style. Apart from neuroticism, the most significant predictor of QoL was the number of major complications for the patient.
Patients demonstrating neurotic personality traits show poorer QoL outcomes and higher levels of distress following PE. Identification of these patients would allow targeted pre- and postoperative intervention to improve outcomes following PE.
本研究旨在确定人格特质和决策风格是否会影响盆腔廓清术后（PE）的生活质量（QoL）结局和心理困扰程度。
从一家四级转诊中心的前瞻性数据库中确定了 2008 年至 2015 年间接受 PE 的患者。邀请患者完成两份经验证的问卷，使用大五人格量表评估人格特质，使用墨尔本决策问卷确定决策风格。利用前瞻性建立的数据库中的 QoL 结局和困扰数据。使用短表 36 版本 2（SF-36v2）和癌症治疗功能评估-结直肠癌（FACT-C）评估身心健康两个方面的 QoL。使用痛苦温度计测量困扰程度。还使用 SF-36v2 测量术后疼痛评分。
在 93 名符合参与条件的患者中，有 42 名患者返回了研究问卷。在多变量分析中，神经质是 QoL 较差和困扰程度增加的最显著预测因素，这在所有使用的测量指标和不同的时间点上都是一致的。其他人格特质也对 QoL 有孤立的统计学显著影响。决策风格方面没有显著发现。除了神经质之外，预测 QoL 的最重要因素是患者的主要并发症数量。
表现出神经质人格特质的患者在接受 PE 后 QoL 结局较差，困扰程度较高。识别这些患者将允许针对这些患者进行术前和术后的干预，以改善 PE 后的结局。
