Division of Plastic and Reconstructive Surgery, McGill University Health Center, Montreal, Canada.
Department of Ophthalmology, McGill University, Montreal, Canada.
Ann Surg. 2022 May 1;275(5):1013-1017. doi: 10.1097/SLA.0000000000004156. Epub 2020 Jul 7.
This study examines and contrasts the effect of risk disclosure on risk acceptance and perceived changes in quality of life (QoL) among individuals with and without facial disfigurement.
Psychological distress has been previously shown to alter patients' perception of certain treatments. Due to the grave risks and complications of FT, it is important to understand whether the psychological trauma associated with facial disfigurement alters their perception of FT and its associated risks.
Participants with and without facial disfigurement were recruited to complete a questionnaire about their perceived QoL, sense of identity, and willingness to proceed with FT in the context of 3 different hypothetical scenarios involving facial disfiguration.
Four hundred nine nonfacially disfigured and 74 facially disfigured participants were included. When both healthy and facially disfigured individuals were presented with the risks and benefits of a FT, they both perceived their QoL to be as low, or significantly lower, than if they had severe facial disfigurement. Furthermore, presenting the risks of FT significantly altered the decision making and risk acceptance of healthy individuals with no facial disfigurement. However, risk disclosure did not affect the decision making among facially disfigured individuals.
This study highlights that presenting the complication profile of FT decreases risk acceptance of FT in healthy individuals but has no significant effects on facially disfigured individuals. The psychological impact of facial disfigurement and its influence on accepting the significant risks of FT should be considered and warrants further investigation.
本研究旨在探讨和对比有面部缺陷和无面部缺陷的个体中，风险披露对风险接受和感知生活质量（QoL）变化的影响。
先前的研究表明，心理困扰会改变患者对某些治疗的看法。由于面部畸形相关的游离皮瓣移植（FT）风险高且并发症多，因此了解与面部缺陷相关的心理创伤是否会改变他们对 FT 及其相关风险的看法非常重要。
招募有面部缺陷和无面部缺陷的参与者，让他们填写一份关于感知 QoL、身份认同感以及在涉及面部畸形的 3 种不同假设情况下对 FT 的意愿的问卷。
共纳入 409 名无面部缺陷和 74 名有面部缺陷的参与者。当健康个体和有面部缺陷的个体都面临 FT 的风险和益处时，他们都认为自己的 QoL 与严重面部畸形时一样低，甚至更低。此外，呈现 FT 的风险显著改变了无面部缺陷的健康个体的决策和风险接受能力。然而，风险披露并没有影响有面部缺陷的个体的决策。
本研究强调，呈现 FT 的并发症概况会降低健康个体对 FT 的风险接受程度，但对面部缺陷个体没有显著影响。应考虑面部缺陷的心理影响及其对面部畸形患者接受重大风险的影响，并值得进一步研究。
