Greenfield Jason A, Kimberly Laura L, Berman Zoe P, Ramly Elie P, Alfonso Allyson R, Lee Olive, Diep Gustave K, Rodriguez Eduardo D
Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y.
Division of Medical Ethics, Department of Population Health, NYU Langone Health, New York, N.Y.
Plast Reconstr Surg Glob Open. 2020 Aug 17;8(8):e2956. doi: 10.1097/GOX.0000000000002956. eCollection 2020 Aug.
The aim of facial transplantation (FT) was to enhance quality of life (QoL) for individuals living with severe facial disfigurement. Yet QoL has proved challenging to assess, as the field lacks a unified approach for incorporating FT recipients' perspectives into meaningful QoL measures. In this study, we review FT recipients' self-reported QoL through a qualitative analysis of publicly available posttransplant interviews to identify the aspects of QoL they report as meaningful.
A conventional qualitative content analysis was conducted through a comprehensive review of publicly available interviews with FT recipients. Data sources included English language audio, video, and online print interviews from 2008 to 2019. Recipient interview data were obtained for both partial and full FT recipients located in North America through Google and YouTube searches. Audio and video interviews were transcribed, and an inductive content analysis was used to develop and apply a coding scheme to all interview transcripts. Codes were subsequently grouped into categories and interpreted into themes.
In total, 81 interviews representing 12 North American, English-speaking face transplant recipients were collected from internet sources, of which 74 interviews remained after exclusion criteria were applied. Three themes emerged representing the dimensions of QoL emphasized by FT recipients: (1) reconstitution and re-embodiment of physical/corporeal selfhood, (2) integrity of cognitive/emotional selfhood, and (3) social selfhood and the importance of social integration.
This study provides an insight into North American FT recipients' experiences, values, and goals and illuminates critical aspects of QoL that are meaningful to this unique patient population, which may not be fully captured by currently available assessment tools. The themes developed in this study link facets of QoL to the overall significance of embodied selfhood among FT recipients and will help inform the future development of FT-specific patient-reported QoL outcome measures.
面部移植(FT)的目的是提高严重面部毁容患者的生活质量(QoL)。然而,事实证明,生活质量评估具有挑战性,因为该领域缺乏一种将面部移植受者的观点纳入有意义的生活质量测量的统一方法。在本研究中,我们通过对公开的移植后访谈进行定性分析,回顾面部移植受者自我报告的生活质量,以确定他们认为有意义的生活质量方面。
通过全面回顾公开的面部移植受者访谈,进行常规定性内容分析。数据来源包括2008年至2019年的英语音频、视频和在线印刷访谈。通过谷歌和YouTube搜索,获取了北美部分和全脸移植受者的访谈数据。对音频和视频访谈进行转录,并采用归纳性内容分析方法,为所有访谈转录本制定并应用编码方案。随后将代码分组为类别并解释为主题。
总共从互联网来源收集了81份访谈,代表12名北美说英语的面部移植受者,在应用排除标准后,剩下74份访谈。出现了三个主题,代表面部移植受者强调的生活质量维度:(1)身体/肉体自我的重构和重新体现,(2)认知/情感自我的完整性,以及(3)社会自我和社会融合的重要性。
本研究深入了解了北美面部移植受者的经历、价值观和目标,并阐明了对这一独特患者群体有意义的生活质量的关键方面,而目前可用的评估工具可能无法完全涵盖这些方面。本研究中形成的主题将生活质量的各个方面与面部移植受者中体现自我的整体重要性联系起来,并将有助于为未来特定于面部移植的患者报告的生活质量结果测量的发展提供信息。