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新冠疫情时期择期脊柱手术取消的经济和心理影响。

The economic and psychological impact of cancellations of elective spinal surgeries in the COVID-19 era.

机构信息

Department of Neurosurgery and Neurooncology, First Faculty of Medicine, Charles University and Military University Hospital Prague, Prague, Czech Republic.

Department of Anesthesiology and Critical Care Medicine, Third Faculty of Medicine, Charles University and Hospital Kralovske Vinohrady, Prague, Czech Republic.

出版信息

Br J Neurosurg. 2024 Apr;38(2):322-326. doi: 10.1080/02688697.2020.1868404. Epub 2021 Jan 18.

Abstract

BACKGROUND

The adoption of health care restrictions due to the COVID-19 pandemic led to the cancellation of elective surgical care. However, the impact on patients is unknown.

OBJECTIVE

To evaluate the psychological and economic impact of the cancellation of scheduled spinal operations.

METHODS

We identified 50 patients with cancelled surgeries between 16 March 2020 and 24 April 2020. Forty-nine (98%) participants were contacted, with whom the modified WES-Pi questionnaire was filled in during a telephone interview.

RESULTS

Of the 49 respondents, 28 (57.2%) were aged <65 years. The most often reported problem (85.7%) was an ongoing limitation in basic daily activities. At least moderate sadness was experienced by 65.3% and disappointment by 73.5% of the patients. More than 80% reported concerns about the continuation and 73.5% about the progression of their symptoms. Out of 27 employees (55.1%), 63% could not work due to severe pain or movement limitation ( < .001). The inability to work was associated with anger ( = .037). The work-related impact of the cancellation was associated with stress ( < .0001) and concerns about continuing the symptoms ( = .004). Two-third of patients would undergo immediate surgery despite the current epidemic situation.

CONCLUSIONS

The cancellations of elective spinal surgeries have a serious psychological impact on patients. This together with potential economic consequences is especially evident in employees unable to work due to pain or movement disability. The information is beneficial for health management. Every effort should be made to resume planned surgical treatment if the epidemiological situation allows it.

摘要

背景

由于 COVID-19 大流行而采取的医疗限制措施导致择期手术治疗被取消。然而,其对患者的影响尚不清楚。

目的

评估取消计划中的脊柱手术对患者的心理和经济影响。

方法

我们确定了 2020 年 3 月 16 日至 2020 年 4 月 24 日期间取消手术的 50 名患者。联系了 49 名(98%)参与者,通过电话访谈对他们进行了改良 WES-Pi 问卷填写。

结果

在 49 名受访者中,28 名(57.2%)年龄<65 岁。最常报告的问题(85.7%)是基本日常生活活动受限。65.3%的患者感到持续悲伤,73.5%的患者感到失望。超过 80%的患者对症状的持续进展表示担忧,73.5%的患者对症状的持续进展表示担忧。27 名员工中(55.1%)有 63%的人因剧烈疼痛或运动受限而无法工作(<.001)。无法工作与愤怒相关( = .037)。取消手术对工作的影响与压力相关( < .0001),并与对继续出现症状的担忧相关( = .004)。尽管目前处于流行状态,仍有 2/3 的患者愿意立即接受手术。

结论

取消择期脊柱手术对患者造成严重的心理影响。这种情况再加上潜在的经济后果,在因疼痛或运动障碍而无法工作的员工中尤为明显。这些信息对健康管理很有帮助。如果流行病学情况允许,应尽一切努力恢复计划中的手术治疗。

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