Fioravanti M, Di Cesare F, Ramelli L, La Torre F, Nicastro A, Messinetti S, Lazzari R
Istituto di Psicologia, Facoltà di Medicina e Chirurgia, Università La Sapienza, Roma.
Ital J Surg Sci. 1988;18(1):55-61.
The post-surgery psychological adjustment to enterostomy was examined in a longitudinal study of 120 patients. Subjects were representative of the general enterostomy patients population. All had undergone surgery in various hospitals located in Rome and its surroundings. Adjustment to enterostomy was longitudinally evaluated by interviewing patients at various intervals after enterostomy: soon after surgery; 1 year after surgery; more than 1 year after surgery. When patients were initially interviewed, information was requested on how they were informed of their clinical condition which led to surgery, as well as of enterostomy and its consequences. 42% reported a low level of understanding about enterostomy on the basis of information received during hospitalization. Patients were consequently divided into two groups, one including those judged as adequately informed (AI), and the other including those judged as not adequately informed (NAI). These groups were compared, for immediate adjustment to enterostomy (within 3-6 mos. since surgery), delayed adjustment (1 yr. since surgery), and prolonged adjustment (more than 1 yr. since surgery). Patients of NAI group demonstrated a consistently poorer pattern of adjustment in all parameters under study (emotional, cognitive, behavioral, social) and their adjustment to enterostomy did not show any spontaneous improvement over the time. AI patients, on the other hand, showed a more favorable level of adjustment since after surgery and a more positive pattern in the follow-up period. Adequate information before surgery and during hospitalization has been evidenced as a necessary component of patient care and a very important element in determining the optimal functional and psychological recovery of patients with enterostomy.(ABSTRACT TRUNCATED AT 250 WORDS)
一项针对120名患者的纵向研究对肠造口术后的心理调适情况进行了调查。研究对象具有肠造口术患者总体人群的代表性。他们均在罗马及其周边地区的多家医院接受了手术。通过在肠造口术后的不同时间间隔对患者进行访谈，纵向评估其对肠造口术的调适情况：术后不久；术后1年；术后1年以上。在患者首次接受访谈时，要求他们提供关于自己因何种临床状况而接受手术、以及肠造口术及其后果的信息。42%的患者表示，根据住院期间获得的信息，他们对肠造口术的了解程度较低。因此，患者被分为两组，一组包括被判定为信息充分的患者（AI），另一组包括被判定为信息不充分的患者（NAI）。对这两组患者在肠造口术的即时调适（术后3 - 6个月内）、延迟调适（术后1年）和长期调适（术后1年以上）方面进行了比较。NAI组患者在所有研究参数（情绪、认知、行为、社交）方面的调适模式始终较差，并且他们对肠造口术的调适情况并未随时间出现任何自发改善。另一方面，AI组患者自术后起调适水平更为良好，在随访期间呈现出更积极的模式。术前及住院期间提供充分信息已被证明是患者护理的必要组成部分，也是决定肠造口术患者实现最佳功能和心理恢复的非常重要的因素。（摘要截选至250词）
