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前往服务欠缺地区的全球头颈部手术之旅后生活质量改善的预测因素。

Predictors of Quality-of-Life Improvements Following Global Head and Neck Surgery Trips to Underserved Regions.

机构信息

Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California-San Diego, San Diego, California, U.S.A.

Division of Rhinology and Endoscopic Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, U.S.A.

出版信息

Laryngoscope. 2021 Sep;131(9):2006-2010. doi: 10.1002/lary.29522. Epub 2021 Mar 18.

Abstract

OBJECTIVES/HYPOTHESIS: To conduct longitudinal postoperative follow-up and discern health-related quality-of-life (HR-QoL) changes using a validated questionnaire among patients undergoing head and neck surgeries during a short-term, global surgical trip in a resource-limited setting. To identify clinicodemographic predictors of post-operative HR-QoL improvements in this setting.

STUDY DESIGN

Retrospective observational study with prospective follow-up.

METHODS

Patients undergoing surgery at Moi Teaching and Referral Hospital in Eldoret, Kenya through the authors' short-term surgical trip (STST) between 2016 and 2019 were asked to complete preoperative Short Form-36 (SF-36) HR-QoL questionnaires, and postoperative SF-36 questionnaires during subsequent follow-up. Preoperative and postoperative SF-36 domain scores, and two composite scores (mental component summary [MCS] and physical component summary [PCS]) were compared. Linear regression models were fit to identify clinicodemographic factors predictors of general health (GH), MCS, and PCS scores.

RESULTS

Among the 26 participating patients, significant improvements were seen in post-operative GH (mean change = 19.8) and MCS (mean change = 11.2) scores. Lower pre-operative GH, MCS, and PCS scores were predictive of greater improvement in the corresponding post-operative scores. Longer time to follow-up was associated with greater improvement in GH score. Mean follow-up interval was 23.1 months (SD = 1.8 months).

CONCLUSIONS

Utilizing the SF-36 questionnaire, we found that patients' perception of their general and psychosocial health improved after undergoing head and neck surgeries through a global STST. This study provides important, preliminary evidence that that elective surgeries performed in low-resource settings convey substantial benefit to patient QoL.

LEVEL OF EVIDENCE

4 Laryngoscope, 131:2006-2010, 2021.

摘要

目的/假设:在资源有限的环境下,通过短期全球外出行医,对接受头颈部手术的患者进行纵向术后随访,并使用经过验证的问卷来识别与健康相关的生活质量(HR-QoL)变化。确定该环境下术后 HR-QoL 改善的临床预测因素。

研究设计

回顾性观察性研究,前瞻性随访。

方法

作者于 2016 年至 2019 年期间在肯尼亚埃尔多雷特的莫伊教学和转诊医院进行短期外出行医期间,邀请接受手术的患者填写术前 36 项简短健康调查问卷(SF-36)HR-QoL 问卷,并在随后的随访中填写术后 SF-36 问卷。比较术前和术后 SF-36 领域评分,以及两个综合评分(心理成分综合评分 [MCS] 和身体成分综合评分 [PCS])。拟合线性回归模型以确定一般健康(GH)、MCS 和 PCS 评分的临床预测因素。

结果

在 26 名参与患者中,术后 GH(平均变化=19.8)和 MCS(平均变化=11.2)评分均显著提高。术前 GH、MCS 和 PCS 评分较低与术后相应评分的改善更大相关。随访时间更长与 GH 评分的改善更大相关。平均随访间隔为 23.1 个月(SD=1.8 个月)。

结论

利用 SF-36 问卷,我们发现通过全球短期外出行医,患者对头颈部手术后自身一般和心理社会健康的感知得到改善。这项研究提供了重要的初步证据,表明在资源匮乏的环境中进行的择期手术确实给患者的生活质量带来了巨大的益处。

证据水平

4.喉镜,131:2006-2010,2021。

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