Hamilton Amber A, Mehta Rena, Sue Epstein B, Fabricant Peter D, Fragomen Austin T, Robert Rozbruch S
Hospital for Special Surgery, Weill Cornell Medical College, Cornell University, New York, USA.
J Child Orthop. 2021 Apr 19;15(2):122-129. doi: 10.1302/1863-2548.15.200207.
Addressing the psychosocial needs of adolescents can improve surgical outcomes. The aim of this retrospective comparative study was to understand the core psychosocial factors that shaped the experiences of adolescents who underwent multiple limb lengthening/reconstruction surgeries (LLRS).
A novel 62-question survey was developed and administered to 31 patients from the study institution. Data was obtained using a self-report inventory assessing medical care, communication/connection to doctor, peer relations, physical space, self-esteem, counselling/clergy, physical/emotional support, school issues and concerns about future. This survey and demographic questions were administered to young adults (now aged 18 to 30 years) who underwent LLRS treatment between the ages of 11 to 20 years.
Psychosocial needs were determined to be within the categories of body image/self-esteem, subjective perception of treatment, patient-physician relationship, role of parents, peer interactions, academic performance and hospital experience. Patients valued parental involvement while also wanting their surgeon to speak directly to them. They preferred to be in private rooms on the paediatric floor and to not socialize while in the hospital. They were indifferent to keeping up with friends, speaking to a counsellor and having their surgeon inquire about their emotions. They expressed concern about pain, carrying out activities and the financial impact of surgery.
Adolescent LLRS patients value focused psychosocial support from their surgeon and caregivers. This perceived level of support influences their ability to cope with their condition. These findings helped us understand the psychological issues and preferences of adolescents who underwent LLRS and can assist orthopaedic surgeons in providing holistic care.
IV.
满足青少年的心理社会需求可改善手术效果。这项回顾性比较研究的目的是了解影响接受多肢体延长/重建手术（LLRS）的青少年经历的核心心理社会因素。
设计了一项包含62个问题的新型调查问卷，并对来自研究机构的31名患者进行了调查。数据通过自我报告清单获得，该清单评估医疗护理、与医生的沟通/联系、同伴关系、物理空间、自尊、咨询/神职人员、身体/情感支持、学校问题以及对未来的担忧。对11至20岁期间接受LLRS治疗的年轻人（现年龄在18至30岁之间）进行了这项调查和人口统计学问题调查。
心理社会需求被确定为身体形象/自尊、对治疗的主观认知、医患关系、父母的角色、同伴互动、学业成绩和医院经历等类别。患者重视父母的参与，同时也希望他们的外科医生能直接与他们交流。他们更喜欢住在儿科病房的私人房间里，住院期间不社交。他们对与朋友保持联系、与顾问交谈以及让外科医生询问他们的情绪漠不关心。他们对疼痛、开展活动以及手术的经济影响表示担忧。
青少年LLRS患者重视来自外科医生和护理人员的针对性心理社会支持。这种感知到的支持水平会影响他们应对自身状况的能力。这些发现有助于我们了解接受LLRS的青少年的心理问题和偏好，并可协助骨科医生提供全面护理。
四级。
