Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Level 1, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore, 117597, Singapore.
Division of Colorectal Surgery and Surgical Oncology, Department of Surgery, National University Cancer Institute, National University Hospital, Singapore, Singapore.
Support Care Cancer. 2022 Jun;30(6):5401-5410. doi: 10.1007/s00520-022-06963-1. Epub 2022 Mar 17.
Colorectal cancer (CRC) surgeries are major, complex, and often associated with debilitating symptoms or significant deconditioning that may impair patients' quality of life. Little is known about how patients and family caregivers cope and their unmet needs during this daunting perioperative phase. This study aimed to explore the experiences and needs of CRC patients who undergo surgery and their family caregivers.
An exploratory qualitative design was adopted. A total of 27 participants comprising fifteen outpatients who had undergone colorectal cancer surgery and twelve family caregivers were recruited through purposive sampling from a public tertiary hospital in Singapore between December 2019 and November 2020. Individual, audio-recorded, semi-structured interviews were conducted, transcribed verbatim, and analyzed using thematic analysis.
Four themes emerged: initial reactions to the diagnosis, impact of the illness and surgery, personal coping, and external support. The lack of apparent assessments on the psychological well-being of patients was found despite several participants exhibiting early signs of distress. Access to psychological support provided by healthcare professionals or peers was selective, and knowledge deficit was prevalent, especially in the preoperative stage.
Psychological priming and strengthening are important for CRC patients' and their caregivers' adaptive coping throughout the treatment continuum. Technology-based, dyadic psychoeducation should be offered preoperatively to ease CRC patients' acceptance of their diagnosis and adjustment to life after surgery while at the same time reduce the burden of family carers.
结直肠癌（CRC）手术是重大、复杂的手术，常伴有使人虚弱的症状或显著的失能，可能会损害患者的生活质量。对于患者和家属在这一令人生畏的围手术期阶段如何应对以及他们的未满足需求，知之甚少。本研究旨在探讨接受手术的 CRC 患者及其家属的经历和需求。
采用探索性定性设计。2019 年 12 月至 2020 年 11 月，通过在新加坡一家公立 tertiary 医院的目的性抽样，共招募了 27 名参与者，包括 15 名接受过结直肠癌手术的门诊患者和 12 名家属照顾者。进行了个体、录音、半结构化访谈，逐字转录，并使用主题分析进行分析。
出现了四个主题：对诊断的最初反应、疾病和手术的影响、个人应对和外部支持。尽管有几名参与者表现出早期的痛苦迹象，但发现尽管对患者的心理健康进行了几次评估，但仍缺乏明显的评估。获得医疗保健专业人员或同行提供的心理支持是有选择性的，知识缺陷普遍存在，尤其是在术前阶段。
心理启动和强化对于 CRC 患者及其照顾者在整个治疗过程中的适应性应对至关重要。应在术前提供基于技术的双相心理教育，以减轻 CRC 患者对诊断的接受程度和对手术后生活的调整，同时减轻照顾者的负担。
