Department of Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium.
Oncological Counselling Team, AZ Sint-Lucas Ghent, Ghent, Belgium.
Colorectal Dis. 2022 Sep;24(9):1032-1039. doi: 10.1111/codi.16145. Epub 2022 May 5.
Many patients are confronted with low anterior resection syndrome after rectal surgery. The perspectives of both healthcare professionals and patients on the impact of bowel problems may differ. This study aimed to explore experiences of healthcare professionals on how to provide, organise and optimise care for patients with low anterior resection syndrome from an interprofessional perspective.
An explorative qualitative design was used. Healthcare professionals were recruited in October 2018 in one general teaching hospital and one university hospital. Twenty one healthcare professionals from different professions caring for patients with low anterior resection syndrome were included in three focus group interviews.
Healthcare professionals confirmed a lack of focus on patients who are confronted with low anterior resection syndrome and stated a need for a standardised approach of care. Additionally, three levels for care optimization emerged from the data: information before surgery with strong emphasis on the timing of informing, counselling of patients when confronted with low anterior resection syndrome and organisation of care.
Healthcare professionals find it important to adopt the moment and amount of information to the coping mechanism and timing of the trajectory. Counselling and follow-up of patients with LARS should be organised proactively and should not remain restricted to pharmacological and nutritional advice. A possible strategy is to develop and implement late effects nurse-led clinics coordinated by the clinical nurse specialist.
许多直肠手术后的患者会出现前侧低位切除综合征。医护人员和患者对肠道问题影响的看法可能存在差异。本研究旨在从跨专业角度探讨医护人员如何为前侧低位切除综合征患者提供、组织和优化护理的经验。
采用探索性定性设计。2018 年 10 月,在一家综合教学医院和一家大学医院招募了医护人员。共有 21 名来自不同专业的医护人员参与了 3 次焦点小组访谈,这些医护人员负责照顾前侧低位切除综合征患者。
医护人员确认对前侧低位切除综合征患者的关注不足,并表示需要标准化的护理方法。此外,数据中还出现了三个护理优化层面:手术前的信息,重点是通知的时间;当患者出现前侧低位切除综合征时的咨询;以及护理的组织。
医护人员认为,根据应对机制和轨迹的时间,调整信息的时机和数量非常重要。应主动为 LARS 患者提供咨询和随访,而不仅仅局限于药物和营养建议。一种可能的策略是开发并实施由临床护士专家协调的、由后期效应护士主导的诊所。