Department of Nursing, Wuhan University Zhongnan Hospital, Wuhan, China.
Department of Gastrointestinal Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China.
PeerJ. 2023 Mar 24;11:e15037. doi: 10.7717/peerj.15037. eCollection 2023.
Due to the changes of bowel physiological structure and functional disorders after rectal cancer surgery, patients will face many bowel dysfunction for a long time, which will greatly affect their quality of life. The purpose of this review is to integrate the qualitative research on the experience of bowel dysfunction and coping strategies in postoperative patients with rectal cancer.
Systematic retrieval of PubMed, EMbase, Cochrane Library, CINAHL, Web of Sciences, PsycINFO, Willey and other databases was carried out by using the method of subject words and keywords. The Critical Appraisal Skill Programme (CASP) Qualitative Studies Checklist was used for Qualitative assessment. The findings were extracted from the included study and synthesized into the final themes, which was evaluated strictly in accordance with the ConQual process.
Nine studies involving 345 participants were included and two main themes were extracted: "Experience a series of changes caused by bowel dysfunction" and "nmet needs and coping strategies facing bowel dysfunction". The changes of rectal cancer patients who experience bowel dysfunction after operation mainly include three parts: bowel dysfunction is more than just a bowel reaction, which covers the bowel symptoms themselves and the subsequent body-related symptoms. The interruption of a normal life, mainly reflected in personal, family, and social life. Complex psychological reactions to bowel dysfunction, psychological changes have a dual nature, showing a positive and negative intertwined. There are two main aspects of unmet needs and coping strategies: the demand is mainly manifested in the need for information and support from medical professionals, while the coping strategy mainly includes diet, activity and drug management.
Rectal cancer patient often experience persistent bowel dysfunction after operation, which has a certain physical and mental effects. A series of new needs of postoperative patients are often not fully met, and patients often rely on their own empirical attempts to seek balance, less can get professional support. Future studies need to focus on how to provide continuous information support for postoperative rectal cancer patients, especially professional care from health care staff.
由于直肠癌手术后肠道生理结构和功能障碍的改变，患者将长期面临多种肠道功能障碍，这将极大地影响他们的生活质量。本综述的目的是整合直肠癌术后患者肠道功能障碍体验和应对策略的定性研究。
采用主题词和关键词的方法，系统检索 PubMed、EMbase、Cochrane Library、CINAHL、Web of Sciences、PsycINFO、Willey 等数据库。使用批判性评估技能计划（CASP）定性研究检查表对定性研究进行评估。从纳入的研究中提取研究结果，并综合成最终主题，严格按照 ConQual 过程进行评估。
纳入 9 项研究，共 345 名参与者，提取出 2 个主要主题：“经历由肠道功能障碍引起的一系列变化”和“面临肠道功能障碍的未满足需求和应对策略”。经历肠道功能障碍的直肠癌患者术后的变化主要包括三个部分：肠道功能障碍不仅仅是肠道反应，它涵盖了肠道症状本身及其后续的身体相关症状。正常生活的中断，主要体现在个人、家庭和社会生活方面。对肠道功能障碍的复杂心理反应，心理变化具有双重性，表现出积极和消极交织。未满足的需求和应对策略主要有两个方面：需求主要表现为对医务人员信息和支持的需求，而应对策略主要包括饮食、活动和药物管理。
直肠癌患者术后常经历持续的肠道功能障碍，对身心有一定影响。术后患者的一系列新需求往往得不到充分满足，患者往往依靠自己的经验尝试寻求平衡，较少能得到专业支持。未来的研究需要关注如何为术后直肠癌患者提供持续的信息支持，特别是来自医护人员的专业护理。
