Department of Population Health Sciences, Duke University School of Medicine, Durham, NC.
Department of Population Health Sciences, Duke University School of Medicine, Durham, NC; Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC; Department of Surgery (Urology), Duke Surgical Center for Outcomes Research & Equity in Surgery, Duke University School of Medicine, Durham, NC.
Urology. 2023 Aug;178:26-36. doi: 10.1016/j.urology.2023.04.018. Epub 2023 May 5.
To describe the experiences of patients undergoing stent removal in the USDRN Study to Enhance Understanding of Stent-Associated Symptoms (STENTS), a prospective, observational cohort study of patients with short-term ureteral stent placement post-ureteroscopy.
We conducted a qualitative descriptive study using in-depth interviews. Participants reflected on (1) painful or bothersome aspects of stent removal, (2) symptoms immediately after removal, and (3) symptoms in the days following removal. Interviews were audio-recorded, transcribed, and analyzed using applied thematic analysis.
The 38 participants interviewed were aged 13-77 years, 55% female, and 95% White. Interviews were conducted 7-30 days after stent removal. Almost all participants (n = 31) described that they experienced either pain or discomfort during stent removal, but for most (n = 25) pain was of short duration. Many participants (n = 21) described anticipatory anxiety related to the procedure, and several (n = 11) discussed discomfort arising from lack of privacy or feeling exposed. Interactions with medical providers often helped put participants at ease, but also increased discomfort for some. Following stent removal, several participants described lingering pain and/or urinary symptoms, but these largely resolved within 24 hours. A few participants described symptoms persisting for more than a day post stent removal.
These findings on patients' experiences during and shortly after ureteral stent removal, particularly the psychological distress they experienced, identify opportunities for improvement in patient care. Clear communication from providers about what to expect with the removal procedure, and the possibility of delayed pain, may help patients adapt to discomfort.
描述美国研究人员在增强对支架相关症状理解的研究(STENTS)中接受支架取出术的患者的体验,这是一项对接受输尿管镜检查后短期放置输尿管支架的患者进行的前瞻性观察队列研究。
我们采用深入访谈法进行了定性描述性研究。参与者反思了(1)支架取出过程中疼痛或不适的方面,(2)取出后立即出现的症状,以及(3)取出后几天内出现的症状。对访谈进行了音频记录、转录,并使用应用主题分析进行了分析。
接受采访的 38 名参与者年龄在 13-77 岁之间,女性占 55%,白人占 95%。访谈是在支架取出后 7-30 天进行的。几乎所有参与者(n=31)都描述说他们在支架取出过程中经历了疼痛或不适,但对大多数(n=25)来说,疼痛持续时间很短。许多参与者(n=21)描述了与手术相关的预期焦虑,一些参与者(n=11)还提到了由于缺乏隐私或感到暴露而引起的不适。与医疗服务提供者的互动通常可以使参与者感到安心,但也会使一些人感到不适。支架取出后,一些参与者描述了持续的疼痛和/或尿症状,但这些症状在 24 小时内基本得到缓解。少数参与者描述了支架取出后超过一天仍有症状持续。
这些发现涉及患者在输尿管支架取出过程中和取出后不久的体验,特别是他们所经历的心理困扰,为改善患者护理提供了机会。提供者就取出过程中可能出现的情况以及延迟性疼痛的可能性与患者进行清晰沟通,可能有助于患者适应不适。