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开发一个概念框架,以检测癌症腹部手术后围手术期症状负担。

Development of a conceptual framework to detect perioperative symptom burden following abdominal surgery for cancer.

机构信息

Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

Department of Psychology, Ludwig Maximilian University, Munich, Germany.

出版信息

Eur J Surg Oncol. 2023 Sep;49(9):106933. doi: 10.1016/j.ejso.2023.05.008. Epub 2023 May 18.

DOI:10.1016/j.ejso.2023.05.008
PMID:37211468
Abstract

BACKGROUND

Abdominal surgery for gastrointestinal malignancies has a significant impact on patients' health-related quality of life. However, there is so far no patient-reported outcome measures (PROM) in the immediate postoperative period to detect the perioperative symptom burden and patients' needs which may precede occult and severe complications. The aim of the study was to create a conceptual framework for the development of a PROM to measure perioperative symptom burden in abdominal cancer patients.

METHODS

This mixed method study was performed between March 2021, and July 2021 as part of a multiphase approach to develop a new PROM. A systematic review of the literature was performed health domains were identified. The relevance of the health domains was assessed in a two-round Delphi study with clinical experts. Qualitative interviews were performed in patients who underwent abdominal surgery for cancer.

RESULTS

The systematic literature review yielded 12 different PROM with 168 items and 55 health domains. The most common health domains involved the "digestive system" and "pain". In total, 30 patients (median age 66 years, 20 men [60%]) were included for qualitative patient interviews. Of 16 health domains identified by the Delphi study, a total 15 health domains were confirmed during patients' interviews. The final conceptual framework included 20 health domains.

CONCLUSION

This study provides the essential groundwork to develop and validate a new PROM for the immediate postoperative period of patients undergoing abdominal surgery for cancer.

摘要

背景

胃肠道恶性肿瘤的腹部手术对患者的健康相关生活质量有重大影响。然而,目前还没有术后即刻的患者报告结局测量(PROM)来检测围手术期的症状负担和患者的需求,这些症状负担和需求可能先于隐匿性和严重的并发症。本研究的目的是为开发一种 PROM 以测量腹部癌症患者围手术期的症状负担建立一个概念框架。

方法

这是一项混合方法研究,于 2021 年 3 月至 7 月进行,作为开发新 PROM 的多阶段方法的一部分。对文献进行了系统回顾,确定了健康领域。通过两轮德尔菲研究,对健康领域的相关性进行了评估,邀请了临床专家参加。对接受腹部癌症手术的患者进行了定性访谈。

结果

系统文献回顾产生了 12 种不同的 PROM,共 168 项和 55 个健康领域。最常见的健康领域涉及“消化系统”和“疼痛”。共纳入 30 名患者(中位年龄 66 岁,20 名男性[60%])进行定性患者访谈。在德尔菲研究中确定的 16 个健康领域中,有 15 个在患者访谈中得到了确认。最终的概念框架包括 20 个健康领域。

结论

本研究为开发和验证用于癌症患者腹部手术后即刻期的新 PROM 提供了必要的基础。

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