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癌症手术失败后患者的体验:一项定性研究。

Patient Experiences After Aborted Cancer Surgery: A Qualitative Study.

机构信息

Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

出版信息

Ann Surg Oncol. 2023 Oct;30(11):6844-6851. doi: 10.1245/s10434-023-14046-6. Epub 2023 Aug 4.

Abstract

BACKGROUND

Surgical resection is a necessary component of curative-intent treatment for most solid-organ cancers but is occasionally aborted, most often due to occult metastatic disease or unanticipated unresectability. Despite its frequency, little research has been performed on the experiences, care needs, and treatment preferences of patients who experience an aborted cancer surgery.

METHODS

Semistructured interviews of patients who had previously experienced an aborted cancer surgery were conducted, focusing on their recalled experiences and stated preferences. All interviews were audio recorded, transcribed, and coded by two independent researchers by using NVivo 12. An integrative approach to qualitative analysis was used-both inductive and deductive methods-and iteratively identifying themes until saturation was reached.

RESULTS

Fifteen patients with an aborted cancer surgery participated in the interviews. Cancer types included pancreatic (n = 9), cholangiocarcinoma (n = 3), hepatocellular carcinoma (n = 1), gallbladder (n = 1), and neuroendocrine (n = 1). The most common reasons for aborting surgery included local tumor unresectability (n = 8) and occult metastatic disease (n = 7). Five subthemes that characterized the patient experience following an aborted cancer surgery emerged, including physical symptoms, emotional responses, impact on social and life factors, coping mechanisms, and support received.

CONCLUSIONS

This qualitative study characterizes the impact of aborted cancer surgery on multiple domains of quality of life: physical, emotional, social, and existential. These results highlight the importance of developing patient-centered interventions that focus on enhancing quality of life after aborted cancer surgery.

摘要

背景

手术切除是大多数实体器官癌症有治愈意图治疗的必要组成部分,但有时会被中止,最常见的原因是隐匿性转移疾病或意外的不可切除性。尽管这种情况很常见,但对于经历过癌症手术中止的患者的经历、护理需求和治疗偏好的研究却很少。

方法

对之前经历过癌症手术中止的患者进行半结构式访谈,重点关注他们的回忆经历和陈述的偏好。所有访谈均通过使用 NVivo 12 由两名独立研究人员进行音频记录、转录和编码。采用定性分析的综合方法——归纳法和演绎法——并迭代地确定主题,直到达到饱和。

结果

15 名经历过癌症手术中止的患者参与了访谈。癌症类型包括胰腺癌(n = 9)、胆管癌(n = 3)、肝细胞癌(n = 1)、胆囊癌(n = 1)和神经内分泌癌(n = 1)。中止手术的最常见原因包括局部肿瘤不可切除性(n = 8)和隐匿性转移疾病(n = 7)。出现了五个描述癌症手术中止后患者体验的子主题,包括身体症状、情绪反应、对社会和生活因素的影响、应对机制和所获得的支持。

结论

这项定性研究描述了癌症手术中止对生活质量多个领域的影响:身体、情绪、社会和存在。这些结果强调了开发以患者为中心的干预措施的重要性,这些干预措施侧重于提高癌症手术中止后的生活质量。

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