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一项关于幼年断指再植术后长期后果及日常生活适应情况的定性研究。

A qualitative study of the long-term consequences and adaptation in daily life after replantation surgery at a young age.

作者信息

Rosberg Hans-Eric, Dahlin Lars B, Carlsson Ingela K

机构信息

Department of Translational Medicine - Hand Surgery, Lund University, Malmö, Sweden.

出版信息

Hand Ther. 2022 Dec;27(4):112-122. doi: 10.1177/17589983221118399. Epub 2022 Oct 4.

Abstract

INTRODUCTION

Impaired functioning is seen in patients following replantation surgery to the thumb or fingers. Our aim was to explore long-term consequences and adaptation in daily life after a thumb and/or multiple finger amputation followed by replantation surgery during young age.

METHODS

Semi-structured interviews were conducted with nine recruited individuals and analysed using content analysis. The participants were asked to describe their hand function, pain, appearance, emotional consequences, impact on daily life and strategies for overcoming daily challenges.

RESULTS

The interviews revealed five main categories: memories of the injury and concerns for the future; hand function, pain and cold sensitivity; feelings about having a visibly different hand; adaptation to impairments and challenges in daily life; and key messages to healthcare professions and advice to future patients.The circumstances of the injury were well remembered. Pain at rest was rare but occurred when grasping. Cold sensitivity was a major issue. Appearance-related concerns varied from none to a major problem. Despite impaired hand function, solutions were found to challenges in daily life. Compensatory strategies, personal resources and support from others were important in this adaptation process.

CONCLUSIONS

Patients with replantation surgery after an amputation during young age adapt to challenges in daily life over time. Healthcare professionals should offer adequate support to enable emotional processing of trauma experience. Appearance-related concerns should be addressed to prevent distress. Information about alleviating strategies to overcome long-term problems with cold sensitivity should be emphasized.

摘要

引言

拇指或手指再植手术后的患者会出现功能受损的情况。我们的目的是探讨年轻时拇指和/或多指截肢后再植手术的长期后果以及日常生活中的适应情况。

方法

对9名招募的个体进行了半结构化访谈,并采用内容分析法进行分析。参与者被要求描述他们的手部功能、疼痛、外观、情绪后果、对日常生活的影响以及克服日常挑战的策略。

结果

访谈揭示了五个主要类别:受伤的记忆和对未来的担忧;手部功能、疼痛和冷敏感;对拥有明显不同的手的感受;适应日常生活中的损伤和挑战;以及给医疗专业人员的关键信息和给未来患者的建议。受伤的情况被清楚地记住。静息时疼痛很少见,但抓握时会出现。冷敏感是一个主要问题。与外观相关的担忧从没有到成为一个主要问题不等。尽管手部功能受损,但仍找到了应对日常生活挑战的方法。补偿策略、个人资源和他人的支持在这个适应过程中很重要。

结论

年轻时截肢后接受再植手术的患者会随着时间的推移适应日常生活中的挑战。医疗专业人员应提供充分的支持,以使患者能够对创伤经历进行情绪处理。应解决与外观相关的担忧,以防止困扰。应强调关于缓解策略的信息,以克服冷敏感的长期问题。

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