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吉达阿卜杜勒阿齐兹国王医疗城乳房切除术后的患者满意度与生活质量

Patient Satisfaction and Quality of Life After Mastectomy at King Abdulaziz Medical City, Jeddah.

作者信息

Barkar Mussab A, Mikwar Zaher, Khalid Adil A, Mohammedamin Ali A, Aloufi Abdulrahman H, Abualhamail Abdulmajeed A, Alghashim Hamad A

机构信息

College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.

College of Medicine, King Abdullah International Medical Research Center, Jeddah, SAU.

出版信息

Cureus. 2023 Dec 24;15(12):e51029. doi: 10.7759/cureus.51029. eCollection 2023 Dec.

DOI:10.7759/cureus.51029
PMID:38149063
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10750441/
Abstract

Background Overall well-being after surgical intervention is one of the most important aspects of assessing quality of life (QOL), yet it is not well explored in the literature. In this paper, it was necessary to involve the patient's perspective of the nature of their QOL. The burden of being diagnosed with breast cancer is an adaptation to a new lifestyle, having to deal with disease stigma, interpersonal relations problems, and being limited to specific clothing. This can be very challenging for patients. This study aims to identify which patient group, based on their treatment regimen, exhibits higher levels of satisfaction and dissatisfaction compared to other groups. Methods A retrospective, cross-sectional study analyzing the QOL among female breast cancer patients who underwent mastectomy, with or without breast reconstruction, in King Abdulaziz Medical City, Jeddah, between 2009 and 2022. Patients' demographics and phone numbers were obtained from each patient's medical record file in our hospital. Phone call-based interviews were conducted to contact patients to assess their QOL, satisfaction, and regrets after surgery. We excluded patients who do not speak Arabic, are illiterate, have memory disorders, patients who underwent lumpectomy or palliative mastectomy, patients with metastatic stage 4 cancer at the time of diagnosis, patients who are males, and patients who passed away. Results A total of 2,309 patients were screened during the period aforementioned; a total of 346 patients met our inclusion criteria. All of whom are female participants with a current mean age of 52.3 ± 11.5 years. There were 301 (86.99%) participants reported being satisfied, while only 45 (13.01%) participants reported being unsatisfied with surgery outcomes. Although the majority of participants were satisfied after mastectomy, many of them still struggled with psychological, social, and/or emotional challenges. These challenges can have a significant impact on a patient's overall well-being and QOL and must be addressed to provide patients with the highest quality of care possible. Conclusion The study findings highlight the significant impact of mastectomy on patients' lives. It is important to consider individual patient experiences and circumstances when evaluating treatment outcomes and patient satisfaction. We observed that patient satisfaction may vary depending on several factors, including patients' baseline satisfaction. Those factors may be psychological, such as body image issues, low self-esteem, the feeling of losing a body part, and fear of recurrence or metastasis. Other factors may be postoperative-related complications, including lymphedema, redundant skin, chronic pain, and operation scar. Additionally, factors may be socially related, such as loss of confidence, social withdrawal, embarrassment, inability to buy prostheses, being limited to specific clothes, and occupational impact.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e26c/10750441/6b32c972beba/cureus-0015-00000051029-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e26c/10750441/8234d22defc6/cureus-0015-00000051029-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e26c/10750441/6b32c972beba/cureus-0015-00000051029-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e26c/10750441/8234d22defc6/cureus-0015-00000051029-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e26c/10750441/6b32c972beba/cureus-0015-00000051029-i02.jpg
摘要

背景 手术干预后的总体幸福感是评估生活质量(QOL)最重要的方面之一,但在文献中对此并未进行充分探讨。在本文中,有必要纳入患者对其生活质量本质的看法。被诊断出患有乳腺癌的负担在于适应新的生活方式,不得不应对疾病污名、人际关系问题以及穿着受限。这对患者来说可能极具挑战性。本研究旨在确定基于治疗方案,哪些患者群体与其他群体相比表现出更高水平的满意度和不满意度。

方法 一项回顾性横断面研究,分析了2009年至2022年期间在吉达阿卜杜勒阿齐兹国王医疗城接受乳房切除术(无论是否进行乳房重建)的女性乳腺癌患者的生活质量。从我院每位患者的病历档案中获取患者的人口统计学信息和电话号码。通过电话访谈联系患者,以评估他们术后的生活质量、满意度和遗憾程度。我们排除了不会说阿拉伯语、文盲、有记忆障碍的患者,接受保乳手术或姑息性乳房切除术的患者,诊断时处于转移性4期癌症的患者,男性患者以及已去世的患者。

结果 在上述期间共筛查了2309名患者;共有346名患者符合我们的纳入标准。所有患者均为女性参与者,目前的平均年龄为52.3±11.5岁。有301名(86.99%)参与者表示对手术结果满意,而只有45名(13.01%)参与者表示不满意。尽管大多数参与者在乳房切除术后感到满意,但他们中的许多人仍在心理、社会和/或情感方面面临挑战。这些挑战可能会对患者的整体幸福感和生活质量产生重大影响,必须加以解决,以便为患者提供尽可能高质量的护理。

结论 研究结果凸显了乳房切除术对患者生活的重大影响。在评估治疗结果和患者满意度时,考虑个体患者的经历和情况非常重要。我们观察到患者满意度可能因多种因素而异,包括患者的基线满意度。这些因素可能是心理方面的,如身体形象问题、自卑、失去身体部位的感觉以及对复发或转移的恐惧。其他因素可能是术后相关并发症,包括淋巴水肿、皮肤冗余、慢性疼痛和手术疤痕。此外,因素可能与社会相关,如信心丧失、社交退缩、尴尬、无法购买假体、穿着受限以及职业影响。

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