Srikandarajah Nisaharan, Clark Simon, Wilby Martin, Marson Tony, Noble Adam
Institute of Systems, Molecular & Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK.
Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK.
Spinal Cord. 2025 Jun 28. doi: 10.1038/s41393-025-01097-7.
Qualitative, semi structured interviews.
Cauda Equina Syndrome (CES) is a neurological emergency that can cause permanent disability to the lower limbs, including pain, weakness, and bladder, bowel and sexual dysfunction. There is little evidence on the lived experience of patients with different severities of CES. This study sought to address this.
The interviews were conducted with persons who had experienced CES and been operated on for this condition in the UK.
A sampling frame was used on a pre-existing database to select a maximum variation sample. Interviews were audio recorded and transcribed for thematic analysis supported by NVivo.
Data saturation was achieved with 22 patients (12 female, 10 male) of whom 10 had CES-incomplete and 12 had CES-complete. Average age was 46 years and time since the operation was 62 months. Most interviews took place at the patients' home or workplace. Data analysis identified 4 main data themes: (1) Varying priorities of physical health; (2) A fragmented healthcare service; (3) The process of adjustment; and 4) Anticipatory anxiety and diminished sense of self-worth.
The identified themes confirm that CES can be a chronic condition, which requires holistic support to address the long-term outcomes. This highlights the importance of using the Cauda Equina Syndrome Core Outcome Set (CESCOS) in CES research studies to record these outcomes.
定性、半结构化访谈。
马尾综合征(CES)是一种神经急症,可导致下肢永久性残疾,包括疼痛、无力以及膀胱、肠道和性功能障碍。关于不同严重程度的CES患者的生活经历,几乎没有证据。本研究旨在解决这一问题。
访谈对象为在英国经历过CES并接受过相关手术的人。
在一个现有数据库上使用抽样框架来选择一个最大变异样本。访谈进行了录音,并转录下来以便在NVivo软件的支持下进行主题分析。
对22名患者(12名女性,10名男性)进行访谈后达到了数据饱和,其中10名患有不完全性CES,12名患有完全性CES。平均年龄为46岁,术后时间为62个月。大多数访谈在患者家中或工作场所进行。数据分析确定了4个主要数据主题:(1)身体健康的不同优先事项;(2)碎片化的医疗服务;(3)调整过程;以及(4)预期焦虑和自我价值感降低。
所确定的主题证实CES可能是一种慢性病,需要全面支持以应对长期后果。这凸显了在CES研究中使用马尾综合征核心结局集(CESCOS)来记录这些结局的重要性。