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[胃癌全胃切除术后男女患者住院康复的综合治疗方法]

[Integrated therapy approach in the inpatient rehabilitation of women and men with total gastrectomy for stomach carcinoma].

作者信息

Gutschmidt S, Hänisch S

机构信息

Klinik Fränkische Saale der Landesversicherungsanstalt Hannover, Bad Neustadt/Saale.

出版信息

Rehabilitation (Stuttg). 1994 Nov;33(4):228-36.

PMID:7800925
Abstract

On the basis of the documented course of 83 in-patient rehabilitation procedures in 28 female and 55 male patients who had undergone total gastrectomy due to cancer of the stomach, "objective" and "subjective" data were analyzed and correlated within an integrative treatment concept in order for one, to obtain as rehabilitation-specific a description as possible of how patients cope with the conditions resulting from their illness, and for the other, to contribute to furthering a multidisciplinary treatment concept, uniting the medical and psychosocial lines of approach. "Objective" data, i.e., data based on therapist assessments, inter alia include laboratory and other measures, diagnostic and therapeutic interventions and their gradings, sociomedical and psychosocial parameters, Karnofsky index, as well as Edinburgh Rehabilitation Status scores, while "subjective" ones, i.e., data based on the patients' own estimates, included symptom scores and judgements relative to treatment course and the so-called therapeutic environment. Findings are presented in detail for both planes (i.e., "objective" and "subjective" parameters) and discussed in light of pertinent literature. In particular the "missing" (yet perhaps expected) correlations among these planes are considered indicative of an urgent need for inclusion of the patient's behaviour and experience in the rehabilitative-therapeutic process. The partially surprising gender differences found are discussed with a view to behavioural patterns that might be conducive to coping with the malignant disease and its sequelae, an integrative treatment approach found to be of utmost importance, in particular in terms of the (therapeutic) relationship with self and others.

摘要

基于对28名女性和55名男性患者进行的83例因胃癌行全胃切除术的住院康复治疗过程的记录,对“客观”和“主观”数据进行了分析,并在综合治疗概念中建立关联,一方面是为了尽可能获得针对康复的描述,即患者如何应对疾病所带来的状况,另一方面是为了推动多学科治疗概念的发展,将医学和社会心理治疗方法结合起来。“客观”数据,即基于治疗师评估的数据,尤其包括实验室检查及其他测量结果、诊断和治疗干预及其分级、社会医学和社会心理参数、卡诺夫斯基指数以及爱丁堡康复状态评分,而“主观”数据,即基于患者自身估计的数据,则包括症状评分以及对治疗过程和所谓治疗环境的判断。详细呈现了两个层面(即“客观”和“主观”参数)的研究结果,并结合相关文献进行了讨论。特别是这些层面之间“缺失”(但可能是预期的)的相关性被认为表明迫切需要将患者的行为和体验纳入康复治疗过程。讨论了所发现的部分令人惊讶的性别差异,涉及可能有助于应对恶性疾病及其后遗症的行为模式,发现综合治疗方法至关重要,特别是在与自我和他人的(治疗)关系方面。

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