Bradbury E T, Kay S P, Tighe C, Hewison J
Department of Plastic Surgery, St James's University Hospital, Leeds, UK.
Br J Plast Surg. 1994 Jul;47(5):324-30. doi: 10.1016/0007-1226(94)90091-4.
The task of decision-making about microvascular toe-transfer surgery is a complex one for parents and their children. The process involves balancing risks and benefits within the context of the emotional responses of the parents and the future needs of their children. This paper describes a model of clinical practice which incorporates that process through a multi-disciplinary approach. The factors which influenced parents in their decision are examined, and the issue of the competence of the child to participate is discussed. 34 families were assessed, of whom 7 did not proceed with surgery. It was found that parents were more influenced by factors within the process, such as communication, than by concerns about technical outcome. Specialised psychological counselling played an integral role in the making of stable decisions.
对于父母及其子女而言，关于微血管脚趾移植手术的决策任务十分复杂。这一过程涉及在父母的情感反应和子女未来需求的背景下权衡风险与益处。本文描述了一种临床实践模式，该模式通过多学科方法纳入了这一过程。研究了影响父母做出决策的因素，并讨论了儿童参与决策的能力问题。对34个家庭进行了评估，其中7个家庭未进行手术。结果发现，父母更多地受到过程中的因素（如沟通）的影响，而非对技术结果的担忧。专业心理咨询在做出稳定决策中发挥了不可或缺的作用。
