Bekkers M J, van Knippenberg F C, van Dulmen A M, van den Borne H W, van Berge Henegouwen G P
The Netherlands Institute of Primary Health Care, NIVEL, Utrecht, The Netherlands.
J Psychosom Res. 1997 Mar;42(3):235-44. doi: 10.1016/s0022-3999(96)00288-7.
A prospective 4-year follow-up study was conducted to compare the psychosocial adjustment process and survival rate of 59 stoma patients with 64 bowel-resected nonstoma patients. Adjustment was assessed at 4 months. 1 year, and 4 years after surgery by the Psychosocial Adjustment to Illness Scale, a self-report questionnaire (PAIS-SR). Analyses of covariance demonstrated that both subgroups experienced the same level of psychosocial problems 4 years after surgery. Interestingly, patients with poor early adjustment scores (4 months after surgery) were at significantly higher risk of dropping out because of death and terminal status during the follow-up period (1 and 4 years postoperatively). The presence of a stoma did not influence the risk rate for dropping out. These results demonstrate the need for prolonged psychosocial guidance of outpatients who have been surgically treated for colorectal cancer or inflammatory bowel disease.
一项前瞻性4年随访研究对59例造口患者和64例接受肠切除的非造口患者的心理社会适应过程及生存率进行了比较。术后4个月、1年和4年时，通过一份自评问卷——疾病心理社会适应量表（PAIS-SR）对适应情况进行评估。协方差分析表明，两个亚组在术后4年时经历的心理社会问题水平相同。有趣的是，早期适应评分较差（术后4个月）的患者在随访期间（术后1年和4年）因死亡和终末期状态而退出研究的风险显著更高。造口的存在并不影响退出风险率。这些结果表明，对于接受过结直肠癌或炎症性肠病手术治疗的门诊患者，需要长期的心理社会指导。
