癌症手术中止后的患者体验:一项定性研究。
Patient Experiences After Aborted Cancer Surgery: A Qualitative Study.
发表日期:2023 Aug 04
作者:
Lena Stevens, Sharla Wells-Di Gregorio, Alexandra G Lopez-Aguiar, Rakhsha Khatri, Aslam Ejaz, Timothy M Pawlik, Erin Scott, Sachin Kale, Jordan M Cloyd
来源:
ANNALS OF SURGICAL ONCOLOGY
摘要:
手术切除是大多数实体器官癌症治疗中根治性治疗的必要组成部分,但有时会因为隐匿性转移疾病或意外的不可切除性而被中止。尽管中止手术频率较高,但对于经历中止癌症手术的患者的经历、护理需求和治疗偏好的研究很少。我们进行了对之前经历中止癌症手术的患者进行的半结构化访谈,重点关注他们回忆起的经历和表达的偏好。所有访谈都被音频录制,转录并通过使用NVivo 12由两名独立研究人员进行编码。采用了定性分析的综合方法――归纳和演绎方法――并迭代地识别主题,直到饱和为止。参与访谈的患者中有15例中止癌症手术。癌症类型包括胰腺癌(n = 9)、胆管癌(n = 3)、肝细胞癌(n = 1)、胆囊癌(n = 1)和神经内分泌肿瘤(n = 1)。中止手术的最常见原因包括局部肿瘤无法切除(n = 8)和隐匿性转移疾病(n = 7)。出现了五个子主题来描述中止癌症手术后患者的经历,包括身体症状、情绪反应、对社交和生活因素的影响、应对机制和所接受的支持。这项定性研究描述了中止癌症手术对生活质量的多个领域的影响:身体、情绪、社交和存在。这些结果凸显了在中止癌症手术后开发以患者为中心的干预措施以提高生活质量的重要性。© 2023年外科肿瘤学会。
Surgical resection is a necessary component of curative-intent treatment for most solid-organ cancers but is occasionally aborted, most often due to occult metastatic disease or unanticipated unresectability. Despite its frequency, little research has been performed on the experiences, care needs, and treatment preferences of patients who experience an aborted cancer surgery.Semistructured interviews of patients who had previously experienced an aborted cancer surgery were conducted, focusing on their recalled experiences and stated preferences. All interviews were audio recorded, transcribed, and coded by two independent researchers by using NVivo 12. An integrative approach to qualitative analysis was used-both inductive and deductive methods-and iteratively identifying themes until saturation was reached.Fifteen patients with an aborted cancer surgery participated in the interviews. Cancer types included pancreatic (n = 9), cholangiocarcinoma (n = 3), hepatocellular carcinoma (n = 1), gallbladder (n = 1), and neuroendocrine (n = 1). The most common reasons for aborting surgery included local tumor unresectability (n = 8) and occult metastatic disease (n = 7). Five subthemes that characterized the patient experience following an aborted cancer surgery emerged, including physical symptoms, emotional responses, impact on social and life factors, coping mechanisms, and support received.This qualitative study characterizes the impact of aborted cancer surgery on multiple domains of quality of life: physical, emotional, social, and existential. These results highlight the importance of developing patient-centered interventions that focus on enhancing quality of life after aborted cancer surgery.© 2023. Society of Surgical Oncology.