在性别确认乳房切除术中,患者发起的外科手术期间沟通
Christian X Lava1,2, Isabel A Snee1, Karen R Li1,2
1Georgetown University School of Medicine, Washington, DC 20007, USA.
Journal of clinical medicine
|June 27, 2024
概括
大多数性别确认乳腺切除术患者在外科手术期间开始沟通. 老年,精神病诊断和缺乏排水预测更高的沟通频率,突出需要加强患者支持.
科学领域:
- 手术瘤学手术瘤学
- 跨性别者健康 跨性别者健康
- 患者沟通 患者沟通
背景情况:
- 性别肯定性乳腺切除术 (GAM) 增强了跨性别和非二进制 (TGNB) 个体的心理社会福祉.
- 对于GAM的外科手术前期可能涉及显著的情绪困扰,对手术结果的担忧和身体不适.
- 门诊GAM与住院手术相比,对患者的随访和教育提出了独特的挑战.
研究的目的:
- 描述患者和手术因素与患者发起沟通 (PIC) 的频率相关的TGNB个体接受GAM.
- 确定性别确认乳房切除术前后PIC的常见原因.
- 了解GAM患者在外科手术前期PIC频率的预测因素.
主要方法:
- 在2018年2月至2022年11月期间在一个中心接受GAM的352名TGNB患者的回顾性审查.
- 收集的数据包括人口统计,手术特征,以及术前PIC (30天前和术后) 的频率和原因.
- 统计分析确定了与PIC频率相关的患者和外科特征.
主要成果:
- 大多数患者 (74.6%) 开始进行术后沟通,术后 (1.3 ± 1.7) 与术前 (0.7 ± 1.3) 相比,术后的频率更高.
- 常见的术前PIC原因包括行政问题,要求和成本/保险;术后的原因集中在伤口护理,活动限制和排水上.
- 年龄较大,有重大抑郁症或泛性焦虑症史,以及没有术后排水,与更高的PIC频率有显著的关联.
结论:
- 术后PIC在GAM患者中很常见,特定的患者因素预测了更高的沟通需求.
- 解决行政问题,提供关于伤口护理,活动和排水管理的清晰术后指令至关重要.
- 加强支持人员和有针对性的干预措施可能会减少PIC频率,并改善GAM接受TGNB患者的治疗结果.
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