为直肠癌拒绝永久性结肠切除术的患者:临床结果和心理方面
Nitzan Goldberg1,2, Mika Appelbaum3, Yaron Rudnicki3,4
1Department of Surgery, Meir Medical Center, Kfar Saba, Israel. Goldberg.nitzan@gmail.com.
概括
许多直肠癌患者拒绝腹腔切除 (APR) 由于担心永久性结肠直肠切除. 心理痛苦,社会耻辱和耻辱是拒绝的关键原因,影响治疗决策.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 手术瘤学手术瘤学
- 癌症治疗对心理的影响
背景情况:
- 腹腔切除 (APR) 是局部晚期直肠瘤的外科选择.
- APR涉及到广泛的组织去除和创建永久的结肠直肠.
- 永久性结肠静脉切除对一些患者来说带来了重大的生活挑战,导致拒绝治疗.
研究的目的:
- 为了调查直肠癌患者的APR手术拒绝率.
- 为了确定患者拒绝APR手术背后的主要原因.
- 了解影响直肠癌治疗决策的心理因素.
主要方法:
- 对推进行APR手术的患者的评估.
- 随访,面试和问卷 (拒绝的原因,抑郁症 (PHQ-9),应对策略 (COPE)).
- 对患者反应的心理分析.
主要成果:
- 在推接受APR的11名患者中,有6人拒绝接受手术.
- 拒绝的主要原因包括社会耻辱,羞耻,抑郁和焦虑.
- 一名患者通过PHQ-9诊断出中度抑郁症.
结论:
- 永久性结肠静脉切除是直肠癌患者的主要心理障碍.
- 强烈的恐惧结肠直肠术导致一些患者拒绝挽救生命的手术.
- 术前支持,包括支持小组和导师,对于接受APR的患者至关重要.
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