探讨闭孔假体对患者的长期影响,头颈部肿瘤上颌骨切除术后。
采用了定性方法,使用半结构化面试。八个男人和四个女人的故意样本,用闭孔假体生活至少五年,被招募。访谈被数字化记录和转录。使用主题分析,两名研究人员分析了这些数据。
数据分为四个主题:1.准备好和闭塞器一起生活,2.与闭塞器一起生活的影响-期望发生什么变化,3.闭塞器的稳定性和保持性,和4。应对策略以帮助调整。与闭塞器一起生活的长期影响跨越了生活的许多方面,包括:咀嚼和进食,说话,处理鼻漏和身体形象改变,就业和亲密关系问题,以及社交时的尴尬。闭塞器的最佳保留和稳定性,正如病人所感知的那样,提高社会信心和参与度。情感的影响对人们的生活有很大的不同。
长期挑战最大的患者有更大的缺陷,已经到了就业年龄,没有重返工作岗位。提高对应对加班心理的理解显然很重要,因为这可以为干预措施提供信息,以促进那些情绪挣扎的人的适应。此外,这项研究的结果可以为交流工具的设计提供信息,以促进共同决策,并为上颌骨切除术后与闭孔一起生活做好准备。
多学科头颈部团队应该为患者提供详细的术前信息,包括对社会的潜在影响,工作和人际关系。修复牙科团队在这些患者的长期管理中发挥着关键作用,因为闭塞器具有有限的寿命,需要持续的维护以促进最佳的保留和稳定性。
To explore the long-term impact for patients living with an
obturator prosthesis, following a maxillectomy for a head and neck neoplasm.
A qualitative approach was employed, using semi-structured interviews. A purposive sample of eight men and four women, living with an obturator prosthesis for at least five years, were recruited. Interviews were digitally recorded and transcribed. Using thematic analysis, two researchers analysed the data.
The data were categorised into four themes: 1. Preparedness for living with an
obturator, 2. Impact of living with an
obturator - what changes to expect, 3. Stability and retention of the
obturator, and 4. Coping strategies to aid adjustment. Long-term effects of living with an obturator spanned many aspects of life to include: chewing and eating, speaking, dealing with nasal leakage and altered body image, employment and intimacy issues, along with embarrassment during social encounters. Optimal retention and stability of the obturator, as perceived by the patient, lead to improved social confidence and engagement. The emotional impact varied greatly on peoples\' lives.
Patients experiencing the greatest long-term challenges had larger defects, were of employment age and had not returned to work. Gaining an improved understanding of the psychology of coping overtime is clearly important, as this can inform interventions to facilitate adjustment for those who are emotionally struggling. Furthermore, the findings of this
study could inform the design of a communication tool to facilitate shared-decision making and aid preparedness for living with an obturator following a maxillectomy.
The multidisciplinary head and neck team should provide patients with detailed pre-operative information, including potential effects on social, work and personal relationships. The restorative dentistry team has a pivotal role in the long-term management of these patients, as obturators have a finite lifespan with ongoing maintenance necessary to promote optimal retention and stability.