背景:随着时间的推移,复杂的血管内主动脉修复术通常涉及多个主要程序,并发症的风险很高,恢复的时间很少。这让病人面临巨大的压力,身体上和精神上,具有潜在的持久影响。关于这些影响的知识有限,谁是最危险的-这方面的信息可以帮助血管护士和其他医疗保健专业人员预测和满足护理需求。
目的:探讨复杂的主动脉腔内修复术对健康和生活质量的影响,与患者的人口统计学和健康特征有关。
方法:前瞻性队列研究。
方法:在一年内从一所大学医院连续招募接受选择性复杂腔内主动脉修复术的患者(n=25)。关于健康残疾的自我报告问卷(WHODAS2.0),术前填写生活质量(WHOQoL-BREF)和焦虑和抑郁症状(HADS),术后1个月和6个月重复.健康和生活质量的预期变化,以及与患者人口统计学和术前健康特征的关联,被评估。在研究进行之前获得了伦理批准。
结果:总体而言,患者在1个月时的健康残疾(WHODAS2.0评分中位数31.5,范围1.1~63.0)显著高于术前(中位数13.6,范围0.0~41.3)(n=22,p=0.017);大多数患者在6个月时康复(中位数11.4,范围3.3~58.7)(n=18,p=.042).在生活质量和焦虑和抑郁症状方面没有发现显着影响(p>0.05)。然而,参与者表现出异质性,某些人在六个月后没有康复(n=8)。与六个月结局较差相关的因素是女性,年龄<70岁,术后并发症,有焦虑或抑郁的病史.
结论:复杂的主动脉腔内修复术对患者健康和生活质量的长期负面影响有限。然而,一些患者在术后六个月没有康复,这可以用个体特征来解释。为了改善恢复结果,血管护士和其他卫生保健专业人员应了解可能的康复轨迹和与康复受损相关的因素,并使用它们来预测和满足患者的个人护理需求。
Complex endovascular aortic repair often involves multiple major procedures over time with a high risk of complications and little time for recovery. This exposes patients to great stress, both physically and mentally, with potentially long-lasting effects. There is limited knowledge about these effects and who is most at risk - information on this could help vascular nurses and other healthcare professionals anticipate and meet care needs.
To investigate the health and quality of life effects of complex endovascular aortic repair, in relation to patients\' demographic and health characteristics.
A prospective cohort study.
Patients undergoing elective complex endovascular aortic repair were consecutively recruited from one university hospital during one year (n=25). Self-report questionnaires on health disability (WHODAS 2.0), quality of life (WHOQoL-BREF) and symptoms of anxiety and depression (HADS) were filled out preoperatively and repeated one and six months postoperatively. Prospective changes in health and quality of life, and associations with patient demographics and preoperative health characteristics, were assessed. Ethical approval was obtained prior to study performance.
Overall, patients had significantly greater health disability at one month (WHODAS 2.0 score median 31.5, range 1.1-63.0) than preoperatively (median 13.6, range 0.0-41.3) (n=22, p=.017); the majority had recovered at six months (median 11.4, range 3.3-58.7) (n=18, p=.042). No significant effects were seen in quality of life and symptoms of anxiety and depression (p>.05). However, the participants showed heterogeneity, with certain individuals not recovered at six months (n=8). Factors associated with worse six-month outcomes were being female, age < 70 years, postoperative complications, and history of anxiety or depression.
Complex endovascular aortic repair have limited long-term negative effects on patients\' health and quality of life. However, some patients are not recovered at six months postoperatively, which could be explained by individual characteristics. To improve recovery outcomes, vascular nurses and other health care professionals should be aware of the possible recovery trajectories and factors associated with impaired recovery, and use them to anticipate and meet the patients\' individual care needs.