The hidden cost of skin scars: quality of life after skin scarring
The hidden cost of skin scars: quality of life after skin scarring
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DOI：
10.1016/j.bjps.2008.03.020
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发表时间：
2008-01-01
影响因子：
2.7
通讯作者：
Bayat, A.
中科院分区：
文献类型：
--
作者：
Brown, B. C.;McKenna, S. P.;Bayat, A.
背景资料：令人惊讶的是，人们对皮肤疤痕如何影响患者的生活知之甚少，尽管专家的临床印象表明，它们的影响与它们的生理和心理影响有关。面部疤痕已被证明会引起高度的焦虑和自我意识，但进一步的工作被忽视了。我们的目的是探讨皮肤疤痕对患者的生活质量（QoL）的影响，并确定潜在的影响，为clinical practice.Methods：我们采用了以需求为基础的方法来生活质量和疤痕患者在专科诊所进行半结构化访谈。转录数据进行了解释现象学分析，以确定共同的主题，在个人的个人experiences.Results：34个疤痕患者（24名妇女，年龄14-70岁，平均= 35.7年，SD = 17.9年）与广泛的疤痕类型，严重程度和发病被招募。从访谈记录中确定了573份关于皮肤疤痕导致需求受损的陈述。这些随后被分为44个主题，涵盖五个主要领域：身体舒适和功能;自我和他人的可接受性;社会功能;对疾病性质和管理的信心;情绪健康。大多数受访者不满意他们的疤痕的外观，由于他们的感知耻辱和心理协会，从而采取不同的应对行为，以隐藏或补偿他们。这往往使他们不合群，干扰他们的沟通技巧、人际关系、工作生活和休闲活动。疤痕的诊断和持久性的关注是常见的，而一般的医生和挫折感目前的治疗复合distress.Conclusions：有五个主要领域的影响疤痕患者的需求，应在他们的管理，这是更大，更复杂的比以前考虑。应提供支持服务，沿着临床医生和公众教育，以改善管理，帮助减少病人的痛苦。还表明需要精心设计瘢痕相关QoL的测量方法，用于临床环境和试验。(C)2008年英国整形、重建和美容外科医生协会。由爱思唯尔有限公司出版。保留所有权利。
Background: Surprisingly little is known about how skin scars affect patients' lives, though specialist clinical impressions suggest their impact is related to both their physical and psychosocial effects. Facial scars have been shown to cause high levels of anxiety and self-consciousness, but further work has been neglected. We aimed to explore the influence of skin scars on patients' quality of life (QoL) and identify potential implications for clinical practice.Methods: We adopted a needs-based approach to QoL and conducted semi-structured interviews with scar patients at a specialist clinic. Transcribed data underwent interpretative phenomenological analysis to identify common themes in individuals' personal experiences.Results: Thirty-four scar patients (24 women; aged 14-70 years, mean = 35.7 years, SD = 17.9 years) with a wide range of scar type, severity and onset were recruited. Five hundred and seventy-three statements were identified from interview transcripts relating to need impairment by skin scars. These were subsequently classified into 44 themes covering five main areas: physical comfort and functioning; acceptability to self and others; social functioning; confidence in the nature and management of the condition; emotional well-being. The majority of respondents were unhappy with their scar's appearance due to their perceived stigma and psychological associations, and thus adopted different coping behaviours to hide or compensate for them. Often this made them unsociable and interfered with their communication skills, personal relationships, work life and leisure activities. Concerns about the diagnosis and persistent nature of scars were common, whilst unempathic management by general physicians and frustrations of current treatment compounded distress.Conclusions: There are five main areas of impact on the needs of scar patients that should be addressed in their management, which are greater and more complex than previously considered. Support services should be made available, along with clinician and public education to improve management and help reduce patient distress. A need for a carefully designed measure of scar-related QoL is also indicated, for use in clinical settings and trials,. (C) 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.