Article
What means „good quality of life“ for FAP patients after restorative proctocolectomy?
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Authors
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Anette Brechtel
- Division of Psychooncology, Department of General Internal and Psychosomatic Medicine, Medical Hospital, University Hospital Heidelberg, Deutschland
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Nadine Osterfeld
- Division of Psychooncology, Department of General Internal and Psychosomatic Medicine, Medical Hospital, University Hospital Heidelberg
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Monika Mussell
- Division of Psychooncology, Department of General Internal and Psychosomatic Medicine, Medical Hospital, University Hospital Heidelberg
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Sabine Sommerfeldt
- Division of Psychooncology, Department of General Internal and Psychosomatic Medicine, Medical Hospital, University Hospital Heidelberg
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Martina Kadmon
- Department of Surgery, University Hospital Heidelberg
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Monika Keller
- Division of Psychooncology, Department of General Internal and Psychosomatic Medicine, Medical Hospital, University Hospital Heidelberg
| Published: | March 20, 2006 |
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Outline
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Background: There are only a few studies having evaluated the quality of life (QoL) of FAP patients after restorative proctocolectomy. Although these studies indicate a good QoL, the clinical experience shows that patients suffer from functional problems and impairments. The main objective of this retrospective study is to evaluate FAP patients’ QoL more in detail by identifying medical and psychosocial factors that might influence it.
Methodology: The sample consists of 116 FAP patients, 63 female, 53 male (mean age: 37,7) with restorative proctocolectomy performed within the past 25 years at the Dept. of Surgery, University of Heidelberg. In addition to study-specific items the following standardized questionnaires were used: MOS-SF-36, Öresland-Score, SWOP-K9 and F-SozU-K-14. The influence of various medical and psychosocial factors on QoL, measured by the SF-36, was analyzed by regression analysis.
Results: According to the results of the SF-36 FAP patients show a good QoL comparable to that of healthy controls for the physical and psychological well-being. However, the results of the Öresland-Score and study-specific items indicate that FAP patients experience functional impairments: e.g. 46% of patients report about frequent stooling, 69% have to follow dietary restrictions, 33% feel socially handicapped, 29% report about impaired sexual functions and 36% about thoughts and worries associated with their disease. According to the regression analysis only psychosocial factors have a significant effect, the most important factor was ‘optimism’ influencing the physical as well as psychological wellbeing.
Conclusions: FAP patients show a good QoL comparable to healthy norm subjects. However, our study indicates that this might rather be a result of the patients’ adaptation- and coping-process that requires personal and social resources instead of being the result of an excellent surgical procedure. Our results demonstrate the importance of psychosocial factors influencing the perception of QoL which has impact on clinical and research strategies. From a clinical point of view it seems to be necessary to identify patients with psychosocial risk factors in order to offer them psychosocial support. For further research we should be aware of the factors moderating the perception of QoL in order to interpret QoL data correctly.
