患者満足度の観点からみた未破裂脳動脈瘤治療適応の個別的決定に関する因子の検討

概要

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Decision making on the prophylactic treatment of unruptured cerebral aneurysms (UCA) is a complicated process. Not only the medical condition but also the patient's psychological factors can influence the patient's decision as to whether to accept possibly invasive procedures or choose conservative management that may include an insidious risk of UCA rupture. Questionnaires were mailed to patients diagnosed with UCA's between January 2002 and December 2012 in three affiliated institutions. The contents were factors affecting individual choices of prophylactic treatment or conservative treatment. At the same time, we examined patients' Quality of Life (QOL) scoring according to Medical Outcome Study Short Form 36 Version2 (SF-36) when the questionnaires were mailed. Of the 114 patients who completed the questionnaires, 55 opted for prophylactic treatment for UCA and 59 chose conservative management for UCA. The prophylactic treatment group was strongly influenced by four factors: annual rupture rate, age, effect of SAH on family members, and personal trust in the doctor (p<0.05). This retrospective study on QOL of the patient after diagnosis showed the reliability of the health professionals and the psychological relationship between doctor and patient are crucial factors in making appropriate decisions in the prophylactic treatment of UCA.
一般社団法人日本脳卒中の外科学会の論文