Symptom Distress and Health Status for Post-Surgical Patients with Pituitary Tumor
Date Issued
2008
Date
2008
Author(s)
Wu, Yi-Jen
Abstract
Patients with pituitary tumor are the third group in neurosurgical operation. Tumor excision is the major therapeutics for these patients. Surgery can remove tumor successfully; however, leaves in diverse symptoms after surgery. These include physiological (for example, blurred vision and acromegaly) and psychological (for example, depression and anxiety) symptoms that will result in different levels of stress to patients’ lives and works. Most patients don’t satisfy with their lives after surgery, and the phenomena conflicts with what we observe during clinical nursing: patients look as healthy people after surgery. Therefore, the purpose of this study is to understand the symptom distress and health status of pituitary tumor patients after surgery.y purposive sampling, the data from 90 patients experienced pituitary tumor operation from one medical center in Taipei city during January 2004 to April 2007 were gathered by questionnaire survey and medical records review. The study result shows that the most patients experienced and most serious symptom is “blurred vision” before surgery, whereas, presently the most common symptom is “fatigue” , and the most serious symptom is “impotence” among male patients. The total symptom improvement rate after surgery is about 50%. The total number of present symptom is significantly higher than the total number of symptom before surgery (t=3.54, p=0.001). However, there is no significant difference between the levels of symptom distress before and after surgery (t=0.35, p=0.727). Each symptom had different improvement rate, which can be divided into four groups according to different time trend: most obvious improved within one month (for example, blurred vision and headache), most obvious improved within half year (excluding one month) (for example, decrease in libido and acromegaly), steady increasing improved within one year (for example, social isolation) and have no obvious improved over one year after surgery (for example, sleep problems and fatigue). Fatigue has lowest improvement rate among these symptoms. The self-rated health statuses of patients are usually between “fair” and “good”. The highest score one is “compare the health status now and just after surgery”, whereas the lowest one is “compare with the health status of same age people.” The most affected social function is “work” and the less affected one is “family life.” Difference analysis result shows that (1) patients who have optimistic personality have fewer total number of present symptom, lower level of present symptom distress and better self-rated health status and social function, (2) the more the support from family, the lower level of present symptom distress and the better self-rated health status and social function, (3) patients who received enough nursing education have lower level of present symptom distress and better self-rated health status and social function. Correlation analysis shows that there are significant negative correlations between “self-rated health status” and “the total number of present symptom” (r=-0.47, p=0.000), between “self-rated health status” and “level of present symptom distress” (r=-0.52, p=0.000), between “social function” and “the total number of present symptom” (r=-0.61, p=0.000), and between “social function” and “the level of present symptom distress” (r=-0.70, p=0.000). There are significant positive correlations between “self-rated health status” and “social function” (r=0.46, p=0.000), and between “the total number of present symptom” and “level of present symptom distress” (r=0.91, p=0.000). The predictors of patients’ self-rated health status are the total number of present symptom (β=-0.35), family support (β=0.28), and personality (β=0.21). A total of 35.7% of the variance was explained. The predictor of social function is the total number of present symptom (β=-0.70). A total of 48.9% of the variance was explained.rom the results of this study, the total number of present symptom and level of symptom distress both affect patients’ health status. Most common symptoms, such as blurred vision, fatigue, sleep problems, and high stressful symptoms, such as sexual dysfunction both impact on the developmental tasks of middle-age patients-work with sense of accomplish and satisfying sexual life. Therefore, patients have worse health status comparing with same age people. However, positive factors, including more family support, optimistic views and ample nursing education, will benefit patients’ self-management of symptom after surgery and promote their health status. We hope the result of this study can be applied on clinical nursing practice, thus patients can have more information that can prepare them more and make them better adapt to the symptom distress after discharged from hospital. The results also provide reference to clinical nursing so that patients can receive more suitable care.
Subjects
pituitary tumor
pituitary tumor surgery
symptom distress
self-rated health status
social function
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