[Longitudinal study on quality of life after gastrectomy for gastric cancer and starting points for intensified care].
This prospective longitudinal study on gastric carcinoma patients with gastrectomy was designed to answer the question about changes in several determinants of the quality of life (QL) at various times before and after surgery and to obtain evidence for specific approaches of therapeutic intervention.


METHODS
36 patients were given a questionnaire structured according to Eypasch et al. (self- assessment) before surgery, at discharge from the hospital, and after 3 and 6 months. The dual structure of the questions makes it possible to determine whether a single item is present at all (prevalence) and to what extent it impairs the quality of life (no impairment/some/moderate/strong impairment--corresponding to 0-3). The data were evaluated per domain of QL as well as item-related.


RESULTS
Postoperatively, 14 patients had to be excluded from the study because of non-radical surgery, complications, recurrences, etc. After 6 months the items of all QL-determinants showed the lowest prevalence with the exception, however, of the somatic determinants, the items of which showed a prevalence of 27 % preoperatively, 64 % at discharge from the hospital, 58 % after 3 months, and 46 % after 6 months. The average degree of QL-impairment increased continuously from 1.17 preoperatively to 1.61 after 6 months. Preoperatively the psychic domain was predominantly impaired, postoperatively the somatic domain.


CONCLUSIONS
Analysis of the subjective quality of life can reveal care deficits. Gastrectomy-associated symptoms seem to influence the quality of life considerably in the first 6 months after surgery. More attention has to be paid to the sequelae of surgery. The high pre- and postoperative frequency of psychic impairment makes it desirable to provide special psychooncological offers of care.
Schmidt-Matthiesen
A
A
Klinik für Allgemein- und Gefässchirurgie, Klinikum der Johann Wolfgang Goethe-Universität. Schmidt-Matthiesen@em.uni-frankfurt.de
Weidmann
R
R
Sänger
P
P
D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D011178:Postgastrectomy Syndromes / Q000523:psychology* / Q000628:therapy; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012017:Referral and Consultation; D012647:Self-Assessment; D012803:Sick Role; D013001:Somatoform Disorders / Q000523:psychology / Q000628:therapy; D013274:Stomach Neoplasms / Q000523:psychology / Q000601:surgery*; D011795:Surveys and Questionnaires
Longitudinaluntersuchung zur Befindlichkeit von Magenkarzinompatienten mit Gastrektomie: Ansatzpunkte zur Intensivierung der Betreuung?