Nursing interventions and influencing subjective QOL in patients at different stages after surgery for rectal cancer

抄録

  We examined the factors influencing subjective quality of life （QOL） at different postoperative stages in 62 patients with rectal cancer who had undergone intersphincteric resection （ISR） or low anterior resection （LAR）. I also examined nursing interventions aimed at improving the patients' subjective QOL. Subjective QOL was analyzed by using the Schedule for the Evaluation of the Individual Quality of Life – Direct Weighting （SEIQoL-DW）.
  In all patients （ISR and LAR groups combined）, the mean SEIQoL-DW index values were 57.7 （patients less than 1 year after surgery）, 66.6 （patients 1 to less than 2 years after surgery）, and 68.7 （patients 2 or more years after surgery）; the SEIQoL-DW index was significantly lower in patients in the first postoperative year than in those 2 or more years after surgery. These results suggest that subjective QOL is lowest during the first postoperative year and improves with time.
  Analysis of components of QOL and their indices, as measured by SEIQoL-DW, revealed that family, hobbies （outdoor）, health, friends, and hobbies （indoor） were the primary determinants of subjective QOL. Analysis of cues with low levels of satisfaction despite high importance in the SEIQoL-DW revealed that, to provide nursing interventions to improve subjective QOL, it is important to focus on interventions that 1） manage the dyschezia affecting the postoperative health of patients who have undergone LAR; and 2） provide lifestyle counseling to increase fulfillment in work or hobbies among patients who have undergone LAR.