| Objective:To explore the current situation and connected factors of expectation of pain treatment in patients with vertebral malignant tumor undergoing interventional surgery,and explore the relationship between expectation of pain treatment,therapeutic effect and therapeutic satisfaction in patients with vertebral malignant tumor undergoing interventional surgery,and understand the changing rules of pain,ECOG performance status and dysfunction in patients with vertebral malignant tumor before and after surgery.Methods:Consistent parallel design of mixed research methods were used.In the quantitative study phase,70 patients with vertebral malignant tumor who met the diagnostic criteria and underwent interventional surgery were enrolled from the interventional ward of the First Affiliated Hospital of China Medical University from October 2021 to October 2022 by convenient sampling method.Data were collected by questionnaire method.A self-designed general data questionnaire,Oswestry Disability Index Scale(ODIS),Generalized Anxiety Disorder Scale(GADS),Visual Analogue Scale/Score(VAS),Expect Scale(Expect Scale,ES)and the Eastern Cooperative Oncology Group-Performance Status Scale(ECOG‐PSS)were selected.Data analysis methods included descriptive statistics,paired T-test,paired design Wilcoxon rank sum test,Mann-Whitney test,Kruskal-Wallis test,generalized linear model,and Spearman rank correlation analysis.In the qualitative study phase,a descriptive qualitative research method was adopted,and object sampling was adopted to select the research objects.Based on the inclusion and exclusion criteria of the quantitative study part,semi-structured interviews were conducted on the patients who had received an excess survey and some patients with vertebral malignancies who had not received an excess survey.The sample size was determined as data saturation based on the fact that no new information was available,and sampling was stopped.A total of two interviews were conducted,including 17 patients interviewed before surgery and 11 patients interviewed after surgery.NVivo qualitative software was used to assist the analysis,and content analysis method was used to analyze the data.Results:1.The effective recovery rate was 97.22%.2.The mean age of 28 male and42 female patients was(65.39±7.54)years and(67.55±9.68)years respectively.Metastatic cancer was found in 92.86%of patients,with lung cancer accounting for the highest proportion(57.14%).Thoracic vertebra(70.00%)and lumbar vertebra(25.71%)were the most common tumor sites.3.The median expectation score of preoperative pain treatment for patients with vertebral malignant tumor(P25,P75)was 88.00(64.75,94.00),and the patients with vertebral malignant tumor had higher expectations for interventional surgery for pain treatment.4.The ODIS score and item score,GADS score and item score and ECOG‐PSS score of patients with vertebral malignant tumor were statistically significant on the first day before surgery and the third day after surgery(P<0.05).5.The results of the generalized linear model showed that patients without a history of vertebral intervention had12.905 times higher expectations than those with a history of vertebral intervention(P<0.001),patients aged≤65 years had 7.969 times higher expectations than those aged>65 years(P=0.003),and patients without knowledge of the condition had6.965 times higher expectations than those with knowledge of the condition(P=0.022).6.Patients with vertebral malignancy tumor had the highest pain score on the last day before surgery,with a median pain score of 7.5 points,which showed a downward trend thereafter,and the median pain score on the day of admission was0.5 points lower than that on the last day before surgery.7.There was a negative correlation between preoperative expectation for interventional surgery and postoperative satisfaction(r_s=-0.724,P<0.001),and a positive correlation between preoperative VAS score on the first and third day after surgery(r_s=0.315,P=0.008;r_s=0.353,P=0.003).8.The results of the preoperative qualitative study summarized three first-level themes,namely,the effect of pain on patients with vertebral malignancies,the expectations of patients with vertebral malignancies for pain treatment,and the reasons why patients with vertebral malignancies have high expectations;the results of the postoperative qualitative study summarized two first-level themes,namely,the evaluation of patients with vertebral malignancies for the effectiveness of pain treatment,and the fit between postoperative results and expectations.Conclusion:1.Patients with vertebral malignant tumor have higher expectations of pain treatment for interventional surgery,which is related to patients’age,whether they understand the disease,whether they have vertebral interventional surgery history,personality factors,medical procedures and family factors.2.The higher the expectation of pain treatment,the lower the satisfaction of postoperative treatment,and the higher the VAS score on the first and third day after surgery.3.After vertebral interventional surgery,the pain,dysfunction,anxiety,and performance status of patients with vertebral malignant tumor were significantly improved after surgery.4.Patients with vertebral malignancies have a higher evaluation of the efficacy of pain treatment after interventional surgery.5.Medical staff should take appropriate measures to relieve patients’pain to improve quality of life,and help patients establish reasonable expectations based on relevant influencing factors to improve patients’treatment satisfaction. |
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