Was ist für Patienten mit einem kolorektalen Karzinom wirklich wichtig? Prospektive Analyse von 80 Patienten mittels eines strukturierten Interviews

Postoperative outcome of patients with colorectal cancer surgery is usually only assessed by mechanistic outcome variables (mortality and morbidity). In contrast, we developed an integrated outcome concept. This concepts includes doctor assessed physical functioning and patient self-reported quality of life and a value judgement of both [1]. For value judgement we tested a structured interview, to obtain further information of clinical relevance beyond that of quality of life questionnaires. Methods: A 6 month follow up was performed in the course of a prospective, double blinded, randomised trial with G-CSF prophylaxis for improvement of postoperative outcome of patients after colorectal cancer surgery [2]. We assessed the objective health status, patients expressed quality of life with questionnaires and the personal experience in an interview lasting about 20 minutes [3]. The interview consisted of an introduction, the possibility to talk about all cancer associated experiences and a structured interview with six questions: 1) How is your general health condition? 2) Are you recovered to the level before operation? 3) What was the worst/ 4) the best/ 5) the most important events for you during the last six months? 6) Where there any major changes in your life circumstances? The interview was tape-recorded for further analysis. Results: From the 80 patients randomised in the trial 63 interviews were obtained. One patient was not operated, 6 died and 10 were either nor able or refused it. Six months after operation 75% of the patients claimed to be in a good or acceptable shape. The worst experience was for 16% the diagnosis cancer, for 14% the operation and for 13% the radio-chemotherapy.