Understanding the reasons for the refusal of cholecystectomy in patients with cholelithiasis: how to help them in their decision?
BACKGROUND: Cholelithiasis is prevalent surgical disease, with approximately 60,000 admissions per year in the Unified Health System in Brazil. Is often asymptomatic or oligosymptomatic and major complications arise from the migration of calculi to low biliary tract. Despite these complications are...
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| Format: | Article |
| Language: | English |
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Colégio Brasileiro de Cirurgia Digestiva
2014-06-01
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| Series: | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202014000200114&tlng=en |
| _version_ | 1818891575787257856 |
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| author | Adilson PERON Ana Laura SCHLIEMANN Fernando Antonio de ALMEIDA |
| author_facet | Adilson PERON Ana Laura SCHLIEMANN Fernando Antonio de ALMEIDA |
| author_sort | Adilson PERON |
| collection | DOAJ |
| description | BACKGROUND: Cholelithiasis is prevalent surgical disease, with approximately 60,000 admissions per year in the Unified Health System in Brazil. Is often asymptomatic or oligosymptomatic and major complications arise from the migration of calculi to low biliary tract. Despite these complications are severe and life threatening, some patients refuse surgical treatment. AIM: To understand why individuals with cholelithiasis refuse cholecystectomy before complications inherent to the presence of gallstones in the bile duct and pancreatitis occur. METHODS: To investigate the universe of the justifications for refusing to submit to surgery it was performed individual interviews according to a predetermined script. In these interviews, was evaluate the knowledge of individuals about cholelithiasis and its complications and the reasons for the refusal of surgical treatment. Were interviewed 20 individuals with cholelithiasis who refused or postponed surgical treatment without a plausible reason. To these interviews, was applied the technique of thematic analysis (Minayo, 2006). RESULTS: The majority of respondents had good knowledge of their disease and its possible complications, were well oriented and had surgical indications by their physicians. The refusal for surgery was justified primarily on negative experiences of themselves or family members with surgery, including anesthesia; fear of pain or losing their autonomy during surgery and postoperative period, preferring to take the risk and wait for complications to then solve them compulsorily. CONCLUSION: The reasons for the refusal to surgical resolution of cholelithiasis were diverse, but closely related to personal (or related persons) negative surgical experiences or complex psychological problems that must be adequately addressed by the surgeon and other qualified professionals. |
| first_indexed | 2024-12-19T17:43:00Z |
| format | Article |
| id | doaj.art-fe2b060039794418a0f9f536a095f163 |
| institution | Directory Open Access Journal |
| issn | 0102-6720 |
| language | English |
| last_indexed | 2024-12-19T17:43:00Z |
| publishDate | 2014-06-01 |
| publisher | Colégio Brasileiro de Cirurgia Digestiva |
| record_format | Article |
| series | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| spelling | doaj.art-fe2b060039794418a0f9f536a095f1632022-12-21T20:12:09ZengColégio Brasileiro de Cirurgia DigestivaABCD: Arquivos Brasileiros de Cirurgia Digestiva0102-67202014-06-0127211411910.1590/S0102-67202014000200007Understanding the reasons for the refusal of cholecystectomy in patients with cholelithiasis: how to help them in their decision?Adilson PERONAna Laura SCHLIEMANNFernando Antonio de ALMEIDABACKGROUND: Cholelithiasis is prevalent surgical disease, with approximately 60,000 admissions per year in the Unified Health System in Brazil. Is often asymptomatic or oligosymptomatic and major complications arise from the migration of calculi to low biliary tract. Despite these complications are severe and life threatening, some patients refuse surgical treatment. AIM: To understand why individuals with cholelithiasis refuse cholecystectomy before complications inherent to the presence of gallstones in the bile duct and pancreatitis occur. METHODS: To investigate the universe of the justifications for refusing to submit to surgery it was performed individual interviews according to a predetermined script. In these interviews, was evaluate the knowledge of individuals about cholelithiasis and its complications and the reasons for the refusal of surgical treatment. Were interviewed 20 individuals with cholelithiasis who refused or postponed surgical treatment without a plausible reason. To these interviews, was applied the technique of thematic analysis (Minayo, 2006). RESULTS: The majority of respondents had good knowledge of their disease and its possible complications, were well oriented and had surgical indications by their physicians. The refusal for surgery was justified primarily on negative experiences of themselves or family members with surgery, including anesthesia; fear of pain or losing their autonomy during surgery and postoperative period, preferring to take the risk and wait for complications to then solve them compulsorily. CONCLUSION: The reasons for the refusal to surgical resolution of cholelithiasis were diverse, but closely related to personal (or related persons) negative surgical experiences or complex psychological problems that must be adequately addressed by the surgeon and other qualified professionals.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202014000200114&tlng=enCholelithiasisMedical ethicsInformed consentBehavioral medicine |
| spellingShingle | Adilson PERON Ana Laura SCHLIEMANN Fernando Antonio de ALMEIDA Understanding the reasons for the refusal of cholecystectomy in patients with cholelithiasis: how to help them in their decision? ABCD: Arquivos Brasileiros de Cirurgia Digestiva Cholelithiasis Medical ethics Informed consent Behavioral medicine |
| title | Understanding the reasons for the refusal of cholecystectomy in patients with cholelithiasis: how to help them in their decision? |
| title_full | Understanding the reasons for the refusal of cholecystectomy in patients with cholelithiasis: how to help them in their decision? |
| title_fullStr | Understanding the reasons for the refusal of cholecystectomy in patients with cholelithiasis: how to help them in their decision? |
| title_full_unstemmed | Understanding the reasons for the refusal of cholecystectomy in patients with cholelithiasis: how to help them in their decision? |
| title_short | Understanding the reasons for the refusal of cholecystectomy in patients with cholelithiasis: how to help them in their decision? |
| title_sort | understanding the reasons for the refusal of cholecystectomy in patients with cholelithiasis how to help them in their decision |
| topic | Cholelithiasis Medical ethics Informed consent Behavioral medicine |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202014000200114&tlng=en |
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