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Journal of the Korean Academy of Family Medicine 1994;15(7):436-445.
Published online July 1, 1994.
The Accuracy of Patient's Self-Report about Bilateral Oophorectomy in Whom Received Hystrectomy and Bilateral Oophorectomy.
Bong Yul Huh, Jang Won Won, Hoon Ki Park, Seok Kyun Woo, Tae Hee Jun
자궁과 양측난소를 적출한 환자의 양측난소적출여부의 인지에 관한 연구
허봉렬, 원장원, 박훈기, 우석균, 전태희
서울대학교병원 가정의학과
: Hysterectomy and hysterectomy with oophorectomy are the one of the most common surgical operations, and the cases of this surgical operations have been increasing now. Moreover, the concern about hormone replacement therapy to postmenopausal women is growing now, therefore the importance of accurate information about oophorectomy state is more emphasized than before. We can get information about oophorectomy state through patient medical record and self-report, but in Korea the only available source of information in reality is patient self-report on primary care setting, regrettably. Many physicians in Korea are skeptical to self-report of patient. Therefore this study is designed to know accuracy of patient's recall about bilateral oophorectomy in whom received hystrectomy and bilateral oophorectomy through medical record review and telephone interview. And we analyze factors with the accuracy of patient's recall.

Methods : The subject of this study is the patients who is accessible through telephone interview and medical record review of those who was received hysterecomy with bilateral oophorectomy in a third grade hospital. Their surgical operations were done from Jan. 1990 to Aug. 1993. The patient proven to have malignancy was excluded. The inforamation about accuracy of their self-report and associated factor was achieved through medical record review and telephone interview.

Results : The number of accessible subject is 117. Of 117 woemn, 112(95.7%) know their hysterectomy state accurately. But the number of persons who know their own bilateral oophorectomy state accurately is 74(63.3%), and the persons who don't know their bilateral oophorectomy state accurately is 43(36.8%). Of whom who don't know accurately their bilateral oophorectomy state, 28(23.9%) women answer that they didn't know whether bilateral oophorectomy had been done or not, 15(12.8%) women denied their bilateral oophorectomy state. Women who know accurately their bilateral oophrectomy state in comparison with who don't know their bilateral oophorectomy state are younger in average age, higher in education level, and have more opportunities of listening doctor's explanation of their post organ extraction state, and have received hormone replacement therapy more. And this differences of two groups are statistically significant. The differences between two groups on monthly salary, having occupation or not, living in city or not, marital state, period after operation, pre-operative diagnosis, and whether she knows post operative diagnosis or not, are not significant statistically. The major determinants in the accurate knowledge of their own bilateral oophorectomy state are whether patients listened Doctor's personal explanation of their state or not, and whether she received hormone replacement therapy ever or not.

Conclusion : The proportion of whom know accurately their own bilateral oophorectomy state is 63.3%. That proportion is considerably low which leads to conclude that it is not advisable to make a clinical decision based on patient self-report state only in this sugical operation cases. And because the most important determinants of the accuracy knowledge of their own bilateral oophorectomy state is whether patients listened medical doctor's personal explanation of their state, therefore the importance of this aspect of doctor's education must be emphasized to medical doctors.
연구배경 : 일차의료에서 난소적출술에 관한 정보는 주로 의무기록과 환자의 자가 보고만이 유일한 정보원인 경우가 많다. 그러나 많은 의사들은 환자의 자가보고의 정확성에 대해 회의적으로 보고있다. 따라서 본 연구는 자궁적출술과 동반된 양측난소적출술을 받은 여성들을 대상으로, 환자의 자가보고의 정확도를 알아보고 이에 영향을 미치는 요인들을 분석하였다.

방법 : 대학병원 산부인과에서 1990년 1월부터 93년 8월까지 자궁적출술과 양측난소적출술을 동시에 받은 환자 중, 악성종양으로 진단된 환자들을 제외하고 의무기록열람과 환자본인과의 전화인터뷰를 통하여 자신의 장기적출에 관한 정확한 인지여부와 이와 관련된 요인들을 조사하였다.

결과 : 대상환자 117명 중 양측난소적출 사실을 정확히 인지하고 있는 사람은 74명(63.3%)이었고, 정확히 기억하지 못하는 사람은 43명(36.7%)이었다. 양측난소적출사실을 정확히 기억하지 못하는 군에서 28명(23.9%)이 잘모르겠다고 대답했으며, 15명(12.8%)이 의무기록과 다르게 대답하였다. 양측난소적출 사실을 정확히 아는 군은 그렇지 못한 군과 비교하여 평균연령이 낮았고, 교육수준이 높았으며 의사에게 설명을 들은 경우가 많았고, 호르몬 보충요법을 받은 경우가 많았으며, 양측난소에 병변이 있는 경우가 많았고, 이들은 각각 통계적으로 유의하였다. 의사에게 환자 본인이 직접 양측난소적출 사실에 대한 설명을 들었는지 여부, 호르몬 보충요법 여부가 양측 난소적출에 관한 정확한 인지를 결정하는 주 요인들이었다. 자궁적출술에 대해서는 117명중 112명(95.7%)이 정확히 기억하고 있었다.

결론 : 자궁적출술과 양측난소적출술을 동시에 받은 환자군에서 양측난소적출 사실을 정확히 인지하는 비율이 63.3%정도로 낮아, 양측난소적출사실에 관한 환자의 자가보고만으로 임상적 판단을 하는 것은 바람직하지 않다. 그리고 양측난소적출사실에 관한 정확한 인지를 결정하는 요인으로 의사가 환자 본인에게 직접 설명하는 것이 중요하므로, 이러한 점이 의사들에게 강조되어야 한다.
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