Petrasch S, Bauer M, Reinacher-Schick A, Sandmann M, Kissler M, Küchler T, Krüskemper G, Dörr T, Schmiegel W
Department of Internal Medicine, Ruhr-University of Bochum, Germany.
Wien Med Wochenschr. 1998;148(21):491-9.
The aim of this study was to evaluate the attitudes of cancer patients towards the medical interview and to determine their psychosocial satisfaction subsequent to the dialogue. The answers given by patients with curable cancer were compared to those given by cancer patients whose treatment intent was palliative and to the replies of patients infected with the human immunodeficiency virus (HIV), a nonmalignant but also incurable state. The subject population comprised a total of 139 patients. Patients had to complete a questionnaire with a total of 34 items. The answers to the questions were rated on a 5-point scale with response options ranging from 1 to 5 or consisting of true-false statements. Cancer patients, palliative and curative, and HIV-positive patients considered their physicians to be honest (x = 4.34, x = 4.58, and x = 4.30, respectively; p = 0.104), and they emphasized that he/she took enough time answering their questions (x = 4.00, x = 4.30 and x = 4391, respectively; p = 0.12). Cancer patients treated with potentially curable disease were more frequently afraid of being informed about additional diagnostic examinations and about the disclosure of results as compared to cancer patients on palliative care (p < 0.05 for both questions). Patients with HIV-infection considered themselves less informed about the treatment they received as compared to curative cancer patients (x = 3.73 and x = 4.28, respectively; p < 0.046). Only 8.0% of the tumor patients on palliative care, but 63.6% of the HIV-positive patients realized that their medication was given with the objective to relieve symptoms (p < 0.001). When asked about additional goals of treatment, 48% of the palliative cancer patients and 15.1% of the HIV-positive patients checked "cure" (p < 0.002). In conclusion, particularly patients with curable cancer were afraid of information they might receive during the medical interview. Cancer patients considered themselves better informed compared to patients with HIV-infection. This is in significant contrast with the actual, measurable knowledge about their disease in the latter group. It is indeed surprising that only a small minority of incurable cancer patients realized that the goal of the medical care they received was relief of symptoms, the principle objective of palliation.
本研究的目的是评估癌症患者对医学问诊的态度，并确定对话后他们的心理社会满意度。将可治愈癌症患者的回答与治疗目的为姑息治疗的癌症患者的回答以及感染人类免疫缺陷病毒（HIV）（一种非恶性但也无法治愈的状态）的患者的回答进行比较。研究对象共包括139名患者。患者必须完成一份共有34个项目的问卷。问题的答案采用5分制评分，回答选项从1到5或由是非陈述组成。接受姑息治疗和可治愈治疗的癌症患者以及HIV阳性患者认为他们的医生是诚实的（分别为x = 4.34、x = 4.58和x = 4.30；p = 0.104），并且他们强调医生花了足够的时间回答他们的问题（分别为x = 4.00、x = 4.30和x = 4.391；p = 0.12）。与接受姑息治疗的癌症患者相比，接受潜在可治愈疾病治疗的癌症患者更频繁地害怕被告知进行额外的诊断检查以及结果的披露（两个问题的p均<0.05）。与可治愈癌症患者相比，HIV感染患者认为自己对所接受治疗的了解较少（分别为x = 3.73和x = 4.28；p < 0.046）。接受姑息治疗的肿瘤患者中只有8.0%，但HIV阳性患者中有63.6%意识到他们的药物治疗目的是缓解症状（p < 0.001）。当被问及治疗的其他目标时，48%的姑息性癌症患者和15.1%的HIV阳性患者勾选了“治愈”（p < 0.002）。总之，尤其是可治愈癌症患者害怕在医学问诊过程中可能收到的信息。与HIV感染患者相比，癌症患者认为自己了解得更多。这与后一组患者对自身疾病的实际可测量知识形成了显著对比。确实令人惊讶的是，只有一小部分无法治愈的癌症患者意识到他们所接受医疗护理的目标是缓解症状，即姑息治疗的主要目标。
