Passalacqua R, Campione F, Caminiti C, Salvagni S, Barilli A, Bella M, Barni S, Barsanti G, Caffo O, Carlini P, Cinquemani G, Di Costanzo F, Giustini L, Labianca R, Mazzei A, Olmeo N, Paccagnella A, Toscano L, Cocconi G
Medical Oncology Division, University Hospital, Parma, Italy.
Lancet. 1999 Apr 17;353(9161):1310-4. doi: 10.1016/S0140-6736(98)10253-2.
An emotional campaign promoting the Di Bella cancer therapy was launched by the Italian media in 1997. Its effects on patients' hopes, feelings, and decision-making processes were largely unknown. We undertook an investigation of this issue.
Between Feb 25 and March 31, 1998, a ten-item questionnaire was distributed to 1300 unselected adult patients attending 13 cancer centres throughout Italy. Four expert psycho-oncologists reviewed the design and validity of the contents of the questionnaire. Sociodemographic information was also collected.
1120 (86%) questionnaires were returned and analysed. The main sources of information were television/radio (62%) and newspapers (26%); only 5% cited doctors. The campaign induced optimism in the patients about the efficacy of the method (ineffective 1%, effective 42%, uncertain 57%), and 53% said their hope of cure was increased. However, 48% felt more confused. 24% do not discuss new treatments with their oncologists, and 20% would like to but cannot. When choosing a treatment, the advice of a trusted doctor was judged more important than scientific progress (53% vs 32%) and 63% would try even unproven treatments in the hope of a cure. Replies to many of the questions were influenced by patients' educational attainment and by the degree of communication with their oncologists.
Science cannot prevent the harm caused by such campaigns and their psychological consequences, particularly for less educated patients. When making decisions, patients are looking for hope from the treatment and trust in their doctor, both of which depend on effective doctor-patient communications that therefore need to be improved.
1997年，意大利媒体发起了一场宣传迪贝拉癌症疗法的情感运动。其对患者的希望、感受和决策过程的影响在很大程度上尚不清楚。我们对这个问题进行了调查。
1998年2月25日至3月31日期间，向意大利各地13个癌症中心的1300名未经挑选的成年患者发放了一份包含10个问题的问卷。4名专业心理肿瘤学家对问卷的设计和内容效度进行了审查。还收集了社会人口统计学信息。
共收回并分析了1120份（86%）问卷。信息的主要来源是电视/广播（62%）和报纸（26%）；只有5%的人提到医生。该运动使患者对该疗法的疗效产生了乐观情绪（无效1%，有效42%，不确定57%），53%的人表示他们治愈的希望增加了。然而，48%的人感到更加困惑。24%的人不与肿瘤学家讨论新的治疗方法，20%的人想讨论但不能。在选择治疗方法时，患者认为值得信赖的医生的建议比科学进展更重要（53%对32%），63%的人甚至会尝试未经证实的治疗方法，以期治愈。许多问题的回答受到患者教育程度和与肿瘤学家沟通程度的影响。
科学无法预防此类运动造成的危害及其心理后果，尤其是对受教育程度较低的患者。在做决定时，患者寻求治疗带来的希望和对医生的信任，而这两者都依赖于有效的医患沟通，因此需要加以改善。
