关于向痴呆症患者告知真相
On telling the truth to patients with dementia.
作者信息
Marzanski M
机构信息
Coventry Healthcare, National Health Service Trust, UK.
出版信息
West J Med. 2000 Nov;173(5):318-23. doi: 10.1136/ewjm.173.5.318.
OBJECTIVES
To discover what dementia sufferers think is wrong with them, what they have been told and by whom, and what they wish to know about their illness.
BACKGROUND
Ethical guidelines regarding telling truth appear to be equivocal. Declarations of cognitively intact subjects, attitudes of family members, and current psychiatric practice all vary, but no previous research has been published concerning what patients with dementia would like to know about their diagnosis and prognosis.
DESIGN
Questionnaire study of patients' opinions.
SETTING
Old Age Psychiatry Service in Worcester, United Kingdom.
PARTICIPANTS
Thirty consecutive patients with dementia.
RESULTS
The quality of information received has been poor, and many patients have no opportunity to discuss their illness with anybody. Despite that, almost half of the participants in this study had adequate insight, and most declared that they would like to know more about their predicament.
CONCLUSIONS
Although many patients would like to know the truth, the rights of those who do not want to know should also be respected. Therefore, the diagnosis of dementia should not be routinely disclosed, but just as in other disorders, health care professionals should seek to understand their patients' preferences and act appropriately according to their choice.
目的
了解痴呆症患者认为自己有什么问题，他们被告知的情况以及告知者是谁，以及他们希望了解关于自己疾病的哪些方面。
背景
关于告知真相的伦理准则似乎模棱两可。认知功能正常的受试者的声明、家庭成员的态度以及当前的精神病学实践各不相同，但此前尚未发表过关于痴呆症患者希望了解其诊断和预后的研究。
设计
对患者意见的问卷调查研究。
地点
英国伍斯特的老年精神病科服务机构。
参与者
连续30名痴呆症患者。
结果
所获信息质量不佳，许多患者没有机会与任何人讨论自己的病情。尽管如此，本研究中近一半的参与者有足够的洞察力，且大多数人表示希望更多地了解自己的处境。
结论
尽管许多患者想知道真相，但不想知道的人的权利也应得到尊重。因此，痴呆症的诊断不应常规披露，但与其他疾病一样，医护人员应设法了解患者的偏好，并根据其选择采取适当行动。
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