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[医生与肿瘤患者之间的沟通动态]

[Dynamics of communication between physician and the oncologic patient].

作者信息

Proia Anna

机构信息

Sezione di Ematologia, Dipartimento di Biotecnologie Cellulari ed Ematologia, Università La Sapienza, Roma.

出版信息

Recenti Prog Med. 2002 Feb;93(2):108-12.

Abstract

The informed consent of patients is ethically and legally required for all medical practice. The disclosure of information to cancer patients is one of the most important issues mostly in oncological practice. Because most patients now want to know the truth about their diagnosis and prognosis, the ability to discuss the cancer diagnosis, disease recurrence, or treatment failure, and to solicit patients' views about resuscitation or hospice care, are important verbal skills for oncologists and other oncology care providers. If clinicians involved in cancer care are able to well communicative with patients, these ones and their families can achieve a good level of quality of life and psychological adjustment. Moreover, the ability to clearly articulate a treatment plan or elicit patient preferences for treatment are prerequisite to informed consent. Despite these imperatives, clinicians do not routinely receive training in key communication skills that could enable them to accomplish these tasks. Disclosure of information needs to be individualized, and social and cultural background has to be taken into consideration. This review considers deficiencies in the conduct of key communication tasks and their consequences. The reasons for these deficiencies are explored and guidelines to resolve these issues and to further new alternative methods are proposed.

摘要

所有医疗行为在伦理和法律上都需要患者的知情同意。向癌症患者披露信息是肿瘤学实践中最重要的问题之一。因为现在大多数患者都想知道自己诊断和预后的真相,所以讨论癌症诊断、疾病复发或治疗失败,并征求患者对复苏或临终关怀的意见,是肿瘤学家和其他肿瘤护理提供者的重要语言技能。如果参与癌症护理的临床医生能够与患者进行良好沟通,患者及其家人就能达到较高的生活质量和心理调适水平。此外,清晰阐述治疗计划或了解患者对治疗的偏好的能力是知情同意的前提条件。尽管有这些要求,但临床医生通常没有接受关键沟通技能的培训,而这些技能可以使他们完成这些任务。信息披露需要个性化,必须考虑社会和文化背景。本综述考虑了关键沟通任务执行中的不足及其后果。探讨了这些不足的原因,并提出了解决这些问题和进一步探索新替代方法的指导方针。

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