Verhoef Marja J, White Margaret A
Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Cancer Pract. 2002 Jul-Aug;10(4):201-7. doi: 10.1046/j.1523-5394.2002.104002.x.
The purpose of this study was to explore why and how patients with cancer decide to forgo conventional cancer treatments in favor of alternative treatments and which factors influence such decisions.
Due to the exploratory nature of the study, this was a qualitative study using focus groups and in-depth interviews in a convenience sample of patients. All patients had received diagnoses of cancer and had refused one or more conventional treatments offered to them by their cancer healthcare professionals.
Thirty-one persons with cancer, widely varying in age and tumor sites, volunteered to take part in the study. Of these, 12 refused all conventional treatment, 13 refused most or some of the treatments recommended, and 6 discontinued conventional treatment. The decision-making model, which emerged from the data, identifies several groups of variables. These include factors that predispose participants to the decision to forgo conventional treatment(s), such as having a close relative or friend who has died from cancer when receiving conventional treatment; experiences around the diagnosis; and factors relevant after the diagnosis, such as beliefs, need for control, side effects of conventional cancer treatment, and communication with physicians. Last, perceived outcomes of the decision proved to be an important theme in the focus groups and interviews.
Patients with cancer may benefit from counseling to help them explore the difference between their diagnosis and treatment plan and those of family members or friends who died of cancer while receiving conventional treatment. Counseling also may be helpful in resolving emotional issues underlying the decision to forgo treatment. Last, patients should have access to healthcare professionals, including physicians and counselors, who would assist them with their decision making without judging or intimidating them.
本研究旨在探讨癌症患者为何以及如何决定放弃传统癌症治疗而选择替代疗法，以及哪些因素会影响此类决定。
由于本研究具有探索性，这是一项定性研究，采用焦点小组和对便利抽样患者进行深入访谈的方法。所有患者均已被诊断患有癌症，并拒绝了癌症医疗专业人员为他们提供的一种或多种传统治疗。
31名癌症患者自愿参与研究，他们在年龄和肿瘤部位上差异很大。其中，12人拒绝了所有传统治疗，13人拒绝了大部分或部分推荐的治疗，6人中断了传统治疗。从数据中得出的决策模型识别出了几组变量。这些变量包括使参与者倾向于决定放弃传统治疗的因素，例如有近亲或朋友在接受传统治疗时死于癌症；诊断前后的经历；以及诊断后的相关因素，如信念、对控制的需求、传统癌症治疗的副作用以及与医生的沟通。最后，决策的预期结果在焦点小组和访谈中被证明是一个重要主题。
癌症患者可能会从咨询中受益，以帮助他们探讨自己的诊断和治疗计划与那些在接受传统治疗时死于癌症的家庭成员或朋友的诊断和治疗计划之间的差异。咨询也可能有助于解决放弃治疗决定背后的情感问题。最后，患者应能接触到医疗专业人员，包括医生和咨询师，他们将协助患者做出决策，而不会评判或恐吓他们。
