Salander Pär
Institutionen för strålningsvetenskaper-onkologi, Norrlands Universitetssjukhus, Umeå.
Lakartidningen. 2003 Feb 13;100(7):510-2, 515-6.
Papers in clinical journals dealing with how to tell cancer patients bad news rely mostly on the opinion of the physician. The purpose of the present study was to contribute with knowledge from the patient's perspective by analysing how patients with recently diagnosed cancer narrate the manner in which they received their diagnosis. A consecutive series of 187 patients who had received their cancer diagnosis 2-8 months prior to the outset of this study were asked to describe the manner in which they learned of their diagnosis in writing. A crucial finding from the submitted 138 written narratives was that the participants often described experiences from the first contact with hospital staff to the end of their treatment, rather than as a single instance of diagnosis communication. The relational meaning of these experiences was obvious. From the patient's perspective, "bad news" reflects the process of being diseased by cancer, and how medical services are available when one is in need of establishing a helpful relationship.
临床期刊上有关如何向癌症患者传达坏消息的论文大多依赖医生的观点。本研究的目的是从患者的角度提供知识，通过分析近期诊断出癌症的患者如何讲述他们得知诊断结果的方式来实现。连续选取了187名在本研究开始前2至8个月被诊断出癌症的患者，要求他们以书面形式描述得知诊断结果的方式。从提交的138篇书面叙述中得出的一个关键发现是，参与者经常描述从首次接触医院工作人员到治疗结束的经历，而不是将其描述为一次单一的诊断告知实例。这些经历的关系意义很明显。从患者的角度来看，“坏消息”反映了患癌症的过程，以及在需要建立有益关系时医疗服务的可获得性。
