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信仰对癌症治疗医疗决策的重要性。

Importance of faith on medical decisions regarding cancer care.

作者信息

Silvestri Gerard A, Knittig Sommer, Zoller James S, Nietert Paul J

机构信息

Department of Medicine and Center for Health Care Research, Medical University of South Carolina, Charleston 29425, USA.

出版信息

J Clin Oncol. 2003 Apr 1;21(7):1379-82. doi: 10.1200/JCO.2003.08.036.

Abstract

PURPOSE

Decisions regarding cancer treatment choices can be difficult. Several factors may influence the decision to undergo treatment. One poorly understood factor is the influence of a patient's faith on how they make medical decisions. We compared the importance of faith on treatment decisions among doctors, patients, and patient caregivers.

METHODS

One hundred patients with advanced lung cancer, their caregivers, and 257 medical oncologists were interviewed. Participants were asked to rank the importance of the following factors that might influence treatment decisions: cancer doctor's recommendation, faith in God, ability of treatment to cure disease, side effects, family doctor's recommendation, spouse's recommendation, and children's recommendation.

RESULTS

All three groups ranked the oncologist's recommendation as most important. Patients and caregivers ranked faith in God second, whereas physicians placed it last (P <.0001). Patients who placed a high priority on faith in God had less formal education (P <.0001).

CONCLUSION

Patients and caregivers agree on the factors that are important in deciding treatment for advanced lung cancer but differ substantially from doctors. All agree that the oncologist's recommendation is most important. This is the first study to demonstrate that, for some, faith is an important factor in medical decision making, more so than even the efficacy of treatment. If faith plays an important role in how some patients decide treatment, and physicians do not account for it, the decision-making process may be unsatisfactory to all involved. Future studies should clarify how faith influences individual decisions regarding treatment.

摘要

目的

关于癌症治疗选择的决策可能很困难。有几个因素可能会影响接受治疗的决定。一个尚未得到充分理解的因素是患者的信仰对其医疗决策方式的影响。我们比较了医生、患者和患者护理人员中信仰对治疗决策的重要性。

方法

对100名晚期肺癌患者、他们的护理人员以及257名肿瘤内科医生进行了访谈。参与者被要求对以下可能影响治疗决策的因素的重要性进行排序:癌症医生的建议、对上帝的信仰、治疗治愈疾病的能力、副作用、家庭医生的建议、配偶的建议以及子女的建议。

结果

所有三组都将肿瘤内科医生的建议列为最重要的因素。患者和护理人员将对上帝的信仰列为第二,而医生则将其排在最后(P<.0001)。将对上帝的信仰置于高度优先地位的患者受正规教育程度较低(P<.0001)。

结论

患者和护理人员在决定晚期肺癌治疗的重要因素上意见一致,但与医生有很大差异。所有人都认为肿瘤内科医生的建议是最重要的。这是第一项表明,对于一些人来说,信仰是医疗决策中的一个重要因素,甚至比治疗效果更重要的研究。如果信仰在一些患者决定治疗的方式中起重要作用,而医生没有考虑到这一点,那么决策过程可能会让所有相关人员都不满意。未来的研究应该阐明信仰如何影响个人关于治疗的决策。

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