Kelly Brian, Burnett Paul, Badger Shirlene, Pelusi Dan, Varghese Francis T, Robertson Marguerite
Department of Psychiatry, University of Queensland, Qld, Australia.
Psychooncology. 2003 Jun;12(4):375-84. doi: 10.1002/pon.678.
There is a paucity of research that has directly examined the role of the health professional in dealing with a terminally ill patient's wish to hasten death (WTHD) and the implications of this for the support and services needed in the care for a dying patient. Themes to emerge from a qualitative analysis of interviews conducted on doctors (n=24) involved in the treatment and care of terminally ill patients were (i). the doctors' experiences in caring for their patients (including themes of emotional demands/expectations, the duration of illness, and the availability of palliative care services); (ii). the doctors' perception of the care provided to their respective patients (comprising themes concerning satisfaction with the care for physical symptoms, for emotional symptoms, or overall care); (iii). the doctors' attitudes to euthanasia and (iv). the doctors' perception of their patients' views/beliefs regarding euthanasia and hastened death. When responses were categorised according to the patients' level of a WTHD, the theme concerning the prolonged nature of the patients' illnesses was prominent in the doctor group who had patients with the highest WTHD, whereas there was only a minority of responses concerning support from palliative care services and satisfaction with the level of emotional care in this group.This exploratory study presents a set of descriptive findings identifying themes among a small group of doctors who have been involved in the care of terminally ill cancer patients, to investigate factors that may be associated with the WTHD among these patients. The pattern of findings suggest that research investigating the doctor-patient interaction in this setting may add to our understanding of the problems (for patients and their doctors) that underpins the wish to hasten death in the terminally ill.
直接研究医疗专业人员在处理绝症患者加速死亡愿望（WTHD）方面的作用以及这对临终患者护理所需支持和服务的影响的研究很少。对24名参与绝症患者治疗和护理的医生进行访谈的定性分析中出现的主题包括：（i）医生照顾患者的经历（包括情感需求/期望、疾病持续时间和姑息治疗服务的可用性等主题）；（ii）医生对为各自患者提供的护理的看法（包括对身体症状护理、情感症状护理或整体护理的满意度等主题）；（iii）医生对安乐死的态度；以及（iv）医生对患者关于安乐死和加速死亡的观点/信念的看法。当根据患者的WTHD水平对回答进行分类时，在WTHD最高的患者所在的医生组中，关于患者疾病病程延长的主题最为突出，而在该组中，关于姑息治疗服务支持和情感护理水平满意度的回答只有少数。这项探索性研究提出了一组描述性结果，确定了一小群参与临终癌症患者护理的医生中的主题，以调查可能与这些患者的WTHD相关的因素。研究结果模式表明，在这种情况下研究医患互动的研究可能会增进我们对支撑绝症患者加速死亡愿望的问题（对患者及其医生而言）的理解。
