Chapman Kristina, Abraham Charles, Jenkins Valerie, Fallowfield Lesley
Centre for Research in Health and Medicine, School of Social Sciences, University of Sussex, Falmer, East Sussex, UK.
Psychooncology. 2003 Sep;12(6):557-66. doi: 10.1002/pon.673.
The study assessed lay understanding of terms used by doctors during cancer consultations. Terms and phrases were selected from 50-videotaped consultations and included in a survey of 105 randomly selected people in a seaside resort. The questionnaire included scenarios containing potentially ambiguous diagnostic/prognostic terms, multiple-choice, comprehension questions and figures on which to locate body organs that could be affected by cancer. Respondents also rated how confident they were about their answers. About half the sample understood euphemisms for the metastatic spread of cancer e.g. 'seedlings' and 'spots in the liver' (44 and 55% respectively). Sixty-three per cent were aware that the term 'metastasis' meant that the cancer was spreading but only 52% understood that the phrase 'the tumour is progressing' was not good news. Yet respondents were fairly confident that they understood these terms. Knowledge of organ location varied. For example, 94% correctly identified the lungs but only 46% located the liver. The findings suggest that a substantial proportion of the lay public do not understand phrases often used in cancer consultations and that knowledge of basic anatomy cannot be assumed. Yet high confidence ratings indicate that asking if patients understand is likely to overestimate comprehension. Awareness of the unfamiliarity of the lay population with cancer-related terms could prompt further explanation in cancer-related consultations.
该研究评估了普通民众对医生在癌症会诊中所使用术语的理解。术语和短语是从50次录像会诊中选取的，并纳入了对一个海滨度假胜地随机抽取的105人的调查中。问卷包括一些包含潜在模糊诊断/预后术语的情景、多项选择题、理解问题以及标注了可能受癌症影响的身体器官的图表。受访者还对自己答案的自信程度进行了评分。约一半的样本理解癌症转移扩散的委婉说法，例如“幼苗”和“肝内斑点”（分别为44%和55%）。63%的人知道“转移”一词意味着癌症正在扩散，但只有52%的人理解“肿瘤在进展”这句话不是好消息。然而，受访者相当自信他们理解这些术语。对器官位置的了解各不相同。例如，94%的人正确识别出了肺部，但只有46%的人找到了肝脏的位置。研究结果表明，相当一部分普通民众不理解癌症会诊中常用的短语，也不能假定他们具备基本解剖学知识。然而，高自信评分表明询问患者是否理解可能会高估他们的理解程度。意识到普通民众对癌症相关术语不熟悉，可能会促使在癌症相关会诊中进行进一步解释。
