Yun Young Ho, Lee Chang Geol, Kim Si-young, Lee Sang-wook, Heo Dae Seog, Kim Jun Suk, Lee Keun Seok, Hong Young Seon, Lee Jung Suk, You Chang Hoon
Research Institute and Hospital, National Cancer Center 809, Madu-dong, Ilsan-gu, Goyang-si, Gyeonggi-do 411-769, Korea.
J Clin Oncol. 2004 Jan 15;22(2):307-14. doi: 10.1200/JCO.2004.07.053.
To ascertain the attitude of cancer patients and their families toward disclosure of terminal illness to the patient.
We constructed a questionnaire that included demographic and clinical information and delivered it to 758 consecutive individuals (433 cancer patients and 325 families that have a relative with cancer) at seven university hospitals and one national cancer center in Korea.
380 cancer patients and one member from each of 281 families that have a relative with cancer completed the questionnaire. Cancer patients were more likely than family members to believe that patients should be informed of the terminal illness (96.1% v 76.9%; P <.001). Fifty percent of the family members and 78.3% of the patients thought that the doctor in charge should be the one who informs the patient. Additionally, 71.7% of the patients and 43.6% of the family members thought that patients should be informed immediately after the diagnosis. Stepwise multiple logistic regression indicated that the patient group was more likely than the family group to want the patient to be informed of the terminal illness (odds ratio [OR], 9.76; 95% CI, 4.31 to 22.14), by the doctor (OR, 4.00; 95% CI, 2.61 to 6.11), and immediately after the diagnosis (OR, 3.64; 95% CI, 2.45 to 5.41).
Our findings indicated that most cancer patients want to be informed if their illness is terminal, and physicians should realize that the patient and the family unit may differ in their attitude toward such a disclosure. Our results also reflect the importance of how information is given to the patient.
确定癌症患者及其家属对于向患者披露晚期疾病的态度。
我们编制了一份包含人口统计学和临床信息的问卷，并将其分发给韩国七所大学医院和一家国家癌症中心的758名连续个体（433名癌症患者和325名有癌症亲属的家属）。
380名癌症患者以及281名有癌症亲属的家庭中的每户一名成员完成了问卷。癌症患者比家属更倾向于认为患者应该被告知晚期疾病（96.1%对76.9%；P<.001）。50%的家属和78.3%的患者认为应由主管医生告知患者。此外，71.7%的患者和43.6%的家属认为患者应在诊断后立即被告知。逐步多元逻辑回归表明，患者组比家属组更倾向于希望患者被告知晚期疾病（优势比[OR]，9.76；95%可信区间，4.31至22.14），由医生告知（OR，4.00；95%可信区间，2.61至6.11），以及在诊断后立即告知（OR，3.64；95%可信区间，2.45至5.41）。
我们的研究结果表明，大多数癌症患者希望在得知自己病情为晚期时得到告知，医生应意识到患者及其家属在对待此类披露的态度上可能存在差异。我们的结果还反映了向患者提供信息方式的重要性。
