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台湾地区的癌症诊断与预后:患者偏好与经历

Cancer diagnosis and prognosis in Taiwan: patient preferences versus experiences.

作者信息

Tang Siew Tzuh, Lee Shiu-Yu C

机构信息

National Yang-Ming University School of Nursing, Taipei, ROC.

出版信息

Psychooncology. 2004 Jan;13(1):1-13. doi: 10.1002/pon.721.

Abstract

Considering the emphasis of nonmaleficence and beneficence and the relative power of family, there is a well-recognized suggestion that, in Asian culture, informing cancer patients about their diagnosis and prognosis should be modified according to the family's opinion. However, up until now, except in Japan, the argument that cancer patients from an Asian culture have different preferences about being informed of their diagnosis and prognosis has not been demonstrated by evidence-based studies especially by directly exploring cancer patients' preferences. The purpose of this study was to describe Taiwanese cancer patients' knowledge and experiences of being informed of their diagnosis and prognosis. Preferences of information from health-care professionals and attitudes toward disclosing information to family and even respecting family's opinions not to disclose the life-threatening diagnosis and prognosis to patients have also been explored from the patient's point of views. Evidence from this study demonstrated that Taiwanese cancer patients' information needs are substantial. However, the common practice of nondisclosure of prognosis and detailed disease-related information by health-care professionals continues. Cancer patients in Taiwan expressed a strong preference for health-care professionals to inform them of disease-related information before disclosing information to their family members. Health-care professionals need to consider and respect cancer patients' views rather than routinely taking the family's opinions into consideration first in the event of disagreement.

摘要

考虑到不伤害原则和有利原则的重要性以及家庭的相对影响力,有一种广为人知的观点认为,在亚洲文化中,向癌症患者告知其诊断结果和预后情况应根据家庭意见进行调整。然而,截至目前,除了日本,尚无基于证据的研究,尤其是通过直接探究癌症患者的偏好,来证明来自亚洲文化背景的癌症患者在得知自己的诊断结果和预后方面有不同偏好。本研究的目的是描述台湾癌症患者得知自己诊断结果和预后的知识及经历。还从患者角度探讨了他们对医护人员提供信息的偏好,以及对向家人披露信息的态度,甚至是对尊重家人不向患者透露危及生命的诊断结果和预后意见的态度。本研究的证据表明,台湾癌症患者对信息的需求很大。然而,医护人员不透露预后和详细疾病相关信息的普遍做法仍在继续。台湾的癌症患者强烈倾向于医护人员在向其家人披露信息之前先告知他们疾病相关信息。在出现分歧时,医护人员需要考虑并尊重癌症患者的观点,而不是惯例性地首先考虑家庭意见。

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