Hagerty R G, Butow P N, Ellis P M, Dimitry S, Tattersall M H N
Medical Psychology Research Unit, School of Psychology and Department of Medicine, University of Sydney, NSW, Australia.
Ann Oncol. 2005 Jul;16(7):1005-53. doi: 10.1093/annonc/mdi211. Epub 2005 Jun 6.
Prognosis is an issue that most doctors and patients describe as difficult to discuss and the best way of presenting prognostic information to optimise patient understanding, psychological adjustment and decision-making is uncertain. A systematic review of the literature was conducted with the aim of clarifying the current available knowledge of patient preferences, clinician views and current practice regarding the communication of prognosis. Eleven primary research questions guided organisation of the review findings, which were: patient preferences for prognostic information and preferred style of communicating prognosis; disclosure of prognosis to family members; physicians' views on communication of prognosis; current practice of delivering prognostic information; patient understanding and awareness of prognostic information; cultural differences in preferences and understanding; impact of prognostic information on patient outcomes; and interventions to facilitate prognostic discussion. Predictors of patient preferences for and understanding of prognostic information were also summarised. Studies are summarised under the subcategories according to the participants' disease stage. It was found that the majority of the published research has been conducted in the early stage cancer setting providing mostly descriptive evidence, and there is little evidence of the best method of communicating prognosis or of the impact of prognostic information on patient outcomes.
预后是一个大多数医生和患者都认为难以讨论的问题，而以优化患者理解、心理调适和决策为目的呈现预后信息的最佳方式尚不确定。为了阐明目前关于患者偏好、临床医生观点以及预后沟通的现行做法的已有知识，开展了一项文献系统综述。十一个主要研究问题指导了综述结果的组织，这些问题是：患者对预后信息的偏好及传达预后的偏好方式；向家庭成员透露预后情况；医生对预后沟通的看法；传达预后信息的现行做法；患者对预后信息的理解和认知；偏好和理解方面的文化差异；预后信息对患者结局的影响；以及促进预后讨论的干预措施。还总结了患者对预后信息的偏好和理解的预测因素。研究根据参与者的疾病阶段在子类别下进行总结。结果发现，大多数已发表的研究是在癌症早期阶段进行的，大多提供描述性证据，几乎没有证据表明传达预后的最佳方法或预后信息对患者结局的影响。
