患者对告知坏消息的看法：你传达的方式真的很重要。
Recipients' perspective on breaking bad news: how you put it really makes a difference.
作者信息
Schmid Mast Marianne, Kindlimann Annette, Langewitz Wolf
机构信息
Department of Psychology, University of Zurich, Social and Health Psychology, Rämistrasse 66, CH-8001 Zürich, Switzerland.
出版信息
Patient Educ Couns. 2005 Sep;58(3):244-51. doi: 10.1016/j.pec.2005.05.005.
OBJECTIVE
The goal of this study was to show that physician communication style of breaking bad news affects how the physician is perceived, how satisfied recipients of bad news are with the consultation, and how they feel after the consultation.
METHOD
Female participants (students, N=159) were asked to put themselves in the shoes of a patient receiving the bad news of a breast cancer diagnosis. Participants were randomly assigned to watch one of three prototypical physician communication styles of breaking bad news on videotape: patient-, disease-, or emotion-centered communication.
RESULTS
Results showed that these three prototypical communication styles were perceived very differently and they determined how satisfied participants were with the consultation and how they felt after the consultation. Participants exposed to the patient-centered communication perceived the physician as most emotional, least dominant, most appropriate when it comes to conveying information, most available and most expressive of hope. Also, they reported to be most satisfied with the visit and they showed the least increase in negative emotions.
CONCLUSION
A patient-centered communication style has the most positive outcome for recipients of bad news on a cognitive, evaluative, and emotional level.
PRACTICE IMPLICATIONS
Results of this study provide guidelines to physicians on how to convey bad news.
目的
本研究的目的是表明医生传达坏消息的沟通方式会影响医生被患者的认知方式、坏消息接收者对会诊的满意度以及会诊后他们的感受。
方法
要求女性参与者（学生，N = 159）设身处地为一名接到乳腺癌诊断坏消息的患者。参与者被随机分配观看录像带上三种传达坏消息的典型医生沟通方式之一：以患者为中心、以疾病为中心或以情感为中心的沟通。
结果
结果表明，这三种典型的沟通方式被感知的方式差异很大，并且它们决定了参与者对会诊的满意度以及会诊后他们的感受。接触以患者为中心沟通方式的参与者认为医生最有情感、最不强势、在传达信息时最合适、最可亲近且最能表达希望。此外，他们报告对此次就诊最满意，并且负面情绪增加最少。
结论
以患者为中心的沟通方式在认知、评价和情感层面上对坏消息接收者具有最积极的结果。
实践意义
本研究结果为医生提供了关于如何传达坏消息的指导方针。
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