Fujimori Maiko, Akechi Tatsuo, Morita Tatsuya, Inagaki Masatoshi, Akizuki Nobuya, Sakano Yuji, Uchitomi Yosuke
Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwanoha 6-5-1, Kashiwa, Chiba 277-8577, Japan.
Psychooncology. 2007 Jun;16(6):573-81. doi: 10.1002/pon.1093.
To understand patients' preferences regarding the disclosure of bad news is important in the clinical oncology setting. The aim of this study was to clarify descriptively the preferences of cancer patients. Five hundred and twenty-nine Japanese cancer outpatients were surveyed regarding their preferences regarding the disclosure of bad news, and several psychosocial and medical demographic variables were analyzed. In a descriptive analysis, more than 90% of the patients strongly preferred to discuss their current medical condition and treatment options with their physician and to have their physicians take the feelings of their family into consideration as well. While half of the patients preferred to receive information regarding their life expectancy, 30% preferred not to receive it. Multiple regression analyses indicated the preferences showing interindividual variations were associated with the level of education and the mental adjustment to cancer scores. A factor analysis revealed four preferences factors: method of disclosure of the bad news, provision of emotional support, provision of additional information, and setting. These four factors had good internal consistency reliability (Cronbach's alpha = 0.93-0.77). Providing emotional support, including the desire for the physician to show consideration for the patient's family, and understanding an individual's communication preferences may be useful for promoting patient-physician communication.
在临床肿瘤学环境中，了解患者对于坏消息披露的偏好非常重要。本研究的目的是描述性地阐明癌症患者的偏好。对529名日本癌症门诊患者进行了关于坏消息披露偏好的调查，并分析了一些社会心理和医学人口统计学变量。在描述性分析中，超过90%的患者强烈倾向于与医生讨论他们当前的病情和治疗选择，并希望医生也考虑其家人的感受。虽然一半的患者希望获得有关预期寿命的信息，但30%的患者不希望获得。多元回归分析表明，显示个体差异的偏好与教育水平和对癌症的心理调适得分相关。因素分析揭示了四个偏好因素：坏消息的披露方式、提供情感支持、提供额外信息和环境。这四个因素具有良好的内部一致性信度（克朗巴哈系数=0.93 - 0.77）。提供情感支持，包括希望医生考虑患者家人的感受，以及了解个人的沟通偏好，可能有助于促进医患沟通。
