Fallowfield L, Jenkins V
Cancer Research UK, Psychosocial Oncology Group, Brighton & Sussex Medical School, University of Sussex, Falmer, Brighton, UK.
Recent Results Cancer Res. 2006;168:105-12. doi: 10.1007/3-540-30758-3_10.
Too many patients leave their consultations with insufficient understanding about their diagnosis, prognosis, the need for further diagnostic tests, the management plans, or the therapeutic intent of treatment. This situation is not entirely due to paternalism or a lack of awareness that patients worldwide desire more information, but rather a reflection of the dismal communication skills training that most healthcare professionals receive. There have been many developments aimed at rectifying this situation, but there are still too few publications available demonstrating efficacy. Nevertheless, evidence shows that communication skills can be taught and that if taught well then the impact endures into the clinic. This chapter looks at some of the history of good evidence-based interventions to improve communication and makes a plea for more research-based evidence for improved patient outcomes following training. Unless attention and resources are given to help healthcare professionals in this core clinical skill then we will never be able to help patients and their families take an informed and educated role in their own cancer care.
太多患者在咨询后,对自己的诊断、预后、进一步诊断测试的必要性、管理计划或治疗意图了解不足。这种情况并不完全归因于家长式作风,也不是因为缺乏认识到全球患者都渴望获得更多信息,而是大多数医疗保健专业人员所接受的糟糕沟通技能培训的反映。已经有许多旨在纠正这种情况的进展,但仍有太少的出版物证明其有效性。然而,有证据表明沟通技能是可以教授的,而且如果教授得好,其影响会持续到临床实践中。本章回顾了一些基于充分证据的改善沟通的干预措施的历史,并呼吁提供更多基于研究的证据,以证明培训后能改善患者的治疗结果。除非关注并投入资源来帮助医疗保健专业人员掌握这一核心临床技能,否则我们永远无法帮助患者及其家属在自身的癌症护理中发挥明智且有见识的作用。