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痴呆症诊断告知:一项关于患者及照料者观点的研究

Dementia diagnosis disclosure: a study of patient and caregiver perspectives.

作者信息

Byszewski Anna M, Molnar Frank J, Aminzadeh Faranak, Eisner Marg, Gardezi Fauzia, Bassett Raewyn

机构信息

The Ottawa Hospital, Faculty of Medicine, University of Ottawa, Ontario, Canada.

出版信息

Alzheimer Dis Assoc Disord. 2007 Apr-Jun;21(2):107-14. doi: 10.1097/WAD.0b013e318065c481.

Abstract

This paper reports the findings of a descriptive, exploratory, qualitative study of patient and caregiver perspectives of the disclosure of a dementia diagnosis. Data were collected at 3 points in time: (1) the disclosure meeting, (2) patient and caregiver interviews, and (3) focus group interviews. Thirty patient-caregiver dyads participated in the disclosure meetings at the Geriatric Day Hospital at the Ottawa Hospital, Ottawa, Canada. Within a week of the disclosure of diagnosis, 27 (90%) patients and 29 (97%) caregivers were interviewed in their homes, and 12 caregivers participated in 3 focus group interviews within 1 month after the disclosure meeting. Most patients and caregivers said they preferred full disclosure of the diagnosis. Patients expressed satisfaction with the physician providing the diagnosis and with their caregivers being present at the disclosure meeting, however, wanted more information about their condition. Caregivers provided further insight regarding the patient response, and suggested the need to emphasize hope in the face of a difficult diagnosis, the use of progressive disclosure to allow the person (and caregivers) to prepare, and the provision of detail about the disease and its progression.

摘要

本文报告了一项关于患者及照护者对痴呆症诊断披露看法的描述性、探索性定性研究的结果。数据在三个时间点收集:(1)诊断披露会议,(2)患者及照护者访谈,(3)焦点小组访谈。30对患者-照护者参与了在加拿大渥太华渥太华医院老年日间医院举行的诊断披露会议。在诊断披露后的一周内,27名(90%)患者及29名(97%)照护者在家中接受了访谈,12名照护者在诊断披露会议后的1个月内参与了3次焦点小组访谈。大多数患者和照护者表示他们倾向于完全披露诊断结果。患者对提供诊断的医生以及照护者出席诊断披露会议表示满意,然而,他们希望获得更多关于自身病情的信息。照护者进一步阐述了患者的反应,并建议在面对艰难的诊断时强调希望,采用逐步披露的方式让患者(及照护者)做好准备,以及提供有关疾病及其进展的详细信息。

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