Mosconi P, Meyerowitz B E, Liberati M C, Liberati A
Laboratory of Clinical Epidemiology, Istituto di Richerche Farmacologiche 'Mario Negri', Milano, Italia.
Ann Oncol. 1991 Apr;2(4):273-80. doi: 10.1093/oxfordjournals.annonc.a057936.
Although there is considerable controversy about what information regarding the diagnosis of cancer is most helpful to patients in meeting their psychological and medical needs, little research exists on what patients who are treated in non-specialized institutions are told about their diagnosis and treatment. We assessed the information that breast cancer patients received about their diagnosis from the perspective of both the patient and the physician, in order to determine whether they agree in their perceptions of communication, and whether the nature of patient-physician communication is associated with patient satisfaction. Questionnaires were completed by 1171 Italian breast cancer patients (representing a 81.5% response rate) and their physicians at the time of surgery for breast cancer. Only a minority of patients (47%) reported having been told that they had cancer. Satisfaction with information was highest among women who had been told the diagnosis. Patient and physician reports of what information was conveyed about the diagnosis differed for over half of patients, with highest satisfaction levels reported when both patient and physician stated that the diagnosis had been conveyed. While comparison of patient and physician reports should not be used to validate either source of information, the degree of patient-physician disagreement found in this research may alert physicians to potential difficulties that can arise in communicating with cancer patients.
尽管对于癌症诊断的哪些信息对患者满足其心理和医疗需求最有帮助存在相当大的争议,但关于在非专科医院接受治疗的患者被告知其诊断和治疗情况的研究却很少。我们从患者和医生两个角度评估了乳腺癌患者收到的关于其诊断的信息,以确定他们在沟通认知上是否一致,以及医患沟通的性质是否与患者满意度相关。1171名意大利乳腺癌患者(回复率为81.5%)及其医生在乳腺癌手术时完成了问卷调查。只有少数患者(47%)报告被告知患有癌症。被告知诊断的女性对信息的满意度最高。超过一半的患者,医患双方关于诊断传达了哪些信息的报告存在差异,当患者和医生都表示已传达诊断时,满意度最高。虽然不应使用医患报告的比较来验证任何一方的信息来源,但本研究中发现的医患分歧程度可能会提醒医生注意与癌症患者沟通时可能出现的潜在困难。