Michiels E, Deschepper R, Bilsen J, Mortier F, Deliens L
Department of Medical Sociology and Health Sciences, Vrije Universiteit Brussel, End-of-Life Care Research Group, Brussels, Belgium.
Palliat Med. 2009 Jun;23(4):345-53. doi: 10.1177/0269216308102043. Epub 2009 Feb 27.
Objective of this study is to examine physicians' practices regarding information disclosure to terminally ill patients and to their relatives, without informing the patient. A questionnaire had been sent to a random sample of 3014 Belgian physicians from different specialties frequently involved in end-of-life care. Responses were analysed using weighted percentages, Chi-square, Mann-Whitney U-tests and a multivariate ordinal logistic regression. Response rate was 58%. Both clinical specialists and general practitioners (GPs) discuss most topics related to terminal illness with their patients except end-of-life hastening options, spirituality, life expectancy and options to withhold/withdraw life-sustaining treatment. The topics which most physicians always discuss with relatives without informing the patient are the aim of treatment, palliative care and incurability. There is a significant difference between clinical specialists and GPs. Clinical specialists and GPs discuss most end-of-life topics with the patient but omit important issues such as end-of-life hastening options and life-expectancy.
本研究的目的是调查医生在不告知患者的情况下，向绝症患者及其亲属披露信息的做法。已向3014名来自不同专业、经常参与临终关怀的比利时医生随机抽样发送了一份问卷。使用加权百分比、卡方检验、曼-惠特尼U检验和多变量有序逻辑回归分析了回复情况。回复率为58%。临床专科医生和全科医生（GP）都会与患者讨论大多数与绝症相关的话题，但不包括加速临终的选择、灵性、预期寿命以及停止/撤销维持生命治疗的选择。大多数医生在不告知患者的情况下总是与亲属讨论的话题是治疗目的、姑息治疗和不治之症。临床专科医生和全科医生之间存在显著差异。临床专科医生和全科医生会与患者讨论大多数临终话题，但遗漏了重要问题，如加速临终的选择和预期寿命。
