Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
Patient Educ Couns. 2009 Dec;77(3):430-6. doi: 10.1016/j.pec.2009.09.013. Epub 2009 Oct 21.
To determine the extent to which physicians in different countries intend to inform terminal patients and relatives about prognosis, and to identify physician characteristics associated with an active approach to such discussions.
In the context of a European research project, a study on disclosing prognosis was conducted in seven countries. A written questionnaire with questions regarding hypothetical cases and actual practices was sent to physicians from specialties involved in the care of dying patients.
10,139 questionnaires were studied. The response rate was greater than 50% in all countries except Italy (39%). The percentage of physicians who indicated that they would actively inform competent patients of their prognosis varied between countries from 52% in Italy to 99% in Sweden. For informing relatives of incompetent patients, rates were higher, ranging from 86% in Denmark to 98% in Australia. Younger physician age and training in palliative care were associated with an active intention to discuss prognosis.
Physicians' intentions to discuss prognosis with patients and families vary largely across countries. Physician age and training in palliative care may also affect intentions.
Continuing training should focus on improving physicians' ability to communicate responsibly about prognosis with patients and families.
确定不同国家的医生告知终末期患者及其家属预后的意愿，并确定与积极讨论此类问题相关的医生特征。
在一项欧洲研究项目的背景下，在七个国家开展了一项关于预后告知的研究。向参与临终关怀的专科医生发送了一份包含假设病例和实际做法问题的书面问卷。
共研究了 10139 份问卷。除意大利（39%）外，所有国家的回复率均超过 50%。表示将积极告知有能力的患者其预后的医生比例因国家而异，从意大利的 52%到瑞典的 99%不等。对于告知无能力患者的家属，这一比例更高，从丹麦的 86%到澳大利亚的 98%不等。年轻的医生年龄和姑息治疗培训与积极讨论预后的意愿相关。
医生与患者和家属讨论预后的意愿在各国之间存在很大差异。医生的年龄和姑息治疗培训也可能影响其意愿。
持续培训应侧重于提高医生与患者和家属就预后进行负责任沟通的能力。
