Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA.
Oncology (Williston Park). 2010 May;24(6):521-5.
Oncologists often do not give honest prognostic and treatment-effect information to patients with advanced disease. One of the primary reasons stated for witholding this information is to "not take away hope." We could find no study that tested if hope was influenced by honest clinical information.
We tested decision-aids in 27 patients with advanced cancer who were facing first-, second-, third-, and fourth-line chemotherapy. These aids had printed estimates of treatment effect and the patient's chance of survival and being cured (always zero). We measured hope using the Herth Hope Index, which ranks patients' responses to 12 questions and yields a maximum score of 48.
The scores on the Herth Hope Index did not change and the patients remained uniformly hopeful about their future. The pretest score was 44.2 (SD 3.9), and it increased to 44.8 (SD 3.86; P = .55 by paired Student's t-test).
Hope is maintained when patients with advanced cancer are given truthful prognostic and treatment information, even when the news is bad.
肿瘤医生通常不会向晚期疾病患者提供诚实的预后和治疗效果信息。医生隐瞒这些信息的主要原因之一是“不剥夺患者的希望”。我们没有找到任何研究表明诚实的临床信息会影响希望。
我们在 27 名面临一线、二线、三线和四线化疗的晚期癌症患者中测试了决策辅助工具。这些辅助工具印有治疗效果和患者生存及治愈机会的估计值（均为零）。我们使用赫特希望指数（Herth Hope Index）来衡量希望，该指数对 12 个问题的回答进行评分，最高得分为 48 分。
赫特希望指数的得分没有变化，患者对未来仍然保持一致的希望。测试前的分数为 44.2（标准差 3.9），增加到 44.8（标准差 3.86；配对学生 t 检验 P =.55）。
当晚期癌症患者获得真实的预后和治疗信息时，即使消息不佳，他们的希望也会得到维持。
