Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Psychooncology. 2012 Jul;21(7):778-84. doi: 10.1002/pon.1979. Epub 2011 Apr 20.
The purpose of this study is to determine how to disclose bad news to patients with cancer in China.
One hundred fifty pairs of hospitalized patients and their family members were investigated using a self-designed questionnaire.
More patients than their families believed that patients should be informed of their illnesses (98.0% vs. 66.7%, p < 0.001), that patients should be informed of their condition completely (69.3% vs. 18.7%, p < 0.001), that patients should be informed as soon as the diagnoses were confirmed (49.3% vs. 14.7%, p < 0.001), and that patients should be informed by doctors (55.3% vs. 10.7%, p < 0.001). κ coefficients between patients and their families on "whether, when and who to disclose" ranged from -0.084 to 0.004. Univariate logistic analyses demonstrated that farmer patients and patients with lower education and lower income were less likely to prefer to be informed completely; farmer patients and patients without an intended curative operation history were less likely to prefer to be informed immediately and directly by doctors. Multivariate analyses showed that farmer patients were less likely to prefer to be informed completely, immediately, and directly by doctors.
There was poor or slight concordance in disclosure preferences between patients with cancer and their families. More patients than their families wanted to be informed completely, immediately, and directly by doctors. Farmer patients with cancer were less likely to prefer to be informed completely, immediately, and directly by doctors.
本研究旨在探讨如何向中国癌症患者告知坏消息。
采用自行设计的问卷对 150 对住院患者及其家属进行调查。
患者比家属更认为患者应该被告知病情（98.0%比 66.7%，p<0.001）、完全告知病情（69.3%比 18.7%，p<0.001）、确诊后尽快告知（49.3%比 14.7%，p<0.001）、由医生告知（55.3%比 10.7%，p<0.001）。患者和家属在“是否告知、何时告知和由谁告知”上的κ系数为-0.084 至 0.004。单因素 logistic 分析显示，农民患者、文化程度和收入较低的患者更不愿意完全告知；无根治性手术史的农民患者更不愿意立即和直接由医生告知。多因素分析显示，农民患者更不愿意完全、立即和直接由医生告知。
癌症患者及其家属在告知意愿方面存在差异或一致性较差。与家属相比，更多的患者希望由医生完全、立即、直接地告知。农民癌症患者更不愿意由医生完全、立即、直接地告知。
