Department of Palliative Care Team, and Psycho-Oncology, National Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka 811-1347, Japan.
Jpn J Clin Oncol. 2011 Aug;41(8):999-1006. doi: 10.1093/jjco/hyr092. Epub 2011 Jul 15.
Communicating the discontinuation of anticancer treatment to patients is a difficult task. The primary aim of this study was to clarify the level of oncologist-reported burden when communicating about discontinuation of an anticancer treatment. The secondary aims were (i) to identify the sources of burden contributing to their levels and (ii) to explore the useful strategies to alleviate their burden.
A multicenter nationwide questionnaire survey was conducted on 620 oncologists across Japan (response rate, 67%).
High levels of perceived burden were reported by 47% of respondents, and 17% reported that they sometimes, often or always wanted to stop oncology work because of this burden. There was a significant association between high levels of burden and: a feeling that breaking bad news would deprive the patient of hope; concern that the patient's family would blame the oncologist; concern that the patient may lose self-control; and a feeling that there was not enough time to break the bad news. Strategies perceived to be useful by oncologists included training in how to effectively communicate to patients discontinuation of anticancer treatment, a reduction in total workload to allow sufficient time to break bad news, and development of a multidisciplinary model to facilitate cooperation with other professionals and facilities.
Many oncologists reported high levels of burden relating to communication of discontinuation of anticancer treatment. A specific communication skills training program, sufficient time for communication and development of a multidisciplinary model could help alleviate the burden on oncologists.
与患者沟通停止癌症治疗是一项艰巨的任务。本研究的主要目的是阐明肿瘤医生报告的在沟通停止癌症治疗时的负担水平。次要目的是（i）确定导致其负担水平的负担来源，（ii）探讨减轻其负担的有用策略。
在日本对 620 名肿瘤医生进行了一项多中心全国范围的问卷调查（应答率为 67%）。
47%的受访者报告称他们感到负担沉重，17%的受访者表示，由于这种负担，他们有时、经常或总是想停止肿瘤学工作。高负担水平与以下因素之间存在显著关联：认为告知坏消息会使患者失去希望；担心患者的家属会责怪肿瘤医生；担心患者可能会失去自控力；以及认为没有足够的时间来传达坏消息。肿瘤医生认为有用的策略包括培训如何有效地与患者沟通停止癌症治疗、减少总工作量以留出足够的时间来传达坏消息、以及开发多学科模式以促进与其他专业人员和医疗机构的合作。
许多肿瘤医生报告称，在沟通停止癌症治疗时感到负担沉重。专门的沟通技巧培训计划、充足的沟通时间和多学科模式的开发可以帮助减轻肿瘤医生的负担。
