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癌症诊断的披露:希腊的经验。

Disclosure of cancer diagnosis: the Greek experience.

作者信息

Tsoussis S, Papadogiorgaki M, Markodimitraki E, Delibaltadakis G, Strevinas A, Psyllakis M, Tabakaki K, Drossitis I, Kabourakis A, Papadimitraki E, Krypotos S, Daskalakis K, Fragiadaki G, Zoumadaki E, Apostolakis S

机构信息

Medical Oncology Unit, "Venizeleio-Pananeio) General Hospital of Herakleion, Herakleion, Greece.

出版信息

J BUON. 2013 Apr-Jun;18(2):516-26.

Abstract

PURPOSE

To analyze the attitude of Greek health professionals towards truth disclosure and factors that may influence it.

METHODS

Through a self-completed questionnaire, we studied the attitudes over the initial disclosure of cancer diagnosis to cancer patients of 132 doctors and 123 nurses, partly involved in cancer patients' care, in 5 general hospitals of Crete, Greece.

RESULTS

Eighty-nine percent of the participants considered information as patient's right and 88% as professional's ethical duty, 64% believed that the whole truth should be revealed, 90% avoided the word "cancer" in the communication and 39% disclosed cancer diagnosis at patient's direct asking. Respondents informed 1/10 of their new cancer patients, mainly due to perceived limited responsibility (23%), patient's low cognitive state (22%), fear of harming the patient (17%) and relatives' objection (15%). Sixteen percent of fellows acknowledged to themselves the responsibility to inform patients. Cooperation, compliance and arrangement of patient's personal issues were considered as benefits from accurate disclosure (88%, 83% and 75%, respectively), the latter more among doctors than nurses (p=0.01) and medical than surgical professionals (p=0.03). Thirty-six percent of the respondents considered the presence of a psychologist necessary during disclosure, nurses more than doctors (p<0.001).

CONCLUSION

Despite adequate theoretical background, Greek non-cancer specialists, doctors and nurses, initially inform accurately a small part of their cancer patients. Appropriate training programs for doctors and non-medical health professionals involved in cancer patients' management are required to upgrade professional-patient communication.

摘要

目的

分析希腊医疗专业人员对如实告知病情的态度以及可能影响该态度的因素。

方法

通过一份自填式问卷,我们研究了希腊克里特岛5家综合医院中部分参与癌症患者护理工作的132名医生和123名护士对于向癌症患者首次透露癌症诊断结果的态度。

结果

89%的参与者认为信息是患者的权利,88%认为是专业人员的道德责任;64%的人认为应该告知全部实情;90%的人在沟通中避免使用“癌症”一词;39%的人在患者直接询问时才透露癌症诊断结果。受访者告知了他们新接诊癌症患者中的十分之一,主要原因是认为责任有限(23%)、患者认知状态低(22%)、担心伤害患者(17%)以及亲属反对(15%)。16%的医生承认自己有告知患者的责任。他们认为如实告知病情能带来合作、依从性以及患者个人事务的妥善安排等好处(分别为88%、83%和75%),其中患者个人事务妥善安排这一好处在医生中比护士中更明显(p=0.01),在医疗专业人员中比外科专业人员中更明显(p=0.03)。36%的受访者认为在告知病情时有必要有心理医生在场,护士的这一比例高于医生(p<0.001)。

结论

尽管有充分的理论背景,但希腊的非癌症专科医生和护士最初仅准确告知了一小部分癌症患者。需要为参与癌症患者管理的医生和非医疗健康专业人员制定适当的培训计划,以提升医患沟通水平。

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