Rumpold Tamara, Lütgendorf-Caucig Carola, Jagsch Reinhold, Dieckmann Karin, Watzke Herbert, Pötter Richard, Kirchheiner Kathrin
Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Strahlenther Onkol. 2015 Jul;191(7):549-56. doi: 10.1007/s00066-015-0816-4. Epub 2015 Feb 18.
Due to concerns about patients' wellbeing, open end-of-life communication is associated with reservation. Furthermore, sociocultural differences must be considered. The objective of this pilot study was therefore to investigate the information preferences of Austrian patients regarding cure rates and prognosis.
The information preferences of 50 advanced lung cancer patients were assessed at their first visit to the Department of Radiation Oncology, Medical University of Vienna. Preferences in terms of content (cure rates and/or prognosis) and depth of the information (additional quantitative estimates) were addressed. After the individually adapted medical consultation, patients' satisfaction with the consultation and the emotional responses to the information were evaluated.
The majority of patients (76 %) requested information about cure rates and/or prognosis; nearly half of these (47 %) wanted additional quantitative estimates. Neither sociodemographic variables, disease characteristics, nor time since diagnosis had an impact on the information preferences. The individually adapted medical information showed no overall negative influence on the emotional responses; only patients receiving prognostic information had significantly higher distress scores after the consultation. High satisfaction with the individually adapted medical consultation was reported by 92 % of patients.
Austrian physicians may offer end-of-life communication and directly ask patients about their information preferences, since patients seem able to decide whether or not prognostic information would overwhelm their emotional capacity and therefore to accept or reject the invitation. The disclosure of cure rates and/or prognosis with or without quantitative estimates-according to the patients' preferences-shows overall no negative impact on emotional reactions. The individually adapted consultation results in high patient satisfaction. Nevertheless, prognostic information may lead to higher distress.
出于对患者福祉的担忧，临终时的开放式沟通伴随着保留态度。此外，必须考虑社会文化差异。因此，这项试点研究的目的是调查奥地利患者对治愈率和预后的信息偏好。
在维也纳医科大学放射肿瘤学系首次就诊时，评估了50例晚期肺癌患者的信息偏好。涉及了信息内容（治愈率和/或预后）和信息深度（额外的定量估计）方面的偏好。在进行个性化的医学咨询后，评估了患者对咨询的满意度以及对信息的情绪反应。
大多数患者（76%）要求提供关于治愈率和/或预后的信息；其中近一半（47%）希望获得额外的定量估计。社会人口统计学变量、疾病特征以及诊断后的时间均未对信息偏好产生影响。个性化的医学信息对情绪反应总体上没有负面影响；只有接受预后信息的患者在咨询后痛苦得分显著更高。92%的患者对个性化的医学咨询表示高度满意。
奥地利医生可以进行临终沟通，并直接询问患者的信息偏好，因为患者似乎能够决定预后信息是否会超出其情绪承受能力，从而接受或拒绝此类信息。根据患者偏好披露有无定量估计的治愈率和/或预后，总体上对情绪反应没有负面影响。个性化的咨询使患者满意度很高。然而，预后信息可能会导致更高的痛苦。
