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探索患者、家属、医生和护士对癌症信息披露的看法和偏好:一项描述性定性研究。

Exploring perceptions and preferences of patients, families, physicians, and nurses regarding cancer disclosure: a descriptive qualitative study.

作者信息

Abazari Parvaneh, Taleghani Fariba, Hematti Simin, Ehsani Maryam

机构信息

Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.

Radiotherapy and Oncology Department, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Support Care Cancer. 2016 Nov;24(11):4651-9. doi: 10.1007/s00520-016-3308-x. Epub 2016 Jun 14.

Abstract

PURPOSE

The aim of this study was to explore perceptions and preferences of cancer patients, their families, physicians, and nurses in disclosing cancer diagnosis.

METHODS

We selected 35 participants (15 patients, 6 family members, 9 physicians, and 5 nurses) by purposive sampling. We collected data by in-depth interviews and used qualitative content analysis for analysis.

RESULTS

Data analysis resulted in three categories: (1) establishing a basis for breaking bad news; (2) adjusting to the tragedy of bad news; and (3) helping the patient cope with the shattering news. The first category comprised the following subcategories: provision of proper background; adhering to a patient-centered approach; and being unhurried. The second category comprised the following subcategories: cancer as a cultural taboo; death as a frightening vision of unattainable dreams and punishment; hope as an opening in the utter darkness of disease; and empathy as liniment for the injuries of disease. The third category comprised the following subcategories: the family as the most powerful healing source for the patient; the force of spirituality in achieving peace; and a multiprofessional, harmonious physician-centered team.

CONCLUSIONS

The findings of this study can help healthcare teams break the bad news of cancer diagnosis in a more effective, satisfactory, and culture-based manner for patients and their families.

摘要

目的

本研究旨在探讨癌症患者、其家属、医生和护士在透露癌症诊断方面的看法和偏好。

方法

我们采用目的抽样法选取了35名参与者(15名患者、6名家属、9名医生和5名护士)。我们通过深入访谈收集数据,并使用定性内容分析法进行分析。

结果

数据分析产生了三个类别:(1)为告知坏消息奠定基础;(2)适应坏消息带来的悲剧;(3)帮助患者应对这一令人震惊的消息。第一类包括以下子类别:提供适当的背景信息;坚持以患者为中心的方法;以及不着急。第二类包括以下子类别:癌症作为一种文化禁忌;死亡作为对无法实现的梦想和惩罚的可怕想象;希望作为疾病完全黑暗中的一线曙光;以及同理心作为治疗疾病伤痛的慰藉。第三类包括以下子类别:家庭作为患者最强大的康复源泉;精神力量在实现平静中的作用;以及一个以医生为中心的多专业和谐团队。

结论

本研究的结果可以帮助医疗团队以更有效、令人满意且基于文化的方式,向患者及其家属透露癌症诊断的坏消息。

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