Fujimori Maiko, Akechi Tatsuo, Uchitomi Yosuke
Office for Promotion of Support for Suicide Survivor, Japan Support Center for Suicide Countermeasures, National Institute of Mental Health, National Center for Neurology and Psychiatry,Tokyo,Japan.
Department of Psychiatry and Cognitive-Behavioral Medicine,Nagoya City University Graduate School of Medical Sciences,Aichi,Japan.
Palliat Support Care. 2017 Jun;15(3):328-335. doi: 10.1017/S147895151600078X. Epub 2016 Nov 2.
Communication based on patient preferences can alleviate their psychological distress and is an important part of patient-centered care for physicians who have the task of conveying bad news to cancer patients. The present study aimed to explore the demographic, medical, and psychological factors associated with patient preferences with regard to communication of bad news.
Outpatients with a variety of cancers were consecutively invited to participate in our study after their follow-up medical visit. A questionnaire assessed their preferences regarding the communication of bad news, covering four factors-(1) how bad news is delivered, (2) reassurance and emotional support, (3) additional information, and (4) setting-as well as on demographic, medical, and psychosocial factors.
A total of 529 outpatients with a variety of cancers completed the questionnaire. Multiple regression analyses indicated that patients who were younger, female, had greater faith in their physician, and were more highly educated placed more importance on "how bad news is delivered" than patients who were older, male, had less faith in their physician, and a lower level of education. Female patients and patients without an occupation placed more importance on "reassurance and emotional support." Younger, female, and more highly educated patients placed more importance on "additional information." Younger, female, and more highly educated patients, along with patients who weren't undergoing active treatment placed more importance on "setting."
Patient preferences with regard to communication of bad news are associated with factors related to patient background. Physicians should consider these characteristics when delivering bad news and use an appropriate communication style tailored to each patient.
基于患者偏好的沟通可以减轻他们的心理痛苦,对于承担向癌症患者传达坏消息任务的医生来说,这是以患者为中心的护理的重要组成部分。本研究旨在探讨与患者在坏消息沟通方面的偏好相关的人口统计学、医学和心理因素。
各类癌症门诊患者在随访就诊后被连续邀请参加我们的研究。一份问卷评估了他们在坏消息沟通方面的偏好,涵盖四个因素——(1)坏消息的传达方式,(2)安慰和情感支持,(3)额外信息,以及(4)环境——以及人口统计学、医学和社会心理因素。
共有529名各类癌症门诊患者完成了问卷。多元回归分析表明,年龄较小、女性、对医生更有信心且受教育程度较高的患者比年龄较大、男性、对医生信心较低且教育程度较低的患者更重视“坏消息的传达方式”。女性患者和无业患者更重视“安慰和情感支持”。年龄较小、女性和受教育程度较高的患者更重视“额外信息”。年龄较小、女性、受教育程度较高的患者以及未接受积极治疗的患者更重视“环境”。
患者在坏消息沟通方面的偏好与患者背景相关因素有关。医生在传达坏消息时应考虑这些特征,并采用适合每个患者的适当沟通方式。