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[痴呆症的诊断披露:一项人种志探索]

[The diagnostic disclosure of dementia: an ethnographic exploration].

作者信息

van Wijngaarden Els, Broekhuis Gert, van Leussen Carolien, Kamper Ad, The Anne-Mei

机构信息

Universiteit voor Humanistiek, Kromme Nieuwegracht 29, 3512 HD, Utrecht, Nederland.

Tao of Care, Amsterdam, Nederland.

出版信息

Tijdschr Gerontol Geriatr. 2017 Sep;48(4):169-176. doi: 10.1007/s12439-017-0222-8.

Abstract

Giving adequate diagnostic information is considered to be fundamental in dementia care. An important question is how the diagnostic disclosure in dementia actually takes place. The aim of this explorative ethnographic study was therefore to provide insight into the disclosure practice of medical specialists. For this study, 22 interviews performed by seven medical specialists were analyzed.The results of this study show that the observed doctors are direct and explicit in disclosing the diagnosis. Actual (medical) information about the diagnosis and the performed investigations is provided. The main areas for improvement are involving the patient in the conversation, align your language to the lifeworld of the patient and his/her significant other(s), avoiding the use of medical jargon, discussing the consequences of the diagnosis for daily life, and explicitly recognizing the emotional and existential challenges associated with the disclosure. In providing further information, doctors could discuss emotional and existential support more specifically.

摘要

提供充分的诊断信息被认为是痴呆症护理的基础。一个重要的问题是痴呆症的诊断告知实际上是如何进行的。因此,这项探索性民族志研究的目的是深入了解医学专家的告知实践。在这项研究中,分析了七位医学专家进行的22次访谈。这项研究的结果表明,观察到的医生在披露诊断时直接且明确。提供了有关诊断和所进行检查的实际(医学)信息。主要改进领域包括让患者参与对话、使语言与患者及其重要他人的生活世界相契合、避免使用医学术语、讨论诊断对日常生活的影响,以及明确认识到与告知相关的情感和生存挑战。在提供进一步信息时,医生可以更具体地讨论情感和生存支持。

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