Hillen Marij A, Smets Ellen M A, Onderwater Astrid, van Laarhoven Hanneke W M, Sommeijer Dirkje W
Amsterdam UMC, afd. Medische Psychologie.
Contact: M.A. Hillen (
Ned Tijdschr Geneeskd. 2018 Aug 10;162:D2513.
To explore motives and experiences of patients with incurable cancer who are looking across the border for second opinions or treatments or are considering to do so.
Qualitative, semi-structured interview study.
A total of 24 patients with incurable cancer from two Dutch hospitals were interviewed by phone. All interviews were coded independently by two researchers and then analysed inductively, without any pre-specified theoretical framework.
Patients were looking for second opinions or treatments because they found it very difficult to accept a sudden diagnosis of incurable disease. They experienced little guidance during this transition. Patients felt they were not offered any treatment options because of imperative protocols. Many patients were in great need of some form of hope. There were often high expectations - unrealistic or not - of the possibilities abroad. Oncologists' reactions to patients' choices were very diverse. While disapproving reactions were unable to influence patients' choices, well-substantiated arguments were sometimes successful in influencing patients' choices.
More guidance seems advisable for some patients to help them deal with a diagnosis of incurable disease. Dutch oncologists might be able to offer alternative forms of hope to these patients, who have a great need for this. If physicians speak with patients about what a treatment abroad may or may not be able to provide, this might benefit patients.
探讨患有无法治愈癌症的患者寻求跨境第二诊疗意见或治疗或考虑这样做的动机和经历。
定性、半结构化访谈研究。
通过电话采访了来自两家荷兰医院的24名患有无法治愈癌症的患者。所有访谈由两名研究人员独立编码，然后进行归纳分析，没有任何预先指定的理论框架。
患者寻求第二诊疗意见或治疗是因为他们发现很难接受无法治愈疾病的突然诊断。他们在这个过渡过程中几乎没有得到指导。患者觉得由于必须遵循的方案，他们没有得到任何治疗选择。许多患者非常需要某种形式的希望。他们对国外的可能性往往抱有很高的期望——无论是否现实。肿瘤学家对患者选择的反应非常多样。虽然不赞成的反应无法影响患者的选择，但有充分依据的论据有时能成功影响患者的选择。
对于一些患者来说，似乎需要更多指导来帮助他们应对无法治愈疾病的诊断。荷兰的肿瘤学家或许能够为这些非常需要希望的患者提供其他形式的希望。如果医生与患者谈论国外治疗可能或不可能提供的内容，这可能会使患者受益。
