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传达坏消息:患者的观点和意见。

Delivering bad news: patient's perspective and opinions.

作者信息

Sobczak Krzysztof, Leoniuk Katarzyna, Janaszczyk Agata

机构信息

Department of Social Medicine and Social Pathology, Medical University of Gdansk, Gdansk, Poland,

出版信息

Patient Prefer Adherence. 2018 Nov 12;12:2397-2404. doi: 10.2147/PPA.S183106. eCollection 2018.

Abstract

PURPOSE

The aim of our research was to gain knowledge about patients' opinions, experiences, and preferences with regard to the way the news is being delivered to them.

MATERIALS AND METHODS

Detailed research was carried out on a group of 314 patients using the CAWI (Computer-Assisted Web Interview) technique. Adult responders who had earlier received bad news were questioned about their opinion about the way the doctor acted while delivering bad news and how he did it.

RESULTS

Patients, who define the following aspects of their visit as negative/lacking: 1) doctor's behavior in the moment of delivering bad news, 2) amount of time devoted to the visit, 3) lack of doctor's attention, 4) usage of medical terminology, 5) doctor's honesty, 6) emotional and cognitive support from the doctor, more often tend to change the doctor in charge of their therapy or decide to cease the medical treatment.

CONCLUSION

Doctors' behavior and the way they deliver news to patients are key elements that strongly influence patients' future therapy. It makes an impact on patient's decision whether to continue or cease the treatment. In the first case, it also leads the patient to choose to continue the treatment under the guidance of the same specialist or to find another one. The data that we acquired and that we will discuss below will form the basis for editing a communication protocol concerning delivering bad news. It is necessary to create such a protocol in order to improve the quality of communication with patients, especially as regards delivering bad news to them.

摘要

目的

我们的研究旨在了解患者对于病情告知方式的看法、经历和偏好。

材料与方法

采用计算机辅助网络访谈(CAWI)技术,对314名患者进行了详细研究。询问了此前收到坏消息的成年受访者对医生告知坏消息时的行为方式及告知过程的看法。

结果

那些将就诊的以下方面定义为负面/不足的患者:1)医生告知坏消息时的行为,2)就诊时间长度,3)医生缺乏关注,4)使用医学术语,5)医生的诚实度,6)医生给予的情感和认知支持,更倾向于更换负责其治疗的医生或决定停止治疗。

结论

医生的行为及其向患者传递信息的方式是强烈影响患者未来治疗的关键因素。这会影响患者关于是否继续治疗的决定。在前一种情况下,这也会导致患者选择在同一位专科医生的指导下继续治疗或另寻其他医生。我们获取并将在下文讨论的数据将构成编辑一份关于告知坏消息的沟通协议的基础。有必要创建这样一份协议,以提高与患者沟通的质量,尤其是在向他们告知坏消息方面。

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