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引入《非洲儿科癌症诊断公告指南》两年后阿比让儿科肿瘤病房诊断公告分析

Analysis of diagnosis announcements in Abidjan pediatric oncology unit 2 years after introduction of the African Pediatric Cancer Announcement Guideline.

作者信息

Couitchéré L, Coze C, Cissé L, André N, Nigué L, Aholi J-M

机构信息

Pediatric Unit, Teaching Hospital of Treichville, Félix Houphouët Boigny University, Abidjan, Côte d'Ivoire.

Department of Pediatric Hematology-Oncology, Timone Children's Hospital, Aix-Marseille University and APHM, 13005 Marseille, France.

出版信息

Arch Pediatr. 2019 Sep;26(6):352-357. doi: 10.1016/j.arcped.2019.06.006. Epub 2019 Jul 25.

DOI:10.1016/j.arcped.2019.06.006
PMID:31353146
Abstract

INTRODUCTION

Announcing the diagnosis allows the therapeutic alliance between physicians and patients to be sealed and it prevents abandonment of treatment. To compensate for the deficit in information received by the families, the Franco-African Group of Pediatric Oncology (FAGPO) has published an "African Pediatric Cancer Announcement Guide" for the group's pediatric oncology units.

OBJECTIVE

To analyze the announcements made to parents and children 2 years after the provision of this guide.

METHODS

Cross-sectional survey conducted from March to July 2016. In total, 69 parents of children followed up in the pediatric oncology unit of Abidjan were interviewed regarding the characteristics of the announcement that was made to them and the information given to the sick child.

RESULTS

Of all the accompanying individuals, 91% reported having benefited from the announcement made with empathy, mainly by a physician. In approximately one quarter of the cases the information had been given to a third party. The main barriers to information were: the negative experiences of parents, the medical terminology, and communication problems. The sick child was rarely informed.

DISCUSSION

The information given was in accordance, in content and form, with the data from Western and African literature. The lack of information given to the child has a dual explanation: the primacy of the community over the individual advocated by African culture and the non-integration of the rights of children in the current code of ethics.

CONCLUSION

The information provided could be improved by practical training of physicians in the technique of breaking bad news to patients and their families and the use of a code of ethics in accordance with the principle of autonomy.

摘要

引言

宣布诊断结果有助于巩固医患之间的治疗联盟,并防止患者放弃治疗。为弥补家庭所获信息的不足,法非儿科肿瘤学组织(FAGPO)已为该组织的儿科肿瘤科室发布了一份“非洲儿科癌症诊断告知指南”。

目的

分析在提供该指南两年后向家长和儿童进行的诊断告知情况。

方法

于2016年3月至7月开展横断面调查。总共对在阿比让儿科肿瘤科室接受随访的69名儿童的家长就向他们进行的诊断告知的特点以及向患病儿童提供的信息进行了访谈。

结果

在所有陪同人员中,91%报告称从富有同理心的诊断告知中受益,主要是由医生进行的告知。在大约四分之一的案例中,信息是告知给第三方的。信息传递的主要障碍包括:家长的负面经历、医学术语以及沟通问题。患病儿童很少被告知。

讨论

所提供的信息在内容和形式上与西方及非洲文献的数据相符。未向儿童提供信息有双重原因:非洲文化倡导集体优先于个人,以及现行道德准则未纳入儿童权利。

结论

可通过对医生进行向患者及其家属传达坏消息技巧的实践培训以及采用符合自主原则的道德准则来改进所提供的信息。

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