University of Washington, Seattle, WA.
J Clin Oncol. 2020 Mar 20;38(9):866-876. doi: 10.1200/JCO.19.00128. Epub 2020 Feb 5.
The delivery of palliative care to patients with advanced cancer and their families, whether done by oncology clinicians or palliative care clinicians, requires patient-centered communication. Excellent communication can introduce patients and families to palliative care in a nonthreatening way, build patient trust, enable symptom control, strengthen coping, and guide decision making. This review covers deficiencies in the current state of communication, patient preferences for communication about palliative care topics, best practices for communication, and the roles of education and system intervention. Communication is a two-way, relational process that is influenced by context, culture, words, and gestures, and it is one of the most important ways that clinicians influence the quality of medical care that patients and their families receive.
为晚期癌症患者及其家属提供姑息治疗,无论是由肿瘤临床医生还是姑息治疗临床医生提供,都需要以患者为中心的沟通。优秀的沟通可以以一种无威胁的方式将姑息治疗介绍给患者和家属,建立患者的信任,控制症状,增强应对能力,并指导决策。这篇综述涵盖了目前沟通状况的缺陷、患者对姑息治疗主题沟通的偏好、沟通的最佳实践,以及教育和系统干预的作用。沟通是一个双向的、关系的过程,受到背景、文化、语言和手势的影响,它是临床医生影响患者及其家属所接受医疗质量的最重要方式之一。