Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico.
Departamento de Tumores Mamarios y Departamento de Investigacion, Instituto Nacional de Cancerologia, Ciudad de Mexico, Mexico.
J Cancer Educ. 2021 Oct;36(5):1098-1104. doi: 10.1007/s13187-020-01703-7.
Communication challenges related to the delivery of bad news are present in oncologists' daily practice. Hence, communication skills are essential for clinicians to handle these situations as appropriately and compassionately as possible. The aim of this study was to identify Mexican oncologists' perceptions on the most important and hardest issues to discuss with patients and their families, as well as the challenges they most commonly encounter when communicating bad news. Physicians from various oncology centers were invited to anonymously complete an electronical survey designed by our multidisciplinary oncology team. Statistical analysis was performed with the SPSS software v25; descriptive statistics were used for the analysis of the survey's answers. In total, 115 physicians were included; most were medical oncologists. Treatment objectives and prognosis were the topics most of them considered relevant to address; while end-of-life care and treatment objectives were the hardest ones to discuss. The most difficult challenges they faced when breaking bad news were being honest without taking away hope and dealing with patients' emotions. Remarkably, we detected a lack of training in delivering bad news to patients among our participants, as a minority of them had formal training in the matter. However, most desired to receive communication skills training and believed a session of 2-5 h would be sufficient. Mexican oncologists face diverse communication challenges when disclosing bad news to patients. Our findings reveal an opportunity to develop formal training programs tailored for Mexican oncologists and to ultimately improve outcomes and patient-centered care.
在肿瘤学家的日常实践中,存在与传递坏消息相关的沟通挑战。因此,沟通技巧对于临床医生来说至关重要,以便尽可能恰当地、富有同情心地处理这些情况。本研究旨在确定墨西哥肿瘤学家对与患者及其家属讨论最重要和最困难问题的看法,以及他们在传达坏消息时最常遇到的挑战。我们邀请了来自不同肿瘤中心的医生匿名填写我们多学科肿瘤团队设计的电子调查问卷。使用 SPSS 软件 v25 进行统计分析;使用调查回答的描述性统计进行分析。共有 115 名医生参与,其中大多数是肿瘤内科医生。治疗目标和预后是他们认为需要解决的最重要的问题;而临终关怀和治疗目标是最难讨论的问题。当他们传达坏消息时,他们面临的最大挑战是诚实地传达信息而不剥夺患者的希望并处理患者的情绪。值得注意的是,我们发现我们的参与者在向患者传达坏消息方面缺乏培训,因为只有少数人接受过这方面的正式培训。然而,他们大多数人都希望接受沟通技巧培训,并认为 2-5 小时的培训课程就足够了。墨西哥肿瘤学家在向患者透露坏消息时面临着各种沟通挑战。我们的研究结果表明,有机会为墨西哥肿瘤学家制定正式的培训计划,最终改善结果和以患者为中心的护理。