Ferraz Gonçalves José A, Almeida Carla, Amorim Joana, Baltasar Rita, Batista Joana, Borrero Yusianmar, Fallé João Pedro, Faria Igor, Henriques Manuel, Maia Helena, Fernandes Teresa, Moreira Mariana, Moreira Susana, Neves Camila, Ribeiro Ana, Santos Ana, Silva Filipa, Soares Susana, Sousa Cristina, Vicente Joana, Xavier Rita
Portuguese Institute of Oncology, Palliative Care, Porto, Portugal.
Unidade de Saúde Familiar Famílias, Santa Maria da Feira, Portugal.
Porto Biomed J. 2017 Nov-Dec;2(6):250-253. doi: 10.1016/j.pbj.2017.05.004. Epub 2017 Jul 5.
The attitudes of family physicians regarding breaking bad news are heterogeneous.Younger doctors seem to see the delivery of bad news more positively.This trend suggests that there will be a more open communication in the future.
Family practice is the specialty with the highest number of doctors and covers all of Portugal, but, as far as we know, no studies have been carried out on the attitudes and practices of Portuguese family practice doctors about breaking bad news. However, the attitude of these doctors may have a high impact on patients.
To study the practice of family physicians on breaking bad news.
A questionnaire, specifically developed for this survey, was given to 196 doctors about 10% of the family physicians of Northern Portugal.
One hundred fifty-nine (81%) of them participated in this study. The median age was 43 (26-64) and 108 (68%) of them were female. One hundred and seven (67%) doctors disclosed on principle the diagnosis and that rate rose to 81% when patients requested the disclosure. One hundred and two (64%) proactively questioned patients about their wish to know the diagnosis and then decided whether to convey it or not. Forty-seven 47 (30%) doctors disclosed the prognosis on principle and that rate rose to 48% when patients requested the disclosure. Seventy-three (46%) often questioned patients proactively about their wish to know the prognosis and then decided whether to convey it or not. One hundred and two (64%) doctors frequently include patients in treatment decisions. Physicians think that the disclosure may affect hope but may also give patients more control of the situation.
Family practitioners disclose the diagnosis of a chronic life-threatening disease often, especially at patients' request. General practitioners do not disclose the prognosis of a life-threatening disease often, even at patients' request.
家庭医生对告知坏消息的态度各不相同。年轻医生似乎对传达坏消息持更积极的看法。这一趋势表明未来将会有更开放的沟通。
家庭医疗是葡萄牙医生人数最多的专科，覆盖整个葡萄牙，但据我们所知，尚未针对葡萄牙家庭医生告知坏消息的态度和做法开展过研究。然而，这些医生的态度可能会对患者产生很大影响。
研究家庭医生告知坏消息的做法。
向196名医生（约占葡萄牙北部家庭医生的10%）发放了专门为本调查设计的问卷。
其中159名（81%）参与了本研究。他们的年龄中位数为43岁（26 - 64岁），其中108名（68%）为女性。107名（67%）医生原则上会披露诊断结果，当患者要求披露时，这一比例升至81%。102名（64%）医生会主动询问患者是否想知道诊断结果，然后再决定是否告知。47名（30%）医生原则上会披露预后情况，当患者要求披露时，这一比例升至48%。73名（46%）医生经常主动询问患者是否想知道预后情况，然后再决定是否告知。102名（64%）医生经常让患者参与治疗决策。医生们认为披露可能会影响希望，但也可能会让患者对情况有更多掌控。
家庭医生经常会披露慢性危及生命疾病的诊断结果，尤其是在患者要求时。全科医生通常不会经常披露危及生命疾病的预后情况，即使在患者要求时也是如此。
