告知坏消息：苏丹医生的认知与实践
Breaking bad news: Awareness and practice among Sudanese doctors.
作者信息
Dafallah Mumen Abdalazim, Ragab Esraa Ahmed, Salih Mahmoud Hussien, Osman Wail Nuri, Mohammed Roaa Omer, Osman Mugtaba, Taha Mohamed H, Ahmed Mohamed H
机构信息
Faculty of Medicine, University of Gezira, Sudan.
Armed Forces Centre for Psychiatric Care, Taif, Saudi Arabia.
出版信息
AIMS Public Health. 2020 Sep 24;7(4):758-768. doi: 10.3934/publichealth.2020058. eCollection 2020.
BACKGROUND
Breaking bad news is an important task for doctors in different specialties. The aim of the study was to assess adherence of Sudanese doctors to the SPIKES protocol in breaking bad news.
METHODS
A descriptive cross-sectional study recruited 192 doctors, at Wad Medani teaching hospital, Sudan. A questionnaire-based on SPIKES protocol was distributed among 10 departments in our hospital. Data were analyzed using SPSS and Microsoft excel.
RESULTS
There were (n = 101, 52.6%) females and (n = 91, 47.4%) males among the participants. 95.3% have been involved in breaking bad news, but only 56.3 received education and training about this issue. 43% admitted bad experience in breaking bad news, while 65.6% mentioned that bad news should be delivered directly to patients. The majority (>90%) agreed training is needed in the area of breaking bad news. Usual adherence to the SPIKES protocol was reported in a range of 35-79%, sometimes adherence was reported in a range of 20-44% while never adherence was reported in a range of zero-13.5%. Consultants, registrars, obstetrician and gynecologists and surgeons achieved high scores in breaking bad news. Training is an important factor in achieving high score in SPIKES protocol. The unadjusted effect of background factors on SPIKES score, showed that only training has significant impact on protocol adherence (P = 0.034, unadjusted; and P = 0.038 adjusted).
CONCLUSION
Large number of Sudanese doctors will try to adhere to SPIKES protocol. Training is an important factor in the success of breaking bad news.
背景
传达坏消息是不同专业医生的一项重要任务。本研究的目的是评估苏丹医生在传达坏消息时对SPIKES协议的遵守情况。
方法
一项描述性横断面研究在苏丹瓦德迈达尼教学医院招募了192名医生。一份基于SPIKES协议的问卷在我院10个科室发放。数据使用SPSS和Microsoft excel进行分析。
结果
参与者中有101名女性（52.6%）和91名男性（47.4%）。95.3%的人参与过传达坏消息，但只有56.3%的人接受过关于这个问题的教育和培训。43%的人承认在传达坏消息时有不好的经历，而65.6%的人提到坏消息应该直接告知患者。大多数人（>90%）同意在传达坏消息方面需要培训。报告的对SPIKES协议的通常遵守率在35%-79%之间，有时遵守率在20%-44%之间，而从不遵守率在0%-13.5%之间。顾问医生、住院医生、妇产科医生和外科医生在传达坏消息方面得分较高。培训是在SPIKES协议中获得高分的一个重要因素。背景因素对SPIKES评分的未调整影响表明，只有培训对协议遵守有显著影响（未调整P = 0.034；调整后P = 0.038）。
结论
大量苏丹医生会尝试遵守SPIKES协议。培训是成功传达坏消息的一个重要因素。
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