Zardoui Arshia, Yekaninejad Mir Saeed, Kazemian Ali, Parsa Mojtaba
Researcher , School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Associate Professor, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
J Med Ethics Hist Med. 2022 Jun 1;15:3. doi: 10.18502/jmehm.v15i3.9549. eCollection 2022.
Breaking bad news to patients is an essential aspect of the physician-patient relationship, but in Iran, this relationship is often disrupted by patients' families. This study investigates the views of patients' companions on breaking cancer news. In this descriptive-analytic cross-sectional study, we conducted research on 170 cancer patients' companions and 170 non-cancer patients' companions. We designed a questionnaire to investigate the subjects' opinions and used CVI, CVR, Cronbach's alpha and ICC for evaluation. In order to compare groups, we used Mann-Whitney, Kruskal-Wallis, Chi-square tests and Spearman's correlation. Most participants believed that patients should be informed of their diagnosis. Cancer patients' companions were more willing to learn the bad news in case they were diagnosed with cancer and were less likely to choose "despair" as the reason for non-disclosure (71% vs. 44%).There was no difference between the two groups in willingness to break the cancer news to patients, choosing who should be informed first, and the reasons for non-disclosure. Most participants believed the family should be the first to know the diagnosis. In this study, most participants believed that patients should be informed of their diagnosis. However, they preferred to learn about the diagnosis before the patient, which confirms the importance of educating the families about autonomy.
向患者传达坏消息是医患关系的一个重要方面，但在伊朗，这种关系常常被患者家属破坏。本研究调查了患者陪伴者对传达癌症消息的看法。在这项描述性分析横断面研究中，我们对170名癌症患者的陪伴者和170名非癌症患者的陪伴者进行了研究。我们设计了一份问卷来调查受试者的意见，并使用内容效度指数（CVI）、内容效度比率（CVR）、克朗巴哈系数（Cronbach's alpha）和组内相关系数（ICC）进行评估。为了比较各组，我们使用了曼-惠特尼检验、克鲁斯卡尔-沃利斯检验、卡方检验和斯皮尔曼相关性分析。大多数参与者认为应该告知患者他们的诊断结果。癌症患者的陪伴者在自己被诊断出患有癌症时更愿意了解坏消息，并且不太可能选择“绝望”作为不告知患者的原因（71%对44%）。在向患者传达癌症消息的意愿、选择谁应该先得知消息以及不告知的原因方面，两组之间没有差异。大多数参与者认为家人应该是第一个知道诊断结果的人。在本研究中，大多数参与者认为应该告知患者他们的诊断结果。然而，他们更倾向于在患者之前得知诊断结果，这证实了对家属进行自主性教育的重要性。
