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自我暴露的患病医生:患者怎么想?

The ill physician who self-discloses: What do patients think?

机构信息

Maccabi Healthcare Services, Mevasseret Tzion, Israel.

Aarburg, Switzerland.

出版信息

Eur J Gen Pract. 2022 Dec;28(1):244-251. doi: 10.1080/13814788.2022.2146091.

DOI:10.1080/13814788.2022.2146091
PMID:36453631
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9718545/
Abstract

BACKGROUND

Physicians with a serious illness face difficult decisions about revealing this sensitive information to patients. Self-disclosure of illness is a largely unexplored topic, particularly from the patient's perspective.

OBJECTIVES

To learn about patients' emotions and reactions to their family physician's sharing with them about having a major illness.

METHODS

The study was carried out in a family practice office in a suburb of Jerusalem, beginning the day that a family physician returned to work after a prolonged illness. A questionnaire study was performed with nine closed and four open questions relating to patients' reactions to learning about the illness. The questionnaire was distributed to 200 consecutive patients ages 18 years or older. Data extraction, compilation, and content analysis were performed to elicit and categorise major themes and issues that arose.

RESULTS

A total of 82% of the patients were pleased that the physician shared the information with them and none were displeased. Patients expressed a wide range of reactions to being told of the illness by the physician himself, among them: empathy, surprise, appreciation, pride, criticism, comfort/discomfort, and closeness. The value of sharing personal experience and the unique connection with the family physician were emphasised.

CONCLUSION

Physician self-disclosure of major illnesses to patients can reveal the physician's humanity, encourage empathy on the part of patients and strengthen the physician-patient relationship. This report adds to current knowledge about when to share this powerful information with patients and highlights the topic's importance in the education of future doctors.

摘要

背景

患有重病的医生在向患者透露这一敏感信息时面临着艰难的决策。医生向患者透露自己的病情是一个很大程度上尚未被探索的话题,尤其是从患者的角度来看。

目的

了解患者对家庭医生向他们透露患有重大疾病的情绪和反应。

方法

该研究在耶路撒冷郊区的一家家庭诊所进行,从一名家庭医生在长期患病后返回工作的那天开始。使用与患者对了解疾病的反应相关的九个封闭问题和四个开放问题进行问卷调查研究。该问卷分发给了 200 名年龄在 18 岁或以上的连续患者。进行了数据提取、编译和内容分析,以引出和分类出现的主要主题和问题。

结果

82%的患者对医生与他们分享信息感到高兴,没有一个人不高兴。患者对医生本人告知他们患病的情况表现出了广泛的反应,包括:同情、惊讶、感激、自豪、批评、安慰/不适和亲近。分享个人经历和与家庭医生的独特联系的价值得到了强调。

结论

医生向患者透露自己的重大疾病可以展现医生的人性,鼓励患者产生同理心,并加强医患关系。本报告增加了当前关于何时与患者分享这一有力信息的知识,并强调了在未来医生教育中这一主题的重要性。

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本文引用的文献

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Sharing My Diagnosis: How Much is Too Much?分享我的诊断结果:多少才算太多?
Ann Fam Med. 2019 Mar;17(2):173-175. doi: 10.1370/afm.2365.
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Doctor self-disclosure in the consultation.
J Prim Health Care. 2018 Jun;10(2):106-109. doi: 10.1071/HC17010.
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"Let Me Tell You About My…" Provider Self-Disclosure in the Emergency Department Builds Patient Rapport.“让我来跟你说说我的……”,在急诊科进行的医生自我披露能建立患者关系。
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Understanding doctors' attitudes towards self-disclosure of mental ill health.了解医生对自我披露心理健康问题的态度。
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To self-disclose or not self-disclose? A systematic review of clinical self-disclosure in primary care.是否进行自我披露?对初级保健中临床自我披露的系统评价。
Br J Gen Pract. 2015 Sep;65(638):e609-16. doi: 10.3399/bjgp15X686533.
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Physician self-disclosure in primary care: a mixed methods study of GPs' attitudes, skills, and behaviour.基层医疗中的医生自我表露:一项关于全科医生态度、技能和行为的混合方法研究。
Br J Gen Pract. 2015 Sep;65(638):e601-8. doi: 10.3399/bjgp15X686521.
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Too much information--the ethics of self-disclosure.信息过多——自我披露的伦理问题。
N Engl J Med. 2014 Jul 3;371(1):8-9. doi: 10.1056/NEJMp1404119.
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"Enough about me, let's get back to you": physician self-disclosure during primary care encounters.“关于我的就说这么多了,让我们回到你身上”:基层医疗问诊过程中医师的自我表露。
Ann Intern Med. 2008 Dec 2;149(11):835-37. doi: 10.7326/0003-4819-149-11-200812020-00015.
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A postal survey of doctors' attitudes to becoming mentally ill.一项关于医生对患精神疾病态度的邮寄调查。
Clin Med (Lond). 2009 Aug;9(4):327-32. doi: 10.7861/clinmedicine.9-4-327.
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What stops us from healing the healers: a survey of help-seeking behaviour, stigmatisation and depression within the medical profession.阻碍我们治愈医者的因素:一项针对医学专业人员寻求帮助行为、污名化和抑郁状况的调查。
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