Sobczak Krzysztof, Leoniuk Katarzyna
Department of Sociology of Medicine and Social Pathology, Medical University of Gdansk, Gdansk, Poland.
Arch Med Sci. 2021 Jan 8;19(4):921-929. doi: 10.5114/aoms/112756. eCollection 2023.
The purpose of our research was to find out patients' preferences concerning their doctors' attitudes and behaviour as they deliver bad news to them.
In national research conducted from February to October 2017 using the computer-assisted web interview (CAWI) technique, we studied the statements of 314 adult patients who had received bad medical news from their doctors. Seventy-nine per cent of them were women and 21% were men. Fifty-nine per cent had higher education and 33% had secondary education. A specially designed closed question survey was used as a tool to collect the data.
Most of the patients (59.6%) expected a doctor-patient relationship based on partnership and collective decisions concerning further treatment. Patients wanted their doctors to be honest with them, to provide them with solid information and an opportunity to ask questions and discuss the suggested solutions. Less than 2 out of 10 patients expected "an empathy specialist". The patients who evaluated their doctors' behaviour and the way bad news was delivered to them negatively were more likely to change doctors or terminate their treatment.
The doctor-patient relationship when an unfavourable diagnosis is being communicated is an important aspect, which defines the way people who participate in this difficult situation behave and communicate. Doctors' behaviour during DBN should meet the patients' expectations. Such an attitude guarantees trust towards doctors and results in more positive evaluations on them. Most importantly, it translates directly into the patients' therapeutic behaviours and treatment effects.
我们研究的目的是了解患者对于医生向他们传达坏消息时的态度和行为的偏好。
在2017年2月至10月进行的一项全国性研究中,我们采用计算机辅助网络访谈(CAWI)技术,研究了314名从医生那里收到坏消息的成年患者的陈述。其中79%为女性,21%为男性。59%的人受过高等教育,33%的人受过中等教育。一项专门设计的封闭式问卷调查被用作收集数据的工具。
大多数患者(59.6%)期望建立基于伙伴关系和关于进一步治疗的集体决策的医患关系。患者希望医生对他们诚实,为他们提供可靠的信息以及提问和讨论建议解决方案的机会。每10名患者中不到2人期望有“一位共情专家”。对医生的行为以及坏消息传达方式评价负面的患者更有可能更换医生或终止治疗。
在传达不利诊断时的医患关系是一个重要方面,它决定了处于这种困境中的人们的行为和沟通方式。医生在传达坏消息期间的行为应符合患者的期望。这样的态度能保证患者对医生的信任,并对他们有更积极的评价。最重要的是,这直接转化为患者的治疗行为和治疗效果。