家庭和文化在坏消息告知中的作用：巴基斯坦的一项多中心横断面研究。
The role of family and culture in the disclosure of bad news: A multicentre cross-sectional study in Pakistan.
作者信息
Shah Sameena, Usman Asma, Zaki Samar, Qureshi Asra, Lal Karishma, Uneeb Saher Naseeb, Bari Naseem, Hasnani Fauzia Basaria, Shah Nasir, Iqbal Saima Parwaiz, Ullah Obaid, Abid Sumera
机构信息
Department of Family Medicine, North Island Hospital Campbell River and District, Island Health, Campbell River, BC, Canada.
Department of Family Medicine, Aga Khan University, Karachi, Pakistan.
出版信息
PEC Innov. 2023 Aug 21;3:100200. doi: 10.1016/j.pecinn.2023.100200. eCollection 2023 Dec 15.
OBJECTIVES
Disclosure of bad news is distressing for patients and family members. Our aim was to assess patients' perceptions and preferences regarding bad news in the health setting.
METHODS
Cross-sectional, multi-centered study supported by an external grant in 15 Government and Private Hospitals across Pakistan. A sample size of 1673 patients and family members was used. Ethics permission/consent was taken from each participating hospital and participant. Responses were compared across provinces, gender, age, education and income.
RESULTS
80% patients preferred their relatives to know the diagnosis first and they wanted the news to be disclosed to them by doctors. Significant association between education level, income and preference for wanting to know the diagnosis was found. Reasons for wanting to know the diagnosis included treatment, prognosis and prevention options whereas reasons for not wanting to know included fear of emotions and God's will.
CONCLUSION
The majority of Pakistani patients want to be informed and want the family to know first. Preferences for disclosure vary across, age, education and income level.
INNOVATION
First countrywide study on this topic. Identifies need for culturally sensitive guidelines that include the family's role in disclosure of bad news.
目的
告知坏消息会让患者及其家属感到痛苦。我们的目的是评估患者在医疗环境中对坏消息的看法和偏好。
方法
在巴基斯坦各地15家政府和私立医院进行的一项由外部资助的横断面多中心研究。样本量为1673名患者及其家属。已从每家参与研究的医院和参与者处获得伦理许可/同意。对不同省份、性别、年龄、教育程度和收入的回答进行了比较。
结果
超过80%的患者希望亲属先知道诊断结果，并且希望医生将消息告知他们。发现教育程度、收入与想知道诊断结果的偏好之间存在显著关联。想知道诊断结果的原因包括治疗、预后和预防选择，而不想知道的原因包括害怕情绪波动和听天由命。
结论
大多数巴基斯坦患者希望得到通知，并希望家人先知道。坏消息告知的偏好因年龄、教育程度和收入水平而异。
创新
关于该主题的首次全国性研究。确定了对具有文化敏感性的指南的需求，该指南应包括家庭在告知坏消息中的作用。
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