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癌症多学科医疗保健专业人员在“告知坏消息”期间的患者-临床医生沟通:患者体验的定性系统评价。

Patient Experiences of Patient-Clinician Communication Among Cancer Multidisciplinary Healthcare Professionals During "Breaking Bad News": A Qualitative Systematic Review.

机构信息

Warwick Manufacturing Group, University of Warwick Coventry, Coventry, UK.

Faculty of Health, University of Canberra, Bruce, Canberra, Australian Capital Territory, Australia; School of Dentistry and Medical Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia.

出版信息

Semin Oncol Nurs. 2024 Aug;40(4):151680. doi: 10.1016/j.soncn.2024.151680. Epub 2024 Jun 25.

Abstract

PURPOSE

To explore patient experiences of patient-clinician communication during the critical moments of "breaking bad news" in cancer care.

METHODS

A qualitative systematic review followed the Joanna Briggs Institute methodology and has been reported according to PRISMA guidelines. Databases, including APA PsycINFO, CINAHL, MEDLINE, and Scopus, were searched from the beginning of their date range coverage to April 2023. Data extraction and quality assessment were performed, and a meta-aggregation approach was used for data synthesis.

RESULTS

Twenty-eight studies were included and represented 976 patients. Key themes included (1) sensing something is wrong (prior to diagnosis), (2) reaction to the diagnosis, (3) information (during breaking bad news), (4) communication with health care professionals, (5) specialist versus nonspecialist centers, (6) decision-making, and (7) feeling supported. The review underscores the need for health care professionals to adeptly navigate and respond to individual patient needs during confronting and distressing times.

CONCLUSIONS

The complexity and individuality of patient-clinician communication suggest that further education is needed among the cancer multidisciplinary team to develop personalized, empathetic communication strategies in clinical practice, catering to diverse patient preferences. The findings call for more inclusive research across different cultures and languages, and a need to understand evolving communication needs, especially in the context of increasing digital communication modalities in health care.

IMPLICATIONS FOR CANCER SURVIVORSHIP

This review provides valuable new insights into developing effective communication strategies that are responsive to the diverse needs of patients undergoing cancer treatment. Its findings emphasize the importance of empathy, flexibility, and a personalized approach in delivering bad news and supporting patients throughout survivorship.

摘要

目的

探索癌症护理中“传达坏消息”关键时刻患者与临床医生沟通的体验。

方法

一项定性系统评价遵循了 Joanna Briggs 研究所的方法,并根据 PRISMA 指南进行了报告。从各数据库的起始日期范围(包括 APA PsycINFO、CINAHL、MEDLINE 和 Scopus)检索到 2023 年 4 月的数据。进行了数据提取和质量评估,并采用元聚合方法进行数据综合。

结果

共纳入 28 项研究,代表了 976 名患者。主要主题包括:(1)在诊断之前感觉到有些不对劲;(2)对诊断的反应;(3)信息(在传达坏消息期间);(4)与医疗保健专业人员的沟通;(5)专科中心与非专科中心;(6)决策;以及(7)感到被支持。该综述强调了医疗保健专业人员在面对和处理困难时期时需要熟练地引导和回应个体患者的需求。

结论

患者与临床医生沟通的复杂性和个体性表明,癌症多学科团队需要进一步接受教育,以在临床实践中制定个性化、富有同理心的沟通策略,满足不同患者的偏好。研究结果呼吁在不同文化和语言背景下进行更具包容性的研究,并需要了解不断变化的沟通需求,尤其是在医疗保健中日益增加的数字沟通模式的背景下。

对癌症生存者的意义

该综述为制定响应癌症治疗患者多样化需求的有效沟通策略提供了有价值的新见解。研究结果强调了在传递坏消息和在整个生存期间支持患者时,同理心、灵活性和个性化方法的重要性。

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