Graham H, Livesley B
Lancet. 1983 Sep 17;2(8351):670-2. doi: 10.1016/s0140-6736(83)92542-4.
91 responses to a standard interview from medical and nursing staff who had cared for 24 elderly patients who died were assessed to determine whether staff and patients knew that dying was part of the diagnosis. 45% of respondents had concluded that their patients knew the clinical diagnosis and 42% that their patients knew death was imminent. Only 18% of respondents had discussed the diagnosis with patients and only 14% had discussed impending death. Other means of communication contributed to the staff's awareness of the patient's knowledge of diagnosis in a further 27% and of impending death in 29%. The needs of 13 of 14 alert dying patients were not adequately appreciated by the staff. Failure of medical and nursing staff to pool perceptions of patients' difficulties may contribute to the inappropriate care of patients dying in hospital and the stress experienced by staff after patients die.
对曾护理过24名已故老年患者的医护人员进行的91份标准访谈回复进行了评估，以确定医护人员和患者是否知晓死亡是诊断的一部分。45%的受访者认为他们的患者知道临床诊断，42%的受访者认为他们的患者知道死亡即将来临。只有18%的受访者与患者讨论过诊断，只有14%的受访者讨论过即将到来的死亡。其他沟通方式使医护人员进一步了解到27%的患者对诊断的知晓情况以及29%的患者对即将到来的死亡的知晓情况。14名意识清醒的临终患者中有13名患者的需求未得到医护人员的充分认识。医护人员未能汇总对患者困难的认知，这可能导致对医院临终患者的不当护理以及患者死亡后医护人员所经历的压力。
