Uchitomi Y, Sugihara J, Fukue M, Kuramoto Y, Akechi T, Oomori N, Yamawaki S
Department of Psychiatry and Neurosciences, Hiroshima University School of Medicine, Japan.
J Pain Symptom Manage. 1994 Jul;9(5):319-24. doi: 10.1016/0885-3924(94)90191-0.
To clarify the psychiatric liaison issues in Japan, this paper briefly introduces a survey of physician attitudes and practices regarding cancer care in Japan and preliminarily reports on an "active" liaison program developed at one Japanese general hospital. The survey of physicians from 31 teaching hospitals, including all cancer centers, revealed that 56% of physicians do not inform patients of a diagnosis of cancer. Thus, actual psychiatric consultation referrals were very few due to the physician's fear of harming his relationship with the cancer patient. One medical unit, in which about one-quarter of the cancer patients were told their diagnoses by the unit chief physician, showed significantly higher rates of psychiatric consultation after the introduction of an "active" liaison program in that hospital. These results suggest that the liaison program can positively influence the rate of psychiatric consultation referrals for cancer patients when the physician discloses the diagnosis to the patient. Consultation-liaison psychiatry in cancer care is expected to develop in Japan, because most physicians report a trend toward informing patients of their cancer diagnosis.
为了阐明日本的精神科联络问题，本文简要介绍了一项关于日本医生对癌症护理的态度和做法的调查，并初步报告了一家日本综合医院开展的“积极”联络项目。对包括所有癌症中心在内的31家教学医院的医生进行的调查显示，56%的医生不会告知患者癌症诊断结果。因此，由于医生担心损害与癌症患者的关系，实际的精神科会诊转诊非常少。在一个医疗单元中，约四分之一的癌症患者由该单元的主任医师告知其诊断结果，在该医院引入“积极”联络项目后，该单元的精神科会诊率显著提高。这些结果表明，当医生向患者披露诊断结果时，联络项目可以对癌症患者的精神科会诊转诊率产生积极影响。由于大多数医生报告有向患者告知其癌症诊断结果的趋势，预计日本癌症护理中的会诊-联络精神病学将会得到发展。
