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公开癌症诊断结果:患者的经历

Disclosing the cancer diagnosis: the patients' experiences.

作者信息

Loge J H, Kaasa S, Hytten K

机构信息

Department of Behavioural Sciences in Medicine, University of Oslo, Norway.

出版信息

Eur J Cancer. 1997 May;33(6):878-82. doi: 10.1016/s0959-8049(97)00001-4.

Abstract

497 Norwegian cancer patients (346 females, 151 males, mean age = 56 years (S.D. = 12)), admitted to a cancer rehabilitation centre, were surveyed on how they were told their diagnosis. Predictors of general satisfaction with the information were assessed. 43% of the subjects were informed by phone, letter or in the corridor/on the round and estimated that the information was presented in less than 5 minutes. Satisfaction with the information was predicted by perceiving the physicians as personally interested (B = 0.528, P < 0.001), comprehending the information (B = 0.245, P < 0.001), being informed in the physicians' offices (B = 0.338, P < 0.001), being informed by physicians at oncological departments (B = 0.278, P = 0.01) and increasing time spent on the disclosure (B = 0.140, P = 0.01). Other aspects of physician-patient communication than the pure presentation of valid information is highly valued by the patients. However, a substantial proportion of physicians present the cancer diagnosis in such a manner that the possibility of engaging in conversation about the diagnosis and the effect upon the patient is very limited. The findings call for remedial attention to the subject and improvement in performance.

摘要

对497名入住癌症康复中心的挪威癌症患者(346名女性,151名男性,平均年龄56岁(标准差=12))进行了关于他们如何得知自己诊断结果的调查。评估了对信息总体满意度的预测因素。43%的受试者通过电话、信件或在走廊/查房时得知诊断结果,且估计信息告知时间不到5分钟。对信息的满意度可通过以下因素预测:认为医生个人感兴趣(B = 0.528,P < 0.001)、理解信息(B = 0.245,P < 0.001)、在医生办公室被告知(B = 0.338,P < 0.001)、由肿瘤科室的医生告知(B = 0.278,P = 0.01)以及披露信息的时间增加(B = 0.140,P = 0.01)。患者非常重视医患沟通中除了单纯提供有效信息之外的其他方面。然而,相当一部分医生告知癌症诊断的方式使得就诊断及对患者的影响进行交谈的可能性非常有限。这些发现需要对该问题予以补救关注并改进工作表现。

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