Adenis A, Vennin P, Hecquet B
Centre Oscar-Lambret, Lille.
Bull Cancer. 1998 Sep;85(9):803-8.
This regional survey was aimed to detect hypothetical variations in attitudes among truth telling in colon cancer by an anonymous questionnaire sent to the 290 gastroenterologists, surgeons and oncologists of the Northern France area. The answers were assessed as always (A), often (O), rarely and never. Diagnosis was revealed to the patient (whether or not he asked the question) or to his spouse in 83%, 40% and 93% of the cases, respectively. The diagnosis of diffuse metastasis was revealed (A + O) to the patient or to his spouse in 23% and 95% of the cases, respectively. Only 3% of the physicians told (A + O) the patient that his condition was incurable while this aspect was A + O revealed to the patient's spouse in 34% of the cases. Most of the time, the diagnosis of colon cancer was revealed by oncologists rather than by surgeons or gastroenterologists. Conversely the full truth was more commonly told to the family by surgeons and gastroenterologists than by oncologists. We found variation in attitudes towards truth telling in colon cancer which depend on the physician's specialty. It seems to us that the magnitude of the full truth told to the patient or his family in Northern France area, is somewhat intermediate between the attitude of doctors in Northern Europe and in Latin Mediterranean or Eastern Europe countries.
这项区域调查旨在通过向法国北部地区的290名胃肠病学家、外科医生和肿瘤学家发送匿名问卷,来检测在结肠癌告知真相方面态度上可能存在的差异。答案被评估为总是(A)、经常(O)、很少和从不。分别在83%、40%和93%的病例中,向患者(无论他是否提问)或其配偶透露了诊断结果。在23%和95%的病例中,分别向患者或其配偶透露了弥漫性转移的诊断结果(A+O)。只有3%的医生(A+O)告知患者其病情无法治愈,而在34%的病例中,这一情况向患者配偶透露(A+O)。大多数情况下,结肠癌的诊断是由肿瘤学家而非外科医生或胃肠病学家透露的。相反,外科医生和胃肠病学家比肿瘤学家更常向家属透露全部真相。我们发现,在结肠癌告知真相方面的态度存在差异,这取决于医生的专业。在我们看来,法国北部地区向患者或其家属透露全部真相的程度,在北欧医生与拉丁地中海或东欧国家医生的态度之间,处于某种中间水平。