癌症患者家属对告知患者癌症诊断态度的分析研究

Study on the families' attitudes towards truth disclosure of cancer to client with cancer

目的调查家属对告知患者癌症诊断的态度,分析家属对告知患者癌症诊断态度的影响因素。方法采用自行设计的"家属对告知患者癌症诊断的态度及影响因素"调查问卷对新确诊、住院3个月内、常见癌症患者的家属194例进行调查。结果同意告知患者癌症诊断的家属占42.3%,不同意告知患者的家属占57.7%。单因素分析显示:患者会出现严重的焦虑和抑郁(χ2=80.046,P=0.00)和患者不会失去信心和希望(χ2=77.099,P=0.00)等条目具有显著性意义。进行logistic回归模型多因素分析显示:患者能更好地安排以后的生活(OR=0.160,P=0.000)和患者不会失去信心和希望(OR=0.192,P=0.000)等是影响家属对告知患者癌症态度的因素。结论家属对告知患者癌症诊断持否定态度的比例较高;家属对告知患者癌症诊断的结果、价值、意义的主观看法是影响家属态度的主要因素;医生所阐明的对待癌症诊断的正确态度会影响家属的态度;患者对癌症诊断的意愿和需求对家属态度的影响较小。

[Objective] To describe the Chinese families＇ attitudes towards the diagnostic truth disclosure of cancer, and to explore the factors affecting the attitudes of eaneer patient＇ families towards honest disclosure. [Methods] Using a self.- developed questionnaire, family members of 194 patients with recently diagnosed common cancer were studied. [Results] Among 194 family members, 42.3% wanted to tell the patients diagnosis while 57.7% did not want the diagnosis to be diselosed. Univariate analysis showed that ＂the client will be under severe depression and anxiety＂（χ2=80.046, P =0.00） had significant statistical differences. Multivariate logistic regression analysis showed that ＂the client is able to survive hopefully＂（OR=0.160, P=0.000） and＂the clients will not lose hope and eonfidence＂ （OR=0.192, P =0.000） etc. are the influential factors of families＇ attitude. [Conclusion]＂Do not tell＂ attitudes of the families were relatively strong. Families＇ perceptions of the result, evaluation and meaning of the truth disclosure were major determinants of families＇ attitudes. Physicians＇ clarity of truth telling would affect the families＇ attitudes. Patients＇ wills and needs regarding truth disclosure have less important impact on the families＇ attitudes.