癌症患者家属选择是否告知患者真实病情的影响因素

The analysis of psychosocial factors influencing cancer families' choosing whether to tell or not to tell the truth to cancer patients

目的:探讨癌症患者家属在选择是否告知患者真实病情的过程中所受到的影响因素。方法:采用主从结合式的Triangulation法,量性资料的收集采用问卷调查法,质性资料的收集采用和13位癌症患者家属进行深入无结构式访谈法。结果:影响家属选择是否告知患者真实病情的最主要因素是家属对告知患者真实病情的主观看法[患者能更好地安排以后的生活(OR=8.326,P=0.00),患者会出现严重的焦虑和抑郁(OR=7.732,P=0.01)等]。同意告知的家属认为患者能够承受压力而且癌症实情不易隐瞒;不同意告知的家属认为告知患者没有意义,只会增加患者的精神负担。结论:家属对告知癌症患者真实病情的意义、价值和结果的主观认识是影响家属选择是否告知患者实情的主要因素,患者的年龄、性别和教育程度不影响家属的选择过程。

Objective To explore the factors that influnce cancer families＇ choosing wether to tell or not to tell the truth to cancer patients. Methods qualitative-quantitative methodological triangulation was used. Quantitative data were collected by questionnaire and qualitative data collection conducted in non-structured in- depth interviews with 13 families. Results The important factors that affected family members choosing is families＇ perceptions of truth telling to cancer patients （The patient would survive hopefully （OR = 8.326,P = 0.00）, The patient would be extremely upset and distressed （OR = 7.732,P = 0.01 ） etc.）. No-tellers thought that disclosure does not make sense but bring pressure on patients; Teller asserted that patient could handle the shock and diagnosis is not easy to conceal. Conclusion Family members＇ perceptions of results and meanings of truth disclosure were major determinants of families＇ choosing whether to tell or not to tell the patient. Patients＇ wishes for disclosure cannot be ignored.