告知恶性肿瘤患者病情相关问题的质性研究

Qualitative research： disease informing among malignant tumor patients

目的针对晚期恶性肿瘤患者，了解患者得知患病前、后的心理感受和最希望得到的病情告知方法。方法通过面对面、半结构性、深度访谈的形式，访问了北京市某三级甲等医院肿瘤科的患者7名，将获得的资料进行整理、分析，提炼出主题。结果肿瘤科患者在被告知病情前、后的心理变化主要归纳为4个主题：担心病情告知的好与坏、在确诊后的病情告知、接受病情告知后的心态调整、最希望的病情告知方式。结论通过了解恶性肿瘤患者知情的特殊性，根据患者的内心感受，评估癌症患者本人的知情意愿，在履行癌症病情告知义务时，需要更好的告知策略，在不使患者和家属产生不利的情况下，达到告知的真实病情的最佳效果。

Objective To study the mental feelings of patients with malignant tumor before and after they were informed the disease situation so as to explore the most hopeful way of disease informing for cancer patients. Methods Totals of 7 patients with malignant tumor in one Grade A hospital were recruited, and face to face, semi - structured, depth interview were used for information collection and the theme was analysed and refined. Results Before and after the patents were informed that they suffered from cancer, four themes were refined from their mental feelings：considering if the disease informing is bad or good, disease informing after diagnose, mentality adjustment after accept the disease informing, the most hopeful way of disease informing. Conclusions It is necessary for nurses to choose the better disease informing way in order to achieve a better informed result, according to patients＇ mental feeling and attitude, after nurses know that cancer patients have particular disease informing.