DIAGNOSTIC DISCLOSURE - A TALE IN 2 CULTURES
DIAGNOSTIC DISCLOSURE - A TALE IN 2 CULTURES
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DOI：
10.1017/s0033291700032803
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发表时间：
1992-02-01
影响因子：
6.9
通讯作者：
SATOH, H
中科院分区：
文献类型：
--
作者：
MCDONALDSCOTT, P;MACHIZAWA, S;SATOH, H
医生和病人之间的诊断沟通被认为在日本和西方国家之间有着根本的不同。为了了解精神病患者的诊断披露，一份包含6个案例插图的问卷被发送给日本（N = 166）和北美（N = 112）的执业精神科医生。虽然这两组中超过90%的人会告知情感和焦虑障碍患者他们的诊断，但只有70%的北美人和不到30%的日本人会同样告知精神分裂症或精神分裂症样障碍患者。日本人倾向于给出一个模糊的替代诊断，如神经衰弱。北美人会与病人讨论鉴别诊断。两组中几乎所有的人都会通知家人，但北美人只有在病人同意的情况下才会这样做。对于有有效治疗方法的疾病，两种文化都有诊断披露;当预后不确定或诊断令人恐惧时，如精神分裂症，文化构建的患者身份观支配着披露实践。
Diagnostic communication between doctors and patients is thought to differ radically between Japan and Western countries. To understand diagnostic disclosure to psychiatric patients, a questionnaire with six case vignettes was sent to practising psychiatrists in Japan (N = 166) and North America (N = 112). While over 90 % of both groups would inform patients with affective and anxiety disorders of their diagnoses, only 70 % of North Americans and less than 30 % of Japanese would similarly inform patients with schizophrenia or schizophreniform disorders. The Japanese preferred alternative was to give a vague alternative diagnosis such as neurasthenia. North Americans would discuss differential diagnoses with the patient instead. Nearly all in both groups would inform the family, but North Americans would do so only with patient consent. For disorders for which there are effective treatments, diagnostic disclosure is common to both cultures; when prognosis is uncertain or the diagnosis is feared, as in schizophrenia, culturally constructed views of patienthood govern disclosure practice.