Concerns about losing control when breaking bad news to terminally ill patients with cancer: Physicians' perspective
Concerns about losing control when breaking bad news to terminally ill patients with cancer: Physicians' perspective
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DOI：
10.1089/jpm.2006.9.673
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发表时间：
2006-06-01
影响因子：
2.8
通讯作者：
Milberg, Anna
中科院分区：
文献类型：
--
作者：
Friedrichsen, Maria;Milberg, Anna
目的：研究和探索当医生向晚期癌症患者透露因无法治愈的癌症而停止或不提供肿瘤特异性治疗的坏消息时，医生所感知的问题。设计：一项定性现象学访谈研究。设置：瑞典奥斯特哥特兰县。参与者：30名具有不同人口统计学特征的医生。结果：根据医生的回答，坏消息被认为涉及以不同方式失去控制的风险，涉及情绪，自我，信心，专业精神和患者信任。四个不同的主要类别描述为问题，感知集中在存在的思想，关系，知识，和感知相关的时间和环境disturbs.Conclusion：医生认为，打破坏消息垂死的癌症患者涉及失去控制的风险。不切实际的想法和缺乏知识助长了这种风险。存在主义/灵性的理论教育和姑息治疗背景下的临床实践可能有助于保持控制。
Objective: To study and explore problems perceived by physicians when breaking bad news to advanced cancer patients about discontinuing or not offering tumor-specific treatment due to incurable cancer.Design: A qualitative phenomenographic interview study.Setting: The county of Ostergotland in Sweden.Participants: Thirty physicians with different demographic characteristics.Results: According to the physicians' answers breaking bad news was perceived as involving a risk of losing control in different ways, regarding emotions, oneself, confidence, professionalism and patient trust. Four different main categories described as problems were identified; perceptions focusing on existential thoughts, relationships, knowledge, and perceptions related to time and environmental disturbances.Conclusion: Physicians perceived that breaking bad news to dying patients with cancer involved a risk of losing control. Existential thoughts and a lack of knowledge contribute to this risk. Theoretical education in existentiality/spirituality and clinical practice in a palliative context may help maintaining control.