Truth-telling at the end of life: A pilot study on the perspective of patients and professional caregivers

被引：50

作者：

Deschepper, Reginald ^{[1
]}

Bernheim, Jan L. ^{[1
,2
]}

Stichele, Robert Vander ^{[3
]}

Van den Block, Lieve ^{[1
]}

Michiels, Eva ^{[1
]}

Van Der Kelen, Greta ^{[1
]}

Mortier, Freddy ^{[4
]}

Deliens, Luc ^{[1
,5
]}

机构：

[1] Vrije Univ Brussel, End Life Care Res Grp, B-1090 Brussels, Belgium

[2] Vrije Univ Brussel, Dept Human Ecol, B-1090 Brussels, Belgium

[3] Sci Soc Flemish Gen Practitioners, Brussels, Belgium

[4] Univ Ghent, Bioeth Inst Ghent, Ghent, Belgium

[5] Vrije Univ Amsterdam Med Ctr, Dept Publ & Occupat Hlth, EMGO Inst, Amsterdam, Netherlands

来源：

PATIENT EDUCATION AND COUNSELING | 2008年 / 71卷 / 01期

关键词：

palliative care; terminal care; euthanasia; communication;

D O I：

10.1016/j.pec.2007.11.015

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Objective: To describe the attitudes towards truth-telling of both terminal patients and professional caregivers, and to determine their perceived barriers to full information exchange. Methods: In-depth inter-views with 17 terminal patients selected through GPs and staff members of Flemish palliative care centres, and 3 focus groups with different professional caregivers. Analysis was based on grounded theory. Results: There was considerable variability in the preferences of patients regarding when and how they wanted to be informed of their diagnosis, prognosis, expected disease course and end-of-life decisions. Major ambivalence was observed regarding the degree to which patients wanted to hear 'the whole truth'. Patients and caregivers agreed that truth-telling should be a 'dosed and gradual' process. Several barriers to more complete and timely truth-telling were identified. Conclusion: The preferences of both patients and caregivers for step-by-step -and hence slow and limited-information prevents terminal patients from reaching the level of information needed for informed end-of-life decision-making. Practice implications: The preference of patients and caregivers to 'dose' the truth may entail some risks, such as a 'Catch 22' situation in which both patients and caregivers wait for a signal from each other before starting a dialogue about impending death. (C) 2007 Elsevier Ireland Ltd. All rights reserved.

引用

页码：52 / 56

页数：5

共 26 条

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