Collusion in doctor-patient communication about imminent death: an ethnographic study
Autor: | A.-M. The, T. Hak, G. Koeter, G. van der Wal |
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Přispěvatelé: | EMGO+ - Quality of Care |
Jazyk: | angličtina |
Rok vydání: | 2000 |
Předmět: |
INFORMATION NEEDS
Male medicine.medical_specialty Attitude to Death Lung Neoplasms media_common.quotation_subject CANCER-PATIENTS Truth Disclosure Small-cell carcinoma Article Right to die Optimism medicine Outpatient clinic Humans Prospective Studies Carcinoma Small Cell Prospective cohort study Qualitative Research General Environmental Science media_common Aged Netherlands Physician-Patient Relations business.industry Communication Right to Die General Engineering General Medicine Middle Aged medicine.disease Prognosis Surgery Family medicine Papers General Earth and Planetary Sciences Observational study Female business Attitude to Health Qualitative research |
Zdroj: | Western journal of medicine, 321(7273), 1376-1381 The, B A M, Hak, A, Koëter, G H & van der Wal, G 2000, ' Collusion in doctor-patient communication about imminent death: an ethnographic study. ', British Medical Journal, vol. 321, pp. 1376-81 . https://doi.org/10.1136/bmj.321.7273.1376 British Medical Journal, 321, 1376-81. BMJ Publishing Group |
ISSN: | 1468-5833 0959-8138 0093-0415 0959-535X |
Popis: | Objective: To discover and explore the factors that result in “false optimism about recovery” observed in patients with small cell lung cancer. Design: A qualitative observational (ethnographic) study in two stages over four years. Setting: Lung diseases ward and outpatient clinic in university hospital in the Netherlands. Participants: 35 patients with small cell lung cancer. Results: “False optimism about recovery” usually developed during the (first) course of chemotherapy and was most prevalent when the cancer could no longer be seen in the x ray pictures. This optimism tended to vanish when the tumour recurred, but it could develop again, though to a lesser extent, during further courses of chemotherapy. Patients gradually found out the facts about their poor prognosis, partly because of physical deterioration and partly through contact with fellow patients who were in a more advanced stage of the illness and were dying. “False optimism about recovery” was the result an association between doctors' activism and patients' adherence to the treatment calendar and to the “recovery plot,” which allowed them not to acknowledge explicitly what they should and could know. The doctor did and did not want to pronounce a “death sentence” and the patient did and did not want to hear it. Conclusion: Solutions to the problem of collusion between doctor and patient require an active, patient oriented approach from the doctor. Perhaps solutions have to be found outside the doctor-patient relationship itself —for example, by involving “treatment brokers.” |
Databáze: | OpenAIRE |
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