補完代替療法を受ける外来がん患者を対象とした主治医と話すことへのためらいの構成概念の検討  [in Japanese] Hesitation in Speaking with Primary Doctors among Cancer Outpatients Who are Undergoing Complementary and Alternative Therapy  [in Japanese]

Access this Article

Author(s)

Abstract

患者と医師とのコミュニケーションは,がん患者の身体的・精神的負担の軽減において重要な役割を担っている.しかし,主治医に話すことにためらいを感じ,伝えるべきことを伝えられずにいるがん患者は少なくない.本研究では,がん患者が標準治療について主治医に話すことへのためらいの因子構造を検討し,主治医に話すことをためらうがん患者の傾向を明らかにすることを目的とした.補完代替療法を行うがん専門クリニックに通院する成人がん患者52名に質問紙調査を実施した結果,がん患者が主治医と話すことへのためらいは「情報の取捨選択に対する葛藤」と「主治医に対するあきらめ」の2因子で構成されていた.また,患者の年齢,ステージ,就業形態,再発の有無によってためらいの程度が異なっていた.患者から主治医へのコミュニケーションの改善には,患者の状況を踏まえたうえで主治医に話すことへのためらいを軽減するかかわりが必要であるといえる.

Background : Effective communication between cancer patients and their doctors is important in alleviating patients' physical and psychological burdens. Hence, there is a growing need to encourage an improvement in patientdoctor communication. Cancer outpatients often hesitate to speak with their doctors even when they have necessary information to provide or questions to ask. This study examines the relationships between patients' hesitation in speaking with their doctors and their communication behaviors. Subjects & Method : The participants were 51 individuals (21 male and 31 female, mean age 62.08±11.38 years) undergoing outpatient treatment with complementary and alternative medicine. They were asked to recall the most recent consultation with their primary doctor, and then completed questionnaires measuring the degree of their hesitation in that particular social exchange. The factors influencing patients' hesitation were analyzed using the maximum likelihood estimation. Subsequently, the relationship between patient characteristics and hesitation was examined using Mann-Whitney U and Kruskal-Wallis tests. Results : The results revealed that indecision regarding the topic of discussion, and the decision to forsake their doctors, are among the prime factors influencing patients' hesitance to engage in effective communication with their primary doctors. A marginally significant difference with respect to age, stage of disease, employment, and recurrence status was observed. In particular, patients with recurrence were more likely to exhibit hesitance in communication compared to patients without recurrence (p=0.05). In addition, patients under 50 years of age were more likely to be indecisive about the topics of discussion, compared to patients in their 60 s (p=0.08). Similarly, patients at stages I-III were more likely to be indecisive than were patients at stage IV (p=0.08). In addition, employed patients were more likely to forsake their doctors than were unemployed patients (p=0.08). However, hesitation did not significantly differ by sex, cancer type, treatment, ECOG performance status, presence or absence of metastasis, residential conditions, or disease duration. Conclusion : To encourage better patient-doctor communication, it is necessary to alleviate patients' hesitation to talk to their primary doctors. Communication skill training programs for patients targeting both the alleviation of patients' hesitation and the amelioration of patients' communication skills may be necessary.

Journal

  • Japanese Journal of Psychosomatic Medicine

    Japanese Journal of Psychosomatic Medicine 55(7), 873-883, 2015

    Japanese Society of Psychosomatic Medicine

Codes

  • NII Article ID (NAID)
    110009969935
  • NII NACSIS-CAT ID (NCID)
    AN00121636
  • Text Lang
    JPN
  • ISSN
    0385-0307
  • NDL Article ID
    026554537
  • NDL Call No.
    Z19-26
  • Data Source
    NDL  NII-ELS  J-STAGE 
Page Top