| 描述: | 目錄
摘要 8
第一章 背景 9
1.1 西方倫理意識的歷史沿革 11
1.2 中國的傳統醫倫思維 13
1.3 台灣的醫倫現況 16
第二章 文獻分析 17
2.1倫理判斷的理論方法 17
2.2 醫療倫理四原則 20
2.3 為什麼應該告知實情 22
2.4 由病人的立場看病情告知 25
2.5 社會文化因素對病情告知的影響 27
研究目的 30
第三章 研究方法 31
3.1 研究對象 31
3.2 收案方式 33
3.3 工具 34
1. 結構性訪談 34
2. 問卷評量 34
3.4 資料分析方法 37
3.5 定義 38
第四章 結果 40
4.1 研究對象 40
4.2 病情告知 42
4.3 WHOQOL-BREF 43
4.4 BDI–II 46
4.5 病人與家屬的話 47
4.6 醫師的話 49
第五章 討論 51
5.1 告知“壞消息”觀念之時代遷移 51
5.2 面對“壞消息”的病人與家屬 54
5.3 病人的憂鬱和家屬的煩惱 56
5.4 無法告知病患“壞消息”的障礙因素 58
5.5 成功告知“壞消息”的技巧 59
第六章 研究限制 62
未來的研究方向 63
第七章 結論 64
參考文獻 65
1. Gold M. Is honesty always the best policy? Ethical aspects of truth telling. Int Med J. 2004, September/October 34(9-10):578-80
2. Hébert PC, Hoffmaster B, Glass KC, et al. Bioethics for clinicians: 7. truth telling. Can Med Assoc J 1997;156(2):225-8
3. Morioka Y. Informed consent and truth telling to cancer patients. Gastroenterol Jpn 1991;26:789-92
4. Oken D. What to tell cancer patients. JAMA 1961;175:1120-
5. Laine C, Davidoff F. Patient-centered medicine a professional evoluation. JAMA 1996;275:152-6
6. Wood WA, McCabe MS, Goldberg RM. Commentary: disclosure in oncology- to whom does the truth belong? Oncologist 2009;14:77-82
7. Fan RP, Li BF. Truth telling in medicine: the Confucian view. J Med Philo. 2004; 29(2): 179-93
8. 孫氏（思邈）千金方．新唐志三十卷
9. Tsai Daniel FC. Ancient Chinese medical ethics and the four principles of biomedical ethics. J Med Ethi 1999; 25: 315-21
10. Shen CW. Approach to the clinical care of terminal ill patients. Clin Med 1984;13:351-60
11. Wang SY, Chen CH, Chen YS, et al. The attitude toward truth telling of cancer in Taiwan. J Psyc Rese. 2004, 57: 53-8
12. 戴正德, 基礎醫學倫理學. 高力圖書公司 2000
13. Mill JS,Bentham J,Ryan A. Ultilitarianism and other essays
14. Rawls J. A theory of justice. 1971
15. Beauchamp TL, Childress JF. Principles of biomedical ethics. New York: Oxford University Press, 1979
16. Gillon R. Medical ethics: four principles plus attention to scope. BMJ 1994;309:184-8
17. Harris J, Shao J, Sugarman J. Disclosure of cancer diagnosis and prognosis in Northern Tanzania. Soc Sci Med 2003; 56: 195-200
18. Mystakidou K, Parpa E, Tsilika E, et al. Cancer information disclosure in different cultural contexts. Support Care Cancer 2004;12:147-54
19. Mystakidou K, Liossi Ch, Vlachos L, et al. Disclosure of diagnostic information to cancer patients in Greece. Palliat Med 1996;10:195-200
20. Mathew LM, Scully JH. Hospice care. Clin Geriatr Med 1986;2:617-34
21. Bostick NA, Sade R, McMahon JW, et al. Report of the American Medical Association Council on Ethical and Judicial Affairs: Withholding information from patients: rethinking the propriety of “therapeutic privilege.” J Clin Ethics 2006;17:302-6
22. Berger JT. Ignorance is bliss? Ethical considerations in therapeutic nondisclosure. Cancer Invest 2005;1:94-8
23. Sullivan RJ, Menapace LW, White RM. Truth-telling and patient diagnoses. J Med Ethi 2001;27:192-7
24. Lin CC. Disclosure of the cancer diagnosis as it relates to the quality of pain management among patients with cancer pain in Taiwan. J Pain Symptom Manage 1999;18:331-7
25. Ptacek JT, Ptacek JJ. Patients perceptions of receiving bad news about cancer. J Clin Oncol 2001;19(21):4160-4
26. Eggly S, Afonso N, Rojas G, et al. An assessment of residents’ competence in the delivery of bad news to patients. Acad Med 1997;72:397-9
27. Jiang Y, Liu C, Huang MJ, et al. Different attitudes of Chinese patients and their families toward truth telling of different stages of cancer. Psycho-Oncology 2007; 16: 928-36
28. Yun YH, Lee CG, Kim SY, et al. The attitudes of cancer patients and their families toward the disclosure of terminal illness. J Clin Oncol 2004;22:307-14
29. Kunin J. Should patients be told the truth about their illness: Jewish perspectives. Isr Med Assoc J 2002;4:737-41
30. Lipson J, Dibble SL, Minarik PA. Culture and nursing care: a pocket guide. SF, CA: University of California Nursing Press 1996
31. Numico G, Anfossi M, Bertelli G, et al. The process of truth disclosure: an assessment of the results of information during the diagnostic phase in patients with cancer. Ann Oncol 2009;Jan:1-5
32. Thomsen OO, Wulff HR, Martin A, et al. What do gastroenterologists in Europe tell cancer patients? Lancet 1993;341:473-6
33. Harrison A, Al-Saadi AMH, Al-Kaabi ASO, et al. Should doctors inform terminally ill patients? The opinions of nationals and doctors in the United Arab Emirates. J Med Ethi 1997;23:101-7
34. Montazeri A, Tavoli A, Mohagheghi MA, et al. Disclosure of cancer diagnosis and quality of life in cancer patient：should it be the same everywhere？ BMC Cancer 2009, 9: 39
35. Hitoshi O, Yosuke U, Mitsuru S, et al. Guidelines for Telling the Truth to Cancer Patients. Jap J Clin Onco 2008;28(1):1-4
36. Hsu C, Wang JD, Hwang JS, et al. Survival-weighted health profile for long-term survivors of acute myelogenous leukemia. Quality of life research 2003;12:503-17
37. 姚開屏. 台灣簡明版世界衛生組織生活品質問卷問卷之發展及使用手冊 2001 http://www.cgm.ntu.edu.tw/whoqol/database.htm
38. 貝克憂鬱量表第二版（中文版）指導手冊
39. 盧孟量、車先惠、張尚文、沈武典. 中文版貝克憂鬱量表第二版之信度和效度. 台灣精神醫學2002;16:301-10
40. 潘璦琬 許瑋玲. 羅序模式檢定貝氏憂鬱量表第二版之建構效度. Formosan J Med 2008;12(3):284-91
41. 柯慧貞、黃耿妍、李毅達、莊麗珍：貝氏憂鬱量表應用於國人周產期憂鬱症篩選之適用性。中華公共衛生雜誌1996;15:208-19
42. Chang HW. Dimensions of the Chinese Beck Depression Inventory-II in a University Sample. Individ Differ Res 2005;3:193-9
43. 民國98年全國癌登年報
44. 2007年度國泰醫院癌症診療照護年報
45. 衛生署網站: http://www.doh.gov.tw/CHT2006/DM/DM2_2.aspx?now_fod_list_no=10642&class_no=440&level_no=3
46. Hasui C, Hayashi M, Tomoda A, et al. Patients’ desire to participate in decision making in psychiatry: a questionnaire survey in Japan. Pschy Rep 2000;86:389-99
47. Glass E, Cluxton D. Truth-telling ethical issues in clinical practice. J Hosp Palliat Nurs. 2004 Oct-Dec; 6(2): 232-42
48. Keating DT, Nayeem K, Gilmartin JJ,et al. Advance directives for truth disclosure. Chest 2005;128:1037–9
49. Meredith C, Symonds P, Webster L, et al. Information needs of cancer patients in the west of Scotland. BMJ 1997;313:724-6
50. Hagerty RG, Butow PN, Ellis PM et al. Communicating prognosis in cancer care:a systematic review of the literature. Ann Oncol 2005; 16: 1005–53
51. Ajaj A, Singh MP, Abdulla AJJ. Should elderly patients be told they have cancer? Questionnaire survey of older people. BMJ 2001;323:1160
52. Rio-Valle JS, Caro MP, Juarez RM, Peña DP, et al. Bad news for the patient and the family? The worst part of being a health care professional.Palliat Care. 2009;25(3):191-6
53. Dosanjh S, Barnes J, Bhandari M. Barriers to breaking bad news among medical and surgical residents. Med Educ. 2001 Mar;35(3):197-205
54. Davis AJ, Koenig BA. A question of policy: bioethics in a multicultural society. Nursing Policy Forum 1996; 2(1):6-11
55. Baile WF, Buckman R, Lenzi R, et al. SPIKES- a six step protocol for delivering bad news: application to the patient with cancer. Oncologist 2000;5:302-11
56. Back AL, Arnold RM, Baile WF, et al. Approaching difficult communication tasks in oncology. CA Cancer J Clin 2005;19:215-31
57. Rappaport W, Witzke D. Education about death and dying during the clinical years of medical school. Surgery 1993;113:163-5
58. Finlay I, Dallimore D. Your child is dead. BMJ 1991;302:1524-5
59. Ford S, Fallowfield L, Lewis S. Can oncologists detect distress in their out-patients and how satisfied are they with their performance during bad news consultations? Br J Cancer 1994;70:667-70
60. Quill TE, Townsend P. Bad news: delivery, dialogue, and dilemmas. Arch Intern Med 1991;151:463-8
61. Girgis A, Sanson-Fisher RW. Breaking bad news: consensus guidelines for medical practitioners. J Clin Oncol 1995;13:2449-56
62. Michael W Rabow and Stephen J McPhee. sBMJ Archive. Beyond breaking bad news: Helping patients who suffer. 2000 (8) MARCH:65-7
63. 蔡淳娟. 解決醫療倫理難題. 聯新亞洲醫學教育有限公司 2008;44-51 |
