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論文 |
論文
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橋本, 秀子 ; 宮本, 謙一
概要:
金沢大学附属病院薬剤部<br />薬剤師として1980年代にがん患者中心の病棟で臨床に密着した業務を展開する中で, 抗がん剤の副作用やがん末期の諸症状に苦しむ患者を目の前にし, 医師や看護師のがん患者への情報提供と彼らの意見を調査した. そ
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の後, 1996年と2005年にも同様の質問を行い, その変化に応じて薬剤師の患者への関わり方を探った. 1988年には72.7%の医師が早期がんでも病名告知しなかったが, 1996年には70%の医師が早期がんのみ病名告知するようになり, 2005年には100%の医師が, 進行度に関係なく病名を告知するとの回答を得た. しかし,「いつまで抗がん剤治療を続けるか」「終末期の症状緩和の技術が未熟である」といった新たな問題が生じており, 薬剤師がスタッフの中で独自の立場で主張することも必要となってきている. Purpose: Doctors were reluctant to disclose a cancer diagnosis to patients in the 1980 s. Clinical pharmacists strive to reduce adverse events caused by chemotherapy and manage pain control and symptoms. We tracked changes in the quality and quantity of information on cancer patients provided by medical staff over 17 years in Kanazawa University Hospital. Methods: We questioned doctors and nurses about the same items in 1988, 1996 and 2005 and compared their replies. Results: Most doctors working on a gastroenterology ward did not reveal cancer diagnoses to patients in 1988 even for early stage cancer, but 70% of doctors did reveal early stage cancer diagnoses in 1996. In contrast, almost full disclosure was achieved irrespective of the stage of cancer progression in 2005. However, medical staff are now confronted with new issues including how long chemotherapy should be continued and planning strategy for the relief of pain and symptoms associated with cancer progression. Conclusion: Our 17-year investigation indicates that doctors provide a more detailed diagnosis in response to increased medical knowledge among patients, and pharmacists need to actively offer up their own opinions about continuation of chemotherapy or palliative care for managing pain and symptoms.
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論文
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安藤, 絹子 ; 橋本, 佳子 ; 吉野, 晴美 ; 橋本, 敦子
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