Hasan MUTLU, Zeki AKCA, Benderli Yasemin CİHAN, Abdullah BÜYÜKÇELİK

The difficulty of saying cancer diagnosis to the patients with cancer

Kanser en çok korkulan hastalık grupları arasında üst sıralarda yer almaktadır. Kanser teşhisi konulan hastalar ve akrabaları ciddi şekilde etkilenmektedir. Bu noktada, doktorun tutumu ve hastaların istekleri değişebilebir. Yeni kanser teşhisi konan hastalara teşhis, öğrenme ve bilgilendirme süreçleri ile ilgili bir anket yapılmıştır. Kayseri Eğitim ve Araştırma Hastanesi Onkoloji Bölümüne başvurmuş ve yeni kanser teşhisi konmuş 200 hastaya tanı konması ve teşhisin söylenmesi ile ilgili aynı kişi tarafından toplam 6 adet soru sorulmuştur. Tanı amaçlı küçük ya da büyük cerrahi operasyon geçiren hastalardan %58,5i hasta olduklarından haberdar değildi. Hastalığından haberdar olmayan hastalardan %85i tanı konulduktan sonra tanıyı bilmek istemiştir. Hastalara söylenen tanısal işlemlerin en önemli sebebi %34,5 ile kitle idi. Ancak, hastalığından haberdar olmayan hastaların %33ü kanser olduklarını kendilerine söylenmeden sezdiklerini ifade etmişlerdir. Hastaların teşhisleri akrabaların tutumları ile, yapılan tıbbi müdahalelerle kendilerine söylenmemiş, bu görev tıbbi onkologlara bırakılmıştır. Her ne kadar hasta yakınları ve hatta hastaların kendileri de tanıdan haberdar olmadıklarını ifade etseler de hastaların en az %33ü durumu sezdiklerini dikkatli bir sorgulama ile ifade etmişlerdir.

Anahtar Kelimeler:

Kanser, tanı, tanının söylenmesi, tanıyı öğrenme isteği

Kanserli hastalara hastalıklarını söylemenin zorluğu

Cancer is located in the higher ranks of the most feared disease groups. The psychology of patients diagnosed with cancer and their relatives have significantly affected. At this stage, the attitude of doctor and requests of patients may change. A questionnaire about the diagnosis and the period of learning and being told to patients was applied to newly diagnosed cancer patients. A total of 6 questions about the stage of establishing diagnosis and being told to patients was asked to a total of 200 newly diagnosed patients and applied to Medical Oncology Department in Kayseri Education and Research Hospital for the first time in an appropriate environment by the same person. Of patients who have undergone minor or major surgical procedure for the diagnose, 58,5% did not know their disease. Of patients who did not know their disease, 85% wanted to know their diagnosis after the diagnosis was established. The most important reason for diagnostic procedures told to patients was mass with the rate of 34,5%. However, of the patients who did not know their disease, 33% stated that they intuited cancer as to be their diagnosis, although the diagnosis was not told them. The diagnosis of the patients are not told them with attitude of relatives, the patient and the physician although a number of examinations and interventional procedures, and this task is left to the medical oncologists. Although the patients' relatives and even patients' themselves say that they do not know their diagnosis, at least 33% of patients intuit their diagnosis if they are carefully interrogated.

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1. Parkin M, Psiani P, Ferlay J. Global cancer statistics. CA Cancer J Clin1999;49(1):33-64
2. Borgsteede SD, Deliens L, van der Wal G, Francke AL, Stalman WA, et al. Interdisciplinary cooperation of GPs in palliative care at home: A nationwide survey in the Netherlands. Scand J Prim Health Care 2007;25:226---31
3. Murray SA, Kendall M, Boyd K, Grant L, Highet G, Sheikh A
Archetypal trajectories of social, psychological, and spiritual wellbeing and distress in family care givers of patients with lung cancer: Secondary analysis of serial qualitative interviews. BMJ 2010;340:c2581
4. Johnsen AT, Petersen MA, Pedersen L, Groenvold M
Symptoms and problems in a nationally representative sample of advanced cancer patients. Palliat Med 2009;23:491---501 5. Brogaard T, Jensen AB, Sokolowski I, Olesen F, Neergaard MA. Who is the key worker in palliative home care? Scand J Prim Health Care 2011;29(3):150-6
6. Gözüm S, Akçay D. Response to the needs of Turkish chemotherapy patients and their families. Cancer Nurs
2005;28(6):469-75
7. M. Beccaro, M. Costantini, P.G. Rossi, G. Miccinesi, M
Grimaldi and P. Bruzzi, Actual and preferred place of death of cancer patients. Results from the Italian survey of the dying of cancer (ISDOC), J Epidemiol Community Health 2006;60:412--- 416
8. Lobb E.A., Butow P.N., Meiser B. et al., Tailoring communication in consultations with women from high risk breast cancer families, Br J Cancer 2002;87;502---508
9. Durusoy R, Karaca B, Junushova B, Uslu R. Cancer patients' satisfaction with doctors and preferences about death in a university hospital in Turkey. Patient Educ Couns 2011;85(3):e285-90
10. Chen S.C., Lai Y.H., Liao C.T., Chang J.T.G., Lin C.C. Unmet information needs and preferences in newly diagnosed and surgically treated oral cavity cancer patients, Oral Oncol 2009;45:946---952
11. Karaöz B, Aksu H, Küçük M. A qualitative study of the information needs of premenopausal women with breast cancer in terms of contraception, sexuality, early menopause, and fertility. Int J Gynaecol Obstet 2010;109(2):118-20
12. Ozbayir T, Malak AT, Bektas M, Ilce AO, Celik GO
Information needs of patients with meningiomas. Asian Pac J Cancer Prev 2011;12(2):439-41
13. Oskay-Özcelik G., Lehmacher W., Könsgen D., Christ H., Kaufmann M.,Lichtenegger W., et al., Breast cancer patients expectations in respect of the physician---patient relationship and treatment management results of a survey of 617 patients, Ann Oncol 2007;18:479---484