Mosaics to Clear - Truth Telling of Adolescent Cancer Patient

• Main Authors: Syun-Yue Wang, 王勛岳
• Other Authors: Pei-Jen Tsai
• Format: Others
• Language: zh-TW
• Published: 2017
• Online Access: http://ndltd.ncl.edu.tw/handle/8c2396

碩士 === 國立暨南國際大學 === 社會政策與社會工作學系 === 105 === In the professional value of social work principles, Autonomy has always been taken seriously. In response of “Patient Self-determination Right Act” passed recently, the health care system should develop more completely to maintain patients’ willing and dignity. Speaking of “Patient Self-determination Right Act”, the key to actually reaching it, is by telling them the truth of their illness. Researcher has found that the number of adolescent cancer patients is rising, but they haven’t been given due autonomy. Furthermore, literatures point out that adolescent cancer patients haven’t been fully informed of the illness because of their the parents’ anxiety. A part of this situation even became family disputes. Though, very less studies takes adolescent patients as subject, or knowing their feelings about “truth telling”. This research is a qualitative research, using semi - structured interviews as primary research method, in order to explore adolescent cancer patients’ experiences and feelings of truth telling, researcher made the parents and adolescents into pairs, the families’ concerns and their recommendations would also be discussed in this study. Finally, 11 valid interviews have been completed, including six teenagers and five the parents. Researcher used “Grounded theory” as the analysis mode, trying to find the response sample configuration homogeneity and to identify the type of truth telling mode. Adolescent cancer patients’ truth telling can be divided into “Confirmed moment” and “Daily communication”. First of all, except the medical team inform the patient directly without parental consent at the first moment, most of the parents will have some misgivings and hesitation about how to tell their children. Adolescents might question intensively or try to challenge their parents for acknowledging their illness. The pattern of confirmed moment truth telling can be subdivided into: “Direct informed type”, “Gradually informed type” and “Informed after lying type”. The pattern of daily communication truth telling can be subdivided into: “Patient autonomous communication mode”, “The parents helping autonomous mode” and “Parent proxy mode”. Researcher have found that if adolescents can participate more in the medical decision-making process, not only can make the autonomy rights of adolescents rise, but also can facilitate the communication quality for adolescents, the parents and medical teams. The parents can also reduce anxiety and self-accusation while acting as the agent of their own children. In the part of suggestions and expectations, the parents and the adolescents considered that truth telling should be: "Direct and open", " Detailed and clear ", "Kind and positive" and "Respect individual differences". Through these methods, we can make truth telling more smoothly and reduce emotional stress to those families. In addition, Researcher also found that: (1) Adolescents' cognitive is quite mature, they might know the truth of illness when the parents are still hesitating. That is, lying, procrastinating and perfunctory are not good ways. (2) Emergencies are good opportunities to communicate with adolescents. Through the discussion, it can effectively help adolescents alleviate their anxiety and reach medical consensus. (3) Moreover, this study have found that manuals, disease publications and social workers’ supports were also useful for truth telling. Otherwise, because of the fact that web search function is quite convenient now, developing the correct network information should be taken into consideration in the future.