BACKGROUND: The traditional relationship between patient and physician in East Asian society has often been described as "paternalistic." However, in an increasingly Westernized world, our knowledge of how patients perceive the role of the physician in their decision making regarding treatment is lacking. OBJECTIVE: This article is part of a larger pilot study exploring the patient-physician dynamic on decision making among Southeast Asian palliative cancer patients. We explore: (1) influence of physicians, (2) the effect of symptom control and quality of life, and (3) dynamics and communication of physicians. DESIGN: An interviewer-administered questionnaire was distributed, with 18 questions related to physician-patient interactions asked. Most questions followed a three point scale: "agree," "neutral," and "disagree," and spontaneous answers beyond this framework were recorded. SETTING/PARTICIPANTS: Thirty patients from the palliative care service were interviewed, including inpatients at Singapore General Hospital and those attending outpatient clinics at the National Cancer Centre. RESULTS: Patients said that they themselves and their physicians were the main influences (80% each), over family members (48.3%). Some patients (26.7%) felt that symptoms were not well controlled, and 42.9% identified low mood or anxiety. Some patients (44.8%) felt that their condition had an effect on decision making. Most patients (89.3%) had a good relationship with the staff, with >80% being comfortable with discussions held. However, 20.7% of patients felt dissatisfied with the information provided, and 62.1% of patients wanted full disclosure of information. SIGNIFICANCE OF RESULTS: Patients appeared to place highest regard in both autonomy and physician input in making decisions, accompanied by an increased desire for more information. These reflect deviation away from traditional thinking of paternalistic doctoring in East Asia.
BACKGROUND: The traditional relationship between patient and physician in East Asian society has often been described as "paternalistic." However, in an increasingly Westernized world, our knowledge of how patients perceive the role of the physician in their decision making regarding treatment is lacking. OBJECTIVE: This article is part of a larger pilot study exploring the patient-physician dynamic on decision making among Southeast Asian palliative cancerpatients. We explore: (1) influence of physicians, (2) the effect of symptom control and quality of life, and (3) dynamics and communication of physicians. DESIGN: An interviewer-administered questionnaire was distributed, with 18 questions related to physician-patient interactions asked. Most questions followed a three point scale: "agree," "neutral," and "disagree," and spontaneous answers beyond this framework were recorded. SETTING/PARTICIPANTS: Thirty patients from the palliative care service were interviewed, including inpatients at Singapore General Hospital and those attending outpatient clinics at the National Cancer Centre. RESULTS:Patients said that they themselves and their physicians were the main influences (80% each), over family members (48.3%). Some patients (26.7%) felt that symptoms were not well controlled, and 42.9% identified low mood or anxiety. Some patients (44.8%) felt that their condition had an effect on decision making. Most patients (89.3%) had a good relationship with the staff, with >80% being comfortable with discussions held. However, 20.7% of patients felt dissatisfied with the information provided, and 62.1% of patients wanted full disclosure of information. SIGNIFICANCE OF RESULTS:Patients appeared to place highest regard in both autonomy and physician input in making decisions, accompanied by an increased desire for more information. These reflect deviation away from traditional thinking of paternalistic doctoring in East Asia.
Authors: Keith Zi Yuan Chua; Elaine Li Ying Quah; Yun Xue Lim; Chloe Keyi Goh; Jieyu Lim; Darius Wei Jun Wan; Simone Meiqi Ong; Chi Sum Chong; Kennan Zhi Guang Yeo; Laura Shih Hui Goh; Ray Meng See; Alexia Sze Inn Lee; Yun Ting Ong; Min Chiam; Eng Koon Ong; Jamie Xuelian Zhou; Crystal Lim; Simon Yew Kuang Ong; Lalit Krishna Journal: BMC Palliat Care Date: 2022-07-04 Impact factor: 3.113
Authors: Rui Song Ryan Ong; Ruth Si Man Wong; Ryan Choon Hoe Chee; Chrystie Wan Ning Quek; Neha Burla; Caitlin Yuen Ling Loh; Yu An Wong; Amanda Kay-Lyn Chok; Andrea York Tiang Teo; Aiswarya Panda; Sarah Wye Kit Chan; Grace Shen Shen; Ning Teoh; Annelissa Mien Chew Chin; Lalit Kumar Radha Krishna Journal: BMC Med Educ Date: 2022-06-17 Impact factor: 3.263
Authors: Eric A Finkelstein; Semra Ozdemir; Chetna Malhotra; Tazeen H Jafar; Hui Lin Choong; Johnny Suhardjono Journal: Kidney Int Rep Date: 2016-12-13