Doctor-Patient Communication without Family Is Most Frequently Practiced in Patients with Malignant Tumors in Home Medical Care Settings

Doctor-Patient Communication without Family Is Most Frequently Practiced in Patients with Malignant Tumors in Home Medical Care Settings

TAKUMA KIMURA,^1,2 TERUHIKO IMANAGA² and MAKOTO MATSUZAKI³

¹Department of General Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
²Department of General Medicine, National Hospital Organization, Higashisaitama Hospital, Hasudai, Saitama, Japan
³Toho University School of Medicine, Center for Clinical Training and Education, Tokyo, Japan

Promotion of home medical care is absolutely necessary in Japan where is a rapidly aging society. In home medical care settings, triadic communications among the doctor, patient and the family are common. And “communications just between the doctor and the patient without the family” (doctor-patient communication without family, “DPC without family”) is considered important for the patient to frankly communicate with the doctor without consideration for the family. However, the circumstances associated with DPC without family are unclear. Therefore, to identify the factors of the occurrence of DPC without family, we conducted a cross-sectional mail-in survey targeting 271 families of Japanese patients who had previously received home medical care. Among 227 respondents (83.8%), we eventually analyzed data from 143, excluding families of patients with severe hearing or cognitive impairment and severe verbal communication dysfunction. DPC without family occurred in 26.6% (n = 38) of the families analyzed. A multivariable logistic regression analysis was performed using a model including Primary disease, Daily activity, Duration of home medical care, Interval between doctor visits, Duration of doctor's stay, Existence of another room, and Spouse as primary caregiver. As a result, DPC without family was significantly associated with malignant tumor as primary disease (OR, 3.165; 95% CI, 1.180-8.486; P = 0.022). In conclusion, the visiting doctors should bear in mind that the background factor of the occurrence of DPC without family is patient's malignant tumors.

keywords —— communication; doctor; family; home medical care; patient

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Tohoku J. Exp. Med., 2014, 232, 21-26

Correspondence: Takuma Kimura, Department of General Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan.

e-mail: takumak@med.kitasato-u.ac.jp