Küchler T, Wood-Dauphinée S
University of Hamburg Hospital Centre, West Germany.
Physiother Can. 1991 Fall;43(4):19-23.
Physical therapists are frequently called upon to aid in the physical rehabilitation of cancer patients. They also share responsibility for the psychosocial aspects of care with other members of the treatment team. The objective of this paper is to provide guidelines to assist physical therapists in providing psychosocial support to cancer patients referred for therapy around the time of diagnosis or during the initial treatment period. Normal and pathological responses of patients faced with the diagnosis and treatment of cancer, including shock, fear, anger, anxiety and depression, are noted. Special attention is given to the importance of common defense mechanisms--denial, regression, rationalization and projection--and the difficulties faced by caregivers in dealing with these defenses. Principles of psychosocial intervention appropriate for use by physical therapists are presented. Two general types are suggested: the first concerns the patient's responses and feelings about the disease and the second involves educating the patient about how to most effectively deal with the disease. Physical therapists have an obligation to provide more than physical restorative services for cancer patients; they should be able to offer psychosocial support in an effort to enhance successful rehabilitation and reintegration to normal living patterns.
物理治疗师经常被要求协助癌症患者进行身体康复。他们还与治疗团队的其他成员共同承担护理过程中的心理社会方面的责任。本文的目的是提供指导方针，以帮助物理治疗师在癌症患者诊断前后或初始治疗期间为前来接受治疗的患者提供心理社会支持。文中指出了患者面对癌症诊断和治疗时的正常和病理反应，包括震惊、恐惧、愤怒、焦虑和抑郁。特别关注常见防御机制——否认、退行、合理化和投射——的重要性，以及护理人员在应对这些防御机制时所面临的困难。文中介绍了适合物理治疗师使用的心理社会干预原则。建议采用两种一般类型：第一种涉及患者对疾病的反应和感受，第二种涉及教育患者如何最有效地应对疾病。物理治疗师有义务为癌症患者提供的不仅仅是身体恢复服务；他们应该能够提供心理社会支持，以努力加强成功康复并重新融入正常生活模式。
