Penson R T, Gallagher J, Gioiella M E, Wallace M, Borden K, Duska L A, Talcott J A, McGovern F J, Appleman L J, Chabner B A, Lynch T J
The Kenneth B. Schwartz Center at Massachusetts General Hospital, Hematology-Oncology Department, Boston, Massachusettts 02114-2617, USA.
Oncologist. 2000;5(4):336-44. doi: 10.1634/theoncologist.5-4-336.
Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded The Kenneth B. Schwartz Center at MGH. The Schwartz Center is a nonprofit organization dedicated to supporting and advancing compassionate health care delivery, which provides hope to the patient, support to caregivers, and encourages the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum where caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members. Psychosocial issues profoundly affect patients with cancer. Of the many complexities that make up the psychosocial dynamic, perhaps the medical profession is most uncomfortable with sexuality. Many elements of sexual behavior remain high-profile taboos. A number of diseases and treatments significantly affect sexual function. Male and female sexuality were discussed in two separate rounds with an emphasis on how to begin a dialogue about sexuality without jeopardizing other aspects of the relationship with patients. Three cases were presented. A patient with prostate cancer considering treatment options for early-stage disease and two patients with gynecologic malignancies; one with a colostomy following cytoreductive surgery for ovarian cancer and the other with a failed vaginal reconstruction for recurrent squamous cell carcinoma of the vagina. Staff discussed the wide diversity of response to sexual dysfunction and the difficulties that patients face. A sensitive and informed approach to discussing sexuality can provide effective support. The elements of successful dialogue are presented in the PLISSIT model.
1995年，马萨诸塞州综合医院（MGH）的癌症患者肯尼斯·B·施瓦茨在去世前不久，在MGH成立了肯尼斯·B·施瓦茨中心。施瓦茨中心是一个非营利组织，致力于支持和推进富有同情心的医疗服务，为患者带来希望，为护理人员提供支持，并促进康复过程。该中心主办施瓦茨中心研讨会，这是一个每月举行的多学科论坛，护理人员在此反思患者、其家人和护理人员所面临的重要社会心理问题，并从同事那里获得见解和支持。社会心理问题对癌症患者有深远影响。在构成社会心理动态的诸多复杂因素中，也许医学界对性问题最感到棘手。性行为的许多方面仍然是备受瞩目的禁忌。一些疾病和治疗方法会显著影响性功能。男性和女性的性问题在两场分别的研讨会上进行了讨论，重点是如何在不危及与患者关系的其他方面的情况下开启关于性问题的对话。会上介绍了三个病例。一名前列腺癌患者正在考虑早期疾病的治疗方案，还有两名妇科恶性肿瘤患者；一名在卵巢癌减瘤手术后进行了结肠造口术，另一名因复发性阴道鳞状细胞癌阴道重建失败。工作人员讨论了对性功能障碍的广泛多样的反应以及患者所面临的困难。一种敏感且明智的讨论性问题的方法可以提供有效的支持。成功对话的要素在PLISSIT模型中有所呈现。
