Armstrong Jennifer, Holland Jimmie
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Oncology (Williston Park). 2004 Mar;18(3):363-8; discussion 373-5.
Oncologists grapple with an element of psychological stress that relates to the suffering their patients experience. Although this stress may not be unique to oncology, it is profound. When these stresses become overwhelming, they lead to physician burnout. It is important to understand what makes an oncologist feel successful, what coping strategies help combat burnout, and what adds to the process of renewal. The doctor-patient relationship plays an important role for many oncologists in this regard, and communication skills are increasingly recognized for their importance in this arena. We outline several clinical scenarios that pose particular challenges to oncologists. These include breaking bad news and the patient's response to hearing bad news, transitions in care and offering end-of-life care, participation in investigational studies, error disclosure, complementary and alternative medicine, spirituality, family discussions, and cross-cultural issues. By highlighting the relevant psychosocial issues, we offer insight into, and tools for, an enriched dialogue between patient and oncologist. The doctor-patient relationship can be viewed as the ultimate buffer for dealing with the hassles encountered in clinical oncology.
肿瘤学家面临着与患者所经历的痛苦相关的心理压力因素。尽管这种压力可能并非肿瘤学所特有，但却非常严重。当这些压力变得难以承受时，就会导致医生职业倦怠。了解是什么让肿瘤学家感到成功、哪些应对策略有助于对抗职业倦怠以及什么有助于恢复过程非常重要。在这方面，医患关系对许多肿瘤学家起着重要作用，而沟通技巧在这个领域的重要性也越来越受到认可。我们概述了几种给肿瘤学家带来特殊挑战的临床场景。这些包括告知坏消息以及患者听到坏消息后的反应、护理过渡和提供临终关怀、参与研究性试验、错误披露、补充和替代医学、精神层面、家庭讨论以及跨文化问题。通过突出相关的社会心理问题，我们为医患之间更丰富的对话提供了见解和工具。医患关系可被视为应对临床肿瘤学中遇到的麻烦的最终缓冲。
