Penson Richard T, Kyriakou Helena, Zuckerman Dan, Chabner Bruce A, Lynch Thomas J
The Kenneth B. Schwartz Center at Massachusetts General Hospital, Department of Medicine, Boston, Massachusetts 02114-2617, USA.
Oncologist. 2006 May;11(5):520-6. doi: 10.1634/theoncologist.11-5-520.
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 that provides hope to the patient and 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. The evolving field of oncology increasingly requires a team of medical specialists working in unison to deliver optimal medical care. While this coordination may maximize the technical synergy of care, it can challenge interprofessional and interdisciplinary connections. Poor and miscommunication and conflicts between staff and between the family and providers adversely affect patient care and quality of life. Furthermore, lack of communication leaves a vacuum that sucks in fear. A recent Newsweek article highlighted the challenges of practicing in the age of high-tech medicine. The author had to beg for a prognosis for her critically ill and dying husband, with unhelpful subspecialists failing to communicate the bigger picture. This article explores the tough issue of how teams handle uncertainty and bad news and how patients and families can be better supported in the multifaceted paradigm of modern care.
1995年，马萨诸塞州总医院（MGH）的癌症患者肯尼斯·B·施瓦茨在去世前不久，在MGH创立了肯尼斯·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，并从其他工作人员那里获得见解和支持。不断发展的肿瘤学领域越来越需要一组医学专家协同工作，以提供最佳医疗护理。虽然这种协调可能会使护理的技术协同效应最大化，但它可能会对跨专业和跨学科的联系构成挑战。工作人员之间以及家属与医疗服务提供者之间沟通不畅和冲突会对患者护理和生活质量产生不利影响。此外，缺乏沟通会造成一种恐惧乘虚而入的真空状态。《新闻周刊》最近的一篇文章强调了在高科技医学时代行医所面临的挑战。作者不得不恳请为她身患重病、生命垂危的丈夫做出预后诊断，而那些无济于事的专科医生未能传达整体情况。本文探讨了团队如何应对不确定性和坏消息这一棘手问题，以及在现代护理的多方面模式中如何更好地支持患者及其家属。
