Philip J, Gold M, Schwarz M, Komesaroff P
Palliative Care Service, The Alfred Hospital, Melbourne, Victoria, Australia.
Intern Med J. 2007 Jan;37(1):49-55. doi: 10.1111/j.1445-5994.2006.01236.x.
Anger in patients and families is a common problem in the care of persons with advanced disease. Whereas it is widely accepted that anger may be a justifiable reaction to significant illness and loss, it frequently creates difficulties for the doctors involved in care. In particular, there is often a personal impact on the doctor at whom anger is directed. This paper examines results of qualitative research with palliative care workers in the context of the broader published literature and the authors' clinical experiences. The ability to interact effectively with angry patients is a skill that is often learned with experience and is extremely useful in both transforming the patients' reaction into a more creative emotion and in developing a therapeutic relationship. Despite conscientious efforts, however, a few patients continue to be angry. A practical approach to anger, useful for the clinician directly involved in care, is outlined along with some strategies to adopt in the face of persistent anger.
患者及其家属的愤怒是晚期疾病患者护理中的常见问题。虽然人们普遍认为愤怒可能是对重大疾病和损失的合理反应，但它常常给参与护理的医生带来困难。特别是，愤怒所针对的医生往往会受到个人影响。本文结合更广泛的已发表文献和作者的临床经验，审视了对姑息治疗工作者进行定性研究的结果。与愤怒的患者有效互动的能力是一项通常通过经验习得的技能，在将患者的反应转化为更具建设性的情绪以及建立治疗关系方面都非常有用。然而，尽管付出了认真的努力，仍有一些患者持续愤怒。本文概述了一种对直接参与护理的临床医生有用的应对愤怒的实用方法，以及面对持续愤怒时可采用的一些策略。
