Timmermans Liesbeth M, van Zuuren Florence J, van der Maazen Richard W M, Leer Jan Willem H, Kraaimaat Floris W
Department of Medical Psychology, Radboud University Nijmegen Medical Centre, The Netherlands.
Psychooncology. 2007 Dec;16(12):1111-20. doi: 10.1002/pon.1177.
The present research paper investigates how cancer patients' monitoring and blunting coping styles are reflected in their communications during their initial radiotherapy consultations and in their evaluations of the consultation. Additionally, it is explored how a patient's disease status (curative versus palliative) influences the effects of his or her cognitive styles.
The study included 116 oncology patients receiving treatment from eight radiation oncologists. For 56 patients treatment intent was palliative and for the remaining 60 curative. The patients' communicative behaviors were assessed using the Roter Interaction Analysis System (RIAS). Within three days the patients completed a monitoring and blunting inventory and after another six weeks they evaluated the treatment decision and treatment information by postal questionnaire.
Monitoring was positively and blunting negatively related to the patient's expression of questions, emotions and decision-making issues. After six weeks 'high monitors' as opposed to 'low monitors' reported having more doubts about the treatment decision and being less satisfied with the information received while 'high blunters' expressed fewer doubts and more satisfaction than 'low blunters' did. Significant associations were all attributable to the palliative treatment group.
Cancer patients' communicative behaviors vis-à-vis their oncologist hinge on their cognitive styles and an unfavorable disease status enhances the effects.
本研究探讨癌症患者的监控和钝化应对方式如何在其首次放疗咨询期间的沟通以及对咨询的评估中得到体现。此外，还探究了患者的疾病状态（治愈性与姑息性）如何影响其认知方式的效果。
该研究纳入了116名接受8位放射肿瘤学家治疗的肿瘤患者。其中56名患者的治疗目的是姑息性的，其余60名是治愈性的。使用罗特互动分析系统（RIAS）评估患者的沟通行为。患者在三天内完成一份监控和钝化量表，再过六周后通过邮寄问卷对治疗决策和治疗信息进行评估。
监控与患者对问题、情绪和决策问题的表达呈正相关，钝化则呈负相关。六周后，与“低监控者”相比，“高监控者”对治疗决策的疑虑更多，对所获信息的满意度更低；而“高钝化者”比“低钝化者”的疑虑更少，满意度更高。所有显著关联均归因于姑息治疗组。
癌症患者与肿瘤医生沟通时的行为取决于其认知方式，不利的疾病状态会增强这种影响。
