Hottensen Dory
Weill Cornell Medical Center, New York-Presbyterian Hospital, New York City, USA.
Clin J Oncol Nurs. 2010 Feb;14(1):106-7. doi: 10.1188/10.CJON.106-107.
Patients and their loved ones often experience anticipatory grief when learning of a diagnosis of advanced or terminal cancer. Anticipatory grief can be a response to threats of loss of ability to function independently, loss of identity, and changes in role definition, which underlie fear of death. Dealing with multiple losses is a primary task that the dying patient must face. When an oncologist delivers bad news, the patient and family members often hear the same discussion through different filters, which can lead to conflict and dysfunction. By providing a supportive and safe environment, oncology nurses can help patients and their loved ones understand that their feelings are common and are experienced by others in similar situations and assist them with developing coping strategies and in redefining their roles within the family and in the outside world. In addition, an important goal at this time is to help the patients reframe "hope" realistically so they may have the opportunity for personal growth as well as reconciliation of primary relationships toward the end of life.
当得知自己被诊断为晚期或终末期癌症时,患者及其亲人常常会经历预期性悲伤。预期性悲伤可能是对失去独立生活能力、身份丧失以及角色定义改变等威胁的一种反应,而这些正是对死亡恐惧的根源。应对多重丧失是临终患者必须面对的首要任务。当肿瘤学家告知坏消息时,患者和家庭成员往往会通过不同的“滤镜”听到同样的讨论,这可能导致冲突和功能失调。通过提供一个支持性和安全的环境,肿瘤护理人员可以帮助患者及其亲人明白,他们的感受很常见,其他处于类似情况的人也会有同样的感受,并协助他们制定应对策略,重新定义他们在家庭和外部世界中的角色。此外,此时的一个重要目标是帮助患者现实地重塑“希望”,以便他们在生命末期有机会实现个人成长,并修复主要人际关系。