Department of General Oncology, MD Anderson Cancer Center, Houston, TX 77030, USA.
Support Care Cancer. 2011 Nov;19(11):1713-7. doi: 10.1007/s00520-010-1007-6. Epub 2010 Sep 19.
Patients with serious illness derive a sense of security by forming strong, healing relationships with their providers. These bonds are particularly strong in life-threatening illnesses, such as cancer, which carry the stigma of death and suffering. These strong relationships create expectations in patients that are not necessarily shared by their clinicians. Providers often focus on treating disease and emphasize technically excellent, "evidence-based" practice while failing to fully appreciate the power of the patient-provider relationship. In contrast, vulnerable patients expect much more than technical competence, including open and clear communication, security, continuity, and access. Patients are often left feeling abandoned when their providers do not meet their expectations, even when their care is technically sound.
METHODS/RESULTS: In this paper, we describe scenarios that can lead to feelings of abandonment and discuss strategies to avoid and respond to them.
These strategies can help us maintain healing relationships with our patients by maintaining their trust, confidence, and satisfaction. Cultivating relational aspects of medical practice requires an interchange and takes time. Experienced doctors know this and continue to do so because being present and staying with the patient during difficult times is a pillar of moral and ethical training and a fundamental attribute of a good physician.
重病患者通过与医护人员建立牢固的、有助于康复的关系而获得安全感。在危及生命的疾病中，这种关系尤为牢固，例如癌症，它带有死亡和痛苦的污名。这些牢固的关系使患者产生了一些期望，但这些期望并不一定为他们的临床医生所认同。医护人员往往专注于治疗疾病，并强调技术精湛、“基于证据”的实践，而未能充分认识到医患关系的力量。相比之下，弱势患者的期望远不止于技术能力，还包括开放、清晰的沟通、安全感、连续性和可及性。当患者的期望得不到满足时，即使他们的护理在技术上是合理的，他们也常常感到被抛弃。
方法/结果：在本文中，我们描述了可能导致被抛弃感的情况，并讨论了避免和应对这些情况的策略。
这些策略可以通过维护患者的信任、信心和满意度来帮助我们与患者保持治疗关系。培养医学实践中的关系方面需要交流和时间。有经验的医生知道这一点，并继续这样做，因为在困难时期的存在和陪伴是道德和伦理培训的支柱，也是优秀医生的基本属性。
