Division of Clinical Psychology, University of Liverpool, Liverpool, UK.
Psychooncology. 2013 Jun;22(6):1402-10. doi: 10.1002/pon.3156. Epub 2012 Aug 14.
To investigate the readiness of patients to address emotional needs up to 18 months following a diagnosis of breast, lung or prostate cancer.
Patients (N = 42) attending pre-treatment, treatment and follow-up clinics were provided with information designed to help them manage their emotional reactions to cancer. Patients were interviewed 3-4 weeks later about their emotional experience of cancer and their attitudes towards managing emotional problems. Qualitative data analysis followed a constant comparative approach.
Patients early in the cancer trajectory, who had not yet been engaged in chemotherapy or radiotherapy, described emotional distress as a temporary and understandable reaction that did not warrant professional intervention. They valued knowing that support was available, but did not want to use it, and were reluctant to acknowledge or address emotional needs. Conversely, patients currently or recently engaged in treatment readily acknowledged their emotional needs and welcomed help to address these.
Drawing on social cognitive and other theories, we suggest that engagement in physical treatment and care allows patients to address emotional needs following a cancer diagnosis. Guidance that emotional needs should routinely be assessed and addressed at key points in the cancer trajectory should therefore be implemented cautiously when patients are only recently diagnosed; psychological intervention may be less appropriate at this time than later.
调查乳腺癌、肺癌或前列腺癌诊断后 18 个月内患者解决情绪需求的准备情况。
为参加治疗前、治疗中和随访诊所的患者提供了旨在帮助他们管理对癌症的情绪反应的信息。在 3-4 周后,对患者进行了有关他们对癌症的情绪体验和对管理情绪问题的态度的访谈。定性数据分析采用了恒定比较方法。
癌症早期阶段、尚未接受化疗或放疗的患者将情绪困扰描述为一种暂时的、可以理解的反应,不需要专业干预。他们重视知道支持是可用的,但不想使用它,并且不愿意承认或解决情绪需求。相反,目前或最近正在接受治疗的患者欣然承认自己的情绪需求,并欢迎帮助解决这些问题。
借鉴社会认知和其他理论,我们认为,接受身体治疗和护理使患者能够在癌症诊断后解决情绪需求。因此,当患者刚被诊断时,应谨慎实施在癌症轨迹的关键节点上常规评估和解决情绪需求的指导;在这个时候,心理干预可能不如以后更合适。