Krenz Sonia, Godel Cindy, Stagno Daniele, Stiefel Frederic, Ludwig Gundula
Psychiatric Liaison Service, University Hospital of Lausanne, Lausanne, Switzerland.
Psychooncology. 2014 Jan;23(1):75-80. doi: 10.1002/pon.3373. Epub 2013 Aug 23.
To investigate the focus of psychodynamic-oriented interventions in cancer patients by means of a qualitative analysis of the therapists' reports.
One hundred thirty-five reports collected within a controlled psychotherapy trial were analyzed; the themes addressed during the intervention were classified in categories reflecting the focus of the intervention and correlated with sociodemographic and medical data and type of intervention.
Twenty main themes were identified and classified in two categories: category 1 corresponded to interventions based on expression and support, and category 2 to interventions based on introspection, with subcategory 2.1 focusing on the patient's psychological functioning and subcategory 2.2 focusing on his way to engage and communicate in relationships. While the most frequently addressed theme was related to the diagnosis of cancer (N = 102/576; 22.6%), the majority of themes were related to other concerns (N = 446/576; 77.4%). Half of the interventions (50.4%) were classified in category 1, 27.4% in category 2.1, and 9.6% in category 2.2. Patients of category 1 entered less often brief psychotherapy (step 2 of the intervention) and more frequently suffered from advances disease.
A wide variety of themes are addressed in psychodynamic interventions in the oncology setting, illustrating that cancer is not the only focus of therapy. Other themes reflect different psychological difficulties triggered by the disease. This study illustrates that cancer patients have different needs, which surpass the event of the disease. Early clarification and comprehension of the demand may therefore be beneficial to adjust the therapeutic approach.
通过对治疗师报告的定性分析，研究以心理动力学为导向的癌症患者干预重点。
对在一项对照心理治疗试验中收集的135份报告进行分析；将干预期间涉及的主题分类，以反映干预重点，并与社会人口统计学和医学数据以及干预类型相关联。
确定了20个主要主题并分为两类：第1类对应基于表达和支持的干预，第2类对应基于内省的干预，其中2.1子类关注患者的心理功能，2.2子类关注患者在人际关系中的参与和沟通方式。虽然最常涉及的主题与癌症诊断有关（N = 102/576；22.6%），但大多数主题与其他问题有关（N = 446/576；77.4%）。一半的干预措施（50.4%）被归类为第1类，27.4%被归类为第2.1类，9.6%被归类为第2.2类。第1类患者较少进入短期心理治疗（干预的第二步），且更常患有晚期疾病。
肿瘤学环境中的心理动力学干预涉及广泛的主题，这表明癌症并非治疗的唯一重点。其他主题反映了该疾病引发的不同心理困难。这项研究表明癌症患者有不同的需求，这些需求超越了疾病本身。因此，尽早明确和理解这些需求可能有助于调整治疗方法。
