Ezhova Ivanka, Martinez Nicole, Ciais Catherine, Fogliarini Anne, Cherikh Faredj, Coso Diane, Peyrade Frédéric
Centre Antoine-Lacassagne, Département des soins de support, 33 avenue de Valombrose, 06189 Nice Cedex, France.
Institut Paoli-Calmettes, Département d'hématologie, 13009, Marseille, France.
Bull Cancer. 2014 Jun;101(6):564-70. doi: 10.1684/bdc.2014.1920.
Announcement of diagnosis is a critical step in establishing a trust-based relationship of quality between patient and physician. Disclosing "bad news" is a difficult and sensitive task which has direct consequences on psychological, emotional and relational levels, as well as on therapeutic management. This is a potentially traumatic experience which requires a long process of integration and psychological adaptation. The hematologist-oncologist occupies a central position: He introduces the framework for a multidisciplinary care, while taking into account the personality and behavior of the teenager or young adult. We propose an analysis of doctor-patient interaction; an overview of psychological issues associate with diagnosis disclosure; suggestions to build and manage communication with patients; and a clarification of the role of the psychologist and of the psychological adjustment at the time of disclosure.
诊断告知是在患者与医生之间建立基于信任的优质关系的关键一步。透露“坏消息”是一项困难且敏感的任务,会对心理、情感和人际关系层面以及治疗管理产生直接影响。这是一次可能造成创伤的经历,需要漫长的整合和心理适应过程。血液肿瘤学家处于核心地位:他引入多学科护理框架,同时考虑青少年或年轻成年人的个性和行为。我们提出对医患互动进行分析;概述与诊断告知相关的心理问题;给出与患者建立和管理沟通的建议;并阐明心理学家的角色以及告知诊断时心理调适的作用。