Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts.
Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
Pediatr Blood Cancer. 2019 Jun;66(6):e27699. doi: 10.1002/pbc.27699. Epub 2019 Mar 8.
Children with cancer and their families deal with uncertainty throughout their treatment course. Clinicians must help patients and families manage uncertainty by engaging them in discussions about their worries and fears. Too often, clinicians avoid or defer discussions about anticipated or worried-about future events-the "what ifs." Failing to engage in these conversations may lead to increased distress. We have developed a framework for having "what if" conversations with patients and families that enables providers to explore families' informational and emotional needs. This framework may enable providers to improve families' prognostic understanding, explore concerns, and examine preferences and goals of care.
儿童癌症患者及其家庭在整个治疗过程中都会面临不确定性。临床医生必须通过与患者和家庭讨论他们的担忧和恐惧来帮助他们应对不确定性。临床医生经常回避或推迟讨论预期或担心的未来事件——“如果......怎么办”。不进行这些对话可能会导致更多的痛苦。我们已经制定了一个与患者和家庭进行“如果......怎么办”对话的框架,使提供者能够探索家庭的信息和情感需求。该框架可以帮助提供者改善家庭对预后的理解,探讨关注点,并检查护理的偏好和目标。