Brenner Keri O, Nathanson Abigail, Sławkowski-Rode Mikołaj
Palliative Care Attending, Stanford School of Medicine, Stanford, CA.
New York University, New York, NY.
Am Soc Clin Oncol Educ Book. 2025 Jun;45(3):e482244. doi: 10.1200/EDBK-25-482244. Epub 2025 May 21.
This article comprises three integrated sections exploring the multidimensional suffering experienced in oncology-from the perspective of both patients and health care professionals. It explores how oncology clinicians can better understand, address, and accompany the suffering of patients with advanced illness and what resources the patients themselves may appeal to when facing a terminal diagnosis. Section 1 outlines a clinical framework for attending to patient suffering when there is no cure, emphasizing psychologic formulation, attunement, and countertransference as therapeutic tools. Section 2 addresses provider overwhelm and distress in response to patient grief, with strategies grounded in neuroscience, meaning making, and emotional regulation. Section 3 considers attending to suffering in oncology in the context of spirituality and focuses in particular on when patients and providers are unable to draw support from religious belief. Together, these insights offer a narrative-driven, psychologically attuned, and spiritually inclusive approach to care.
本文由三个相互关联的部分组成,从患者和医护人员的角度探讨了肿瘤学中所经历的多维度痛苦。它探讨了肿瘤临床医生如何更好地理解、应对和陪伴晚期疾病患者的痛苦,以及患者在面对终末期诊断时可能求助于哪些资源。第一部分概述了在无法治愈的情况下关注患者痛苦的临床框架,强调心理分析、共鸣和反移情作为治疗工具。第二部分探讨了医护人员因患者悲伤而产生的倦怠和困扰,并提出了基于神经科学、意义构建和情绪调节的应对策略。第三部分在灵性背景下考虑肿瘤学中的痛苦问题,特别关注患者和医护人员无法从宗教信仰中获得支持的情况。这些见解共同提供了一种以叙事为驱动、心理上协调一致且在灵性上包容的护理方法。