Weisman A D
Psychiatry. 1981 May;44(2):161-8. doi: 10.1080/00332747.1981.11024101.
Comprehensive cancer care is a combination of tumor treatment with understanding the special concerns and needs of cancer patients. To understand the psychosocial problems of cancer patients requires knowledge of protocol (treatment of the tumor), plight (nonmedical ramifications of cancer), and promise (the caregiver's view of the patient's predicament). Caregivers can sometimes be more distressed by the plight of their patients than are patients themselves. In extreme instances, their vulnerability leads to what is called "Caregiver's Plight," a set of responses which interfere with adequate understanding and may result in progressive vocational demoralization, change to another field, and drastic impairment of self-esteem. Therapeutic suggestions for identifying and correcting caregiver's plight are proposed, including knowing how to cope better and how much to promise, sharing concern with colleagues, attempting to make smaller contributions, and using an exercise called the "Absent Witness," an imaginary self-monitoring review.
综合癌症护理是将肿瘤治疗与理解癌症患者的特殊担忧和需求相结合。要理解癌症患者的心理社会问题，需要了解治疗方案（肿瘤治疗）、困境（癌症的非医学影响）和希望（护理人员对患者困境的看法）。有时，护理人员可能比患者自身更因患者的困境而痛苦。在极端情况下，他们的脆弱性会导致所谓的“护理人员困境”，这是一系列会干扰充分理解的反应，可能导致职业上的逐渐士气低落、转投其他领域以及自尊的严重受损。文中提出了识别和纠正护理人员困境的治疗建议，包括知道如何更好地应对以及给予多少希望、与同事分担担忧、尝试做出较小的贡献，以及运用一种名为“缺席见证者”的练习，即一种想象中的自我监督审视。
