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对放射治疗的情绪反应。

Emotional reactions to radiation treatment.

作者信息

Peck A, Boland J

出版信息

Cancer. 1977 Jul;40(1):180-4. doi: 10.1002/1097-0142(197707)40:1<180::aid-cncr2820400129>3.0.co;2-5.

Abstract

Fifty patients sent to the Radiotherapy Service of the Mount Sinai Medical Center of New York City were interviewed by a psychiatrist. The focus of the initial interview was what they were told when referred for radiation. Although 60% were told by their doctors they had cancer, all arrived at the treatment center unprepared for the frequency, number, and procedure of treatment and for the efficacy of treatment by radiation. Patients believed that requiring radiation was very bad news. Radiation was feared as inherently damaging and quite possibly carcinogenic. Few expected it to be curative. Interviews after completing treatment revealed an incidence of depression and anxiety even greater than in the pre-treatment interviews, indicating that radiation treatment is stressful in itself. Fewer than one-third judged themselves improved by radiation. More than one-third felt worse and judged treatment to have been ineffective, not realizing their new distress resulted from side effects of radiation. Patients suffer irrational fears of damage and death because of erroneous preconceptions of radiation which doctors fail to correct. Ironically, the lay and medical concepts of the dismal manifestations and futility of radiation treatment are entirely false. In this series, only one patient suffered damage due to radiation. Sixty percent were free of signs of cancer at follow-up 18-36 months later.

摘要

一位精神科医生对送往纽约市西奈山医疗中心放疗科的50名患者进行了访谈。初次访谈的重点是他们在被转介接受放疗时被告知的内容。尽管60%的患者被医生告知患有癌症,但所有患者在到达治疗中心时,对治疗的频率、次数、程序以及放疗的疗效都毫无准备。患者认为需要放疗是个非常糟糕的消息。放疗被视为具有内在伤害性且很可能致癌,因而令人恐惧。很少有人期望它能治愈疾病。治疗结束后的访谈显示,抑郁和焦虑的发生率甚至比治疗前的访谈更高,这表明放疗本身就会带来压力。不到三分之一的患者认为自己因放疗而有所改善。超过三分之一的患者感觉更糟,认为治疗无效,没有意识到他们新出现的痛苦是放疗副作用所致。由于医生未能纠正患者对放疗的错误先入之见,患者对伤害和死亡产生了不合理的恐惧。具有讽刺意味的是,外行和医学上关于放疗的可怕表现和无用性的观念完全是错误的。在这个系列中,只有一名患者因放疗受到伤害。18至36个月后的随访中,60%的患者没有癌症迹象。

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