Bryant L H, Heiney S P, Henslee-Downey P J, Cornwell P
University of South Carolina School of Medicine, Columbia, USA.
Cancer Pract. 1997 Jul-Aug;5(4):234-40.
The authors describe a proactive model of psychosocial care for patients undergoing blood or marrow transplantation and their families.
This program for blood or marrow transplantation patients, developed at the Center for Cancer Treatment and Research, Richland Memorial Hospital, and the University of South Carolina School of Medicine in Columbia, South Carolina, involves pretransplant comprehensive psychosocial assessment; development and implementation of an individual psychosocial treatment plan; monitoring and medical management of neuropsychiatric problems; and psychotherapeutic sessions with a psychiatrist. These functions are achieved through the use of a multidisciplinary psychosocial team and ongoing consultation-liaison with the entire blood or marrow transplantation team.
This positive, proactive model demonstrates significant benefit to patients, families, and the blood or marrow transplantation healthcare team. Benefits of this model are derived from psychosocial assessment during work-up, subsequent planning, and communication with the entire team, thus allowing early identification of problems and avoiding escalation and the likelihood of negative outcomes. Less energy is exerted and less resources expended when problems are resolved with early intervention rather than with intensive interventions during transplant. The psychosocial staff members develop strong relationships with patients and families before transplant, increasing the power of interventions and receptivity of the patient. The blood or marrow transplantation team benefits from the ongoing presence of psychosocial staff and the consistency of approaches offered by team members. An integral part of this approach is teaching psychosocial care to all staff members and modeling approaches to problems. Other blood or marrow transplantation centers and centers providing other intensive anticancer therapies may benefit by adapting this model into the day-to-day care of their patients.
作者描述了一种针对接受血液或骨髓移植的患者及其家属的积极主动的心理社会护理模式。
该针对血液或骨髓移植患者的项目由南卡罗来纳州哥伦比亚市的里奇兰纪念医院癌症治疗与研究中心以及南卡罗来纳大学医学院开发，包括移植前全面的心理社会评估；制定并实施个性化心理社会治疗计划；监测和医疗管理神经精神问题；以及与精神科医生进行心理治疗。这些功能通过多学科心理社会团队的使用以及与整个血液或骨髓移植团队持续的会诊联络来实现。
这种积极主动的模式对患者、家属以及血液或骨髓移植医疗团队都显示出显著益处。该模式的益处源于在检查、后续规划过程中的心理社会评估以及与整个团队的沟通，从而能够早期发现问题并避免问题升级以及负面结果的可能性。当通过早期干预而非在移植期间进行强化干预来解决问题时，消耗的精力更少，资源也更少。心理社会工作人员在移植前与患者及其家属建立了牢固的关系，增强了干预的效果以及患者的接受度。血液或骨髓移植团队受益于心理社会工作人员的持续参与以及团队成员提供的方法的一致性。这种方法的一个重要组成部分是向所有工作人员传授心理社会护理知识并为解决问题树立榜样。其他血液或骨髓移植中心以及提供其他强化抗癌治疗的中心，通过将该模式应用于患者的日常护理中可能会受益。
