Söllner W, Zingg-Schir M, Rumpold G, Mairinger G, Fritsch P
Department of Medical Psychology and Psychotherapy, Leopold-Franzens-University of Innsbruck, Austria.
Psychother Psychosom. 1998;67(2):94-104. doi: 10.1159/000012266.
The aim of the study was to identify melanoma patients who suffered significant distress and were judged to be in need of supportive counselling, on the one hand, and, on the other, to investigate patient interest in such support.
Out of 236 melanoma patients, who constitute a representative sample of melanoma patients in Western Austria, 215 patients participated in the study and were assessed with regard to psychosocial distress, coping strategies, social networks and interest in receiving psychosocial support. Multiple logistic regression analyses were performed with regard to patient interest in receiving psychosocial support either from the attending oncologist or from a mental health professional.
65 patients (30.2%) experienced moderate and 30 patients (14.0%) severe distress, which was predominantly caused by tumour-related fears, tension and disturbance of emotional well-being. 83% of the severely distressed patients wanted psychosocial support from their oncologists, whereas only half of them were interested in additional support from a psychotherapist. In particular, patients who showed fear of tumour progression and felt that they were insufficiently informed about their disease preferred to consult their dermatologist for psychosocial support. On the other hand, patients with poor prognosis, receiving only low levels of support from their social network, and exhibiting a depressive coping style, showed interest in getting supplementary support from a psychotherapist.
These findings underline the importance of educating oncologists with a view both to improve their communication skills and to help them identify patients making poor adjustment to illness in order to offer them appropriate emotional support.
本研究的目的一方面是识别出遭受严重困扰且被判定需要支持性咨询的黑色素瘤患者,另一方面是调查患者对这种支持的兴趣。
在构成奥地利西部黑色素瘤患者代表性样本的236名黑色素瘤患者中,215名患者参与了研究,并在心理社会困扰、应对策略、社会网络以及接受心理社会支持的兴趣方面接受了评估。针对患者从主治肿瘤学家或心理健康专业人员那里接受心理社会支持的兴趣进行了多项逻辑回归分析。
65名患者(30.2%)经历了中度困扰,30名患者(14.0%)经历了重度困扰,这主要是由与肿瘤相关的恐惧、紧张以及情绪幸福感的扰乱所导致的。83%的重度困扰患者希望从他们的肿瘤学家那里获得心理社会支持,而其中只有一半的人对来自心理治疗师的额外支持感兴趣。特别是,那些表现出对肿瘤进展恐惧且觉得自己对疾病了解不足的患者更倾向于向皮肤科医生咨询心理社会支持。另一方面,预后较差、从其社会网络获得的支持水平较低且表现出抑郁应对方式的患者,对从心理治疗师那里获得补充支持表现出兴趣。
这些发现强调了培训肿瘤学家的重要性,以便一方面提高他们的沟通技巧,另一方面帮助他们识别出对疾病适应不良的患者,从而为他们提供适当的情感支持。