BEHAVIORAL OBSERVATIONS ON PARENTS ANTICIPATING THE DEATH OF A CHILD.
BEHAVIORAL OBSERVATIONS ON PARENTS ANTICIPATING THE DEATH OF A CHILD.
复制标题
对父母预期孩子死亡的行为观察。
DOI：
10.1001/jama.1963.03710080111117
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发表时间：
1963
期刊：
影响因子：
8
通讯作者：
D. Hamburg
中科院分区：
文献类型：
--
作者：
S. B. Friedman;P. Chodoff;J. Mason;D. Hamburg
在医学实践中，很少有任务比帮助患有致命疾病的孩子的父母更困难的了。由于医生无法改变悲惨处境的现实，他经常感到完全无法减轻父母的痛苦。然而，了解父母所经历的压力的性质，并认识到他们应对这种情况的独特方式，应该能让医生在大多数情况下提供有用的支持。美国国立卫生研究院 (NIH) 参与了一项关于慢性心理压力条件下肾上腺皮质反应的 46 名患有肿瘤疾病的儿童的家长参与的研究，这项工作已在其他地方报道过。1 本文关注的是这项研究进行期间两年内获得的临床印象，以及这些发现对照顾患有类似疾病的儿童的医生的意义，补充了目前的文献。2-8 主题和概述研究方法 46 名受试者代表 27 名儿童的父母一方或双方，所有儿童均被转诊至国家癌症研究所医学分部接受化疗药物治疗。在所有情况下，孩子之前都曾在其他地方住院接受临床评估，转诊建议最常由医生在向父母传达诊断结果时提出。在少数情况下，转诊事宜是在孩子临床病程后期才开始的。
There are few tasks in the practice of medicine as difficult as trying to help the parents of a child afflicted with a disease which is invariably fatal. Since the physician cannot change the reality of the tragic situation, he frequently feels totally unable to lessen the parental suffering. However, understanding the nature of the stress as experienced by the parents, and appreciating that there are characteristic ways in which they cope with the situation, should enable the physician to offer helpful support in a majority of cases. Forty-six parents of children with neoplastic disease were involved at the National Institutes of Health (NIH) in a study of the adrenal cortical response under conditions of chronic psychological stress and this work has been reported elsewhere.1 The present paper is concerned with the clinical impressions gained over a 2-year period while this study was in progress and the implication of these findings to physicians caring for children with similar diseases, adding to what is presently in the litenature.2-8 SUBJECTS AND GENERAL METHOD OF STUDY The 46 subjects represented one or both parents of 27 children, all of whom had been referred for treatment with chemotherapeutic agents to the Medicine Branch of the National Cancer Institute. In all cases, the child had previously been hospitalized elsewhere for clinical evaluation, and the suggestion for referral was most frequently made by a physician at the time he communicated the diagnosis to the parents. In a minority of cases, the matter of referral was initiated at a time later in the child9s clinical course.