Early diagnosis of vulnerability in cancer patients
Early diagnosis of vulnerability in cancer patients
复制标题
癌症患者脆弱性的早期诊断
DOI：
10.1097/00000441-197603000-00007
复制
发表时间：
1976
期刊：
影响因子：
--
通讯作者：
A. Weisman
中科院分区：
文献类型：
--
作者：
A. Weisman
摘要：新诊断的CA患者既面临心理社会问题，又面临生理问题。为了评估诊断的影响，并为以后的情绪困扰寻找重要线索，对163名患有乳房、结肠、肺部、霍奇金氏病和恶性黑色素瘤的新患者进行了访谈、心理测试和人格问卷评估，然后定期随访6个月。脆弱性只是衡量情绪困扰和应对同时出现的问题的能力减弱的一个参数。研究发现，较脆弱的患者初诊时有更多的症状，且全身症状比CA的类型或分期更明显。高危患者普遍悲观，预计几乎不会康复，也几乎不会从重要的其他人那里获得支持。他们有更多的婚姻问题，倾向于压抑情绪，但经常有抑郁史。否认本身并不意味着脆弱。对治疗的犹豫不决和对过去的后悔更能预示未来的情感问题，而不是拖延。在整个观察期间，大多数患者几乎没有表现出否认，但更脆弱的患者往往在否认和接受之间摇摆不定。通过学习倾听和提出机智的问题，医生可以获得这些信息，然后进行有效的干预。
Abstract:The newly diagnosed CA patient faces psychosocial as well as physical problems. To assess the impact of diagnosis, and to find significant clues for later emotional distress, 163 new patients with CA of the breast, colon, lung, Hodgkin's disease, and malignant melanoma were evaluated by interviews, psychological testing, and personality inventories, then followed regularly for six months. Vulnerability was but one parameter that measured emotional distress and faltering capacity to cope with concurrent problems. It was found that the more vulnerable patients had more symptoms when first diagnosed, and that systemic symptoms were more significant than the type of CA or the staging. High vulnerability patients were generally pessimistic, anticipating little recovery and practically no support from significant others. They had more marital problems, tended to suppress feelings, but often had a history of depression. Denial in itself did not mean vulnerability. Indecision about treatment and regrets about the past were more indicative of future emotional problems than was delay. Most patients showed little denial throughout the period of observation, but more vulnerable patients tended to vacillate between denial and acceptance. By learning to listen and ask tactful questions, this information can be elicited by the physician who can then intervene effectively.