Talking about cancer

  Today, malignant tumors are still the first cause of death. It is a normal psychological reaction for patients to have negative emotions such as fear, helplessness, anger, anxiety, depression and even despair. However, considering the important influence of emotional factors in the occurrence, development and prognosis of tumors, how to alleviate the negative emotions of patients has become one of the problems that patients, family members and related professionals are eager to understand and solve.
  In the whole process of diagnosis, treatment and final rehabilitation, different patients will have different levels of adverse emotional reactions due to individual differences and surrounding support systems. Clinically, we often feel that it is difficult to communicate effectively with cancer patients. They often show negative emotions such as loneliness, suspiciousness, irritability, and anger. Some of these emotions are related to the disease itself, while others may be caused by improper communication.
  From thinking, emotion to behavior, step by step patient guidance, is to improve the courage and confidence of cancer patients, thereby improving the quality of life of patients and improving treatment compliance. Today, let’s take a look at these two typical cases by means of “on-site restoration”.
Pathological report “reverse”

■Case background

  The patient, female, 38 years old, had a sensation of irritability, crying, arrogance, anger and other emotional reactions after a partial resection of the left breast tumor. At the same time, she refused treatment and refused to communicate, which caused the normal order of the ward to be affected. The head nurse recommends providing psychological assistance to the patient.
■Consultation site

  Consultant: I heard that I am not happy recently. I hope to help you. Can you tell me what happened?
  Patient: (After a moment of silence) The report from the first outpatient to the pathological section of the operation told me that it was benign, but yesterday’s pathology report was not…
  Consultant: Oh, this is a blue sky, no thoughts. ready.
  Patient: I didn’t have a little mental preparation. I thought I could go home after I took the line.
  Consultant: Yes, I was able to leave the hospital the day after tomorrow.
  Patient: It is reasonable to say that this also blames others, and blames their own bad life.
  Consultant: It is not easy for you to think this way. There will always be or not the body that eats the rice. As long as we cooperate with the doctor, we will definitely recover.
  Patient: How do I cooperate with treatment? In addition to telling me so coldly that the official pathology report is not good, I need to perform an extended range of surgery, and nothing else. I hope that the doctor can tell me more about the situation and to be more detailed. Is this requirement excessive? I want to know how many situations like me do, how can it happen? The same is the pathology report, why is it different from the previous pathology report? What should I do next? Will the same problem occur again after the second surgery? Do you still need chemotherapy or radiotherapy?
  Consultant: Oh, it turned out to be the case. I am really sorry! It is our work that is not done well and does not feel your feelings. Your request is not excessive. If the doctor can tell you the details, I believe you will be able to accept it.
  Patient: I will accept it. I know that they are very busy, very hard, and sometimes they have to work late to get off work.
  Consultant: Thank you for your understanding. I will pass your wishes and requests to the relevant doctors, let them explain the situation to you in as much detail as possible. Do you think this is good?
  Patient: Ok, thank you very much.
  Consultant: Thank you. The body is our own, we must cooperate with the doctor to treat it. When you encounter something that doesn’t go well, you should find someone to express your thoughts in time. Only then can others understand you and help you.
■ Tips

  1. Listen carefully and give patients a chance to vent their negative emotions.
  2. Unconditional acceptance, understanding and tolerance, no comment, no blame.
  3. Guide the patient to analyze the reasons behind the emotions.
  4. Help patients learn to face the disease without escaping.
  5. Give support, encouragement, and establish and improve confidence in disease resistance.
  The premise of effective communication is listening. It is necessary to understand the general psychological state and emotional reaction of cancer patients, and then to understand the unique background and disposition of different patients. Only in this way can we help them from understanding, understanding, and effective communication.
The temptation of a new dress

  Clinically, when we face the expectation, anxiety, fear and despair of the eyes of the late patients, we often have a hard time to start. The sharing of hopes in Case 2 can help everyone to cope with the negative emotions of patients with advanced cancer.
■Case background

  Female 47 years old, right breast cancer patients, because the tumor has been local metastasis, the doctor recommended chemotherapy first, depending on the results of chemotherapy to determine whether surgery. Five times of chemotherapy, the effect is not good, the doctor adjusts to radiotherapy, the patient is worried all day, feeling anxious and afraid.
■Consultation site

  Consultant: Hello, what can I help you?
  Patient: I have breast cancer. Because the tumor is too large to be operated, 5 times of chemotherapy has been performed, and radiotherapy is now started.

  Consultant: Oh, when and how did the tumor be discovered?
  Patient: I personally felt a lump two years ago. I had a B-ultrasound and a molybdenum target in my hometown hospital. The diagnosis was benign. The medical examination diagnosis last year was also benign. In February of this year, I came to Shanghai because of the sudden enlargement of the mass and the possibility of malignancy. I can’t think of a doctor in Shanghai saying that you can’t have surgery for the time being, you have to do chemotherapy first. But now I have chemotherapy for 5 times and then let me do radiotherapy, I am very scared.
  Consultant: In this case, whoever is afraid of worrying about it, this is a normal emotional reaction… Can you tell me what is your biggest wish now?
  Patient: I didn’t want to live a while ago. Really, I have never said anything. I really don’t want to live, chemotherapy is too painful, think about it, it’s better to die soon… But now I don’t think so, I want to live, my biggest wish is to live well! I have been suffering for a lifetime, my husband is two years younger than me. I am busy with my family. After I fell ill, he started to be very good to me. He even learned to cook rice and cook. Recently, I feel that his feelings have changed a bit… I think if I die, he will marry and become a family later. All housework is done by him. Whenever I think about it, I feel very wronged! Besides, my son is in high school, I want to see my son admitted to college…

 Consultant: Your greatest wish is to live, to live well! This is great! I am sincerely happy for you, have you ever thought about how you can live well!
  Patient: I don’t know. I haven’t dared to go out since I was sick. I am afraid of being told gossip, afraid that I will know that I have this disease.
  Consultant: People will get sick when they eat grains. Do you think that you will not see people after you get sick?
  Patient: Yes. My husband’s sister pointed at me and said, “A dead horse is a living horse doctor, so that my brother is not affected, and I have to use so much money at home. It’s better to die early.” (The patient couldn’t help but start crying, consult The teacher immediately handed the paper towel and gently held her hand to wait for her emotions to calm down.) Actually my husband is really good to me. If I say that he is not good, my family will blame me.
  Consultant: I understand. But I believe that your feelings are real. If you think that his feelings have changed, it must have changed. Sometimes I feel that I can’t tell the truth. I can only say that I can’t say it.
  Patient: Thank you, I said to people for the first time, I only told you.
  Consultant: Thank you for your trust! So, are we going to follow the topic just now? How do you think about how to live well?
  The patient suddenly looked at the counselor and shook his head.
  Consultant: If you are in a bad mood, if you are suffering, worried and afraid all day long, do you think these emotions will be good for your body?
  Patient: No. Oh, I understand a bit.
  Consultant: Right! The disease is treated by a doctor, but you need to cooperate with the doctor. At least we can maintain a stronger and optimistic attitude when facing the disease. This can be done through our efforts. Are you right? ?
  Patient: Well. But I dare not go out now, afraid to meet an acquaintance.
  Consultant: Do you meet an acquaintance in Shanghai?
  Patient: Not here.
  Consultant: After we have consulted today, you will go to the mall and buy some new clothes.
  Patient: Buy new clothes?
  Consultant: Yes, buy new clothes, dress yourself beautifully, will make you feel happy}
  Patient: I am sure to be happy to buy new clothes. I used to wear very beautiful clothes. I have not bought a new dress.
  Consultant: As long as you are happy, happiness is conducive to the early recovery of the disease.
  Patient: However, it costs money to buy new clothes. I can’t spend money now.
  Consultant: You just didn’t say that you would feel wronged and worthless for yourself if you want to remarriage and have to do housework after your death.
  Patient: Yes, yes.
  Consultant: Then, have you thought that the money you have worked hard to save will not be used, will it be left for others? Find ways to make yourself happy every day, just to live well. Do you think I am saying this right?
  Patient: Yes, the teacher is right.
  Consultant: If you want to see me next time, be sure to wear new clothes and dress yourself up to see me!
  The patient nodded and said that he agreed.
■ Tips

  1. Must tell the patient “cancer, death”, believe in medicine, believe in hospital, believe in doctor.
  2. Comfort the patient and tell him that anyone who has a similar encounter will have a similar emotional response.
  3. You need to tentatively ask a series of open questions, such as “What is your biggest wish now?” “What is your biggest worry?” “What do you want to do most at the moment?” Change and slow down the current negative emotions.
  4. Encourage patients to go out of their homes, start with a small thing, and slowly integrate into the familiar living environment.