How to tell cancer patients: A contribution to a theory of communicating the diagnosis

Author(s): Bergenheim, A. T., Bergstrom, P., Henriksson, R.

Journal/Book: J Psychosoc Oncol. 1998; 16: 10 Alice St, Binghamton, NY 13904-1580, USA. Haworth Press Inc. 79-93.

Abstract: How to tell patients they have cancer is an important question in cancer care. The question provokes distress in physicians, and a failure in relating the diagnosis may arrest patients' process of coping with anxiety and reduce their subjective well-being. This contribution to a theory of communicating about the diagnosis is empirically based on an earlier study in which patients with malignant brain tumors were interviewed and is theoretically based on contemporary object-relational psychoanalysis. The authors propose that a beneficial physician-patient encounter can be viewed as characterized by the acknowledgement of the physician as an unconscious protection against death and as a facilitating environment for the patient's reconstructive process. The implications of these propositions are discussed. The authors also propose that the transference from the child-parent relationship to the patient-physician relationship enables physicians to use introspection as a means to improve their skillfulness regarding ''How to tell.'' Thus, introspection may provide physicians with guiding knowledge grounded in themselves.

Note: Article Salander P, Umea Univ, Dept Oncol, S-90185 Umea, SWEDEN

Keyword(s): BAD-NEWS; INFORMATION; PREFERENCES; PERSPECTIVE; DISCOURSE; ONCOLOGY; HOPE; WELL

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