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首页> 外文期刊>The oncologist >A staff dialogue on aggressive palliative treatment demanded by a terminally ill patient: psychosocial issues faced by patients, their families, and caregivers.
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A staff dialogue on aggressive palliative treatment demanded by a terminally ill patient: psychosocial issues faced by patients, their families, and caregivers.

机译：绝症患者需要就积极的姑息治疗进行工作人员对话：患者，其家人和护理人员所面临的社会心理问题。

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Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded The Kenneth B. Schwartz Center at MGH. The Schwartz Center is a nonprofit organization dedicated to supporting and advancing compassionate health care delivery which provides hope to the patient, support to caregivers, and encourages the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum during which caregivers discuss a specific cancer patient, reflect on the important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from their fellow staff members. In this article, the case presentation and verbatim dialogue from the rounds are discussed with an emphasis on staff psychosocial issues. The case presented was of a 32-year-old man, who developed small cell osteosarcoma and was treated at MGH. He died after undergoing multiple courses of relatively ineffective chemotherapy. The case is made all the more poignant because of the pleasures, hopes, and stresses of having a child late in the course of his illness. Staff identified closely, both with him and his family, and their concern for him brought joy and meaning to their work, yet this complicated their ability to deal with his impending death. They felt that his unwillingness to admit defeat prevented them from saying goodbye to someone whom they loved and admired. Despite this, staff recognized that, ultimately, the patient's emotional needs and wishes had to be respected as a first priority and that constructive closure can be worked toward, if not achieved. In such situations, it is vital to have a colleague support system and a forum for discussion of such issues in order to defuse distress and reassure staff that they are doing all that can be done as professionals and caregivers.
机译：麻省总医院（MGH）的癌症患者Kenneth B. Schwartz在1995年去世前不久，在MGH成立了Kenneth B. Schwartz中心。 Schwartz中心是一个非营利性组织，致力于支持和推进富有同情心的医疗保健服务，为患者提供希望，为护理人员提供支持，并鼓励康复过程。该中心赞助施瓦茨中心回合（Schwartz Center Rounds），这是每月一次的多​​学科论坛，在此期间，护理人员讨论特定的癌症患者，反思患者，其家人及其护理人员所面临的重要社会心理问题，并从其同事中获得见识和支持。在本文中，讨论了各轮案件的陈述和逐字对话，重点是员工的心理社会问题。所报告的病例是一名32岁的男子，该男子发展为小细胞骨肉瘤，并在MGH接受治疗。他经历了相对无效的多疗程化疗后死亡。由于孩子生病后期的乐趣，希望和压力，使案件变得更加严厉。员工与他和他的家人都保持了密切的联系，他们对他的关心为他们的工作带来了欢乐和意义，但这使他们应对他即将死亡的能力变得复杂。他们认为他不愿接受失败使他们无法向他们所爱和敬仰的人说再见。尽管如此，工作人员意识到，最终必须将患者的情感需求和愿望作为头等大事，如果没有实现，可以朝着建设性的方向努力。在这种情况下，至关重要的是要有一个同事支持系统和一个讨论此类问题的论坛，以减轻困扰和使工作人员放心，他们正在做专业人员和照顾者可以做的所有事情。

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