1, researcher Zhang Kan, doctoral supervisor of Institute of Psychology, Chinese Academy of Sciences, and chairman of China Ergonomics Society, chairman of Chinese Psychological Society, won the second prize of natural science of China Academy of Sciences and the second prize of military scientific and technological progress of the General Armament Department.
Wang Qi Yueyang traditional Chinese medicine hospital radiotherapy department
2. Professor Zhang, director of rehabilitation department of Beijing Cancer Hospital, has created a set of theories and methods in the research of combining comprehensive rehabilitation treatment of cancer with clinic. In 2000, he cooperated with Li Ka-shing Foundation to open a hospice hospital in Beijing Cancer Hospital.
Moderator: Hello, audience friends! This is CCTV's live program "The Road to Health". Today we are going to discuss whether we should hide our illness from cancer patients. When learning that the patient is terminally ill, many family members' first reaction is to hide their illness. Does this happen often?
Zhang: As a patient, he has many rights like ordinary people, but as a patient, there are two basic rights that are often easily overlooked, that is, the patient's right to know about the disease and the right to choose treatment. In clinical practice, there is no exact statistics on how many patients directly explain their illness after diagnosis, but we realize that about 70%-80% of patients' families will ask our doctors or nurses to hide their illness from patients after diagnosis. As doctors and nurses, this is often the way to deal with it. Once diagnosed, patients are usually asked to invite their families and then talk to them.
Moderator: Why is the first reaction of family members to hide their illness?
Zhang Kan: First of all, we should care about and sympathize with the family members of cancer patients or malignant tumors, because they are all going through a very painful psychological process. At present, our knowledge of cancer and our ability to treat cancer are generally lacking. Once we know that our loved ones have cancer, our first reaction is that they must be hopeless. At this time, the most important thing for family members is to alleviate the patient's pain and think it is best to hide the illness. There are two misunderstandings here. One is that the patient is definitely hopeless, but now the level of tumor treatment is constantly improving, which does not mean that if you have a tumor, you must wait for death. Another misunderstanding is that people's psychological endurance and ability to resist emergencies are very strong. Many times, we underestimate the psychological endurance of patients, and most people can still face it correctly after knowing the condition.
Moderator: Do those family members who hide their illness usually get the expected results?
Zhang: For a long time, family members have two completely different attitudes towards patients with major diseases. One is to gradually explain the illness to the patient in a reasonable way, and the other is to do everything possible to hide the illness. The latter method often brings a lot of harm to patients. In fact, it is very difficult to hide the illness from the patient. After a patient falls ill, he will often feel suspicious, and the family members' secretive psychology will increase the psychological burden of the patient. From our actual work, it is also found that concealing the illness from patients often brings some very serious consequences. For example, I once met an early breast cancer patient, but her family didn't tell her that she was cancer in order to hide her illness, and they didn't dare to take her to a special cancer hospital to see a doctor, and they looked for remedies for her everywhere. Results After half a year, the tumor became bigger and bigger. She went to our hospital for examination again, and she had changed from a patient with primary breast cancer to a patient with tertiary breast cancer. The patient died soon. The biggest evil consequence of concealing the illness is that it can't provide patients with corresponding treatment in time and delay the illness.
Moderator: Let's look at the situation of a patient and his family:
Patient's (female's) family: I walked outside for a long time after hearing the news, and then I went to see my sister. I looked embarrassed at that time and didn't want to see her mental outlook, but she was a very smart person and it was hard to hide.
Patient (male): At that time, they didn't want me to know, but I could feel it myself, because I lost ten pounds in April and ten pounds in May. One night, my son was still smoking at midnight. I think he is more stressed than me. Later, after I took the initiative to ask about my illness, I was also practical, and then I actively accepted treatment.
Patient (male): It is actually very simple for patients to understand the condition. One is to look at the laboratory sheet, the other is to look at the case card, and you can also look at the location and location of the disease. I think it is self-deception to conceal the illness, which is not good for patients and their families.
Zhang: As a matter of fact, we have made great efforts to conceal the illness. Many family members asked us to compile fake cases and even issue fake case reports. However, from practice, we find that diseases cannot be concealed. Now is the information age, patients can know the situation from many aspects. Once sick, their mental state is also very sensitive and suspicious. On the contrary, this concealment will add more psychological pressure to patients.
Zhang Kan: People are very sensitive, especially when they are sick. They are very sensitive to all the changes around them. People live in society, and the most basic thing in society is the need for mutual trust. Once a patient feels lonely because his family hides his illness, it is very unfavorable to his illness.
Moderator: If you tell the patient about your illness, will the advantages outweigh the disadvantages?
Zhang: This should be the case in most cases, but notice should have an art of notice, not a simple notice.
Zhang Kan: Good health and illness are contradictory. People are conscious and emotional. Once you know that your illness can mobilize all your positive factors (subconsciously or consciously) to fight the disease, then it is definitely beneficial to cooperate with the treatment.
Moderator: Let's take a look at the patient's own statement:
Patient: After I got cancer, the doctor told me that I could only live for five years. After I know this situation, I actively treat and exercise, mobilize my positive factors, combine traditional Chinese and western medicine, and take medicine on time. I have always thought that good treatment will prolong life span or even ten years. So I think the right to know is very important, which is only good for patients and their families.
Moderator: What is the relationship between emotions and tumors?
Zhang Kan: Emotion is closely related to tumor. The more positive people's emotions, including emergencies, the better for their health. An appropriate emergency state is most conducive to mobilizing the enthusiasm of the body. Foreign experiments show that the recovery and life extension of patients with advanced cancer who actively mobilize their emotions are obviously better than those who do not actively mobilize their emotions.
Moderator: Is the art of telling cancer patients about their illness profound?
Zhang Kan: First of all, medical staff and their families should have great trust and sympathy for patients, and they should grasp three principles in informing them: 1, and they should inform them positively. 2. The information should be complete. 3. Pay attention to the target in the process of informing. Basically follow two principles, if the patient's knowledge level is high, he should be informed in detail, and if his understanding ability is not enough, he can be informed simply. It also depends on the patient's own attitude. If the patient is very scared, tell him in detail what he can overcome and how to overcome the disease.
Moderator: What should I do if the patient has negative emotions after telling the real condition?
Zhang Kan: This is also the actual situation. We should learn to observe whether patients are developing in a negative or positive direction, and give appropriate psychological guidance. If the patient is really depressed, he should seek help from a local clinical oncologist or psychologist who knows the situation better.
Moderator: Some netizens said that informing people with strong psychological endurance should be beneficial to treatment, but it may bring bad consequences to people with poor psychological endurance, right?
Zhang: Even if the patients' psychological endurance is different, if they don't tell their illness, they will still know, which invisibly increases their psychological pressure, which is very unfavorable for treatment. Therefore, even people with poor psychological endurance, we still have to find a way to tell them. This is a question of informing art. We can encourage the patient with the power of some role models, so that he will accept it more easily.
Zhang Kan: It allows patients to communicate with people who have the same disease or similar experience, and makes patients feel that they are not alone and can recover.
Key points of plan
1, patients have the right to know, so do cancer patients.
2. It is necessary to inform patients of their illness in time, and pay more attention to the art of informing.
Only by facing the reality can we defeat cancer.