Preoperative attitudes, fears and expectations of non-small cell lung cancer patients.

Knowing preoperative fears in cancer patients should help us to overcome perioperative psychological problems. One hundred and three patients underwent a semistructured interview addressing the effect of preoperative information on disease and forthcoming operation, attitude towards operation, expectations for the postoperative time and family support. Evaluation was performed by three psychologists by qualitative structured content analysis according to Mayring. Interrater reliability was 85%. Only 42 patients (40.8%) were informed in detail about their diagnosis. Eighty-three patients (80.6%) considered the information given on their disease and the forthcoming operation as understandable, 57 patient (55.3%) experienced reduction of fear. Eighty-three patients (80.6%) showed a positive attitude to the operation, 21 (20.4%) expected an impairment of later life after operation although becoming healthy again. Diffuse fears were named in 47 cases (45.6%), 19 (18.4%) patients were afraid of metastases, 11 (10.7%) of postoperative death, 19 (18.4%) of pain, 11 (10.7%) of mutilation and 17 (16.5%) of surgical complications. Seventy-three patients (70.9%) had good family support, seven (6.8%) not. Of the support group 32 patients (31%) considered their relatives' empathy as onerous. Problems, that are self-evident to the attending staff may be insurmountable for the patients. If we succeed to overcome their most simple fears they can focus their energy on mastering the postoperative course.

Learning in groups: Teamshaping in the teaching of medical psychology.

OBJECTIVES: Although it is of growing importance in modern medicine, the ability to work in teams usually plays no explicit role in medical education. We compared the method of Teamshaping with 'traditional' teaching. DESIGN: Ninety-six students in 6 groups pursued a course in medical psychology with traditional teaching methods, while 46 students in 4 groups participated in Teamshaping. To evaluate the team approach, we used the Group Climate Questionnaire, Short Version (GCQ-S). SETTING: University of Vienna, Medical School. SUBJECTS: Third-year medical students. RESULTS: In terms of group climate both groups benefited from teaching, regardless of the method. Teamshaping, however, initially imposed a greater strain on the students than traditional teaching. This changed towards the end of the seminar. Teamshaping produced a stronger sense of commitment and a reduction of perceived conflicts. CONCLUSION: The model is recommended for teaching medical students because it not only extends traditional teaching towards small group learning but adds a competency in teamwork. It introduces students to a better working style and gives them an additional perspective for use in their future profession.