RESUMO
Breaking bad news is one of the most stressful duties of the physician in oncology. Among other issues, it includes discussion of cancer diagnosis or the failure of therapy. The oncologist is often puzzled by an apprehension regarding the delivery of bad news. The fear to be exposed to unexpected strong emotional reactions by the patient, such as aggression or despair, may cause the oncologist to adopt unproductive coping strategies such as discussion about technical details while avoiding to deliver the main message. However, good communication skills are the key for a satisfying conversation with the patient. The oncologists' discomfort induced by the above mentioned apprehension is one of the most important barriers for a successful conversation.
Assuntos
Neoplasias/patologia , Relações Médico-Paciente , Revelação da Verdade , Comunicação , Emoções , Humanos , Neoplasias/terapia , PrognósticoRESUMO
Due to its life threatening character, a cancer diagnosis represents an existential rupture, disturbing an individual's life trajectory perceived beforehand as a continuum. As a consequence, a patient's physical, psychological, social and spiritual equilibrium may be disturbed, calling for a support by clinicians, which surpasses biomedical treatment. A key element of support relies on patient-centered communication, which not only demands technical skills, but also a reflective approach on interpersonal factors which shape the relationship, on the choice and the idealized representation of the clinician's profession as well as its limits. This article summarizes main aspects of patient-physician communication and our experience as teachers of the so-called Communication Skills Training. It provides a review on research in progress in this field and finally indicates other elements of support, which contribute to the << narrative reconstruction >> of the patient facing the rupture induced by cancer.