The emotional involvement of physicians in the Oncology Intensive Care Unit: a phenomenological-hermeneutic study.

Background: This phenomenological-hermeneutic study is about the experiences of physicians in the Oncology Intensive Care Unit of the Careggi University Hospital, in Florence. The Oncology Intensive Care Unit is a place of great emotional impact and can be create stressful situations. The emotional labor can lead to the development of cynicism, depersonalization and emotional exhaustion. The objective of the study was to learn about and come into contact with the experiences of operators who operate in a highly specialized and critical context. Method: A semi-structured interview was conducted on 11 physicians in the Oncology Intensive Care Unit of careggi hospital. The interviews were transcribed and subjected to content analysis using the phenomenological-hermeneutic method. The results concerning the emotional involvement of doctors were placed in three macro categories: difficulties, what helps and needs. Results: The interviews highlight the difficulty doctors have in coming into contact with the potentially deadly disease and a further aggravating element appears to be the identification with the patient himself. This condition of difficulty can lead doctors to commit medical errors or to reduce the quality of care. Conclusion: The results that emerged provide a more detailed understanding of the landscape of emotional reactions of working with the cancer patient in the intensive care unit. In light of the high emotional burden and the inherent possibility of developing burnout in this target population of health care workers, knowing the main critical issues and needs reported may facilitate a more effective tailored intervention.

Psychological impact of BRAF mutational status in advanced melanoma patients.

BACKGROUND: The aim of the study was to highlight the psychological aspects involved in patients with advanced melanoma and to describe the differences between subjects who are positive and negative for the BRAFv600e genetic mutation, a variable that leads to a different medical approach to cancer therapy. The hypothesis is that following knowledge of the genetic mutation and the therapeutic possibilities inherent to it, mutation positive patients (BRAF+) exhibit fewer negative psychological reactions than negative patients (BRAF-) at the time of diagnosis. METHODS: The tests used (SF-12, MHQ) were administered at the time of diagnosis and after three months. RESULTS: The main findings suggest a greater impairment of quality of life at T1 than at T0, regardless of the mutation; BRAF mutated patients show more favorable scores at diagnosis and a reversal of the trend at three months after diagnosis. CONCLUSIONS: The results obtained, in line with the literature under review, show a significant general psychological distress in the present oncological sample, suggesting the importance of a psychological, as well as medical, care of the patient and the family.

Melanoma diagnosis: traumatic impact of the event on the patient.

BACKGROUND: The aim of our study was to consider the distressing impact of the diagnosis in a group of patients with metastatic melanoma, and the effects it could have on the quality of life of the patients. METHODS: We proposed an Impact Event Scale (IES-R) to a group of 31 patients. The patients were positive to the distress thermometer (DS) and accepted the psychological support. After six months from the start of the treatment we made a semi-structured interview of 10 multiple choice questions. RESULTS: Sixty-five per cent of women and 50% of men report that all the event related to the disease, cause emotions that recall the disease. Eighty-two per cent of women compared to 50% of men, report that the thought of their medical condition tends to affect their quality of sleep; the patients report feelings of anger and irritation (41% of the women and 78% of the men). CONCLUSIONS: The traumatic aspects following the diagnosis of melanoma burst powerfully into the life of these patients, who show different reactions, also according to gender.