Diversity in the psychological approach

The same applies to the patient’s psychological care. Each team member should be aware of and take into account the importance of the other team members’ participation in the patient’s care.

In our psychological approach to cancer patient care, whatever the treatment phase, good coordination is necessary between all care team members. This coordination is essential when giving information to the patient and when dealing with his reactions to the announcement of treatment, of prognosis, or of complications, and when dealing with misunderstood explanations and the potential recriminations from the patient himself or from his family.

It is essential for the patient that his physician’s initial discourse be reformulated whilst respecting the limits set by that physician.

The level of understanding and the listening capacity of the patient vary with time. Patients often swear that no-one has informed them of such and such a medical examination, whilst their physician and/or nurse have clearly explained to them the advantages and the drawbacks of the act in question. Occasionally the patient will try to take advantage of the diversity of the participants involved in his care, making false statements in order to obtain the truth.

Keeping the patient’s medical file correctly up-to-date enables caregivers to politely and kindly refute the patient’s statements. The patient doesn’t lie out of bad will; he has forgotten! His listening capacity did not enable him to absorb the information at the right time. He needs to be told again, with a language that he is able to understand.

It is important that team work be calmly co-ordinated.

Certain team members, because of their personal empathy, will tend to be more in phase with the patient than others.

This also applies to physicians. There is no need to feel ashamed when realising that a colleague is more in phase with our patient than we are ourselves. For other patients the situation can be totally reversed. For the patient, the possibility of choosing a ‘preferred’ physician within the care team is an advantage. This preference can also be observed among other caregivers and it should be respected, without, however, allowing the patient to refuse care form another member of the team or to demand care from the one and only caregiver he has ‘chosen’.

Staff and liaison meetings, be they within hospitals or in rural practices (offering time for dialogue between physicians and district nurses) enable discussion on the respective contribution of each member of the team on the psychological aspects of patient care.

The dialogue between hospital and independent urban and rural medical practices is encouraged and promoted more and more (handover forms).