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KANSER TANISI KONAN HASTALARDA KÖTÜ HABER VERME: HEKİME DÜŞEN GÖREV

BREAKING BAD NEWS IN CANCER PATIENTS: THE MISSION OF CLINICIAN

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Abstract (2. Language): 
Cancer is a fatal disease that interrupts human life unexpectedly. It is known as the most common reason for death following the deaths from cardiac disorders. In most people, the term “cancer” has been associated with death because there is almost no one who has not met someone with cancer within his/her social medium. Therefore, the psychosocial problems created by cancer diagnosis are inevitable. Normal response to cancer diagnosis varies from nervousness, anxiety, denial of the disease due to grief over the loss of health, and perceiving the progress of the disease as a battle to recognition of the disease as part of fate. In the literature, the expression of a fatal disease has been termed as “breaking bad news”. Reporting the bad news to a patient is really a hard task for physicians because inability to predict how the patient and his/her relatives will react and lack of awareness on how to handle their reactions on the part of physician is a difficult situation. Generally, the experience and personality type of the reporting physician affect the style of informing. Review of the talks held in evaluating the diagnosis, treatment, and progression of the disease with the patient will guide us in determining whether our style of expression and our manner meet the needs of the patient. This signifies the importance of education in communication skills. However, to date, patient-physician communication has not been a standard part of medical training curricula. In this review, the ideal framework for reporting bad news has been evaluated.
Abstract (Original Language): 
Kanser, insan hayat›n› beklenmeyen flekilde kesintiye u¤ratan ölümcül bir hastal›kt›r. Günümüzde kardiak nedenli ölümlerden sonra en s›k ölüm nedeni olarak bilinmektedir.Ço¤u insanda kanser kelimesi ölüm ile ba¤daflt›r›lmaktad›r. Zira yak›n çevresinde kanserden dolay› s›k›nt› çeken birisini görmeyen yok gibidir. Dolay› s›yla böyle bir tan›n›n insanlarda oluflturaca¤› psikososyal sorunlar kaç›n›lmazd›r. Kanser tan›s›na normal yan›t; endifle, gerginlik kaybedilen sa¤l›k için keder ve üzüntüden hastal›¤›n önemini yads›ma, bu süreci savafl gibi alg›lama yada kaderci bir kabullenmeye kadar de¤iflir. Ölümcül hastal›k tan›s›n›n söylemi literatürde kötü haber verme olarak adland›r›lm›flt›r. Kötü haberi vermek hekimler aç›s›ndan da hastaya söylenmesi gerçekten zor bir görevdir. Hastan›n ve ailesinin nas›l tepki verece¤ini kestirememe ve bu tepkilerle nas›l bafl edilece¤inin bilinememesi hekim aç›s›ndan s›k›nt›l› bir durumdur. Genellikle hekimin deneyimleri ve kiflilik yap›s› söylem tarz›n› belirlemektedir. Hastalar ile tan›y›, hastal›kla ilgili tedavi ve seyri hakk› nda yap›lan konuflmalar› gözden geçirdi¤imizde, anlat›m ve tav›rlar›m›z›n hastalar›n ihtiyaçlar›n› karfl›lay› p karfl›lamad›¤›n› de¤erlendirebiliriz. Bu da iletiflim becerileri konusunda e¤itim alman›n önemini ortaya koymaktad›r. Halbuki halen hekim - hasta iletiflimi standart t›p e¤itiminin bir parças› olamam›flt›r. Bu yaz›- da kötü haber vermenin ideal flartlar› irdelenmifltir
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REFERENCES

References: 

1. Amiel GE, Ungar L, Alperin M, Baharier Z, Cohen R, Reis S.
Ability of primary care physician”s to break bad news: a performance:
a performance based assessment of an educational
intervention. Patient Educ Couns 2006; 60:10-15.
2. Ateflci FÇ, O¤uzhano¤lu NK, Baltalarl› B, Karada¤ F, Özdel
O, Karagöz N. Kanser hastalar›nda psikiyatrik bozukluklar ve
iliflkili etmenler. Türk Psikyatri Dergisi 2003; 14:145-152.
3. Ayan M.T›bbi Müdahalelerden Do¤an Hukuki Sorumluluk.
Konya, Kazanc› Hukuk Yay›nlar›, 1991.
4. Back AL, Arnold RM, Tulsky JA, Baile WF, Fryer-Edwards
KA. Teaching communication skills to medical oncology fellows.
J Clin Oncol 2003; 2: 2433-2436.
5. Baile WF, Lenzi R, Parker PA, Buckman R, Cohen L. Oncologists”
attitudes toward and practices in giving bad news: an
exploratory study. J Clin Oncol 2002; 20:2189-2196.
6. Brewin TB. Three ways of giving bad news. Lancet 1991;
337:1207-1209.
7. Cassileth BR, Zupkis RV, Sutton-Smith K, March V. Information
and participation preferences among cancer patients. Ann
Intern Med 1980; 92:832-936.
8. Derogatis LR, Morrow GR, Fetting J, Penman D, Piasetsky S,
Schmale AM,Henrichs M, Carnicke CL Jr.The prevalence of
psychiatric disorders among cancer patients. JAMA 1983;
249:751-757.
9. Devrimci H, Ünlüo¤lu G. Kanser hastalar› ve yak›nlar›nda
psikiyatrik bozukluklar. 3P dergisi 1998; 6:196-206.
10. Dias L, Chabner BA, Lynch TJ Jr, Penson RT. Breaking bad
news: A patient”s perspective. Oncologist. 2003; 8:587-96.
11. Elbi H. Kanser ve Depresyon,Psikiyatri Dünyas› 2001; 5; 5-
10.
12. Ersoy MA. Kanser hastalar›nda inkar, tedavi ekibiyle iliflki,
bilgilendirme, kanser tan›s›n›n söylenmesi, alternatif tedavi
yöntemlerine baflvurma ve depresyon iliflkisinin incelemesi.
3P Dergisi 2000; 8:17-26.
13. Gautam S, Nijhawan M. Communicating with cancer patients.
Br J Psychiatry 1987; 150:760-764.
14. Girgis A, Sanson-Fisher RW. Breaking bad news. 1: Current
best advice for clinicians. Behav Med 1998; 24:53-59.
15. Goncalves F,Marques A, Rocha S, Leitao P, Mesquita T, Moutinho
S. Breaking bad news: experiences and preferences of
advanced cancer patients at a Portuguese Oncology centre.
Palliat Med 2005; 19:526- 531.
16. Grassi L, Gritti P, Rigatelli M, Gala C. Psychosocial problems
secondary to cancer: an Italian multicentre survey of consultation-
liaison psychiatry in oncology. Italian Consultation-Liaison
Group. Eur J Cancer 2000; 36:579-585.
17. Greenlee RT, Murray T, Bolden S, Wingo PA. Cancer statistics,
2000 CA Cancer J Clin. 2000; 50:7-33.
18. Hardman A, Maguire P, Crowther D. The recognition of
psychiatric morbidity on a medical oncology ward.J Psychosom
Res. 1989; 33:235-239.
19. Hasta Haklar› Yönetmeli¤i.Resmi Gazete, Tarih: 01.08.1998;
Say›:23420.
20. Loge JH, Kaasa S, Hytten K. Disclosing the cancer diagnosis:
the patients” experiences. Eur J Cancer 1997; 33:878-882.
21. Mete HE, Önen Ö. Kanserli Hastalarda Depresyon, Duygu
Durum Dizini, 2001; 4: 184-191.
22. Okyayuz ÜH. Ölümcül Hastal›k Tan›s› Almak : Bir yaflam krizi
kötü haber verilmeli mi? Kriz Dergisi. 2003; 11; 29-35.
23. Özçak›r A. T›p E¤itiminde ‹letiflim ve Klinik Beceriler Dersi
verilmeli mi? ‹ntern Ö¤renci Görüflleri T›p Bilimleri Dergisi
2002; 22:185-189.
24. Özkan S, Psikiyatrik ve psikososyal aç›dan kanser. Konsültasyon
Liyezon Psikiyatrisi 1998-1999; 40-152.
25. Ptacek JT, Eberhardt TL. Breaking bad news. Areview of the
literature.JAMA. 1996; 276:496-502.
26. Ptacek JT, Ptacek JJ, Ellison NM. "I”m sorry to tell you ..."
physicians” reports of breaking bad news. J Behav Med 2001;
24:205-217.
27. Rabow MW, McPhee SJ. Beyond breaking bad news: how to
help patients who suffer. West J Med 1999; 17: 260-263
28. fienol S, Bitlis V, Ünal E, Göçmen H, Tan D, Çetin A. Kanser
teflhis tedavisi amac› ile bir cerrahi klini¤inde yatan hastalarda
psikiyatrik tan›lar.Türk Psikiyatri Dergisi 1994; 5:103-108.
29. Vandekieft GK. Breaking Bad News, Amercan Family Physician;
2001; 64: 12.
30. Voelter V, Mirimanoff RO, Stiefel F, Rousselle I, Leyvraz S.
Breaking bad news. Rev Med Suisse 2005; 1:1352-1353.

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