Palliative care and communication : experiences in the clinic / Anne-Mei The.

Format:

Book

Author/Creator:

The, Anne-Mei.

Series:

Facing death

Standardized Title:

Palliatieve behandeling en communicatie. English

Language:

Dutch

English

Subjects (All):

Lungs--Cancer--Netherlands.

Lungs.

Lungs--Cancer.

Terminal care.

Medical personnel and patient.

Netherlands.

Medical personnel and patient--Netherlands.

Terminal care--Netherlands.

Lungs--Cancer--Palliative treatment--Netherlands.

Lungs--Cancer--Palliative treatment.

Cancer--Psychological aspects.

Cancer.

Lung Neoplasms.

Terminal Care.

Palliative Care.

Neoplasms--psychology.

Medical Subjects:

Lung Neoplasms.

Netherlands.

Terminal Care.

Palliative Care.

Neoplasms--psychology.

Physical Description:

xii, 254 pages ; 24 cm.

Place of Publication:

Buckingham ; Philadelphia : Open University Press, 2002.

Language Note:

Translated from the Dutch.

Contents:

Mr van der Ploeg 1

Research question, methods and presentation 2

The book 4

Part I Bad news and choosing therapy 7

1 Patients 9

Mr Wiersema 9

Bad news and the choice of treatment 10

Not feeling sick 12

Truth and patterns of disclosure 12

Meeting Mr Dekker 15

Mr Dekker kept his problem hidden from his wife 16

Bad news and the choice for treatment 17

Prognosis 20

Patients' narratives 22

Intermezzo: meeting 23

Mr Heuvel's bad news interview 24

Choosing chemotherapy 27

2 Doctors and nurses 29

Small-cell lung carcinoma and treatment 29

Choosing therapy 31

Under the spell of The Riddle 34

Clinical trials 35

Intermezzo: doctor and anthropologist 36

The exception: the patient who refuses treatment 37

The oncology nurse 39

'The whole family suffers' 41

The nurses' perspective 41

Part II Therapy, optimism and perseverance 45

3 The rising curve 47

The treatment is working 47

The outpatient clinic 48

Mr Wiersema 49

'I think it'll be gone after three courses of treatment' 49

Mr Wiersema's secret 50

Alternative therapies 52

Mr Dekker and Mr Wiersema support each other 54

A period of relative mental calm 55

4 Rescue therapy 57

Discussion about Mr Heuvel's treatment 57

The treatment obsession 59

The 'dip' after chemotherapy 60

The opposing perspectives of doctors and nurses 62

5 Optimism and recovery 66

X-rays and scans 66

Partial and complete remission 67

'Brigit is cured!' 68

The generation of optimism about recovery 69

The pessimistic patient as exception 72

'What doctors really tell patients' 74

Communication between doctors and nurses 75

Involuntary play acting 77

Consequences: the nurses' frustration 78

6 Reflection and anxiety 80

'So I can tell my wife you're satisfied?' 80

Mr Wiersema perseveres 81

Mrs Dekker is worried 82

'Klaas wants to go on holiday, now' 83

Mr Koster reflects on his life 85

Caught between optimism and fear 86

Part III Variations on a recurrence 89

7 Recurrence 91

Mr Dekker 91

Metastases in the head 92

More chemotherapy 94

Recurrence: counselling and emotions 95

Mr Wiersema 96

The other patient's recurrence 97

The lecture 98

Loyalty toward the doctor 99

Mr Dekker feels unwell again 100

Mr Dekker's progression 101

Mr Dekker becomes aware 102

Mr Bokjes' recurrence 104

The doctor leads through the chaos 105

'In practice the doctor decides' 106

On choosing therapy once again 108

8 Declining optimism 109

'You have to reap the benefits of treatment now' 109

'Are they telling me everything?' 110

Mr Wiersema's numbness 111

The worry increases 111

Dr Racz 112

The interview with Mrs Dekker 113

A different attitude 116

The style of the doctor 116

Infection or progression? 118

St Nicholas 120

Metastases in the brain 121

The realization of truth 122

The confrontational meeting with Mr Dekker 124

Reunion in the waiting room 125

The confrontation with other patients and defence mechanisms 126

Mr Koster's recurrence 126

The fear of emotions 127

The magical power of treatment 128

9 No therapy for Mr Wessels 130

Mr Wessels has a recurrence 130

Preparing patients for brain metastases 132

'Now I understand what the doctor meant' 132

Mr Wessels wants to stop treatment 134

The patient as expert 135

Biography and development 136

Talking about prognosis and variations in the final phase of life 137

Part IV Parting 139

10 Breaking down optimism and ambivalence 141

Mr de Jager perseveres 141

Going down fighting 143

'Mr de Jager is a good example of how things can go wrong' 144

'They never contradict us' 146

Practical explanations 147

Doctors and the dilemma of optimism 148

Two sides to the story 151

The Riddle, the medics and society 151

'Do I have to repeat it again?' 152

Mrs Gruter gets better 153

Patients' ambivalence 156

11 The familiar hospital 159

Mr and Mrs Wessels keep coming to the outpatient clinic 159

Attachment and parting 160

Mr Fresco goes home 161

Mr Fresco's partner sends him to the hospital 162

The attraction of the hospital for patients for whom treatment options have been exhausted 163

Contrasts and tensions between GPs and hospital specialists 164

Mr Fresco's GP 165

The GP's frustration 168

12 Parting 171

Mr Dekker's parting 171

Consciously taking leave 172

The death of a fellow patient 173

Resuscitation 174

Anger and resistance 176

Mr Dekker's shadow 176

The silent killer and the address book 178

Causal attribution and smoking 179

Mr Wiersema does not show up at the outpatient clinic 180

Mr Wiersema's parting 181

Knowing and not knowing 183

Individual styles of living and dying 184

Biography and development 185

Mr Wiersema's funeral 185

Phases of the illness trajectory and the bad news interview 189

Long-term and short-term perspectives 194

Public information and hidden information 197

Ambiguity and the hope of a cure 200

The restitution narrative and other stories 203

The latent realization of approaching death 207

'Choosing' treatment 209

Informed consent perspective and care perspective 214

The collusion 221

Optimism about recovery 221

Model 222

Patients' needs 223

Avoiding responsibility 225

Care director 227

Self-care 228

Relatives reflect 230

The role, influence and dilemmas of the researcher 232

Between detachment and involvement 234.

Notes:

Includes bibliographical references (pages [237]-244) and index.

ISBN:

0335212069

0335212050

OCLC:

48620207