How to deal with anxious, angry and irrational family members of cancer patients?

When patients learn that they have gynecological tumors, they find it difficult to bear such a huge blow and think that they have been sentenced to death. Their family members panic, become impulsive, anxious, and angry. Out of fear of tumors, they may turn their nervousness, worry, disappointment, and dissatisfaction into anger and vent it on the front-line medical staff. We medical staff often hear various voices of questioning:

Why don't you give us treatment? If anything happens to my family, I will never forgive you!

Some irrational family members may even attack frontline medical staff, and our medical staff will definitely feel very aggrieved.

In extraordinary times, we are responsible for saving people from danger. We are under tremendous physical and mental pressure and have to face the anger of patients and their families. How should we respond at this time?

01 Ensure personal safety

The medical staff share the same feelings as the patients. However, when we encounter family members who lose their minds and even beat others, the most important thing for us is to protect our own personal safety. We should seek help from colleagues and security guards in time to control the out-of-control family members.

Of course, some family members do not harm medical staff. On the contrary, they threaten the hospital with their own lives. In this case, while calming the family members, it is also important to immediately call colleagues and security personnel to ensure the personal safety of the family members.

02 Avoid such family members

We medical staff need to identify the anxiety and anger of family members as early as possible and nip the conflict in the bud. All family members hope that their loved ones can be treated quickly and fully recover, but some patients are in a serious condition during acute attacks, and the public lacks a correct understanding of the disease. Family members may have unrealistic ideas and expect that patients can fully recover after entering the hospital for treatment.

At this time, patients and their families often ask questions like: When will the illness be cured? How long will the hospital stay be? Are the medical care, nursing care, and daily living services in place during the hospital stay? At this time, if there is no effective communication with the patient and his family, it will lead to tension between the doctor and the patient.

In this regard, we can take the following measures to avoid medical disputes:

01 Explain the diagnosis and treatment plan in detail to the patient and his family, and inform them of the maximum expected and worst-case outcomes after treatment;

02 Explain the severity, prognosis and complications of the disease, and issue a notice of serious or critical illness when necessary;

03 Encourage patients and their families to pay attention to official information, help them distinguish the authenticity of information, narrow the information asymmetry between them and professionals, and improve patients and their families' scientific understanding of gynecological tumors.

At the same time, by controlling the psychological state of the family members at each stage, we can take the initiative in the family communication process. Some patients and their families do not understand the medical advice because of anxiety, or are unable to accept the doctor's advice and over-idealize the medical results. If you encounter these communication difficulties, you can ask a psychologist or therapist to help with communication.

Be anxious for others and think about others

Doing the above points may prevent family members from losing their minds, but there are always some family members you can't predict. When the outbreak point appears, they will still become anxious, angry, or even lose their minds. At this time, we must not confront them and let them express their dissatisfaction. This is "recognition". We can look at the problem from another angle. Doctors and patients should have "empathy" when facing tumors. Only by putting themselves in each other's shoes can we understand each other.

Empathizing with family members can help us control their psychological changes at any given time. For example, when they are anxious or complaining, we can pat their shoulders and nod to show our understanding. When they are calm, we can further understand the reasons for their loss of control and how to solve them. Family members are angry because they think the doctor has a bad attitude, the treatment process is not transparent, or they are dissatisfied with the treatment results and monitoring measures.

Under the influence of fear that they will also be infected, watching their loved ones suffer from the disease, family members are prone to extreme mentality and produce angry and aggressive words and deeds against doctors. Then, if the attitude is considered bad, explain the reason; if the effect is not satisfactory, inform the possible prognosis and the current condition of the disease; if there is fear of tumors, explain the medical management policy and disease knowledge... Let them know that medical staff and patients are from the same nostril, and our enemy is the disease, not the other party!

Empathy and problem solving are important, but how can we actively deal with our own insecurities? In the current tense atmosphere of doctor-patient relationship in the whole society, giving more care and understanding in the busy and high-pressure work of the front line is a little more help to ourselves, which may heal the physical and mental trauma of ourselves, patients and their families.

The formation of a doctor-patient community may reduce the anxiety of both parties, so that they can face and defeat the tumor together.

References:

[1] Liu Pengfei. Research on social work group intervention for stress relief of cancer patients' family members: A case study of Jiangsu Provincial People's Hospital[D]. Nanjing University of Aeronautics and Astronautics, 2018.

[2] Wang Hui. Exploring the anxiety coping methods of cancer patients’ family members. Health Must-Read (Second Half Edition). 2012, (8).

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Author: Wang Yun, Shanghai Mental Health Center

Wang Yun

Master of Medicine, Attending Physician, Shanghai Mental Health Center

Has been engaged in clinical diagnosis and treatment of psychiatry and teaching of medical students for a long time

2019 Outstanding Teacher of Shanghai Medical College, Fudan University

Secretary of the CSNP Chinese Depression Researchers Alliance

The first author has published more than ten papers in domestic and foreign journals

Expertise: Clinical diagnosis and treatment of depression and anxiety disorders, neurosis, schizophrenia, and consultation on general psychological issues such as study, work, marriage and love.

Clinic hours: Psychiatry on Tuesday morning, psychological counseling on Thursday afternoon and Saturday morning.

Funded by Shanghai Science and Technology Commission's Science Popularization Project

(Project No.: 20DZ2311100)