Doctor-patient communication – psychological support for patients with blood disorders

  The doctor-patient relationship is the most basic interpersonal relationship in medical practice, and the coordination or otherwise of this relationship directly affects the development and healthy operation of the practice activities in the entire health care field. Good doctor-patient communication is necessary to achieve patient-centeredness, reduce patients’ physical and psychological pain, and create the best physical and psychological state, as well as to promote understanding and support between doctors and patients and improve the effectiveness of treatment. Psychological guidance is an important part of the whole treatment. The vast majority of patients with hematological diseases have a great psychological burden, and they feel that they are on the verge of life and have brought major disasters to their families. To address the psychological problems of patients, targeted psychological counseling is provided according to their personality, education level, personal background and psychological needs, so that patients can be relieved from the heavy mental pressure. Therefore, in addition to relying on rich clinical experience in TCM and advanced medical care technology, early detection of psychological changes and giving timely psychological guidance and psychological care are of great significance to the therapeutic effect of diseases in patients with hematological diseases. The psychological guidance and treatment of TCM are discussed in the Nei Jing and many later generations of TCM doctors have also played and experienced in practice. Using the theory of the seven emotions that cause disease in TCM, the psychological guidance method of emotion and spirit together with Chinese medicine treatment can improve the efficacy and shorten the course of treatment, and the use of psychological guidance and intentional therapy intervention in subhealthy people can prevent the occurrence of disease and improve the quality of life.  1. Common psychological states of patients with hematological diseases 1.1 Stability psychology Most of the patients with this psychological state have a mild disease course, are confident about the improvement of the disease, are emotionally stable and can actively cooperate with the treatment, and like to collect extensive information about the disease and understand the process of their disease and the possibility of cure.  1.2 Anxiety and fear psychology Patients who used to be in good health conditions often cannot bear the painful blow of learning that they are suffering from hematological diseases, and have various anxiety and fear psychologies. Patients usually think of their hard-working career, warm family, colorful life is about to say goodbye, and they can not get rid of to reverse the situation, so present insomnia, anxiety, high tension and other states. In addition, the unfamiliar environment such as changing housing during the process of seeking medical treatment, the threat of the disease to the patient’s life, and the lack of companionship of relatives can all lead to anxiety and fear in patients.  1.3 Pessimism and despair These patients lack full understanding of hematological diseases and believe that having a hematological disease is a terminal disease, coupled with the fact that hematological diseases are prolonged and many patients die due to complications such as infections and bleeding, which is a negative stimulus for patients and can easily produce strong psychological stress reactions, resulting in weakened self-control and self-regulation. As patients with hematological diseases mostly apply chemotherapy, immunosuppressants, hormones, etc., the course of treatment is long, the side effects are large, such as nausea, vomiting, hair loss, physical changes and other inconveniences to them, so psychologically feel extreme pessimism and despair, high mental tension, coupled with the pressure of medical costs, the thought that they will lose their rightful family and social status, the road of life has been so great setbacks, pessimism appears, the loss of The confidence of life.  2.Psychological guidance measures for patients with hematological diseases 2.1 Establish confidence to meet the requirements First of all, the patient’s self-confidence should be established, patients seeking medical consultation to warm reception, can seriously, politely, correctly and clearly explain the condition, help patients familiar with the medical environment, to establish confidence in recovery. Patients should be treated with love, patiently listen to their complaints, and give reasonable and effective answers to their concerns. Mobilize the patient’s positive psychological factors, so that the patient is confident and hopeful to get through the long and changeable course of the disease. Give appropriate health education according to the condition and the patient’s ability to understand, including missionary work to help the patient’s family acquire the knowledge and skills to care for the patient.  2.2 Diversion catharsis and listening therapy Because patients have different cultural levels, social backgrounds, and life histories, they have different levels of understanding of the disease. For example, in terms of age, children worry about the pain of the disease; young people worry more about their future, their ability to work and live in the future; middle-aged people worry about their relatives, such as their minor children and elderly parents; and the elderly have a relatively lighter psychological burden. Therefore, it is important to provide counseling for different patients. As long as the doctor can establish a good trusting relationship with the patient, use the guidance method, move with emotion and reason, and provide targeted guidance to change the patient’s incorrect perceptions, the results will be good. Doctors should not only explain to patients the causes, conditions and hazards of the disease, so that patients pay attention to the disease, but also tell patients to cooperate with doctors and active treatment. At the same time, patients should be instructed to self-regulate, have a positive and optimistic attitude towards the disease, and eliminate fear and distress. There are many ways to vent bad emotions, such as talking, finding someone to talk to, writing, watching movies, painting, traveling and so on. But there are also some methods, such as smashing things in anger, attacking others, boredom when alcohol to solve the “sorrow”, etc., although these methods can be bad emotions out, but it is temporary, but for the future to bring new and greater worries, and even cause more serious adversity. Therefore, in the use of cathartic diversion method, according to the actual situation, through normal channels and channels, using the appropriate form of catharsis, control the degree of catharsis, so as to achieve a good cathartic effect. Secondly, listening is also an important skill of doctor-patient communication, which reflects respect for the patient and means that the doctor is willing to see and respond to things from the patient’s point of view and is a kind of integration into the patient’s situation. A natural and sincere smile from the doctor will bring comfort and encouragement to the patient and help alleviate the patient’s fear and anxiety caused by the illness, which helps to enhance the emotional empathy and trust between the doctor and the patient. Through trustful communication, it achieves to let patients get rid of unpleasant emotions and gain psychological relief.  2.3 Cognitive-behavioral therapy According to the theory that cognition affects emotion and behavior, it is a kind of psychotherapy to change patients’ bad cognition and thus correct bad behavior during the course of the disease. Applying cognitive therapy to the psychological adjustment of patients with hematological diseases, it allows patients to grasp some corresponding knowledge of daily care and health care, tells in-depth knowledge about hematological diseases and provides current treatment information, so as to relieve patients’ psychological fear and anxiety caused by the lack of relevant medical knowledge, achieve soothing patients’ emotions and improve the treatment effect. For example, common patients have low immunity and are prone to infections, bleeding and other complications. Doctors should provide patients with timely knowledge of daily prevention and care of fever, mouth ulcers, gum swelling and bleeding. And let patients understand that what affects their condition is not only the condition itself, but their own perception and understanding of the matter at hand. With a change in perception, one’s emotional and physical state will subsequently be much smoother and happier than before. How big an impact does one’s perception of things really have? So big that you cannot estimate it. What kind of perception you take, it will influence you subconsciously and live with you.  2.4 Psychological treatment According to Chinese medicine, the treatment of illness should be through the treatment of essence, qi and god. The doctor’s medication mainly targets essence and qi, and the treatment of god should mainly target the mental activities. In the mental activities of people, there are seven emotions: joy, anger, worry, thought, grief, fear and fright, but too much and too little of the seven emotions can lead to mental or physical abnormalities. With the cooperation of their families, the patients are guided to pay attention to the outside world through conscious and unconscious psychological guidance, and they are assisted to express their views and confide their sufferings by using the communication skills of therapy. And a lot of factual education can be given to make them believe in the curability of the disease. If patients experience anxiety symptoms such as insomnia, irritability, and decreased appetite, diversionary methods can be used, including shifting the patient’s emotions, attention, intentions, and pain sensations. The patient can also be relieved of unnecessary doubts, suspicions, or excessive worries through the method of releasing doubts. Chinese medicine believes that “the heart wants to be real, so that less thought”, using the method of releasing doubts can release doubts and guide patients to understand things correctly. This includes reasoning and explanation, hinting, and releasing doubts with doubts. In addition, let the patient establish confidence, first of all, the patient’s family should have confidence in the treatment, which requires the usual more family psychological guidance, including detailed explanation of the status of treatment, the possibility of treatment, the possible problems in the treatment, the trend of the development of the disease, the daily care of patients and dietary regimen.  3. Discussion In recent years, with the change of medical model, the developmental role of psychosocial factors in the therapeutic intervention of various diseases has been paid more and more attention. In order to adapt to the development of society, on the basis of rich clinical experience, doctors should also master the corresponding knowledge of psychological care to create a good medical, psychological and social environment for patients, so that they can change their bad habits, maintain an optimistic spirit and positive psychological state, enhance the immune function of the body, cooperate with the treatment, and develop in the direction of health. Even if a complete cure cannot be achieved, it is very meaningful to improve the quality of life of patients and prolong their life time.