First visit is never forgotten

Abstract

Background: The first oncological visit is a central moment in the treatment and in the establishment of the therapeutic relationship; the meeting with the oncologist involves psychological aspects and has a strong emotional impact on patients ( pts). First visit is the time of diagnosis communication and therapeuthic condivision. Pts arrive at the first visit with expectations, fears, fantasies, ideas not only about their health conditions, but also about the doctor and the relationship with him. Materials and methods: In our Oncology Unit we give an important value to the first visit. We recognize that disease has both an organic and a psychological component. That is the reason why we choose to plan the majority of first visits both with doctor and psychologist. This is an important legitimation of emotional impact of cancer and the possibility that the experiences related to that event can then find spaces of expression, listening and processing. Cohoperation between psychologist and oncologist can improve a positive exchange between two visions to face pts that are often different. Steps of the first visit are: - Preliminary view of the medical oncologist and psychologist - Presentation to the patient and the caregivers of the Psycho-Oncology Service - Drafting of brief psychological report that will be included in the medical record - Possible first date for a psychological support if necessary The aims: - Increase the therapeutic alliance and adherence to treatment path - Focus on patients and family members considered 'at risk' for an early taking care, to decrease the risk of psychopathological manifestations - Facilitate the comparison between different professionals. Results: In 2014 we made 210 joint visits (65% of total), 52 pts with breast cancer, 47 colon, 35 with gastric cancer, 21 with gynecological cancer, 25 lung, 15 melanoma and 15 more. 28 pts and eight caregivers were taken into care after the first visit, while in other situations it is active a surveillance in cohoperation with the team of care. Conclusions: The presence of the psychologist in the Unit, the cohoperation and the communication with health staff has improved early detection of psychological suffering situations. Psychoncological service integrated with oncological treatment is a valuable resource for patients and caregiver that are facing a state of vulnerability.