A patient knows that his symptoms suggest that he may have lung cancer but insists that it is just a cold. Which of the following nursing responses would be helpful in this situation? Select all that apply

Question

a. "The prospect of a serious health problem can be very frightening for most people.".
b. "Cancer is frightening, but denying it is unhelpful. You need to face your illness.".
c. "Most symptoms such as yours turn usually out not be very serious illnesses.".
d. "There's a support group for cancer patients tomorrow, and I'd like you to go.".
e. "Tell me about what helps you cope, what has helped when life has been difficult.".
f. "There are some new treatments for lung disease; the outlook is better now.".

Answer 1

A, E, F
The patient appears to be exhibiting the defense mechanism, denial, which in the short term can be adaptive. It is important to preserve adaptive defense mechanisms until the patient is able to muster more effective means of coping. Nursing interventions that support adaptive defense mechanisms while building his ability to cope more effectively with the distressing prospect of his potentially serious illness would be appropriate. These could include conveying empathy, conveying hope, providing an opportunity to process the situation and related feelings when he feels ready, correcting distortions or misinformation, identifying other coping options, and connecting him with support consistent with his cultural and personal preferences. These interventions could be therapeutic at a later stage of adjustment to his situation, but confronting the patient would prevent the use of denial as an adaptive way of coping at this time. Directing the patient to face cancer or to attend a cancer support group is premature at this time. Indicating that most situations such as this patient's turn out not to be serious represents potentially false reassurance and is usually done more to reduce the nurse's anxiety than the patient's.