Chochinov Harvey Max, Cann Beverley J
University of Manitoba, Manitoba Palliative Care Research Unit, Cancer Care Manitoba, Winnipeg, Manitoba, Canada.
J Palliat Med. 2005;8 Suppl 1:S103-15. doi: 10.1089/jpm.2005.8.s-103.
In recent years, medical and allied health publications have begun to address various topics on spirituality. Scholars have posited numerous definitions of spirituality and wrestled with the notion of spiritual pain and suffering. Researchers have examined the relationship between spirituality and health and explored, among other topics, patients' perceptions of their spiritual needs, particularly at the end of life. This paper summarizes salient evidence pertaining to spirituality, dying patients, their health care providers, and family or informal caregivers. We examine the challenging issue of how to define spirituality, and provide a brief overview of the state of evidence addressing interventions that may enhance or bolster spiritual aspects of dying. There are many pressing questions that need to be addressed within the context of spiritual issues and end-of-life care. Efforts to understand more fully the constructs of spiritual well-being, transcendence, hope, meaning, and dignity, and to correlate them with variables and outcomes such as quality of life, pain control, coping with loss, and acceptance are warranted. Researchers should also frame these issues from both faith-based and secular perspectives, differing professional viewpoints, and in diverse cultural settings. In addition, longitudinal studies will enable patients' changing experiences and needs to be assessed over time. Research addressing spiritual dimensions of personhood offers an opportunity to expand the horizons of contemporary palliative care, thereby decreasing suffering and enhancing the quality of time remaining to those who are nearing death.
近年来，医学及相关健康领域的出版物已开始探讨各种关于灵性的话题。学者们提出了众多关于灵性的定义，并对灵性痛苦的概念进行了深入探讨。研究人员研究了灵性与健康之间的关系，并探讨了诸多话题，其中包括患者对其灵性需求的认知，尤其是在生命末期。本文总结了与灵性、临终患者、其医疗服务提供者以及家庭或非正式照料者相关的显著证据。我们审视了如何定义灵性这一具有挑战性的问题，并简要概述了有关可能增强或支持临终灵性层面的干预措施的证据状况。在灵性问题和临终关怀的背景下，有许多紧迫的问题需要解决。有必要努力更全面地理解灵性福祉、超越、希望、意义和尊严等概念，并将它们与生活质量、疼痛控制、应对丧失以及接受程度等变量和结果联系起来。研究人员还应从基于信仰和世俗的视角、不同的专业观点以及多样的文化背景来阐述这些问题。此外，纵向研究将使我们能够评估患者随时间变化的经历和需求。针对人格灵性层面的研究为拓展当代姑息治疗的视野提供了契机，从而减少痛苦并提高濒死患者剩余时间的生活质量。
