Ando Michiyo, Morita Tatsuya, Lee Virginia, Okamoto Takuya
Faculty of Nursing, St. Mary's College, Kurame City, Fukuoka, Japan.
Palliat Support Care. 2008 Dec;6(4):335-40. doi: 10.1017/S1478951508000539.
The present study investigated what types of transformation terminally ill cancer patients experienced from diagnosis until the terminal stage, what meanings terminally ill cancer patients attributed to their illness, and whether or not those who attributed positive meaning to their illness achieved high levels of spiritual well-being as a preliminary study.
Ten terminally ill cancer patients in the hospice wards of two general hospitals participated. A clinical psychologist conducted a semistructured interview with the patients individually for about 60 min. Patients completed the FACIT-Sp and HADS before the interview and talked about the meanings of cancer experience. The contents of the interviews were analyzed qualitatively. Patients were separated into high and low levels of spiritual-well being by the median of FACIT-Sp scores.
Three types of transformation were extracted: "group with peaceful mind," "group with both positive attitude and uneasy feeling," and "groups with uneasy feeling." As attributed meanings to the illness, five categories were extracted: "positive meaning," "natural acceptance," "negative acceptance," "search for meaning," and "regret and sorrow." Patients in the high level spiritual well-being group attributed the meaning of illness to "positive meaning" and "natural acceptance," and those in the low level spiritual well-being group attributed it to "regret and sorrow" and "search for meaning."
Some Japanese terminally ill cancer patients experienced positive transformation, and patients who attributed "positive meaning" and "natural acceptance" to their illness experience achieved high levels of spiritual well-being.
作为一项初步研究，本研究调查了晚期癌症患者从确诊到晚期经历了哪些类型的转变，晚期癌症患者将何种意义赋予他们的疾病，以及那些将积极意义赋予其疾病的患者是否实现了高水平的精神幸福感。
两家综合医院临终关怀病房的10名晚期癌症患者参与了研究。一名临床心理学家对患者进行了约60分钟的半结构式个体访谈。患者在访谈前完成了FACIT-Sp量表和医院焦虑抑郁量表（HADS），并谈论了癌症经历的意义。对访谈内容进行了定性分析。根据FACIT-Sp得分的中位数将患者分为精神幸福感高和低两组。
提取出三种转变类型：“心态平和组”、“态度积极且有不安感组”和“有不安感组”。作为对疾病赋予的意义，提取出五类：“积极意义”、“自然接受”、“消极接受”、“寻求意义”以及“遗憾与悲伤”。精神幸福感高的组将疾病的意义归因于“积极意义”和“自然接受”，而精神幸福感低的组将其归因于“遗憾与悲伤”和“寻求意义”。
一些日本晚期癌症患者经历了积极的转变，那些将“积极意义”和“自然接受”赋予其疾病经历的患者实现了高水平的精神幸福感。
