Interdisciplinary Center for Palliative Medicine, Ludwig-Maximilians-University, Munich, Germany.
J Pain Symptom Manage. 2010 Oct;40(4):502-9. doi: 10.1016/j.jpainsymman.2010.02.010. Epub 2010 Jul 1.
The construct "meaning in life" (MiL) has recently raised the interest of clinicians working in psycho-oncology and end-of-life care and has become a topic of scientific investigation.
The aim of this study was to compare MiL in palliative care (PC) patients with a representative sample of the German population.
In this cross-sectional study, all PC patients treated in the PC inpatient unit and through the PC consult service at Ludwig-Maximilians-University Hospital, Munich, from May 2005 to July 2007 were eligible to participate. Patients were interviewed by a doctoral student, psychologist, or physician, all previously trained to administer the Schedule for Meaning in Life Evaluation (SMiLE) in a standardized way. In the SMiLE, respondents first list individual areas that provide meaning to their life before rating their current level of importance and satisfaction with each area. Overall indices of weighting (IoW, range 20-100), satisfaction (IoS, range 0-100), and weighted satisfaction (IoWS, range 0-100) are calculated.
One hundred PC patients completed the SMiLE: the IoS was 70.2 ± 19.7, the IoW was 84.7 ± 11.5, and the IoWS was 72.0 ± 19.4. The representative sample (n=977) scored significantly higher in the IoS (82.8 ± 14.7) and IoWS (83.3 ± 14.8) but not in the IoW (85.6 ± 12.3). Compared with healthy individuals, PC patients are more likely to list partner, friends, leisure, spirituality, well-being, nature/animals, and pleasure as meaningful areas. Examining the satisfaction ratings, it is noteworthy that PC patients' satisfaction scores are fairly high (and not lower than their healthy counterparts') in a number of domains: family, partner, home/garden, spirituality, and finances. On the other hand, they score significantly lower in nature/animals, leisure, friends, well-being, altruism, work, pleasure, and health.
These findings underscore the potential of the SMiLE for identifying areas that are particularly important to individuals, and that can be targeted by the PC team to improve overall life satisfaction at the end of life.
“生活意义”（MiL）这一概念最近引起了从事心理肿瘤学和临终关怀的临床医生的兴趣，并成为科学研究的一个课题。
本研究旨在比较姑息治疗（PC）患者与德国代表性人群的 MiL。
在这项横断面研究中，2005 年 5 月至 2007 年 7 月期间，慕尼黑路德维希-马克西米利安大学医院 PC 住院病房和 PC 咨询服务治疗的所有 PC 患者均有资格参加。由博士生、心理学家或医生对患者进行访谈，他们都经过了标准化的 Schedule for Meaning in Life Evaluation（SMiLE）管理培训。在 SMiLE 中，被调查者首先列出对他们的生活有意义的个人领域，然后对每个领域的当前重要性和满意度进行评分。总体加权指数（IoW，范围 20-100）、满意度（IoS，范围 0-100）和加权满意度（IoWS，范围 0-100）。
100 名 PC 患者完成了 SMiLE：IoS 为 70.2±19.7，IoW 为 84.7±11.5，IoWS 为 72.0±19.4。代表性样本（n=977）在 IoS（82.8±14.7）和 IoWS（83.3±14.8）方面的得分显著更高，但在 IoW（85.6±12.3）方面则不然。与健康个体相比，PC 患者更有可能将伴侣、朋友、休闲、精神信仰、幸福、自然/动物和愉悦列为有意义的领域。在考察满意度评分时，值得注意的是，PC 患者在一些领域的满意度评分相当高（并不低于健康对照组）：家庭、伴侣、家和花园、精神信仰和财务状况。另一方面，他们在自然/动物、休闲、朋友、幸福、利他主义、工作、愉悦和健康方面的评分显著较低。
这些发现强调了 SMiLE 用于确定对个人特别重要的领域的潜力，这些领域可以由 PC 团队来确定，以提高生命末期的整体生活满意度。
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