Palliative and Supportive Services, Flinders University, Adelaide, Australia.
Palliat Med. 2011 Apr;25(3):266-77. doi: 10.1177/0269216310389225. Epub 2011 Jan 12.
Palliative care encompasses physical, psychosocial and spiritual care for patients and caregivers. No population data are available on bereaved people who subsequently report that additional spiritual support would have been helpful.
In a population survey, a respondent-defined question was asked regarding 'additional spiritual support' that would have been helpful if someone 'close to them had died' an expected death in the previous five years. Data (socio-demographic [respondent]); clinical [deceased]) directly standardized to the whole population were analysed.
There were 14,902 participants in this study (71.6% participation rate), of whom 31% (4665) experienced such a death and 1084 (23.2%) provided active hands-on (day-to-day or intermittent) care. Fifty-one of the 1084 (4.7%) active caregivers identified that additional spiritual support would have been helpful. The predictors in a regression analysis were: other domains where additional support would have been helpful (OR 1.69; 95% CI 1.46-1.94; p<0.001); and being female (OR 3.23; 95% CI 1.23 to 8.33; p=0.017). 'Additional spiritual support being helpful' was strongly associated with higher rates where additional support in other domains would also have been helpful in: all bereaved people (2.7 vs 0.6; p<0.0001); and in active caregivers (3.7 vs 0.8; p<0.0001).
People who identify that additional spiritual support would have been helpful have specific demographic characteristics. There is also a strong association with the likelihood of identifying that a number of other additional supports would have been helpful. Clinically, the need for additional spiritual support should open a conversation about other areas where the need for further support may be identified.
姑息治疗包括对患者和照护者的身体、心理社会和精神关怀。目前尚无关于随后报告额外的精神支持会有所帮助的丧亲人群的人群数据。
在一项人群调查中，针对“如果某人‘亲近的人去世’，在过去五年内预期死亡，那么额外的精神支持会有所帮助”这一问题，采用受访者定义的问题进行了询问。对直接标准化到整个人群的社会人口统计学（受访者）和临床（死者）数据进行了分析。
这项研究共有 14902 名参与者（参与率为 71.6%），其中 31%（4665 人）经历过此类死亡，1084 人（23.2%）提供积极的日常或间歇性护理。在 1084 名积极护理者中，有 51 人（4.7%）认为额外的精神支持会有所帮助。回归分析的预测因素为：其他需要额外支持的领域（OR 1.69；95%CI 1.46-1.94；p<0.001）和女性（OR 3.23；95%CI 1.23 至 8.33；p=0.017）。“额外的精神支持会有所帮助”与其他领域也需要额外支持的可能性高度相关：所有丧亲者（2.7 对 0.6；p<0.0001）和积极护理者（3.7 对 0.8；p<0.0001）。
认为额外的精神支持会有所帮助的人具有特定的人口统计学特征。与识别许多其他额外支持也会有所帮助的可能性也存在很强的关联。从临床角度来看，对额外精神支持的需求应开启一场对话，以确定是否需要进一步支持其他领域。
