Clark Paul G, Brethwaite Drucilla S, Gnesdiloff Sabine
Department of Social Work, George Mason University, 4400 University Drive, Fairfax, VA 22030, USA.
J Soc Work End Life Palliat Care. 2011;7(2-3):195-215. doi: 10.1080/15524256.2011.593156.
Despite advances in the quality and availability of hospice and palliative care for people with end stage cancers, research addressing the psychosocial needs of family members and concerned others during the dying process has been limited primarily to caregivers. In addition, many of these studies focused on the recently bereaved. In this study, the authors sought to broaden that perspective by examining the psychosocial needs of secondary survivors, a term that applies to caregivers, family members, and others who felt a caring bond with a dying person. A qualitative exploration of needs expressed by secondary survivors following the conclusion of a structured 8-week psychoeducational grief group experience revealed that secondary cancer survivors experience a sense of isolation and powerlessness that is often unrecognized by physicians, nurses, oncology social workers, or other health care professionals. Furthermore, these secondary survivors needed support that extends well beyond activities that are traditionally associated with the physical and emotional care of the dying. Social work intervention strategies directed toward helping secondary survivors assert personal needs, develop greater proximity with the health care team, and prepare for the processes associated with end-of-life may be helpful later during bereavement.
尽管晚期癌症患者临终关怀和姑息治疗的质量和可及性有所提高，但针对家庭成员及其他相关人员在临终过程中社会心理需求的研究主要局限于护理人员。此外，这些研究大多聚焦于新近丧亲者。在本研究中，作者试图通过考察二级幸存者的社会心理需求来拓宽这一视角，二级幸存者这一术语适用于护理人员、家庭成员以及其他与临终者有情感纽带的人。对参加完为期8周的结构化心理教育悲伤小组活动后的二级幸存者所表达需求进行的定性探索表明，癌症二级幸存者会经历一种孤立感和无力感，而医生、护士、肿瘤社会工作者或其他医疗保健专业人员往往并未认识到这一点。此外，这些二级幸存者需要的支持远远超出了传统上与临终者身体和情感护理相关的活动。旨在帮助二级幸存者表达个人需求、与医疗团队建立更密切联系以及为临终相关过程做好准备的社会工作干预策略，可能在丧亲后期有所帮助。
