Georgetown University School of Nursing and Health Studies, 3700 Reservoir Road Northwest, Washington, DC 20057, USA.
J Pain Symptom Manage. 2012 Oct;44(4):626-30. doi: 10.1016/j.jpainsymman.2012.07.010.
Increasingly in the U.S., health care clinicians fail to recognize and accept when curative goals are no longer realistic. At this point, futile efforts at cure can fuel false hopes in patients and their loved ones. The clinician's need to be "doing something" may result in treatment that violates the dignity and well-being of the patient and this can lead to the patient's ultimate hopelessness and despair. This article uses a personal narrative to explore the hopelessness of a patient diagnosed with nonresectable pancreatic cancer and the challenge it raised for the author, who was a friend and a nurse to the patient. Hope is described as a virtue that takes as its object "a future good, difficult but possible to obtain," and that sits squarely between false hopes and despair. Spiritual care that addresses three universal spiritual needs (meaning and purpose, love and relatedness, and forgiveness) is recommended as a valuable intervention to address hopelessness.
在美国，越来越多的医疗保健临床医生未能认识到并接受治愈目标不再现实的情况。此时，徒劳无益的治愈努力可能会给患者及其亲人带来虚假的希望。临床医生需要“有所作为”，这可能导致治疗方式侵犯了患者的尊严和福祉，从而使患者最终感到绝望和无助。本文通过个人叙述探讨了一位被诊断为不可切除胰腺癌的患者的绝望，以及这对作者（患者的朋友和护士）提出的挑战。希望被描述为一种美德，其对象是“未来的美好，困难但有可能实现的”，它直接介于虚假的希望和绝望之间。建议提供关注三个普遍的精神需求（意义和目的、爱和关联性以及宽恕）的精神关怀，作为解决绝望的有价值的干预措施。
