Department of Psychosocial Oncology and Palliative Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Palliat Med. 2013 Dec;27(10):925-31. doi: 10.1177/0269216313499961. Epub 2013 Aug 9.
Psychosocial factors are a major determinant of well-being in patients with advanced disease. However, the development of valid and reliable measures of meaningful and relevant outcomes and randomized controlled trials to assess the impact of novel interventions are relatively recent accomplishments.
To discuss significant developments in psychosocial research, including work of the author, in palliative populations and to identify areas where uncertainty and controversy persist.
The impact of systematic research on psychosocial factors in palliative care over the past four decades is discussed. Particular attention is paid to the development of relevant measures of psychological outcomes and to the results of pilot studies and randomized controlled trials of psychosocial interventions.
A variety of factors, including methodological limitations, protective attitudes of health-care providers, and the progressive deterioration of patients with terminal disease, have presented obstacles to psychosocial research in palliative care. The more recent development of valid and reliable measures of psychological distress and psychological well-being has significantly advanced research in the field. Pilot studies and randomized controlled trials of psychosocial interventions have yielded promising results, although the demonstrated impact on primary outcomes in these studies has typically been modest.
Psychosocial research in palliative care has grown in rigor and volume over the past several decades, and a variety of novel interventions have been developed and evaluated. However, the findings from this research have only begun to have an impact on clinical practice in palliative care.
社会心理因素是晚期疾病患者幸福感的主要决定因素。然而，有效的和可靠的有意义和相关结果的衡量标准的发展以及评估新干预措施影响的随机对照试验相对较新。
讨论在姑息治疗人群中社会心理研究的重要进展，包括作者的工作，并确定存在不确定性和争议的领域。
讨论了过去四十年中姑息治疗中社会心理因素的系统研究的影响。特别关注相关心理结果衡量标准的发展，以及心理社会干预的试点研究和随机对照试验的结果。
姑息治疗中的社会心理研究面临着多种因素的挑战，包括方法学限制、卫生保健提供者的保护态度以及终末期疾病患者病情的逐渐恶化。最近发展的有效和可靠的心理困扰和心理幸福感衡量标准极大地推动了该领域的研究。心理社会干预的试点研究和随机对照试验取得了有希望的结果，尽管这些研究中对主要结果的影响通常是适度的。
在过去几十年中，姑息治疗中的社会心理研究在严谨性和数量上都有所增加，并且已经开发和评估了各种新的干预措施。然而，这项研究的结果才刚刚开始对姑息治疗的临床实践产生影响。
