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危及生命的疾病和改变人生的变故背景下的精神性。

Spirituality in the context of life-threatening illness and life-transforming change.

作者信息

Young William C, Nadarajah Sheeba R, Skeath Perry R, Berger Ann M

机构信息

Pain and Palliative Care Service,National Institutes of Health Clinical Center,Bethesda,Maryland.

Department of Nursing,Bowie State University,Bowie,Maryland.

出版信息

Palliat Support Care. 2015 Jun;13(3):653-60. doi: 10.1017/S1478951514000340. Epub 2014 Apr 28.

Abstract

OBJECTIVE

Individuals with life-threatening illness often engage in some form of spirituality to meet increased needs for meaning and purpose. This study aimed to identify the role of spirituality in persons who had reported positive, life-transforming change in relation to life-threatening cancer or cardiac events, and to connect these roles to palliative and supportive care.

METHOD

A purposive sample of 10 cardiac survivors and 9 cancer survivors was recruited. Once the participants had given informed consent and passed screening in relation to life-transforming change and distress, they engaged in a semistructured one-hour qualitative interview on the theme of how their life-transforming change occurred in the context of their life-threatening illness. In the present article, our phenomenological analysis focuses on participants' references to purpose and meaning in their lives, with particular attention to the role and context of participants' spirituality.

RESULTS

Participants mentioned spirituality, meaning, and purpose in many contexts, including connecting with family and friends, nature, art, music, and sometimes creating a relationship with God. Participants often accessed spirituality by enhancing connections in their own lives: with a higher power, people, their work, or themselves. These enhanced connections gave participants greater meaning and purpose in their lives, and substantially helped participants to adjust to their life-threatening illnesses.

SIGNIFICANCE OF RESULTS

Understanding the roles and contexts of spirituality among patients with a life-threatening illness allows us to develop better palliative and supportive care plans. Spiritually oriented supportive care may include support groups, yoga, meditation, nature, music, prayer, or referral to spiritual or religious counselors. A quantitative scale is needed to help healthcare clinicians assess the spiritual and coping needs of individuals with life-threatening illness.

摘要

目的

患有危及生命疾病的个体常常会以某种形式投身于精神追求,以满足其对生命意义和目的与日俱增的需求。本研究旨在确定精神追求在那些报告因危及生命的癌症或心脏事件而产生积极、改变人生的变化的人群中所起的作用,并将这些作用与姑息治疗和支持性护理联系起来。

方法

招募了10名心脏疾病幸存者和9名癌症幸存者作为有目的的样本。一旦参与者签署了知情同意书,并通过了关于改变人生的变化和痛苦的筛查,他们就参与了一次为期一小时的半结构化定性访谈,主题是他们的改变人生的变化在危及生命的疾病背景下是如何发生的。在本文中,我们的现象学分析聚焦于参与者对其生活目的和意义的提及,尤其关注参与者精神追求的作用和背景。

结果

参与者在许多情境中提到了精神追求、意义和目的,包括与家人和朋友、自然、艺术、音乐的联系,有时还包括与上帝建立关系。参与者常常通过加强自己生活中的联系来获得精神追求:与更高的力量、他人、工作或自己建立联系。这些增强的联系赋予了参与者生活中更大的意义和目的,并极大地帮助参与者适应危及生命的疾病。

结果的意义

了解危及生命疾病患者中精神追求的作用和背景,使我们能够制定更好的姑息治疗和支持性护理计划。以精神追求为导向的支持性护理可能包括支持小组、瑜伽、冥想、自然、音乐、祈祷,或转介给精神或宗教顾问。需要一个定量量表来帮助医疗保健临床医生评估患有危及生命疾病的个体的精神和应对需求。

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