Kudla Dorothea, Kujur Julius, Tigga Sumanti, Tirkey Prakash, Rai Punita, Fegg Martin Johannes
Department of Palliative Medicine, Ludwig-Maximilians-University, Munich, Germany.
Jesu Ashram, Matigara, Darjeeling District, West Bengal, India.
J Pain Symptom Manage. 2015 Jan;49(1):79-88. doi: 10.1016/j.jpainsymman.2014.05.013. Epub 2014 Jun 14.
The experience of Meaning in Life (MiL) is a major protective factor against feelings of hopelessness and wishes for hastened death in palliative care (PC) patients. However, most instruments for MiL assessment have been developed only in Western countries so far. Little is known about MiL experience in Asian PC patients.
This study aimed to provide a Hindi version of the Schedule for Meaning in Life Evaluation (SMiLE), test its feasibility and validity in Indian PC patients, and compare the results with previous studies in Germany.
Indian PC patients in a hospice for the destitute were eligible to participate in this cross-sectional study. In the SMiLE instrument, respondents individually listed MiL-giving areas before rating their satisfaction with and importance of these areas. Overall indices of satisfaction (IoS, range 0-100), weighting (IoW, range 0-100), and weighted satisfaction (IoWS, range 0-100) were calculated.
A Hindi forward-backward translation of the SMiLE was made. Two hundred fifty-eight Indian PC patients took part in the study (response rate 93.5%). Convergent validity of the SMiLE was found with the World Health Organization Quality of Life-Brief version (r = 0.17; P = 0.008) and the Idler Index of Religiosity (public religiousness: r = 0.25, P < 0.001 and private religiousness: r = 0.29, P < 0.001). Indian PC patients' IoW was 65.8 ± 22.1, IoS 68.6 ± 17.4, and IoWS 70.2 ± 17.0. In multivariate analyses of covariance, they differed significantly from German PC patients only in IoW (IoW: 84.8 ± 11.5, P < 0.001; IoS: 70.2 ± 19.7; IoWS: 72.0 ± 19.4). Compared with Germans, Indians more often listed spirituality (P < 0.001) and social commitment (P < 0.001) and less often social relations (P = 0.008).
Preliminary results indicate good feasibility and validity of the Hindi version of the SMiLE. MiL experience also seems to be a coping resource for Indian PC patients.
生活意义体验是姑息治疗（PC）患者抵御绝望感和加速死亡愿望的一项主要保护因素。然而，到目前为止，大多数生活意义评估工具仅在西方国家开发。对于亚洲PC患者的生活意义体验知之甚少。
本研究旨在提供《生活意义评估量表》（SMiLE）的印地语版本，测试其在印度PC患者中的可行性和有效性，并将结果与德国之前的研究进行比较。
一家贫困者临终关怀机构中的印度PC患者有资格参与这项横断面研究。在SMiLE工具中，受访者先分别列出赋予生活意义的领域，然后对这些领域的满意度和重要性进行评分。计算总体满意度指数（IoS，范围0 - 100）、权重指数（IoW，范围0 - 100）和加权满意度指数（IoWS，范围0 - 100）。
完成了SMiLE的印地语前后向翻译。258名印度PC患者参与了研究（应答率93.5%）。发现SMiLE与世界卫生组织生活质量简表具有收敛效度（r = 0.17；P = 0.008），与伊德勒宗教指数也具有收敛效度（公众宗教信仰：r = 0.25，P < 0.001；私人宗教信仰：r = 0.29，P < 0.001）。印度PC患者的IoW为65.8 ± 22.1，IoS为68.6 ± 17.4，IoWS为70.2 ± 17.0。在多变量协方差分析中，他们与德国PC患者仅在IoW方面存在显著差异（IoW：84.8 ± 11.5，P < 0.001；IoS：70.2 ± 19.7；IoWS：72.0 ± 19.4）。与德国人相比，印度人更常列出精神层面（P < 0.001）和社会承诺（P < 0.001），而较少列出社会关系（P = 0.008）。
初步结果表明SMiLE印地语版本具有良好的可行性和有效性。生活意义体验似乎也是印度PC患者的一种应对资源。
