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日本全国关于临终幻觉的调查:“我已故的母亲带我去了天堂”。

Nationwide Japanese Survey About Deathbed Visions: "My Deceased Mother Took Me to Heaven".

作者信息

Morita Tatsuya, Naito Akemi Shirado, Aoyama Maho, Ogawa Asao, Aizawa Izuru, Morooka Ryosuke, Kawahara Masanori, Kizawa Yoshiyuki, Shima Yasuo, Tsuneto Satoru, Miyashita Mitsunori

机构信息

Department of Palliative and Supportive Care, Palliative Care Team, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan.

Palliative Care Team, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan.

出版信息

J Pain Symptom Manage. 2016 Nov;52(5):646-654.e5. doi: 10.1016/j.jpainsymman.2016.04.013. Epub 2016 Sep 19.

Abstract

OBJECTIVES

Primary aim was to clarify the prevalence and factors associated with the occurrence of deathbed visions, explore associations among deathbed visions, a good death, and family depression. Additional aim was to explore the emotional reaction, perception, and preferred clinical practice regarding deathbed visions from the view of bereaved family members.

METHODS

A nationwide questionnaire survey was conducted involving 3964 family members of cancer patients who died at hospitals, palliative care units, and home.

RESULTS

A total of 2827 responses (71%) were obtained, and finally 2221 responses were analyzed. Deathbed visions were reported in 21% (95% CIs, 19-23; n = 463). Deathbed visions were significantly more likely to be observed in older patients, female patients, female family members, family members other than spouses, more religious families, and families who believed that the soul survives the body after death. Good death scores for the patients were not significantly different between the families who reported that the patients had experienced deathbed visions and those who did not, whereas depression was more frequently observed in the former than latter, with marginal significance (20 vs. 16%, respectively, adjusted P = 0.068). Although 35% of the respondents agreed that deathbed visions were hallucinations, 38% agreed that such visions were a natural and transpersonal phenomenon in the dying process; 81% regarded it as necessary or very necessary for clinicians to share the phenomenon neutrally, not automatically labeling them as medically abnormal.

CONCLUSIONS

Deathbed vision is not an uncommon phenomenon. Clinicians should not automatically regard such visions as an abnormal phenomenon to be medically treated and rather provide an individualized approach.

摘要

目的

主要目的是阐明濒死幻觉的发生率及其相关因素,探讨濒死幻觉、善终与家属抑郁之间的关联。附加目的是从丧亲家属的角度,探索他们对濒死幻觉的情绪反应、认知以及偏好的临床处理方式。

方法

在全国范围内开展问卷调查,涉及在医院、姑息治疗机构和家中去世的癌症患者的3964名家属。

结果

共获得2827份回复(71%),最终对2221份回复进行了分析。报告有濒死幻觉的占21%(95%可信区间,19 - 23;n = 463)。在老年患者、女性患者、女性家属、非配偶家属、宗教信仰更强的家庭以及相信死后灵魂不灭的家庭中,更易观察到濒死幻觉。报告患者经历过濒死幻觉的家庭与未经历过的家庭相比,患者的善终评分无显著差异,但前者的家属抑郁发生率更高,具有边缘显著性(分别为20%和16%,校正P = 0.068)。虽然35%的受访者认为濒死幻觉是幻觉,但38%的受访者认为此类幻觉是临终过程中自然的、超个人的现象;81%的受访者认为临床医生有必要或非常有必要中立地分享这一现象,而不是自动将其标记为医学异常。

结论

濒死幻觉并非罕见现象。临床医生不应自动将此类幻觉视为需医学治疗的异常现象,而应提供个性化的处理方式。

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